background

Bioidentical Hormone Therapy in Menopause Ankara

Menopause is an important turning point in a woman's life. During this process, hormonal changes in the body can cause many physical and emotional symptoms. Problems such as hot flashes, night sweats, insomnia, mood swings, and bone loss can make daily life difficult. Considering the increased health risks after menopause, hormone therapy becomes an option for many women. However, traditional hormone replacement therapy (HRT) can cause side effects in some women or may not be desirable. This is where bioidentical hormone therapy (BHT) comes into play. I often hear patients say, "Doctor, I've entered menopause. Should I use hormones?" You come to me with this question, and your mind is confused because some doctors say you should definitely use them, while others say never. There is a lot of confusion about this issue in our country. So what should we do now?" We will answer these questions in this article. You may have come across different opinions about hormone replacement therapy during menopause. While menopause is a natural process, it has become a destructive process in the last century as human life has extended. It is a process where estrogen and progesterone hormones, as well as testosterone and DHEA hormones, decrease in a woman's body. Especially estrogen and progesterone are hormones that protect a woman's heart, blood vessels, bones, and brain. And in this regard, women are luckier than men. With the disappearance of these hormones during menopause, rapid deterioration, aging, and illness begin throughout the woman's body. During menopause, we must provide bioidentical hormones, which are the same molecules produced in our ovaries. These natural hormones bind to carrier proteins and are transported to cells in the same way as they do in the body. We can administer the estrogen that women have lost (E2: estradiol and E3: estriol) in the form of patches, creams, or gels as treatment. For progesterone, we prefer to use micronized natural progesterone (vaginal or oral). First and foremost, as experienced and trained gynecologists in this field, we evaluate whether our patients are suitable for hormone replacement therapy through examination and medical history. Women who respect and care for their bodies and lives will inevitably benefit the most from bioidentical hormone replacement therapy.

Thickening of the uterine wall
Bioidentical Hormone Therapy in Menopause: Restoring Natural Balance

What are bioidentical hormones and how do they benefit during menopause? Let's take a closer look at this topic.

What are bioidentical hormones?

Bioidentical hormones are hormones that are chemically identical to hormones such as estrogen, progesterone, and testosterone produced naturally by the body. It is similar to taking thyroid hormone or insulin as medication when your thyroid gland is underactive. These hormones are produced naturally or obtained from plant sources and are recognized as natural hormones by the body's hormone receptors. They are not synthetic hormones, so they do not cause the receptors to misinterpret them or lead to cancer. Unlike traditional synthetic hormone treatments, which are the same for everyone, bioidentical hormones are customized for each individual. They can be prepared based on the individual's blood levels and may have an effect closer to the body's natural balance. These hormones are administered to the body as estrogen, progesterone, and in some cases testosterone. Estrogen is one of the most effective hormones for alleviating menopause symptoms, and progesterone is particularly important for maintaining uterine, breast, and bone health.

What are the benefits of bioidentical hormone therapy during menopause?

Bioidentical hormone therapy is a method used to improve the quality of life of women during and after menopause. The main benefits of this treatment are as follows:

1. Reduces Hot Flashes and Night Sweats

Sudden fluctuations in body temperature caused by declining estrogen levels can make daily life difficult. Bioidentical hormone therapy can significantly reduce these symptoms by balancing estrogen levels.

2. Improves Sleep Quality

Sleep disorders commonly seen in menopause are related to hormonal fluctuations. Night sweats and anxiety, in particular, can disrupt sleep patterns. Estrogen and progesterone supplements can improve sleep quality with their relaxing and balancing effects.

3. Supports Mood and Psychological Health

Decreased estrogen levels can also affect the production of happiness hormones such as serotonin. This can lead to depression, anxiety, and mood swings. Bioidentical hormones stabilize mood by balancing these hormones. They prevent sudden irritability and tension.

4. Maintains Bone Health

The positive effects of estrogen on bone density are well known. The risk of bone loss (osteoporosis) increases due to estrogen deficiency after menopause. Bioidentical hormone therapy helps reduce the risk of osteoporosis by slowing bone loss.

5. Supports Skin and Hair Health

During menopause, you may experience skin dryness, loss of elasticity, and hair loss. Estrogen support increases collagen production in the skin, giving it a healthier and more vibrant appearance.

6. Supports Sexual Health
During menopause, decreasing estrogen and testosterone levels can lead to problems such as vaginal dryness, loss of libido, and discomfort during sexual intercourse. Bioidentical hormone therapy supports sexual health by maintaining the moisture balance of vaginal tissues. It corrects the person's decreased libido.

7. Supports Mental Health

It has recently been discovered that estrogen has receptors in the brain. It is known that the estrogen hormone stimulates nerve cells in the hippocampus and has positive effects on cognitive functions. Estrogen, which plays a role in functions such as thinking and memory, may increase the risk of brain fog, forgetfulness, and Alzheimer's and dementia with advancing age due to its decrease during menopause. Therefore, bioidentical hormone therapy is necessary to benefit from the brain-protective effects of estrogen after menopause.

8. Protects Heart and Vascular Health

Women have a lower risk of dying from a heart attack than men before menopause. With the onset of menopause and the decrease in estrogen levels, this risk increases. It rises to the same level as men. Studies have shown that bioidentical hormone therapy may have positive effects on cardiovascular health. In women receiving treatment, this risk has decreased again. We recommend that women who are going through menopause, especially those with a family history of heart disease or heart attack, or who experience hot flashes, undergo a cardiology examination and be evaluated for bioidentical hormone therapy.

9. Vaginal Dryness and Improvement of Sexual Function

Sexual intercourse becomes painful for women, leading to avoidance of sexual activity and decreased sexual desire. Bioidentical hormone therapy eliminates vaginal dryness. Medications such as E2 and E3 in the form of gels, creams, or vaginal suppositories are preferred for local vaginal application. Sexual desire returns, and pain and burning are eliminated. The effects of bioidentical hormone therapy may vary from person to person and may not be the same for everyone. Each woman's treatment, application method, duration, and dosage may vary. During the treatment process, the medication's usage method and dosage may be adjusted at regular intervals. We work with you to develop a personalized treatment plan, taking into account the benefits and risks of treatment.

How is bioidentical hormone therapy administered?

Bioidentical hormone therapy can be administered in different forms. The most common methods we use are as follows: • Cream and gel form: Applied to the skin for absorption. • Oral tablets: Taken daily. However, this treatment may not be suitable for all women due to side effects such as the first-pass effect in the liver and embolism.
• Skin patches: Provides long-term and balanced hormone release for up to 1 week.
• Nasal spray or sublingual drops: Provides rapid absorption and may be more comfortable for some patients. The preferred form varies depending on the individual's needs and the doctor's recommendation. Absorption through the skin means that the hormone does not pass through the liver, reducing the risk of clotting; it is much safer, especially for those at risk.
Hormone replacement is a serious matter. We do not recommend using synthetic hormones taken orally. You should receive bioidentical hormone therapy applied to the skin. Additionally, have your carotid arteries and breasts checked to ensure there are no concerns for either you or us. There should also be no chronic inflammatory processes in your body so that we can start this treatment comfortably.

Nutrition and Lifestyle Recommendations for Menopause

In addition to bioidentical hormone therapy, certain lifestyle changes can help you get through menopause more comfortably:
• Drink plenty of water: Dehydration can increase hot flashes. • Turn to plant-based sources of estrogen: Foods such as soy, flaxseed, and chickpeas contain natural estrogen. • Avoid sugar and processed foods: Sudden fluctuations in blood sugar can trigger mood swings.
• Exercise regularly: Try to do resistance and weight-bearing exercises to maintain bone density and prevent muscle loss. You can walk, do Pilates, yoga, or light weight training.
• Manage stress: Meditation, breathing exercises, and social activities can lower your stress levels.

Possible Side Effects of Bioidentical Hormone Therapy

Like any treatment, bioidentical hormone therapy may have some side effects. These side effects can usually be controlled with dose adjustments: • Headaches
• Mild stomach discomfort
• Breast tenderness
• Mild weight changes
• Breakthrough bleeding
If these side effects persist, consult your doctor to adjust the dosage or method of application. In conclusion, bioidentical hormone therapy may be an option to help alleviate your symptoms. The menopause process is, of course, a unique experience and journey for each individual. While some women may experience this phase with minimal discomfort, while for others the symptoms can be quite challenging. Bioidentical hormone therapy offers the closest solution to the body's natural hormonal balance, making this process more comfortable for the individual. If you are struggling with menopause symptoms, you can consult a specialist to determine the most appropriate method for you. Remember that the challenges of being a woman and the changes and transformations that come with it can be addressed, and that a healthy, balanced menopause is possible.

Bioidentical Hormone Replacement Therapy

Today, bioidentical hormones are often used to alleviate menopause symptoms with personalized treatment plans. Bioidentical hormone therapy is a treatment method that uses artificial hormones that are very similar to the natural hormones produced by the human body. Often referred to as hormone replacement therapy (HRT), this treatment is used to manage symptoms that arise due to declining hormone levels, particularly in women after menopause. The decrease in estrogen and progesterone hormones during menopause can cause a variety of symptoms. These symptoms include: • Hot flashes
• Excessive sweating
• Sleep problems
• Skin and hair changes
• Bone loss (osteoporosis)
• Mood swings
Bioidentical hormone therapy can help control these symptoms. The treatment typically involves the use of hormones such as estrogen, progesterone, and testosterone, which are derived from plants and processed to resemble the body's own hormones. These hormones are very similar in structure to natural hormones, so they are more easily accepted by the body and may cause fewer side effects.

The Logic Behind Bioidentical Hormone Therapy

In hypothyroidism, when the thyroid gland does not produce enough hormones, thyroid hormone is administered externally. Similarly, in bioidentical hormone therapy, the missing hormones are supplemented externally. This treatment aims to restore hormonal balance in the body by replacing deficient hormone levels. Bioidentical hormone therapy is generally administered for a period of 5 to 10 years. Treatment is often preferred in the following cases: • Menopause
• Early menopause
• Surgical menopause (menopause following removal of the uterus or ovaries)
• Postmenopausal period
Early initiation of treatment is important for effective control of symptoms and reduction of long-term health risks. Hormone replacement therapy not only prevents menopausal symptoms, but also reduces the increased risks associated with menopause. These risks include: • Cardiovascular disease
• Weight gain
• Bone loss (osteoporosis).

Are there any risks associated with bioidentical hormone replacement therapy?

Bioidentical hormone replacement therapy may not be suitable for every woman. Therefore, a physical examination, a comprehensive medical history assessment, and necessary laboratory tests, including carotid Doppler examination, Pap smear test, and radiological examinations, should be performed before starting bioidentical hormone replacement therapy. In addition, treatment should be planned taking into account the individual risk factors (e.g., history of cancer, risk of cardiovascular disease, coagulation disorders). Although bioidentical hormone replacement therapy uses compounds that are compatible with the body and closest to the body's natural hormones, various side effects may occur. For this reason, it must be used under the supervision of a doctor. Hormone levels can be regularly monitored during treatment. Before and during bioidentical hormone replacement therapy, hormone levels are measured from the individual's blood sample. The effects of synthetic hormone replacement therapy may not be clearly observed. However, in bioidentical hormone replacement therapy, since the hormones are biochemically very similar to those produced naturally by the body, they can be measured more accurately in the blood. This facilitates monitoring hormone levels during treatment and adjusting doses according to individual needs. Additionally, this feature allows bioidentical hormone therapy to be tailored to the individual. Dosage adjustments are also possible, starting with a low dose and gradually increasing it according to the individual's needs. These bioequivalent hormones, which are not available in ready-made forms in our country, are prescribed by specialists and prepared by pharmacists as compounded medications. In hormone replacement therapy, estrogen hormone is administered in gel form. Bioequivalent progesterone is generally available in our country in ready-made form as micronized progesterone. This form can be used both orally (by mouth) and vaginally. However, depending on the individual's specific needs, progesterone can also be prepared as a compounded medication. For testosterone, the bioequivalent form is generally available as a compounded medication. While ready-made forms are more limited, testosterone is typically used in gel, cream, injection, or implant forms. It is very important for women to be informed about bioidentical hormone replacement therapy. Starting hormone replacement therapy early is important to prevent health problems that may develop in the later stages of menopause. Women can learn about this information and start treatment in time, which can improve their quality of life. Bioidentical hormone therapy can be customized for each individual. Women's awareness of these treatment options contributes to the creation of an individual plan tailored to their needs. There may be misinformation and unnecessary fears about hormone treatments in society. When women have the right information, they can overcome these misconceptions and make the best decision for themselves.