Posted on: 22.11.2021 Posted by: Drlark Comments: 0

June 17, 2004


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


    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


    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


Read More on Menopause:

Getting Started

What is Menopause?

Quiz: Is it Menopause?

Keep it SIMPLE Tip — Taking Herbs

Nutritional Therapies

Power Nutrients for Menopause


Making the HRT Decision

Who Benefits from HRT

If You Must Take HRT

JAMA Study on HRT

Weaning off HRT



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