Declining estrogen levels have specific effects on women, including:
[Hoffman, “The Mature Woman,” Williams Gynecology 2016 /p1 A; Thurston, Obstetrics and Gynecology Clinics of North America 2011 /p490 A]
- Physical symptoms, such as vasomotor symptoms (night sweats, hot flashes and flushes) and vaginal dryness.
- Metabolic and structural changes such as bone loss, skin thinning, fatty replacement of the breast, changes in blood lipids, and atrophy of the bladder and urethra.
- Vasomotor symptoms include hot flashes and night sweats, often considered to be the cardinal symptoms of menopause.
Hormone therapy is usually prescribed using the lowest effective dose and for only the amount of time that is needed based on clinical judgment and the needs of the individual patient. [“The Mature Woman,” Williams Gynecology 2016 /p3 A]
Hormone Imbalance Test
The following tests can be used to evaluate for hormone imbalance:
Pellet Therapy For Women
Serum or Blood Testing: serum or blood can be used to test for hormone imbalance. [Estrogens Lab Tests Online AACC 2018 /p1 A /p3 A;
Progesterone Lab Tests Online AACC 2018 /p1 A;
FSH Lab Tests Online AACC 2018 /p1 A /p2 A]
Saliva Testing: the FDA and the North American Menopause Society have expressed concerns about the reliability of the values obtained in this manner. [NAMS, Menopause 2012 /p16 A; Cirigliano, Journal of Women’s Health 2007 /p613 A]
BHRT in Women
+ Decrease vasomotor symptoms, including hot flashes and night sweats, often considered to be the cardinal symptoms of menopause
+ Prevent osteoporosis
+ Minimize physical symptoms, such as vasomotor symptoms (night sweats, hot flashes and flushes) and vaginal dryness
+ Reduce metabolic and structural changes such as bone loss, skin thinning, fatty replacement of the breast, changes in blood lipids, and atrophy of the bladder and urethra
Progestin is a form of progesterone. Taking progestin helps reduce the risk of cancer of the uterus that occurs when estrogen is used alone. Estrogen plus progestin sometimes is called “combined hormone therapy” or simply “hormone therapy.” Estrogen-only therapy sometimes is called “estrogen therapy.” [Hormone Therapy Fact Sheet ACOG /p2 A]
Subcutaneous implants have been identified as a convenient and practical method for delivering drugs that provides greater assurance that patients will take the prescribed medication and may have a more predictable therapeutic outcome than other delivery methods. [Lin, AAPS PharmSciTech 2001 /p1 A]
Studies have shown that there is a correlation between the time that the markers of hormone insufficiency return to normal and the time required for blood hormone levels to reach the end of the delivery from the pellet. [Lin, AAPS PharmSciTech 2001 /p9 B] Other studies suggest that the method by which pellets are manufactured may have an impact on the time required for the hormone to be released from the pellet. [Wang, Journal of Biomedical Materials Research Part B: Applied Biomaterials 2011 /p562 A]
Although the clinical effects of hormone optimization vary depending on the patient and the type of treatment, the objective for many women is to benefit from one or more of the following:
Protection from Osteoporosis: Studies have found that estrogen has benefits for preventing bone loss and may defend against problems like osteoporosis or hip fractures in some patients. [Files, Mayo Clinic Proceedings 2011 /p674 B] Pellet Therapy for Women
Decreased hot flashes and night sweats: Clinical studies have shown that oral hormone replacement therapy is effective in alleviating hot flashes and night sweats, two of the most common symptoms associated with menopause and sleep disturbances. [MacLennan Cochrane Database System Rev 2004]
Improved sex drive and reduced vaginal dryness: Up to 45 percent of menopause or postmenopausal women might be affected by vaginal atrophy, which causes symptoms like vaginal dryness, pain during sex, itching, irritation, burning and discharge. Hormone replacement may be prescribed to alleviate these symptoms.
Women may also experience:
+ Increased lean body mass
+ Decreased fat mass
+ Increased bone mineral density