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Safe and effective Bioidentical Hormone Replacement Therapy (BHRT) at Vivify Health & Wellness.

 

At Vivify Health & Wellness, we take a holistic approach to your body, your health, and your hormones.  We will get you the facts on the risks and the benefits of hormone replacement therapy.  Estrogen and progesterone play many very important roles in your health and the way that you feel.  Here at Vivify Health & Wellness, we can help you to optimize the benefits of your hormones to revive that youthful and vibrant version of you.

Why Choose Bioidentical Hormone Replacement Therapy (BHRT)?

 

Sometimes your doctor will offer synthetic hormone replacement options, such as premarin or progestin.  At vivify Health & Wellness we offer a natural approach to hormone replacement with Bioidentical Hormone Replacement Therapy (BHRT).  The hormones we use for BHRT are derived from plant sources and created to be chemically identical to the hormones your body naturally produces.  The hormones we most often look at with BHRT are estrogen, progesterone, and testosterone.  Treatments with BHRT allows your body to resume its healthy hormonal balance, control uncomfortable and troubling symptoms, and optimize your health and wellness.

What makes Bioidentical Hormones so Special?

 

Bioidentiacl hormones are a safe option for hormone therapy because down to the molecular level they are identical to the hormones your body naturally produces.   BHRT provides you with a natural alternative to treat hormone deficiency with hormones exactly like the ones you have been making your whole life.  Synthetic hormones are chemically tweaked to be unique and different from those you naturally produce.  These chemically altered hormones can help manage symptoms of menopause, but they can also result in disastrous effects on your health.  At Vivify Health & Wellness we don’t prescribe these synthetic hormones because we value your health and well-being.  Our goal at Vivify Health & Wellness is to balance your hormones using hormones biologically identical to your human hormones to improve your bone health, your brain health, your heart health, and your quality of life.

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Why Consider Hormone Replacement at all?

 

Hormone replacement therapy for women is a personal choice.  The decline in hormones after child bearing years is a natural process that women have experienced for years.  In women, we call this menopause or climacteric.  This is the time when many women experience trouble sleeping, hot flashes, mood swings, night sweats, and weight gain.  Hot flashes are really just the tip of the iceberg.  Menopausal women are at a higher risk for cardiovascular disease, depression, insomnia, osteoporosis, insulin resistance, and dysfunction in the hypothalamic-pituitary-adrenal axis.  Hormone replacement therapy with bioidentical hormones is not just about helping you to feel well, but it is about keeping you healthy and improving your quality of life as you enter this next phase along your journey.

Breast Cancer and BHRT

 

When trying to understand the risk of breast cancer in women with hormone replacement therapy (HRT) we need to first understand the difference between bioidentical hormones and synthetic hormones.  Progestins and Medroxyprogesterone acetate (MPA) are synthetic and not bioidentical hormones, but progesterone is a bioidentical hormone.  Premarin and conjugated equine estrogens (CEE) are not bioidentical, but estradiol and estriol are bioidentical hormones.  Large population and peer reviewed research by Fournier et al. in 2005 showed that the breast cancer risk was 40% higher with synthetic MPA and 10% lower with bioidentical progesterone.  In 2007, Fournier et al. showed a 69% increased breast cancer risk when MPA was combined with estradiol, but no change in breast cancer risk when using bioidentical progesterone and estradiol.  This finding was confirmed with the 2013 French E3-EPIC study of 80,000 women where an increased risk of breast cancer was seen with women taking progestins and estrogens, but no changes in breast cancer risk when taking bioidentical progesterone with estrogens.  The fact is that the risk for breast cancer IS increased with synthetic progestins, but the risk is NOT increased, and is actually decreased, when using natural bioidentical progesterone. .

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Cardiovascular Risk and BHRT

 

Over the years many women have been afraid to consider hormone replacement therapy, particularly as a result of the Women’s Health Initiative (WHI) study from the 1990s that was wrought with many criticisms and controversies.  With growing research, we now know that hormone replacement therapy with bioidentical hormones given correctly can be performed safely and effectively with no increased cardiovascular risk.  In 2011, Harman et al. pointed out there is a reduced risk for coronary artery disease after 5-6 years of starting hormone replacement treatment.  This is why a short course of hormone therapy treatment is not recommended for menopausal or perimenopause women, as the cardiovascular benefits take years to be realized.   However, women who experience menopause without hormone therapy will experience a known increase risk of cardiovascular disease.  Mahajan et al (2019) showed that women who faced early menopause actually had improved cardiovascular health by being placed on early HRT..

What about blood clots?  Specifically, a type of blood clot we refer to as a venous thromboembolism (VTE)?  Vinogradova et al. in 2019 showed with a study of 80,000 women from 40 to 79 years of age that the highest risk for VTE is in women using non-bioidentical conjugated equine estrogens (CEE) & and Medroxyprogesterone acetate (MPA), but there was no increased VTE risk was seen with estrogen applied to the skin (transdermal).  Caufriez et al. (2007) also showed that while both oral estrogen synthetic progestins increase cardiovascular and invasive breast cancer risk, but that bioidentical estradiol applied to the skin (transdermal) and bioidentical progesterone taken by mouth do not increase that risk.  Additionally, even though the risk is different when applied topically or by mouth, the benefits of estrogen are the same whether applied topically (transdermal) or orally (by mouth).  This is why here at Vivify Health & Wellness, we never prescribe estrogen by mouth.

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BHRT & the Brain

 

Estrogen has many positive effects on the brain.  It increases blood flow and brings glucose and oxygen to neurons to keep them healthy, it protects neurons, it increases important neurotransmitters, and it decreases generation of beta amyloid peptides of Alzheimer’s.  The naturally occurring hormone estriol or E3 is a type of estrogen that binds to beta estrogen receptors in the brain and is protective for brain function.  This is one of the reasons BHRT often includes estriol or B3.  Estrogen also aids in the formation of neurotransmitters in the brain, especially serotonin which is very important in managing depression, irritability, anxiety, and pain sensitivity. .Progesterone metabolizes in the GABA centers of the brain to aid in restful sleep

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Osteoporosis and BHRT

 

We have known for many years that one of the biggest risk factors for osteoporosis (loss of bone density) is the drop in hormones that occurs during and after menopause.  Estrogen, especially estradiol (E2) is very important in maintaining bone structure.  Bioidentical natural progesterone is associated with the production of new bone, whereas synthetic progestins are not (Prior et al., 2018).  Testosterone is another important hormone in women that helps to preserve bone.  Hormone replacement therapy stands as one of the most effective treatments for prevention of bone lass and fracture that is associated with menopause. .

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Estrogen has many beneficial effects on cardiovascular function.  We know that estrogen improves plasma lipids, helps to maintain healthy endothelial cell integration, and promotes healthy nitric oxide production.  Estrogen is known to improve many cholesterol biomarkers.  It increases the good cholesterol (HDL), it decreases the bad cholesterol (LDL), and it decreases lipoprotein (a) (which is a type of LDL).  Estrogen is also known to decrease homocysteine, which is an amino acid that when elevated is a risk factor for heart disease.  Estriol, a type of estrogen known as E3, has been shown by Mishra et al. (2006) to decrease the constriction of the coronary arteries that feed the heart.  The CHOIICE Study (Stephenson et al., 2013) showed improved cardiovascular biomarkers CRP, fibrinogen, clotting factors, fasting glucose, triglycerides, and blood pressure with BHRT; and that health outcomes were favorably impacted.

BHRT and Mortality

 

The term all-cause mortality is used in statistics to describe the total number of deaths related to a condition.  In studying menopause over the years many researchers have compared the all-cause mortality of women on hormones versus those who are not.  Mikkola published studies in 2015 with over 300,000 women in Finland showing that stopping HRT resulted in an increased risk in all-cause-mortality, with the risk for cardiac death and stoke increasing the first year after stopping HRT and going down thereafter.  The Nurses’ Health Study evaluated over 121,000 women and concluded a lower risk of death in women taking postmenopausal hormones than those not taking hormones, and the largest reduction in risk was seen in women with coronary risk factors (Goldstein et al., 1997).  In 2013, Sarrel et al. estimated that over the previous decade between 18,600 to 91,600 postmenopausal women, ages 50-59 years old, who had had a hysterectomy may have died prematurely because they did not take estrogen.  In fact, many studies have demonstrated a lower all-cause mortality with women on HRT than those who are not.    

Why Consider BHRT?

 

Because hot flashes are just the tip of the iceberg! Hormone therapy is not only about symptom management, it is about living longer, living healthier, and living with a better quality of life.  Along with healthy eating, regular exercise, mindfulness, relaxation, and healthy lifestyle; healthy hormones is just one other key component in having that healthiest version of you maintain a long and fruitful healthy lifespan.

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References:

  • Caufriez, Anne. "Hormonal replacement therapy (HRT) in postmenopause: a reappraisal." . Vol. 68. No. 4. Elsevier Masson, 2007.

  • Fournier, Agnes, et al. "Breast cancer risk in relation to different types of hormone replacement therapy in the E3N‐EPIC cohort." International journal of cancer 114.3 (2005): 448-454.

  • Fournier, Agnès, Franco Berrino, and Françoise Clavel-Chapelon. "Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study." Breast cancer research and treatment 107.1 (2008): 103-111.

  • Grodstein, F., Stampfer, M. J., Colditz, G. A., Willett, W. C., Manson, J. E., Joffe, M., ... & Hennekens, C. H. (1997). Postmenopausal hormone therapy and mortality. , (25), 1769-1776.

  • Harman, S. Mitchell, et al. "Timing and duration of menopausal hormone treatment may affect cardiovascular outcomes." 124.3 (2011): 199-205.

  • Mahajan, Annil, Ranu Patni, and Varun Gupta. "Menopause and cardiovascular disease." 10.2 (2019): 55.

  • Mikkola, Tomi S., et al. "Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality." 22.9 (2015): 976-983.

  • Mikkola, Tomi S., et al. "Increased cardiovascular mortality risk in women discontinuing postmenopausal hormone therapy." 100.12 (2015): 4588-4594.

  • Mishra, Rajesh G., et al. "Metabolite ligands of estrogen receptor-β reduce primate coronary hyperreactivity." 290.1 (2006): H295-H303.

  • Porch, Juliet V., et al. "Estrogen–progestin replacement therapy and breast cancer risk: the Women's Health Study (United States)." 13.9 (2002): 847-854.

  • Prior, J. C. (2018). Progesterone for the prevention and treatment of osteoporosis in women. , (4), 366-374.

  • Sarrel, P. M., Njike, V. Y., Vinante, V., & Katz, D. L. (2013). The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years. , (9), 1583-1588.

  • Stephenson, Kenna, Pierre F. Neuenschwander, and Anna K. Kurdowska. "The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women." 17.1 (2013): 74-85.

  • Vinogradova, Yana, Carol Coupland, and Julia Hippisley-Cox. "Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases." 364 (2019).

  • Writing Group for the Women's Health Initiative Investigators. "Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial." Jama 288.3 (2002): 321-333.

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