A Few Points to Consider About Hormone Therapy Choices Before Discussing with Your Clinician

By: Red Hot Mamas

Published: May 26, 2010

Written by Menopause Minute^® Editors

Three out of every four women experience symptoms during the menopause transition due to hormone fluctuations. The troubling symptoms, associated with menopause, can make women feel miserable and erode a woman’s quality of life. They may affect both personal and business relationships, as well.  Troubling symptoms can last for years, like a mortgage. Many women are in a quandary, faced with the complex medical and personal decision, what is the best option to manage uncomfortable symptoms?

I can honestly say that I sometimes turn to chocolate, but it simply doesn’t do the job entirely to quell my symptoms. And I’ve put on extra pounds because of my M&M consumption. So, my advice would be to use M&Ms cautiously as a remedy for menopausal symptoms and to look into other options.

Menopausal hormone therapy (HT), however, is a highly effective way to relieve symptoms such as hot flashes, night sweats and vaginal dryness. HT can be very helpful for many women, but it may not be right for everyone. The choice to take it is a complex one and women need guidance in making an informed decision.

As more scientific results appear from clinical trials, staying up to date is a daunting task. The U.S. Food and Drug Administration (FDA) continuously provides and updates information on clinical trials so women and their clinicians can better understand the risks and benefits of the products available on the market. The FDA is an agency within the Department of Health and Human Services and is responsible for protecting the public health by assuring the safety, efficacy of human drugs and helping people get accurate, science based information they need when using medicine to improve their health (www.fda.gov).

Choosing an FDA-approved drug means it has undergone extensive clinical trials and rigorous testing to ensure its safety and efficacy and can be sold in the U.S. Nonetheless, it’s important to realize that every drug may carry some risk.

The Women’s Health Initiative (WHI) was a clinical trial designed to look at risks and benefits of HT and its effect on heart disease, osteoporosis, breast cancer, colorectal cancer. This study had disappointing results, which left women confused and uncertain, about traditional HT. Some of the findings convinced women that the potential risks of hormone therapy outweighed the potential benefits.

Women who had an intact uterus were assigned to take Prempro, a conjugated estrogen plus medroxyprogesterone acetate or placebo daily; and those women who had a hysterectomy were assigned to take  Premarin (conjugated equine estrogen) or a placebo daily.  Since the (WHI) only investigated one type of oral conjugated estrogen, the study design left out all other types of FDA approved oral, and transdermal estrogens.

Another study was conducted in France (ESTHER), which concluded that hormone delivery through the skin is safer and less harmful than those absorbed through the liver.  Transdermal estrogen does not pass through the liver and is absorbed through the skin.  In essence, there should not be a blanket assumption, that the media portrays, that all hormone therapy has adverse outcomes. 

Bioidenticals are becoming a more popular choice among many women who were left unsure about traditional hormone therapy after WHI.  But not all bioidentical hormones are equal: when bioidentical hormones are prepared by compounding pharmacists they are not approved by the FDA. They are only regulated through state boards of pharmacy which do not adhere to the same strict processes as the FDA-approved drugs.  Oversight and regulations change from state to state.  Therefore, quality, safety and efficacy of hormone therapy from compounding pharmacies is difficult to standardize.  Women should stay clear of unregulated drugs, such as non FDA approved bioidenticals, as they are a risky business.  

There are many FDA government approved bioidentical hormone therapy options on the market which clinicians can prescribe. 

Current FDA-approved Hormone Products*

ORAL	TRANSDERMAL (Gels, lotions, sprays)	Transdermal Patches	Vaginal
Estrace	Estrogel gel	Estraderm	Estrace cream
Estradiol generic	Estrasorb lotion	Vivelle	Estring ring
Prometrium	Divigel gel	Climara	Prochieve 4% gel
	Elestrin gel	Vivelle Dot	Vagifem tablets
	Evamist spray		Femring ring

*Chart content adapted from The Female Patient magazine. The products in blue contain bioidentical estrogen. The products in orange contain bioidentical progesterone. A list of all FDA-approved hormone therapy products can be found here.

Let’s break the confusion and mark your calendar for Tuesday, August 4, 2009 to learn more about menopausal hormone therapy, including transdermal and bioidentical hormone therapy and the importance of FDA approval.

All the information you need on hormone therapy will be available on our live, free Webinar, The Buzz on Bioidenticals.  Prizes will be randomly awarded to 5 people who register and watch the Webinar. Register today!

Expert guidance is necessary to determine if hormone therapy treatment is the right choice for you in managing your symptoms.  We encourage you to have a "heated discussion" with your clinici
an about the potential benefits and risks of hormone therapy.  And join us in your learning process.  We look forward to your participation on our webinar.

Don’t forget the date, Tuesday, August 4th!!!

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