Although the debate over the safety of hormone replacement still rages in the press, it appears some semblance of common sense is beginning to be heard. Yes, we need more confirming studies, but today’s women – myself included – cannot be put on hold and forced to wait another 10 to 20 years until all of the definitive studies have been completed. As with so many other issues in medicine, physicians have to use their best clinical judgment based on the information available now. Each woman needs to make these decisions with input from her own physician.

After all my years of practice, I still believe we should try to mimic the normal human physiology whenever possible. That’s why I use topical over oral hormones, cyclic over continuous progesterone, natural over synthetic hormones whenever possible and blood serum measurement of estrogen and progesterone to get the optimal therapeutic dosage for each individual woman. My goal with any patient is to give the lowest dose of hormone that corrects her symptoms and still gives her therapeutic levels of her natural hormones. However, no prescription drug, including hormones, is without side effects or totally free of risks. That’s why it requires a prescription: so your physician can safely develop a hormone program that is monitored and takes into account all your medical concerns. Because the Endocrinologist is the definitive hormone specialist, it’s ideal to have bioidentical HRT prescribed and monitored by an Endocrinologist. However, there is a shortage of Endocrinologists who treat menopause. For that reason it is important to seek out a gynecologist, internist or family practitioner who has acquired expertise in treating menopause with bioidentical hormone therapy and to take responsibility for educating yourself about menopause and its related conditions.

Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD. Dr. Johnson was a medical writer and pharmacist before medical school and utilized these skills to research 450 medical journal articles to develop her book. She has no financial conflicts of interest or ties to any pharmaceutical company. Her only objective is determining the most effective, safest therapy for patients.

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