Could It Be Right for You?

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At some point, all women experience menopause — a decrease in hormones that results in the end of menstruation. A woman has reached menopause when she has not had a menstrual period for a full year.

Most women also experience a transitional phase called perimenopause, which usually causes 5 to 10 years of periodic symptoms associated with menopause.

Hormone therapy can help reduce the symptoms women experience as they approach and experience menopause. One choice for this therapy is bioidentical hormone therapy (BHT).

What Are Bioidentical Hormones?

Bioidentical hormones are identical to hormones that are created by the human body, but they are derived from natural plant products, including wild yams and soybeans.

Some bioidentical hormones are compounded, which means that a compounding pharmacist puts together a combination of hormones that is tailored to each patient.

Menopause and Its Symptoms

The hormones that decrease as a woman ages include estrogen, progesterone and testosterone. The production of these hormones typically starts to decline during a woman's mid-30s.

By the time a woman is in her 50s or 60s, she produces only about 25% of the hormones she did in her 20s and 30s. The majority of women reach menopause between the ages of 45 and 55, but it can occur anytime between ages 40 and 59.

A woman's body produces three types of estrogen. One of them, estriol, is the most protective type of estrogen. In fact, some studies show that estriol (also called E3) may protect against cancer. Women with low estrogen levels may experience symptoms such as foggy thinking or memory loss, depression, hot flashes, night sweats, vaginal dryness, heart palpitations and dry skin.

Progesterone levels in a woman's body can start to drop as early as age 35. Women with decreasing progesterone levels may experience moodiness, irritability, concentration difficulty, depression and insomnia.

Synthetic progesterone is called progestin. It may have side effects such as increased appetite, fluid retention, irritability, depression, weight gain, breast tenderness and bloating. Natural progesterone may lower cholesterol, lower blood pressure, offer some protection against breast cancer and increase the positive effects of estrogen on blood vessels.

Finally, declining testosterone levels can contribute to a decreased or absent sex drive and an inability to enjoy sex. Taking testosterone may help increase sex drive. It also may help maintain bone strength and muscle mass, improve skin tone, decrease body fat and improve memory and mood.

Starting Therapy

BHT is available through a compounding pharmacy. Pharmacists who work there take each individual component — such as hormones — and combine them into a formulation specifically for you, as prescribed by your health care provider. The pharmacist may put the hormones together in several different ways, including the following:

• a pill you swallow

• a lozenge, which is like a cough drop

• a cream or gel for the skin

• a cream or gel for the vagina.

Many experts believe that the most effective way to deliver BHT is through a lozenge, a skin cream or a skin gel, because these preparations allow hormones to directly enter the bloodstream.

It is important to know that compounded drugs, including hormones, are not reviewed by the FDA for safety and effectiveness. The FDA encourages patients to use FDA-approved drugs whenever possible.

Alternate versions of BHT (not created at compounding pharmacies) are commercially available and FDA-approved, such as some patches and the vaginal ring.

BHT Is for Men, Too

Men also experience a decline in hormones — namely, testosterone — as they age. Some men experience this decline as early as their 40s and 50s. Symptoms include fatigue, loss of energy, decreased sex drive, decreased erectile function and depression.

Testosterone can be prescribed in a gel or cream. It should not be given orally because it is not as effective, and it could negatively affect the liver.