Oestrogen Trends

New Transdermal Options in Managing Menopause Allow for Better Individualization of Therapy

Menopausal women have an increasing number of treatment options available to them, including transdermal oestrogen therapies with different delivery systems. These options are welcome because they allow women more choices in tailoring hormone therapy to their individual needs and preferences. Individualising care is the key to effective treatment as its all about making YOU feel better.

Over the past decade, transdermal oestrogen delivery products have become increasingly popular because they allow oestrogen to be absorbed directly through the skin into the bloodstream without first passing through the liver. This helps minimize the side effects associated with oestrogen pills, such as the risk of cardiovascular complications. When taken orally, oestrogen must be first filtered through the liver where it is modified before entering the bloodstream, increasing the risk of blood clots and elevated levels of a cardiovascular risk factor called C-reactive protein. By avoiding this initial processing by the liver, transdermal therapies decrease the risk of cardiovascular side effects and, with their direct absorption into the bloodstream, effectively manage menopausal symptoms with a lower dose of oestrogen than oral therapies.

Transdermal delivery systems also provide more consistent management of vasomotor symptoms, such as hot flushes and night sweats that result from fluctuating levels of oestrogen. Whereas the delivery of oral oestrogen peaks and then declines, transdermal delivery systems allow a continuous absorption of oestrogen through the skin at a steady level without fluctuations. This consistent delivery of estrogen provides the stable hormone levels needed to better manage menopause symptoms throughout the day.

How Should Hormone Therapy be Prescribed?

Individualised therapy is the key to effective Hormone Replacement treatment. Therapy that is customised to the needs of the individual woman will help minimize side effects and maximize the effectiveness of treatment.  While oestrogen is the most commonly prescribed hormone for menopausal women, we often  need to add progesterone and androgens (testosterone & DHEA) to the treatment for women whose symptoms have not responded to oestrogen therapy. Women who have had a hysterectomy may take estrogen alone, but, because oestrogen causes cells to multiply and may increase the risk of uterine cancer, women with an intact uterus may need progesterone as well.

Women are “Naturally” Responsive to Bioidentical Treatments
In the confusion that followed the release of the initial Women’s Health Initiative (WHI) study results, many women turned to alternative, so-called “natural” treatment options such as black cohosh, dong quai and evening primrose oil. It is important for women to understand that, although these products may be natural to the plant world, they are not natural to a woman’s body, and they may be safe and effective treatments but not as proven or powerful in symptom control.

The therapeutic reality is that a woman’s body is much more responsive to oestradiol and the micronized progesterone, which are bio-identical to the oestrogen and progesterone produced by the ovaries. Women respond to these prescription products because they are so similar to what a woman’s body makes naturally prior to the midlife changes in her body.

For women considering natural hormones compounded by our compounding lab the advantage is having many different strengths and combinations of all hormones in a delivery system that is convenient for you. These new remedies of progesterone and estrogen are bio-identical, customised formulations based on each woman’s hormone levels.

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