How Long Can I Safely Stay On My Hormone Therapy?

How long can I safely stay on my hormone therapy?

I am frequently asked the question, “How long can I safely stay on my hormone therapy? and I usually ask the woman, How long do you want to continue to feel well?” In all seriousness, there are no long-term studies that enable me to answer this question. Taking hormones less than five years seems to carry very little risk. However, the longer you take hormones the higher your risk.

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Why Is It Important To Measure Estrogen Blood Levels? Part 2 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

3. YOU CAN’T JUST GO BY “HOW YOU FEEL!”

I strongly endorse monitoring estradiol and testosterone blood levels to ensure appropriate dosage and effectiveness of hormone therapy. Monitoring estradiol levels in thousands of women since 1986 has led me to develop more precise hormone regimens producing blood levels comparable to a low physiologic range. As noted earlier, monitoring blood levels is especially important with topical therapy. Most post- menopausal women who see me initially have NEVER had their estrogen level checked!

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Why Is It Important To Measure Estrogen Blood Levels? Part 1 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

Many women who initially see me for menopause have never had their estradiol level checked. Their previous physician may have diagnosed menopause with an elevated FSH, but usually no further tests are done. I’d like to go through various reasons why I believe it is important to monitor estradiol levels.

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Does Estrogen-Only HRT Decrease Breast Cancer Risk? Here’s The Rest of The Story!

Estrogen-Only Hrt

A recent study in Lancet Oncology looking at data from the Women’s Health Initiative (WHI) reported that the use of estrogen (Premarin) alone was NOT associated with an increased risk of breast cancer and the use of estrogen-progestin (Prempro) increased the risk of breast cancer.

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Natural Menopause

Natural Menopause

The average age for menopause is 50 to 55. I’ve seen an occasional woman who has regular monthly periods and then one month has her last period and never has another. However, this is the exception rather than the rule. Typically, women begin with perimenopausal symptoms in their forties. As a woman approaches the end of perimenopause, the periods become lighter and start to become more infrequent. She may skip several months without a period, and then finally the periods stop completely. When the decline in hormones occurs very gradually, a woman may not experience severe symptoms because her body has had time to compensate for the decline in estrogen and progesterone. Often the age of menopause is genetically determined and it is helpful to ask when an older sister or mother went through menopause. A catastrophic, stressful life event can bring on menopause earlier than expected.

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Hysterectomies – Understand that the Body doesn’t like Drastic Changes

Understand that the body doesn’t like drastic changes. All the hormones of the endocrine system are in constant balance with each other. When estradiol (your body’s own estrogen) levels fall at menopause, especially if it occurs suddenly as in surgical removal of the ovaries, it’s a shock to the system. It’s as if the body is gong through “withdrawal,” but in this case it’s not a drug like an antidepressant or a sedative. It’s a vital hormone that your body has had for 40+ years! Withdrawal of estradiol sets off alarms in your body causing release of cortisol and other stress hormones. Some women may only respond with severe hot flashes, drenching night sweats and insomnia. In women with a family history of anxiety disorders, estradiol withdrawal may trigger panic attacks which are the worst case of anxiety.

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MARINA JOHNSON
M.D., F.A.C.E.
MEDICAL DIRECTOR

BOARD CERTIFIED
IN ENDOCRINOLOGY
& METABOLISM AND
INTERNAL MEDICINE

10670 N Central Expressway
Suite 510
Dallas, Texas 75231-2111

214.574.4376 office
214.574.4377 fax

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