Choosing HRT

Posted on: 22.11.2021 Posted by: Drlark Comments: 0

June 17, 2004

Menopause

If You Must Take HRT

If you do choose to take synthetic HRT, follow

these precautions:

Choose the lowest dose that works
Research has shown this to be 0.625 mg for the Premarin oral tablet,

made from conjugated mare’s urine, and 0.05 mg for the estrogen

transdermal patch (brand names of these made-from-plants estrogen

delivery systems include Alora, Climara, Estraderm, FemPatch,

and Vivelle). Starting at higher doses increases the likelihood

of side effects such as anxiety, mood swings, fluid retention,

and breast tenderness. Some women find that even the tiniest dose

of estrogen, 0.3 mg, provides adequate relief from menopause symptoms.

If you choose to use a progestin, again start with the lowest

possible dose to avoid side effects such as headaches, depression,

acne, fatigue and bloating. That’s usually 5 to 10 mg for Provera,

the most commonly prescribed synthetic progestin, or 200 mg of

the natural oral micronized progesterone.

In general, you are better off with natural progesterone,

synthesized from plants in a lab, than with the synthetic progestins.
Choose the most comfortable delivery
system

Replacement hormones come in pills, patches, creams, gels, vaginal

rings, injections, implanted pellets, and suppositories. And that

doesn’t count what you can get by consuming phytoestrogens as

food, or herbs that do a wonderful job of eliminating menopause

symptoms.

The only way to know what method works for you is to experiment.

A few women hit it right the first time they try. Everyone else

needs to methodically work her way through the options with a

caring physician. Interview several physicians until you find

one who has a philosophy that matches yours. Remember, this will

be a long-lasting relationship.
Work closely with your doctor to find
the right solution for you.

The best hormone replacement regimen for you may not be the one

that works for your sister, aunt, cousin, friend, or mother. It

has to be individually tailored for you: the right combination

of hormones, the right dose, the right delivery system.

Get a full health screening
that includes a complete physical exam, including a pelvic

and breast exam and a Pap smear to check for cancer or a pre-cancerous

lesion of the cervix.

Have blood tests for
liver function, blood sugar, cholesterol, triglyceride levels,

calcium and phosphorus levels, and thyroid function.

Get a complete blood
count to check for anemia.

Have a mammogram.

Get a bone density test
(DEXA, dual x-ray absorptiometry) to help determine the level

of bone loss.

Review your family’s
medical history for clues about your risk of heart disease,

osteoporosis, and cancer.

Have an endometrial
biopsy or vaginal ultrasound to check for hyperplasia (too

many cells on the lining of the uterus) if you suffer from

heavy irregular menstrual bleeding or spotting.

Have your doctor test
your hormone levels to determine if you’re in menopause or

perimenopause.