A Balancing Act?

Its important to note that if you try one hormone therapy and find it "isn't working" that is isn't necessarily the kind of hormone but may be the dosage that needs tweaking. And its also important to note that the HysterSisters have found that its important to try a hormone therapy for a month or so before changing to another kind or dosage.

Why?

Our body's hormone levels fluctuate quite a bit during the first few months post-op hysterectomy as our body systems are trying to find new balance.

Keep a hormone diary noting symptoms and level of intensity of suffering.

And given some time, as the symptoms are more consistent, you might find help towards altering your hormone therapy with this chart:

Too Much, Too Little

Supplements for Your Menopause Health?

Black cohosh, chaste tree, red clover, calcium, essential fatty acids---the array of dietary supplements is mind boggling and leaves us feeling overwhelmed and confused. Do they help with sudden menopause? Are they safe? Which ones should be used?

When used responsibly, dietary supplements help alleviate menopausal changes, fortify your diet, enhance stamina, bolster immunity and reduce risk of chronic illnesses such as osteoporosis and cancer. Vitamins, minerals and herbs can be used by women who aren’t taking medicine to manage their menopausal symptoms as well as by women who are taking medicine to manage their menopausal symptoms.

However, sometimes the types of supplements recommended may vary between these two groups. In either case, it is imperative to have a basic working knowledge of the supplements you wish to try. This includes information about dosage, duration of use, side-effects and drug interactions, even though readily available over-the-counter, supplements can still interact with certain medications. As a general rule of thumb, allow at least two hours to elapse between taking medicine and nutritional supplements.

Also, if you are taking medication, undergoing cancer treatments or are scheduled for surgery or a procedure; be sure to discuss your supplements with your doctor and pharmacist. Sometimes you need to suspend taking specific vitamins and herbal products immediately before and during cancer treatments or prior to a surgical or invasive procedure.

Choosing Herbal Products?

Excerpt from Sudden Menopause by Debbie DeAngelo:

Consult a knowledgeable professional (qualified herbalist, pharmacist, etc.) and a credible text book.

Educate yourself about herbs before taking them. Just as you would read information about a pharmaceutical drug’s actions, side-effects and contraindications before taking it, you should be equally informed about herbs.

Do not disregard mainstream medicine, especially for the treatment of serious illness. Herbs can be very effective in the prevention of illness, the improvement of symptoms or the treatment of mild problems. If you intend to use them or are using them to complement your medical regimen, be sure to inform your doctor and pharmacist.

Do not use herbs indiscriminately. They can be powerful medicines and are worthy of the same respect as pharmaceutical medication.

Unless you are a botanist, gathering your own herbs can be dangerous.

Purchase herbs from reputable companies that have some longevity in the business. This helps to ensure a quality product and reduces the likelihood of adulteration. Contact the manufacturer with any questions you have about the product. Credible companies will welcome inquiries.

Use herbal preparations as directed on the package. Herbs are sold in many forms (capsules, tablets, extracts, powders, tinctures, teas, creams, dried), so dosages and instructions vary. To be safe, start out with the smallest dose and gradually increase the amount you take. Do not exceed the recommended dosage or duration. If taking herbs on an empty stomach induces nausea, try taking them with food. If you experience a severe or allergic reaction, discontinue the herb and see medical advice.

Check the expiration date and try to buy your products at a store with good turnover.

Some herbs are phytohormones. If you are not a candidate for estrogen therapy, you may wish to avoid these preparations as well.

Hormone Choices?

Conjugated Estrogens: (Premarin®, Cenestin®)

Synthetic hormones are defined as hormones that are created by a pharmaceutical company for trademark/brand name reasons to take the place of hormones (or to add to the hormones) created by the ovaries. Chemically, they are not identical to the original hormone of the ovaries. Conjugated estrogens are a mixture of different estrogen female hormones manufactured from pregnant mare's urine (however Cenestin is made completely from yams and soy).

Estropipated Estrogens: (Estratab®, Menest®)

Esterified Estrogens: (Ogen®, Ortho-Est®)

Bio-identical Estrogens: (Estrace®, Vivelle Dot®, Climara patch®)

Bio-identical hormones by definition means that the hormone is chemically identical to the hormones that are produced by the ovaries.

Compounded Estrogens: (Estradiol, Estrone, Estriol)

Compounded hormones are bio-identical hormones that use FDA approved hormone raw ingredients but are created with unique dosages and delivery methods according to your specific needs. Prescriptions for compounded hormones are filled in a pharmacy by a registered pharmacist according to a doctor's prescription. (See more info below for more about compounded hormone therapy.)

Progesterone is available in synthetic and bio-identical forms. Many women, even after a hysterectomy, enjoy benefits of its use to help with symptoms such as anxiety and insomnia.

Testosterone is available in synthetic and bio-identical forms as well. Many women, during menopause, discover a lack of energy, a lowering of the libido and other sexual functions that can sometimes be helped with some testosterone therapy. Currently there are no FDA approved pharmaceutical testosterone products but the HysterSisters have found compounded testosterone is helpful.

Bio-Identical Hormones? Synthetic? What's the difference?

There is much in the media these days about "Bio-Identical Hormones". Bio-identical hormones are manufactured hormones (estrogen, progesterone, testosterone) that are created using plant materials to be molecularly identical to the original biological hormone created by your ovaries.

Conjugated estrogens have MORE atoms in the molecule so that it does not look exactly like the atoms in the estrogen that your body makes. In some people, the extra atoms make no difference at all. In a lot of people, the extra atoms cause more side effects. Since getting the right hormone mix is hard enough, it seems like a good idea to stick with the kind that looks exactly like the kind your body makes.

Hormones are messengers in the body. They are like keys. The cells that actually do things have little locks. When a hormone comes by, it sees whether it fits the lock. Estrogen fits the lock exactly and opens up the cell. With the extra atoms, like an extra bump in a key, conjugated estrogen like Premarin® or Cenestin® fits the lock less well, so it creaks and jams and the cells don't always open up quite right. Hence, possible side effects.

The only reason that conjugated estrogens have these extra atoms is so that the pharmaceutical megacorporations can "own" them and manufacture them under a patent.

However, you might be one of the lucky ones who don't notice a difference.

What are Compounded Hormones?

Compounding pharmacies differ from other pharmacies in that they make customized prescription medications for patients in addition to dispensing products prepared by pharmaceutical companies which the other pharmacies sell.

Compounding pharmacists can prepare bio-identical hormones for replacement therapy based on your needs. Working with your doctor based on symptoms you have (and in some cases, also based on hormone testing) the pharmacist can make your hormones not only in the strength and dose you need but also can make them in various forms. Common forms are creams, pills, troches (lozenges) and sublingual drops. This makes compounded prescriptions versatile and a good choice for women whose needs aren’t met by the bio-identical or synthetic products available from conventional pharmacies.

If you are interested in finding a compounding pharmacy near you, use the locator service from this link: http://www.iacprx.org. If there isn’t a compounding pharmacy close by, it is still possible to benefit from their services as many offer mail order delivery. A compounding pharmacist can guide your doctor on how to write the prescriptions. If your doctor isn’t willing to prescribe compounded hormones, referrals can be made for doctors who use the pharmacy’s services.

You may want to check with your insurance company to be sure compounded hormones are covered. Sometimes demonstrated need and persistence go a long way toward getting this option approved.

Where to Apply Compounded Hormone Creams or Gels?

Your doctor or compounding pharmacist should provide you with directions on how to use your compounded hormone creams. The following is a list of generally accepted sites for application:

It is important to note that:

Supplements Ideas for Managing Menopausal Symptoms

by Debbie DeAngelo, author of Sudden Menopause

Many hysterectomized women report fatigue for up to one year after surgery. Ashwagandha is an ayurvedic herb that naturopaths use to improve stamina. Since it supports the adrenal glands, it has the added benefit of helping to balance hormones by counteracting the effects of cortisol (a stress hormone).

Many women report Ashwagandha buoys energy levels, improves sleep, and assists in managing hot flashes, night sweats and mood swings. For optimal effectiveness, take 500-1,000 mg in the morning and again early afternoon.

Ashwagandha should be cycled at two to three month intervals with a two to four week break in between. You should notice a difference in two to four weeks. Do not combine this herb with sedatives or alcohol and avoid using if you have an overactive thyroid.

Another option for “red-hot” menopausal women is this hot flash cocktail. This combination of vitamins can be used alone or in conjunction with most herbal products as well as dietary sources of soy and ground flaxseed. Here is the recipe:

Hot Flash Cocktail

And don't forget to ask your doctor about taking supplements.

Clinical Trials and Research Projects