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HRT for Women

History of Menopause

alignNatural menopause is defined as 12 months of amenorrhea (not having a menstrual cycle) due to the absence of viable ovarian follicles. If not induced surgically, menopause typically occurs in women between 50-52 years of age. The average age of menopause is 51 years. The first report of using of ovarian extracts to relieve vasomotor symptoms of menopause occurred in 1897. This extract was called Ovarin. In 1993, Ayerst Laboratories developed Emmenin by extracting estrogens from the urine of pregnant women. Emmenin was used in the treatment of women who had undergone a hysterectomy. By 1937 progesterone was isolated and was shown to prevent ovulation. Ayerst Laboratories marketed Premarin (CHT) in 1942, one year after reports linked estrogens to cervical cancer. Premarin (CHT) would eventually become the number one form of estrogen therapy in the United States. As use of synthetic estrogens increased, so did reports of increased endometrial cancers, leading to the inclusion of a progesterone derivative to prevent endometrial hyperplasia (thickening leading to cancer). Introduced in 1953, compounded Hormones & Me regimens were not popularized until the 1980’s by Dr. Jonathan Lee.

Estrogen

The three most common estrogens produced in females are estradiol, estone, and estriol. Functions of estrogens include:

  • Normal growth and development of female sex organs
  • Maintains secondary sex characteristics
  • Regulates body temperature
  • Protects against bone loss
  • Effects mood, cognition, and concentration
  • Imbalances can decrease thyroid function
  • Promotes sperm production

(↓metabolism,↑ fat storage)

Estrogen Related Symptoms
Estrogen Deficiency Estrogen Excess
Hot Flashes Heart Palpitations Weight Gain Irritability
Night Sweats Dry Skin Breast Tenderness Anxiety
Vaginal Dryness Low Sex Drive Breast Fibroids Fluid Retention
Vaginal Atropy Memory Lapses Uterine Fibroids Emotional Lability
Bladder Issues Headaches Spotting/Bleeding Sweet Cravings
Depression Frequent UTIs Fatigue Brittle Nails
Bone Loss Nocturnal Awakenings Hair Loss

Progesterone

Unlike the estrogens, the female body produces only one progesterone hormone.

Functions of progesterone include:

  • Metabolizes to other active hormones
  • Maintains pregnancy
  • Prepares breast for lactation and protects from fibroids
  • Stimulates new bone formation
  • Increases insulin secretion
  • Relaxes smooth muscle
Estrogen Related Symptoms
Progesterone Deficiency Progesterone Excess
Hot Flashes Heart Palpitations Drowsiness
Night Sweats Headaches Fatigue
Sleep Disturbances (onset) Low Sex Drive Depression
Spotting Irritability Incoherence
Emotional Lability Fluid Retention
Anxiety
Depression

Testosterone

Similar to progesterone, there is only one Testosterone hormone and is produced in women’s ovaries. Functions of testosterone include:

  • Enhances libido
  • Improves energy level
  • Increases mental alertness
  • Maintains skin and hair health
  • Increases muscle strength and lean body mass
Testosterone Deficiency Progesterone Excess
Fatigue Night Sweats Enlarged Clitoris Aches/Pains
Weight Gain Heart Palpitations Weight Loss Aggression
Low Sex Drive Lack of caring/detached Acne Memory Problems
Headaches Depression Deeper Voice Thinning Skin
Decreased muscle tone Decreased Oily Skin
Hot Flashes Concentration Facial Hair
Memory lapses Muscle Pains/Joint Pains Loss of Scalp Hair

DHEA (Dehydroepiandrosterone)

There is also only one DHEA hormone and it is produced in women’s adrenal gland. Functions of DHEA include:

  • Increases muscle mass strength and lean body mass
  • Activates immune function
  • Improves sleep
  • Decreases joint soreness
  • Helps decrease the effects of stress

DHEA is believed to cause symptoms. Exact symptoms related to DHEA deficiency are still being identified and supplementation is mainly guided by lab results.

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