By Grattan Woodson, MD, FACP
Having a physician who is skilled in women’s health, understands gynecoendocrinology, and is comfortable prescribing compounded pharmaceuticals is a requirement for successful bioidentical hormone supplementation. It is this physician who will monitor your clinical response to treatment, evaluate you for any side effects, and adjust the dose of your compounded prescription to precisely meet your needs. The bene ts described below can only be obtained from a compounding pharmacy because pharmaceutical companies do not manufacture bioidenticals. All of these elements are necessary to ensure a successful outcome for a woman on balanced bioidentical hormone supplementation.
How the Hormones are Delivered
In my opinion, the preferred way for a postmenopausal woman to supplement with bioidentical hormones is by using an elegant cream formulation of balanced hormones given vaginally at bedtime. This is done by using a simple applicator and has four bene ts. First, the dose required for topical administration is only 1/10 the dose if given orally. Second, topical use avoids these hormones passing through the liver first before going through the body, which eliminates the high risk of blood clotting seen with oral estrogen use. Third, giving the supplement as a nightly vaginal cream restores the health and function of the vagina lost at menopause, which improves intimacy. Lastly, the veins that drain the vagina are the same ones that drain the ovaries, meaning that over the six hours the hormones are absorbed from the vagina, the body receives the same bioidentical hormones the ovary would make in small doses, similar to what it would expect to receive from the same entry point nature intended.
My goal is to provide patients with as normal a hormonal background as possible, mimicking nature, to provide her with what she had before menopause.
The Importance of Staying Balanced
I advocate using four bioidentical hormones in appropriately selected postmenopausal women whether they have had a hysterectomy or not. By appropriately selected, I mean healthy women within 10 years of menopause who have not had breast cancer or cardiovascular disease. I evaluate every patient before I prescribe hormones to her to ensure I keep her safe and I monitor her regularly to ensure she stays that way.
It’s my opinion that nature intended women to have all these hormones rather than just one or two. My goal is to provide patients with as normal a hormonal background as possible, mimicking nature, to provide her with what she had before menopause. This means including bioidentical estradiol, testosterone, progesterone, and DHEA, the four principal regulatory steroid hormones that become deficient or insufficient with menopause and aging. We need all four of these hormones because they have mutually supportive, and in some instances, opposing, effects that are important for health and well-being. Incomplete replacement, which has been the traditional practice, results in less than optimal results.
Brookhaven Women’s Health and Wellness is a full-service facility dedicated to providing women in early menopause with a suite of services to help them obtain optimal health and wellness using nutrition, exercise, compounded balanced bioidentical hormone supplementation, minimally invasive cosmetic services, hair restoration, weight management, osteoporosis management, and stem cell therapy for arthritis and tendonitis. For more information, call Kim Teasley, our Director of Women’s Health Services at 404.574.2373 or visit FemeRegen.net.