Menopause and Bioidentical Hormone Therapy

What is Perimenopause?

Perimenopause is the time of life leading up to the menopausal transition.  The definition of menopause is 12 months without a menstrual cycle.  This can happen anytime between the ages of 45 and 55.  According to the American College of Obstetricians and Gynecologists (ACOG), a common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer than usual for you, or they may become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal as you approach menopause, you still should report them to your health care provider. Abnormal bleeding may be a sign of a problem. Talk to your health care provider if you have any of the following:

  • Bleeding between periods

  • Bleeding after sex

  • Spotting at anytime in the menstrual cycle

  • Bleeding that is heavier or lasts for more days than usual

Hot Flashes

Hot flashes are one of the most common symptoms of perimenopause. A hot flash is a sudden feeling of heat that spreads over the face and body. The skin may redden like a blush. You also may break out in a sweat. A hot flash may last from a few seconds to several minutes or longer. Hot flashes are not harmful, but they sometimes are embarrassing and may interfere with daily life.

Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night (night sweats) may wake you up and cause you to feel tired and sluggish during the day.

Vaginal and Urinary Tract Changes

As estrogen levels decrease, changes take place in the vagina. Over time, the vaginal lining gets thinner, dryer, and less elastic. Vaginal dryness may cause pain during sexual intercourse. Vaginal infections also may occur more often.

The urinary tract also changes with age. The urethra can become dry, inflamed, or irritated. Some women may need to urinate more often. Women may have an increased risk of urinary tract infections after menopause.

Bioidentical Hormone Therapy

BIOIDENTICAL hormones come from plant sources. They include commercially available products and compounded preparations. Compounded bioidentical hormones are made by a compounding pharmacist from a health care provider’s prescription. After your visit, we will draw baseline labs and determine your necessary dosing.  We work closely with a Chicago-based compounding pharmacy, WellFuture Pharmacy, to ensure high quality compositions and effective treatment for your menopause and perimenopausal symptoms. 

PELLET Therapy is a widely accepted way to administer hormone therapy by placing a small implant under the skin, which releases a small, physiologic dose of hormones.  Over 40 years of research has been done on hormone pellet therapy, with a very low incidence of side effects. 

BIOIDENTICAL and PELLET Hormone Therapy has been shown to improve:

  • Sex Drive and Libido

  • Insomnia

  • Hot Flashes/Sweats

  • Mood

Alternative Treatments

Plant-Based Alternatives

Plants and herbs that have been used for menopause symptoms include soy, black cohosh, and Chinese herbal remedies.  We also recommend rhubarb and yam based therapy, Estrovera, available online or through our office.  

Keep in mind, excess amounts of herbals or vitamin supplements may negate any positive benefits, especially if used in conjunction with bioidentical hormone therapy.  Be sure to discuss ALL your supplements with your physician to make sure you're getting the best possible outcome.

Vaginal Moisturizers and Lubricants

Vaginal moisturizers and lubricants are over-the-counter products that can be used to help with vaginal dryness and painful sexual intercourse. They do not contain hormones, so they do not have an effect on the vagina’s thickness or elasticity. Vaginal moisturizers replace moisture and restore the natural acidity of the vagina. You can use a moisturizer every 2–3 days as needed.

Lubricants can be used each time you have sexual intercourse. There are many types of lubricants. Water-soluble lubricants are easily absorbed into the skin and may have to be reapplied frequently. Silicone-based lubricants last longer and tend to be more slippery than water-soluble types. Oil-based lubricants include petroleum jelly, baby oil, or mineral oil. Oil-based types should not be used with latex condoms because they can weaken the latex and cause the condom to break.

Some of the lubricants we recommend are:

  • Slippery Stuff

  • Replens

  • UberLube

  • RepHresh

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