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Menopause
ging with health, strength, beauty, and wisdom.
Bioidentical Estrogen and Progesterone At our office we offer salivary hormone testing and individualized prescriptions. These are the same hormones the female body makes. Bioidentical Estradiol (E2) is the most readily available for of natural replacement. It comes in a pill 1-2 mg/day or patches .05- .1 mg changed each week, or a cream (apply to vagina every other day for 3 weeks), or a ring (apply to vagina every 90 days). Other forms of bioidentical estrogen include E1 and E3. Individualized formulations of these are available through compounding pharmacies. Natural Progesterone comes as Prometrium 100 mg/day as a continuous or 200 mg / day for 14 days as a cyclic regimen. You can also try Progest 2% cream ½ tps each day. All above come from plant bases sources. ¨ Symptoms – useful for hot flashes, mood swings, memory loss, vaginal dryness, libido changes. Progesterone is very helpful for abnormal bleeding. ¨ Risk reduction – osteoporosis, osteoarthritis, tooth loss, vision loss, and colon cancer. Decrease risk for Alzheimer’s disease and Parkinson’s disease. May increase risk of breast cancer is used greater than 5 years, but decreases risk of death. ¨ Testing – There are serum and saliva tests now available to assess your needs for the three types of estrogen, progesterone, and testosterone. An individual prescription can then be offered. Info about saliva tests www.gsdl.com Alternative and Additions
lternatives for hormone replacement are available if you have contraindications to Estrogen or Progesterone or if you feel that symptoms are low or risks are high. ¨ Hot Flashes – Choices include soy (phytoestrogens) 25-60 g/day of soy protein, flax oil, black cohash 40 mg twice/day, relaxation and breathing techniques, exercise, yoga, and acupuncture. Chlonidine, Effexor, and Paxil are other medications that may help. Smoking, caffeine, and spicy foods tend to worsen hot flashes. ¨ Mood Swings – Many women find solitude and self-expression necessary at this time. For depression-exercise, yoga, stress management. St John’s Wort 300 mg/3xday, or SSRI type antidepressant may be helpful. Black cohosh may also be useful. For anxiety- Valerian 200 mg 3/day has been used. Support groups, sleep, nutrition, therapy, and massage can also be helpful. DHEA 25 mg/day or ginseng may be helpful for energy in women under stress. ¨ Vaginal dryness and libido – you can increase you water intake, do kegel exercises to tone the PC pump, use Ky Jelly, Vitamin E, increase the soy in your diet. Testosterone tablets or gel and or counseling can be used for libido concerns. ¨ Memory loss and Alzheimer’s disease – ginkgo 120 mg twice / day can be helpful. Risk Reduction
lternatives are also available to help reduce risk of important disease. ¨ Cardiovascular disease – exercise, diet, Vitamin D, folic acid, weight loss, stress management can all be helpful. ¨ Osteoporosis – Calcium 1500 mg/day, Vitamin D, Magnesium, weight-bearing exercise, smoking cessation, Raloxifene 60 mg/day, and alidronate are potential choices. ¨ Optimize Health – Holistic, individualized, and team approach to overall wellness also includes a healthy diet, regular excise, smoking cessation, routine health screening, and stress management. Good nutrition including a multivitamin with antioxidants (E, C, etc) B complex, and minerals especially selenium, calcium, and chromium is essential to health. Eat three regular meals a day. The diet should include Omega 3 fatty acids and below in trans fat, and simple sugars.
Information Resources The Wisdom of Menopause and Women’s Bodies Women’s Wisdom by Dr. Christiane Northup Passionate Marriage by Dr. David Schnarch Web sites: National Center for Complementary and Alternative Medicine nccam.nih.gov American College of Ob/Gyn www.acog.com
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