30 May
30May

Hormone Replacement

                                                                                      Over  the past several decades, hormone replacement therapy (BHRT) has been concurrently at the forefront of medical science, and the focal point of public interest, while being effectively prepared and administered to millions of patients. While researchers and physicians have been making great strides in knowledge and treatment, Oprah has talked about it, Suzanne Summers has written about it, and Compounding Pharmacies have provided BHRT as a means help patients get back on the road to good health and wellness.  Hormone replacement therapy has been used to treat the symptoms of menopause and other hormonal imbalances in both sexes. However, HRT is most often spoken of (and will be so here) as female hormone replacement, which is traditionally contrasted with testosterone replacement therapy (TRT). Nevertheless, it should be made very clear that both HRT and TRT may be required by and administered to either gender. More specifically, custom HRT is a method of providing specific hormones (which often involves combinations of hormones) in the exact dosages required to meet a patient’s uniquely individual needs. The method by which hormones are customized is called ‘compounding’.[1]


Functions of BHRT

Hormone replacement therapy is the method used to treat not only the symptoms of menopause, but all other hormonal imbalances as well. A hormone will only act on a part of the body if it ‘fits’, and can therefore be thought of as a type of ‘key’. Its target site (such as a cell) has specially shaped receptors which are analogous to ‘locks’ on their cell walls. If the key(hormone) fits the lock (receptor site), then the hormone will work by impacting the target site (cell), and altering the function of its tissue and/or organ. The primary affected glands include:

  • Pituitary gland- inside the brain, oversees the other glands and keeps hormone levels in check. It can also bring about a change in hormone production somewhere else in the system by releasing its own ‘stimulating’ hormones.
  • Thyroid gland- inside the neck, controls the rate of metabolism.
  • Parathyroid glands- inside the neck surrounding the thyroid gland, control the level of calcium in the bloodstream.
  • Adrenal glands- atop each kidney, make a number of different hormones, such as adrenaline and cortisol in times of stress, as well as sex hormones.
  • Pancreas- inside the abdomen, an organ of digestion which makes insulin to control the amount of sugar in the bloodstream.
  • Ovaries- inside the female pelvis, make female sex hormones like estrogen.
  • Testes- inside the male scrotum, make male sex hormones like testosterone.

Some common problems of the endocrine system that may be addressed by HRT include:  premenstrual syndrome- symptoms include cramping, bloating, breast tenderness and mood swings;  thyroid problems- when the gland is overactive (hyperthyroidism) or underactive (hypothyroidism). and Adrenal issues such as poor sleep, fatigue, anxiety, and weight gain

How Hormone Replacement Works

The endocrine glands receive feedback from the hypothalamus - a small but important part of the brain which contains several small nuclei with a diversity of functions. It plays an important role in both the nervous and endocrine systems. All vertebrate brains contain a hypothalamus, which in humans, it is roughly the size of an almond and located just below the thalamus and right above the brain stem. Linked to another small and vital gland called the pituitary gland, the hypothalamus controls certain metabolic processes and other activities of the autonomic nervous system by synthesizing and secreting neurohormones, often called hypothalamic-releasing hormones. These hypothalamic releasing hormones control and regulate the major endocrine glands (pituitary, pineal, thymus, thyroid, adrenals, and pancreas) as well as within the sex organs (male testes and female ovaries). Hormones are your body's chemical messengers, they travel throughout the bloodstream to specific cells, tissues, and organs where they work at varying speeds inducing a wide range of homeostatic and other physiological processes central to which are:

  • The release of 8 major hormones by the pituitary gland
  • Growth and development
  • Cellular repair
  • Body temperature
  • Hunger, thirst and food, and water intake
  • Sexual behavior and reproductive functions
  • Daily cycles in physiological state and behavior also known as circadian rhythm
  • Mediation of emotional responses and mood
  • Digestion
  • Circulatory and respiratory function

The goal of BHRT is to optimize function, prevent morbidity with aging, and to enhance quality of life. With proper modification, adjustment, and titration, the benefits of BHRT far outweigh the risks. 

Common Symptoms of Hormone Imbalance

  • Irritablility
  • Premenstrual Syndrome (PMS)
  • Irregular menstrual cycle
  • Moodiness
  • Hot flashes
  • Infertility
  • Post-partum depression
  • Decreased libido
  • Weight gain
  • Endometriosis
  • Fibrocystic breasts
  • Vaginal Dryness
  • Painful sexual intercourse
  • Sleep disturbances
  • Night sweats

Limitations on Commercially Made HRT

There are many mass-produced hormone treatments on the market today. However, every woman's body, and her individual hormonal makeup, is different and each requiring a unique balance of hormones. That's why more women are turning to custom compounded HRT for their hormone replacement needs. There is also a valid scientific concern that many commercially available HRT products are drugs acting like hormones and not actual bioidentical human hormones. This causes a great deal of confusion as well as carry significant medical risks to patients.

Compounded Dosage Forms

  • Troches
  • Sublingual drops 
  • Capsules
  • Gels and foams
  • Suppositories
  •  Vaginal creams
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