About Hormone Replacement Therapy (HRT)

As we age, the production of sex hormones in men and women declines. In men, this is often referred to as andropause, and, in women, this is known as menopause.  While this is a normal part of the aging process, these periods are often associated with uncomfortable or undesirable symptoms that can impact daily life. The drop in sex hormones can cause, in women, vaginal dryness or hot flashes, whereas, in men, low testosterone (low T) can cause erectile dysfunction and loss of muscle mass. Other symptoms common to both sexes include low libido, thinning bones, thinning hair and skin, decreased clarity of thought and memory capacity, mood swings, depression, weight gain, problems losing weight, and fatigue. The decline in sex hormones may be accompanied by high cholesterol, and a reduction in thyroid function (hypothyroidism). Other conditions such as cardiovascular disease, hypertension and diabetes become more prevalent during this phase of life. Hormone replacement therapy supplies the sex hormones that are no longer produced in a bioidentical form and in quantities that are comparable to the hormone levels of a healthy person at age 30.  The symptoms experienced during menopause or andropause are often completely reversible with hormone replacement therapy.

Is Hormone Replacement Therapy (HRT) Always Appropriate?

No. Hormone replacement therapy is not always necessary. For example, there are women with mild to moderate hot flashes that are effectively controlled with phytoestrogenic herbs, proper nutrition and stress reduction techniques. With mild symptoms or when otherwise appropriate, it’s important to provide the least aggressive treatment necessary to be effective. However, for some perimenopausal women, the symptoms caused by reduced hormones can hinder everyday life and hormone replacement therapy may be indicated. In severe cases, hot flashes are so intense that going out in public becomes difficult or women may develop osteoporosis. When symptoms are severe, hormone replacement therapy is necessary to bring their hormones into balance to mitigate or reverse symptoms.

Is Hormone Replacement Therapy (HRT) Safe?

Hormone replacement therapy offered at Cascade Integrative Medicine emphasizes the use of bioidentical hormones that are derived from plant sources and are formulated by compounding pharmacists. Chemically and biologically, bioidentical hormones act on hormone receptors identically to those the body naturally produces. The bioidentical hormones prescribed at Cascade Integrative Medicine are transdermal, which means they are absorbed through the skin. The use of transdermal bioidentical hormones as part of a hormone replacement therapy regimen allows the timed-release of hormones into the bloodstream, mimicking the body’s natural hormone delivery system.

During hormone replacement therapy, hormone levels must be measured regularly at 3-4 month intervals to ensure that they are kept within a safe physiological range. lt is known that if bioidentical hormones are maintained within an appropriate range, hormone replacement therapy is safe and effective. While studies of the use of Premarin (a conjugated horse estrogen that behaves differently than human estrogen) and medroxyprogesterone (a synthetic progesterone that does not act on our hormone receptors the same way our natural progesterone does) have shown a link between the administration of these hormones and cancer, bioidentical hormone replacement does not pose this risk.