For even the most active and health-conscious women, menopause can cause hormone imbalances that trigger hot flashes, night sweats, low libido, fatigue, low energy, and difficulty losing weight. “These changes [during menopause] occur because their estrogen fluctuates and their testosterone production lessens,” says Dr. Gino Tutera, M.D., founder of SottoPelle Therapy a leader in bio-identical hormone replacement therapy.
The good news it that hormone therapy can relieve these symptoms that menopausal and post-menopausal women experience thanks to off-balance hormone levels. The bad news is that that not all forms of hormone replacement therapy are equal.
Dr. Tutera shares why. “The dangers of hormone replacement therapy—synthetic hormones or concentrated estrogen—include increased problems with clotting and chronic abnormalities. In lay terms, that means some hormone supplements can present an augmented risk for heart attacks and strokes,” he says.
But that doesn’t rule out all forms of hormone treatments.
“Bio-identical [biologically identical] hormones don’t carry those risks, especially if utilized in topical creams, patches or pellets,” Dr. Tutera says. “Those forms of hormone deliveries using 17 beta estradiol are perfectly safe to use because they don’t utilize the liver to be metabolized so it doesn’t stimulate and increase the clotting.”
What are bio-identical hormones? Forms of estrogen (the female body has three types throughout the life and reproductive cycle) that are naturally occurring in the human body, particularly estradiol, which is the dominant estrogenic hormone in the non-pregnant animal.
If you take the synthetic forms (usually delivered orally), they have to be processed through the liver, which increases the chance of forming clots in the legs or lungs. But bio-identical hormones delivered through creams, patches, or pellets do not impose risks to active women, as far as concerns about clotting and increasing the chance of heart attack and stroke, Dr. Tutera says.
And there’s more. “Women entering this stage of life or looking into hormone replacement therapy need to be aware that women are traditionally under-treated for testosterone deficiency,” Dr. Tutera says. “The human female carries levels of testosterone that are ten times higher than their estrogen level. Research shows that a pre-menopausal woman needs to make 300 milligrams of testosterone daily to be normal.”
Testosterone contributes to muscle and bone health, but your body produces less as it ages. “By age 40, women produce 50 percent less testosterone. By the time they hit menopause, they’ve lost the other 48-50 percent of that testosterone production,” Dr. Tutera says. “Testosterone deficiency leads to muscle atrophy and bone loss so, even for active women, muscle and bone loss will be encountered.”
Testosterone also helps protect the breasts against cysts and nodules, Dr. Tutera says, citing that as the reason why doctors recommend women get regular mammograms at age 40-45.
The bottom line: “I would recommend hormone replacement therapy in any post-menopausal woman and only with the usage of bio-identical hormones, those which do not use the liver,” Dr. Tutera says. More info here.