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DESCRIPTION
Estrogens are the hormones responsible for female sex characteristics. Estrogen deficiency begins in the pre-menopausal years and progresses as a women goes through menopause. Most of the signs and symptoms of menopause result from the decrease in estrogen production. Hormone replacement therapy (HRT) or just estrogen replacement therapy (ERT) is used to diminish menopausal signs and symptoms and help prevent other medical problems.
MEDICATION
HRT usually consists of an estrogen hormone plus a progestogen (progestin) hormone. The two hormones combined protect against endometrial cancer, a risk with estrogen taken alone. Estrogen therapy alone may be used for women who have had a hysterectomy.MoonDragon's Information: Obgyn Procedures:
Hysterectomy - Abdominal
The dose, form and regimen for the medications will be determined depending on the individual patient's requirements, age and reason for the replacement therapy. Most frequently, patients take both medications daily continuously (others may take them on a cyclic schedule during the month).
Doses or schedules may need to be adjusted to completely resolve the symptoms of menopause. The medications can be supplied in oral form or skin patch (for estrogen). Also, an estrogen cream is available that can be prescribed to relieve vaginal symptoms.
For long-term protection from osteoporosis and cardiovascular disease, HRT must be taken indefinitely.
If a scheduled dose is missed, take it as soon as possible. If it is almost time for the next dose, skip the missed one. Don't double an oral dose and never wear more than one patch at a time.
If nausea is a problem, take the tablets with food or immediately after a meal. The nausea usually disappears with continued use.
EFFECTS OF THERAPY
Relieves hot flashes (sweating episodes) and vaginal symptoms of irritation and dryness that can cause pain and discomfort during sexual intercourse.
Prevention of osteoporosis.
Helps prevent cardiovascular diseases.
The therapy may ease the emotional and nervous symptoms of menopause (e.g., depression, irritability or insomnia) associated with other post-menopausal symptoms such as hot flashes. Medical evidence is uncertain that HRT will keep a woman feeling young or promote soft or unwrinkled skin.
PRECAUTIONS
Previous reaction or allergic response to estrogens or other medications or food.
Smoking or taking other prescription or non-prescription medications.
Family history of bone disease, cancer, endometriosis, epilepsy, fibroids, gallbladder disease, migraine headaches or excess of calcium in the blood.
A woman and her health care provider should discuss the benefits and risks with hormone therapy in terms of her individual medical history, general health, age, and other circumstances.
CONTRAINDICATIONS
Breast cancer (depending on when the diagnosis was made).
Past history or active blood-clotting disorder (thrombophlebitis) is generally not a contraindication, but should always be discussed with the health care provider.
Known or suspected pregnancy.
Endometrial cancer (depending on when the diagnosis was made).
Undiagnosed vaginal bleeding. It needs to be evaluated before hormone treatment is initiated.
RISKS, POSSIBLE SIDE EFFECTS OR ADVERSE REACTIONS
HRT is generally well tolerated. The most common undesirable side effect is abnormal uterine bleeding, which usually diminishes in time. Notify your health care provider if it does occur.
Swollen feet or legs.
Mood changes.
Breast tenderness.
Pelvic cramping.
Fatique.
Depression.
Headaches.
Symptoms of a blood clot -- sudden or severe headache, sudden loss of coordination, sudden loss or change in vision, pains in the chest, groin, or leg (especially the calf), sudden unexpected shortness of breath, sudden slurring of speech, weakness or numbness in arm or leg.
Medical studies indicate no increased risk of breast cancer with hormone replacement therapy.
Note: The usual dosages of hormone replacement therapy for menopausal symptoms are kept low and less likely to cause side effects or adverse reactions as are the higher doses used in oral contraceptives or used to treat some cancers.
FOLLOW-UP EXAMINATIONS
Women taking hormones should have an annual pelvic examination, including a Pap smear test, and a mammogram.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has symptoms of menopause and is interested in hormone replacement therapy.
Following any treatment, unexpected side effects occur.
Any of the symptoms of a blood clot occur. This is an emergency!
HELPFUL MENOPAUSAL HERBS
A paste made from aloe vera gel and slippery elm powder, mixed to the consistency of toothpaste and inserted into the vagina at night, can relieve vaginal dryness.
Damiana enhances sexual desire and pleasure.
Amaranth, chickweed, dandelion greens, nettle, seaweed, and watercress are rich in calcium and can prevent osteoporosis.
Anise, black cohosh, fennel, licorice, raspberry leaf, sage, sarsaparilla, squawvine, unicorn root, and wild yam root are natural estrogen replacements. Caution: Do not use licorice on a daily basis for more than 7 days in a row, and avoid it completely if you have high blood pressure. Do not use sage if you suffer from any type of seizure disorder.
Chamomile and valerian root help to calm the body and promote restful sleep. Caution: Do not use chamomile on an ongoing basis, and avoid it completely if you are allergic to rag weed.
Gotu Kola and Dong Quai relieve hot flashes, vaginal dryness, and depression.
Andrew Weil, M.D., a well-known physician and author, recommends trying the herbs dong quai, chaparral, and damiana, two capsules of each taken once daily at noon, or, if used as a tincture, one dropperful in a cup of warm water. Vitamin E, in doses of 400 to 800 IU per day, has also been reported to be helpful. People with high blood pressure should use no more than 100 IU per day. Jesse Hanley, M.D., a family practitioner in Malibu, California, has found that certain Chinese herbs, called Changes for Women, by Zand Herbal, and Menofem, by Prevail, are helpful in reducing menopausal symptoms for some women. These supplements are available at most health food stores.
Siberian ginseng aids in relieving depression and in the production of estrogen. Caution : Do not use this herb if you have hypoglycemia, high blood pressure, or a heart disorder.
Note: Bulk herbs are available from Mountain Rose Herbs. Nutritional supplements, tinctures, extracts, tablets and capsules are available from HerbalRemedies.com. See links below.
MENOPAUSAL SUPPLEMENTS & PRODUCTS
Nutrients Supplement Suggested Dosage Comments Very Important Lecithin granules
Or
Capsules1 Tablespoon 3 times daily, before meals.
1,200 mg 3 times daily, before meals.Important as an emulsifier for vitamin E, which reduces hot flashes and related symptoms. Lecithin, Vegetarian Granules, NOW Foods, 97% Phosphatides, Pure and Fresh, 1 lb., Lecithin, Liquid, NOW Foods, Vegetarian, 16 fl. oz. Multi-enzyme complex
With
Hydrochloric Acid (HCl)As directed on label. Take with meals. To aid digestion
HCl production declines with age. Caution: Do not use HCl if you have a history of ulcers. Plant Enzymes, NOW Foods, Vegetarian, 120 VcapsPrimrose oil
Or
Black Currant Seed OilAs directed on label.
As directed on label.Act as sedatives and diuretics. Good for hot flashes. Important for production of estrogen. Evening Primrose Oil, NOW Foods, 100% Pure, 4 fl. oz., Evening Primrose Oil, Cold-Pressed, Nature's Way, 500 mg, 250 Softgels, Evening Primrose Oil, Cold-Pressed, Nature's Way, 1300 mg, 120 Softgels, Black Currant Oil, 500 mg, NOW Foods, 100 Softgels Vitamin B complex As directed on label. For improved circulation and cellular function. Use a sublingual form for best absorption. Or consider injections (under a health care provider's supervision). Ultimate B, B Complex Formula, Nature's Secret, 60 Tabs Plus extra
Pantothenic acid (Vitamin B-5)100 mg 3 times daily. A powerful anti-stress vitamin needed for adrenal function. Pantothenic Acid, 100% Natural Vitamin B-5, Nature's Way, 250 mg, 100 Caps And
Pyridoxine (Vitamin B-6)50 mg 3 times daily. Minimizes water retention and eases symptoms. Pyridoxine, Vitamin B-6, Nature's Way, 100 mg, 100 Caps Vitamin E Start with 400 IU daily and slowly increase the dosage until hot flashes are relieved, up to 1,600 IU daily. Reduces hot flashes and many other symptoms. Use emulsion from for easier assimilation and greater safety at high doses. Vitamin E 1000, NOW Foods, 1000 IU, 100 Gels, Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels, Vitamin E Skin Cream, NOW Foods, 28,000 IU, 4 oz. Important Boron 3 mg daily. Do not exceed this amount. Enhances calcium absorption. Boron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz., Ionic Boron Single Mineral, 6 mg, 2 fl. oz, Trace Minerals, Boron Chelate, Nature's Way, 3 mg, 100 Caps Calcium
And
Magnesium2,000 mg daily.
1,000 mg daily.To relieve nervousness and irritability, and to protect against bone loss. Use chelate forms. Just An Ounce, Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz., Cal-Mag Pre-Chelated Calcium &Magnesium, Vital Earth, 240 Gelcaps Silica As directed on label. Supplies silicon, needed for connective tissue and for calcium uptake. Cellfood Silica Liquid Drops, 4 fl. oz. (118 ml), Original Silica Gel Capsule, 90 Vcaps, Nature's Way Zinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Aids in protecting against bone loss and reducing symptoms. Use Zinc Gluconate lozenges or Optizinc for best absorption. Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz., Ionic Zinc, 50 mg, 2 fl. oz., Trace Minerals, Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps, Zinc Lozenges w/Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges Helpful L-Arginine
And
L-Lysine500 mg twice daily.
500 mg daily, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 and 100 mg vitamin C for better absorption.Detoxifies the liver and ammonia.
Aids liver function. See Amino Acids for more information. L-Arginine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 100 Caps, L-Lysine, Pharmaceutical Grade, Stable Tartrate Form, NOW Foods, 500 mg, 100 CapsMeno-Fem from Prevail
(Note: Unable to locate on the internet)As directed on label. Contains gamma-oryzanol, a component of rice bran oil effective in controlling uncomfortable symptoms of menopause. Multi-glandular complex As directed on label. For hormonal stability. See Glandular Therapy for more information. Immuno-Gland Plex, Organic Glandular (Hypoallergenic), Allergy Research Group/Nutricology, 60 Caps Multi-vitamin & Mineral complex
With
PotassiumAs directed on label. Take with meals.
99 mg daily.All nutrients are needed for normal hormone production and function.
To replace potassium lost through perspiration during hot flashes. Alive! Whole Food Energizer, Multi-Vitamin & Mineral W/ Naturally Occurring Iron (No Iron Added), Nature's way, 180 Tabs, Alive! Whole Food Energizer, Rice & Pea Protein w/ Naturally Occurring Iron, Ultra-Shake Powder, Apple Cinnamon Flavor, Nature's Way, 2.2 lb.And
Selenium200 mcg daily. An important trace mineral linked to normal hormonal balance. Selenium Supplement, Yeast Free, NOW Foods, 200 mcg, 180 Caps, Selenium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz. Vitamin C 3,000 - 10,000 mg daily, in divided doses. For hot flashes. Vitamin C Liquid, w/Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, 1000 mg, 16 fl. oz., Dynamic Health, Vitamin C 1000 w/Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Vcaps
HELPFUL PRODUCTS
Keat's Good Health Guide About Natural Progesterone Cream
In this Keat's Good Health Guide, Dr. Norman Shealy answers all your questions about natural progesterone cream, a viable and safe alternative to synthetic hormone replacement therapy. As a major building block for both testosterone and estrogen plus virtually all other adrenal hormones, natural progesterone can help prevent osteoporosis, ease PMS, menopausal symptoms, figroids, migraine headaches, lift depression - and more. Offering health benefits to both men and women.
Natural Hormone Replacement For Woment Over 45, Jonathan Wright
Book about Natural Hormone Replacement for Women over 45.
Wild Yam Cream from Dreamcastle contains progesterone and phyto-estrogens, which are natural estrogens found in plants. Wild Yam Cream is a safe, natural alternative to hormone replacement therapy without the risk of weight gain or other negative side effects.
ESTROGENEX - is a nutritional supplement, available without a prescription, designed to normalize all hormone levels, yielding a wide spectrum of health and anti-aging benefits.
Progesterone Cream helps women experiencing the symptoms of menopause. Progesterone Cream is a safe alternative to hormone replacement therapy. Progesterone Cream Contains progesterone and phyto-estrogens, natural estrogens found in plants. Progesterone Cream Avocado Oil is blended with vitamin E, Aloe Vera and other herbs for fast absorption & effectiveness.
Premenopausal symptoms, endometriosis, weight gain, low sex drive, fibrocystic breasts, heart disease, and osteoporosis-most women will experience these or other hormone-related problems. And today, millions of women concerned about aging must decide whether or not to undergo synthetic hormone replacement therapy and suffer its side effects and increased risks of cancer. But there is revolutionary news about completely safe, Natural Progesterone, the only hormone supplement women may need as they age. The exciting clinical findings from its use were first spread by word of mouth, then in a groundbreaking book written by acclaimed California physician John R. Lee. Now, in this expanded and completely updated edition, Dr. Lee brings you lifesaving facts that even your doctor may not know about Premarin, Provera, and other HRT drugs; gives you an easy-to-follow nonprescription "Hormone Balance" program; and tells you how to stay energized, strong, sexually vigorous, and free from "female problems" before menopause, during the menopausal years, and beyond.
Premenopausal symptoms, endometriosis, weight gain, low sex drive, fibrocystic breasts, heart disease, and osteoporosis—most women will experience these or other hormone-related problems. And today, millions of women concerned about aging must decide whether or not to undergo synthetic hormone replacement therapy—and suffer its side effects and increased risks of cancer. But there is revolutionary news about completely safe, natural progesterone, the only hormone supplement women may need as they age. The exciting clinical findings from its use were first spread by word of mouth, then in a groundbreaking book written by acclaimed California physician John R. Lee. Now, in this expanded and completely updated edition, Dr. Lee brings you lifesaving facts that even your doctor may not know about Premarin, Provera, and other HRT drugs; gives you an easy-to-follow nonprescription "Hormone Balance" program; and tells you how to stay energized, strong, sexually vigorous, and free from "female problems" before menopause, during the menopausal years, and beyond.
Based on current scientific research and our clinical experience, we have developed a formula that helps women through menopause while they avoid the risks that come with hormone replacement therapy.
Black cohosh (Cimicifuga racemosa) has been used traditionaly as a relaxant, sedative, and antispasmodic. Menopause causes the signals between the ovaries and pituitary gland to diminish, slowing down estrogen production and increasing luteinizing hormone (LH) secretions. Hot flashes can result from these hormonal changes. A German clinical study demonstrated that an extract of black cohosh decreases LH secretions in menopausal women – but produces no homronal changes. The studies, therefore, support the usefulness of black cohosh for symptomatic relief from hot flashes, but not as a substitute for hormone replacement therapy. 1 tsp. 2 to 3 times a day depending on condition.
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