Category Archives: Hormone Replacement Therapy

The 45th presidents recent tweets banning transgender people from serving in the military because of their potential medical costs underscores the difficulties the transgender community faces in accessing quality health care. They often face stigma and discrimination by health professionals, and even if they have insurance, they may not have coverage for gender affirming procedures like hormone replacement therapy (HRT) or sex affirming surgery (SAS).

On some insurance plans, including Maryland Medicaid, prior authorization is required for someone who is transgender to receive HRT or SAS. Prior authorization is typically used to confirm that extraordinary requests are medically necessary, like transplants or cosmetic surgery. The transgender community shouldnt have to ask permission and submit claims before receiving life-affirming care.

According to the World Professional Association for Transgender Health, the standards of care for the transgender community include psychotherapy, HRT, changes in gender expression and SAS. Individuals may choose to use all, some or none of these in their health management of gender expression. These are particular therapeutic needs for this population. Although there may be some overlap with cisgender people (those whose personal gender identity corresponds with their birth sex) like psychotherapy, prostate exams and mammograms it is unethical to require preauthorization for other care that is specific to a community because it is different from the majority.

Currently the Affordable Care Act does not exclude the transgender population from some medically necessary care based on gender identity. This means a man can get insurance coverage for a pap smear, but not HRT. The language in the act is ciscentric, and wasnt specific enough to make insurance companies provide coverage for HRT and SAS. Even the quality metrics Maryland uses for its insurance plans do not include sexual orientation and gender identity information. So people in the community who are shopping for private insurance have no way of knowing if their care is covered in benefit plans. Transgender people have not been given a seat at the table in health care decision-making.

Fortunately, as a state, we can shift insurance coverage to include transgender specific care starting with Medicaid. Coverage under Medicaid would give the most vulnerable population access to quality care: 26 percent of the transgender population lives under the federal poverty line ($12,060 for individuals per year). Poverty in this community leaves people susceptible to violence, drug abuse and depression. Providing this population with access to life affirming care through Medicaid would set an example for private insurance plans to start allowing trans-specific health coverage.

This small step toward transgender insurance parity under Medicaid offers huge opportunities for the community in the health care field and beyond. There would be more understanding of hormone therapy and its side effects, long-term effects and dosing. Visibility in the health care arena can transition bias and discrimination among providers to compassion and understanding. Shifts in provider perception will result in the quality care needed to address the mental illnesses, housing instability and drug abuse that runs in the community. The increased demand to address those needs could transform into a specialized field of transgender health. The possibilities are endless.

California already mandates insurance coverage for life-affirming care in the transgender community. No significant changes were made to their budget for the accommodation, and insurance surcharges on private insurances were actually dropped because there was no significant cost for adding trans-specific care to their benefits.

Every year the transgender community becomes more and more visible; we are doing them a great disservice by ignoring their needs for health care specific to their community. We can take these steps of social progress and apply it on a national level and provide access to quality health care to all Americans.

Chigo Oguh (coguh@umaryland.edu) is a graduate student at the University of Maryland, Baltimore.

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Md. Medicaid should cover trans-specific care - Baltimore Sun

The camper was never meant to be anyones home, but the 120-acre spread it sits on is the closest thing to a home the tenant has ever known. More importantly, it marks the place where one way of life ends, andanother begins. In most cases, a name doesnt matter.

For this story, its critical.

Start with Mark.

For the first 20 years of his life, he was a tattooed, muscled roughneck who worked oil rigs, collected muscle cars and raced mud bog trucks; a real self-described Wyoming redneck. When Mark was 21, he legally changed his name to Misty. And for the first time in his life, Mark felt he was who he is supposed to be a woman. Mark, now Misty, puts on eye shadow, wears frilly shirts and dons tennis shoes with pink laces when she climbs under the car to change the oil.

Misty is very much a mans man. In this regard, her gender identity is still at odds with her sex in that shes still very much a guy when it comes to her interests, including her preference for dating women. Ironically, the more comfortable she feels in her female body with breast implants and hormone therapy, the more ostracized she becomes in the community.

Life would be easier if Misty left Wyoming.

But just as her personal interests havent changed, she loves everything shes always loved about living out West. She doesnt expect people to understand, nor does she blame anyone for their reaction, particularly given where they live. Wyoming isnt exactly open-minded when it comes to homosexuals and transgenders. The Code of the West is pretty straightforward when it comes to gender: guys are guys.

Despite all masculine traits to the contrary, she identifies female, which she realizes is hard to explain to someone who was born with the correct body.

I dont think its an issue of want. You have to, she says, biting a corner of her blunt thumbnail. Essentially, you have the base knowledge that somethings not right. Eventually, it eats away at you like a cancer. But its not eating away at your body, its eating away at your soul.

The reverberation in her Pops garage is squint-worthy. A lit Marlboro dangling from one corner of her mouth and mirror Raybans pushed back on the top of her head, Misty smiles through the windshield of her vintage Camero and gives it another rev.

Its an original SS, she screams over the roar, rattling off a list of bits and pieces that apparently make it faster and louder. Under the white-striped ebony hood, the engine screams.

She jumps out to show off some of the original components underneath the hood, struggling with one hand to release the latch. The other hand rests idly at her side like an inflated surgical glove, swollen with a staph infection that wont seem to go away, despite the daily trips to Casper for antibiotics.

She slammed her hand under the hood of her truck last week.

This is where Misty and Mark begin to diverge. Despite the long hair and frosty pink eye shadow, her hands still belong to Mark. Thick-knuckled with half moons of grease under the nails, these are hands used to doing dirty work.

This has always been her passion. Shes a certified mechanic and, as Mark, had worked for years in the trade, even owning her own shop.

Now, as Misty, its much harder to find work. People arent exactly clamoring to hire a former man who now identifies as a female. The trouble is that though her genders changed, her skills havent.

Doors dont exactly open to a man wearing make up and pink shoelaces and introducing herself with a girls name. Usually, the employer says that she doesnt fit their company image or says there are no openings. Sometimes shes just met with abject stares and smirks.

Its funny people will hire ex-cons no problem, Misty says, flicking an ash on the ground after a deep inhale, but forget about hiring a transgender.

Unfortunately for Misty, she falls into both categories. Worse, she bears the label of a registered sex offender given that she went to jail after a lusty night of heavy petting with a 14 year old an encounter that landed her two years in prison and another year of probation. Shes been out for less than 10 months.

Misty is stoic when it comes to defending that charge. She screwed up, plain and simple. The girl lied about her age, Misty says, and she didnt think to check her ID.

Thats completely on me and Ive served my time.

Misty shrugs. Shit happens.

I may have a shitty reputation as a person, she says, squinting as she tightens a bolt, but Im a damned good mechanic.

Smart, too, she adds, not afraid to admit she has an IQ of 142. She loves working on cars and would prefer spending her days in a garage away from people. Cars make sense to her, people dont.

That includes herself.

All her life she felt that something wasnt quite right but it took her years to realize that it was her gender.

Shed always felt more comfortable as a female, beginning with her earliest memory of her sister and cousin dressing her up in their clothing, but how, as a boy, do you admit that out loud? Especially when its clear your parents disapprove. Misty remembers being confused when her father beat the hell out of her after finding Mark wearing a dress, berating his sisters for trying to turn him into some kind of sissy.

Clothing plays a big part in Marks gender identity, both as a haven and a form of torture. She prefers feminine clothing and always has. Mistys worst childhood memories revolve around holidays and being forced to wear suits and ties. She had no idea why it made her miserable.

Her confusion, too, was compounded as a teenager, when she went to see the doctor about a bladder infection, and according to Misty, found out she also had a uterus and was therefore considered innersex, the term for a person born with the sexual or reproductive anatomy of both a female and male. Oddly, innersex births are more common that one might think. According to the Intersex Society of North America, it occurs in nearly one in every 2,000 births.

The fact that she had a uterus didnt exactly make the situation any better.

How do you approach a person with that statement, Misty laughs, bitterly. She didnt have anyone to talk to about this when she was younger, so she just tried to live with it and do her best to fit in.

Trying to do anything outside of the social norm as a teenager is hard enough, she says. It doesnt matter what it is. Its not met well.

This grin-and-bear-it strategy didnt work, however, and after two suicide attempts in her early twenties, she realized she only had one choice: Become a woman or die.

Theres no way to explain how it feels to be born with the wrong body. You either get it or you dont. What Misty can tell you, however, is that the day she buried Mark and became Misty was the moment she realized what it felt like to breathe.

First the name change, then came breast implants, hormone replacement therapy, make up and female clothing.

Its hard to explain, Misty says, but when you start to transform physically, the mental follows. These thoughts and feelings have always been inside her but up until now shes worked hard to hide it. With every step toward transition, she feels a weight being lifted.

Its kinda like being on deadline, Misty pauses. Like theres so much stress and pressure trying to get the work done, but the second that you meet that deadline, you instantly feel a sense of relief.

There are a lot of people who dont get what it means to be transgender, she adds. People think its some kind of fetish, guys who like to put on make up and dresses and pretend to be a girl.

For Misty, it means living in a body where she feels she finally belongs. Its real. The make up and clothing reinforce her sense of femininity. Shes not doing this for attention.

Believe her. Theres nothing fun about being stared at or having obscenities yelled at you or otherwise being treated like some kind of freak, especially here.

Look around you, she shrugs. Lets face it, Wyoming hasnt exactly evolved a lot. If you want to experience the old West, just go outside.

Regardless of geography, Misty chooses to live as a woman with the goal of saving enough money to have gender reassignment surgery, a procedure that involves turning her penis into a vagina. The hefty price tag$22,000 just for the surgery alonekeeps it a faraway dream, but shes determined to make it happen. Shes met the criteria, talked to several doctors and has done the research. Now, its just a matter of when.

Im not going to cave, Misty says, slamming the hood as she reaches into her back pocket for another smoke. Its not in my nature. Id be more afraid of meeting my maker and telling him why I didnt have the courage to do what I needed to do.

Theres an official process involved when it comes to switching genders. In order to officially become a woman, surgically speaking, Misty had to first prove she has lived in a female role for over a year and had to do so many months of hormone therapy replacement treatment. She also had to have a psychological evaluation that validated, that yes, she identified as a female.

That part, logistically speaking, was easy.

The harder part comes now as she leaves Marks world behind in order to become Misty. One doesnt ever get to easily dispose of a body, even if just in name only.

First there are a few demons to exorcise, starting with teenage Mark, a tough guy with a chip on his shoulder.

I wasnt a very nice person back then, Misty says, shrugging.

And those who knew him in high school, like Maria Bromley, would agree. Though Maria hated Mark in high school, shes since fallen in love with Misty, who shes learned to see in an entirely new light.

He was pretty much a total a**hole, Maria says, cuddling now against Mistys shoulder.

Its fair to say I wasnt a very nice person, Misty says with a tight-lipped grin. As Misty, shes still trying to get used to pubic affection and other social niceties like smiling.

You think? Maria jokes. Mark pretty much told you exactly what he thought.

Back then Mark was pumped up with muscles and enjoyed going to school drunk and doing everything he could to mess with teachers.

He was also pretty violent. A lot of this anger stemmed from hating his life and his circumstances.

Its hard to be happy when you feel like every part of your life is a lie, Misty says, staring through the kitchen window. Outside, the finger-like branches of a maple tree bend in the gusty wind as if clenching together in a fist.

Marks also left behind some causalities, including three daughters from two different women from relationships in his late teens. Misty doesnt have too many good things to say about one of the moms, Katie, who cleared out his checking account one day while he was at work and refuses to let her see her girls, despite the fact they have joint custody.

Mistys youngest girl was given up for adoption when Misty was working out of the country on a drilling rig. Misty didnt know the daughter was hers until a year after she returned.

Nonetheless, its a sore spot.

My children mean everything to me, Misty says defiantly, when pressed to remember the last time shes seen or talked to any of them.

Shes vague about their lives. Misty repeats how much she loves them. Marks oldest daughter picked her new name Misty, she quietly recalls.

She has no idea when shell see them again.

This is a common refrain in Mistys life: people who have wronged her or dislike her leaving unseen emotional scars.

Nonetheless, Misty makes it clear that she doesnt put up with anyones crap or abuse.

She tells a story about an elderly woman who lived in a trailer park near her years ago and how this woman would always complain about Mistys truck being too loud. So Misty checked the local noise ordinance and set her engine to two decibels below the max. When she worked on her truck, it sounded like a drag strip. The woman called the police who came out to test the decibel levels, which were always within the legal range. The woman finally sold her trailer and moved, Misty says, smiling.

The lesson is clear: hurt me, and Ill hurt you. Leave me alone, and Ill be cool to you.

Shes still dealing with a lot of anger, Misty confesses. Its going to take some time.

Maria needs a cigarette.

Theyre in my purse, babe, Misty says, twisting in her chair to grab a small glittery bag off the floor near Marias feet.

The door shuts behind Maria and soon a cloud of smoke fills the window behind Mistys head.

They are in her grandfather Gale Lane, or Pops, kitchen, the one home where Mistys always been welcome. For the past decade, Pops has been slowly declining with Alzheimers and at present has little recollection of his earlier life.

Pops and Bonnie, Marks step-grandmother, have been the only people in her life who have half-way understood, or at least accepted Misty, no matter what. For that, she loves them deeply.

Theres a lot of pain in Mistys past, starting with Marks relationship with his dad, which deteriorated even more when he began dressing in his sisters clothes.

Picture a six-foot something mans man, Misty describes her father. The fact that Misty mainly takes after her motherwho left the family when Mark was 9was another sore point for her father. Basically, my dad had a lot of reasons for beating the shit out of me.

That was just the start of Marks problems, which culminated in him getting into lots of trouble at school, and, finally, for reasons Misty refuses to disclose, eventually landed Mark in a juvenile facility at age 13.

After shuffling throughout several facilities throughout the state, he ended up in a group home in Douglas, which left some good memories. The woman who ran the place was kind, Misty says. Life there wasnt too bad.

Eventually, Mark graduated from high school, enrolled in college, then headed to the oil field. Misty got a commercial drivers license and went to mechanic school.

The door opens and Maria is back. She wants to clear the air about Marks violent past. Mark was dealing with a lot of anger because he couldnt be the person he needed to become, she insists.

Maria likens it to being in an abusive relationship. Her voice gets soft as she describes how that life becomes your reality and when youre stuck in the middle of it, you know that anything you do can never be right because youll never be able to please that person. You become somebody youre not.

Thats how Misty felt, she says. She couldnt find any glimmer of happiness in herself, so how on earth could she find happiness anywhere else?

The waitress at the Village Inn does a double take when Misty, in a male voice, orders a double cheeseburger and a Coke with fries. Up until that point, Misty and Maria had been just two more attractive blonde women in a morning when she already seen plenty. Now, the waitress takes a closer look at the woman with the male voice.

Sometimes, Misty softens her voice to blend in, but only when she wants to.

A couple of middle-aged cowboys at a nearby table swivel in their seats to eyeball Misty with prolonged stares. Blondes always turn a few heads, but theres something about her face that doesnt quite fit. Much like a face can either look 20 or 50, gender too is revealed in the bones. The men smirk.

This is typical of the range of reactions Misty gets in public: stares, smirks, double takes, name calling, or, conversely, the conscious effort to pretend that shes not transgender.

The waitress immediately falls into the latter, overdoing the pronouns with too many self-conscious references to ladies and girls, even joking with Maria about Mistys ability to eat like a man without putting on weight.

Shes a skinny bitch, Maria laughs, playfully slapping Misty.

Right? the waitress answers, joking at how just looking at Mistys lunch makes her fat.

Misty smiles indulgently before lifting her burger in both hands and taking a big bite. She cant control the way people react to her, nor does she care. She doesnt expect people to understand.

And though people in Wyoming are less open to diversity, they tend to be pretty laid back when it comes to minding their own business. And while in the urban circles of the hyper-politically correct, transgenders are fighting for pronoun equalitypreferring to be referred to in the third-person as them and they in effort to embrace both sides of their sexMisty isnt carrying any flags.

That said, shes less sympathetic to the name-calling and blatant attempts to pick a fight. She willand hasfought back.

I always tell them that I may look silly but theyre going to look even sillier when they get their ass kicked by a tranny.

Misty, unlike Mark, stays out of the bars. That helps avoid fights, though not entirely.

Misty doesnt exactly mince words. Social skills in general can be a problem for her, she concedes. She blames her Aspergers Syndrome for being too blunt. She sees things as strictly black or white, very little gray; success or failure, nothing in-between.

Misty drops a pen on the table, then lifts it in the air. You either have the ability to pick up or not, she says.

Maria covers her face and shakes her head. Trying means nothing?

Nope.

Maria gives up.

Misty rubs her thumb over a clump of mascara thats fallen under Marias left eye. She holds her chin and rubs gently.

More:
Transitioning: Controversy, corrections and new-found peace, Misty Lane is finally finding happiness with herself - Douglas Budget

Along with the growing stressors of modern life, theres been a corresponding dependence on fatigue fighters such as energy drinks, triple-shot lattes and Mountain Dew. We take supplements to re-charge our metabolic systems, often reaching for quick-fix solutions when what we really need is to rest and recharge. But then, whos got the time?

But without time spent each day in an anabolic state, or what Niwot author and pharmacist Dr. Izabella Wentz calls a state of rest and digest, were basically telling our bodies that were unsafea situation that, over a sustained period, triggers biologic responses that can lead to autoimmune conditions.

At 27, Wentz was diagnosed with Hashimotos disease, also known as hypothyroidism, an autoimmune condition that results in an underactive thyroid gland. Wentz often felt cold, with other symptoms including hair loss, acid reflux, fatigue and depression. Like many autoimmune sufferers, she was told by doctors that her symptoms were just in her head.

One doctor told her she was experiencing the normal signs of aging, she said. That was her wake-up call. From then on Wentz took a more active role in figuring out her own road back to health.

That plan led to remission, and her recovery eventually led to the publication of her latest New York Times bestseller, Hashimotos Protocol: a 90-day plan for reversing thyroid symptoms and getting your life back, which released on March 28, 2017.

The condition runs in Wentzs family, and she attributes her mother as the force behind the book, urging her to write so that my cousins in Poland would start feeling better too, she said.

The thyroid is a small, butterfly-shaped gland that produces hormones such as thyroxine (T4) and triiodothyronine (T3), which stimulate vital processes throughout the body. Not coincidentally, thyroid hormones impact the proper functioning of the bodys heat production, its ability to make use of vitamins, proteins, carbohydrates and fats, along with fertility and growth. In hypothyroidism, the bodys immune system attacks its own cells, and if not caught in its early stages, the gland can become permanently damaged.

Hormone replacement therapy is the first step on the road to recovery, but because Hashimotos is so complex, Wentz recommends several dietary and lifestyle changes as well.

Gluten seems to be a major trigger for producing an autoimmune response. Cardiologist and author, Dr. William Davis, argues in his 2011 book, Wheat Belly: Lose the Wheat, Lose the Weight, that genetically altered Frankenwheat has been imposed on the public by agricultural geneticists and agribusinesses to disastrous results for the collective gut.

But whatever the cause of the populations prevalent wheat sensitivities, Wentzs protocol encourages a 90-day abstinence from flare-up triggers such as wheat, alcohol and caffeine, and recommends that anyone diagnosed with Hashimotos to remain gluten-free indefinitely.

An estimated 20 million Americans suffer from some form of thyroid disease, according to the American Thyroid Association. And though theres a disproportionate number of women hit with thyroid conditions, theres no known reason why. But Wentz offers some theories, which include exposure to toxins in personal care products, along with pregnancy, genetics and culture.

Women often put themselves last, she said. Theres a stigma attached to women who demand attention or have too many needstheyre considered high maintenance.

In addition, [Women] jump from one activity to the next, from school to work, to childrens sports, to homework to dinner. Were rushed in the mornings, we eat in the carour time is overly scheduled.

For every one man, she said, five to eight women are diagnosed with a thyroid condition.

Hashimotos triggers also include nutrient depletions, food sensitivities and intestinal permeability (also known as leaky gut), among others. So it makes sense that treatment includes changes in eating and other lifestyle behaviors.

Taking probiotics helps to balance gut flora, and the removal of triggering foods from the diet can make huge changes in an autoimmune sufferers sense of well-being. But the biggest impact, for Wentz, happened when she started taking a thiamine supplementsimple vitamin B1.

Youll know in five days if its going to help, she said. It helped resolve her fatigue issues. Another easy solution with a huge payoff came over-the-counter as well: digestive enzymes. Other recommendations include gut-healing nutrients, such as Omega-3s, zinc, L-glutamine and bone broth.

Stress causes the adrenal glands to pump out extra hormones, shifting the body from a relaxing, digesting and healing state, to a fight-or-flight response state. To promote the rest-and-digest state, Wentz suggests introducing more self-care activities. Sipping hot lemon water in the mornings for its liver-supporting properties while enjoying a warm water foot soak will give the metabolism a boost.

You can add lavender or other essential oils to the water, [and] set your intentions for the day, she said.

She also recommends spending an hour every day reading inspirational or spiritual books, Whatever you find uplifting, she said. Journaling can also be helpful. You can make a list of your health goals and journal about it. Then check in with yourself.

She also suggests celebrating small successes. Maybe your hair has stopped falling out (though maybe it hasnt grown back yet), but stillits progress, she said. Listen to your body, she continued. If youre tired, take a nap. If youre taking a lot of Maalox, eat less acid-forming foods, such as fresh vegetables, and avoid sugar, caffeine and alcohol. You can do anything for 90 days. The results may just be worth it.

Wentz has a Facebook community where people with Hashimotos write in with questions ranging from how to combat a vitamin B12 deficiency (she recommends sublingual tablets), to whether or not sufferers should stop dyeing their hair (yes). Visit her at Facebook.com/thyroidlifestyle. Hashimotos Protocol, and Wentzs first book, Hashimotos Thyroiditis, are available at most major book retailers.

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Niwot author pioneers interventions for Autoimmune Disease - Left Hand Valley Courier

Going through menopause is usually a difficult time for women and there are a lot of physical changes that take place. So often we hear about the hot flushes, sleepless nights and lowered libido. But is it really that bad and what actually happens? Specialist Clinics of Australia owner and clinical director Dr Garry Cussell debunks the top five myths of menopause and sheds light on how to make this time of transition as easy and as possible.

Whilst the average age that women hit menopause is 51 to 52 years old, it can in fact happen to women in their 40s (early menopause) or even younger (premature menopause). Surgery or medical treatments that affect hormones such as chemotherapy and radiation therapy can bring on early menopause or premature menopause. Genetic factors also play a role in determining the age a woman will hit menopause but every woman has her own moment, says Dr Cussell.

Lack of estrogen can cause symptoms such as itchiness, decreased lubrication, and pain during sexual intercourse and incontinence of urine. These symptoms generally appear a few years after the onset of menopause and affect up to 50% of post-menopausal women. Many women believe that the only way to treat these symptoms is with invasive surgery or Hormone Replacement Therapy but these days there are a lot of safe alternatives out there. GynaeLase is a quick, non-invasive and relatively painless laser procedure that relieves these symptoms without surgery or HRT. It encourages renewed functional activity in the treated sections of tissue through a special heat effect. Optimum results are usually achieved after three treatments as the process of collagen neogenesis takes time to develop, with the effect of tissue tightening and collagen build-up increasing after each treatment.

Laxity and atrophy can be bothersome conditions and impact on happiness and sexual function. Even the healthiest of women will experience the natural process of laxity, and this can be exacerbated by child birth or weight gain. GynaeLase helps treat these symptoms and the vast majority of patients at Specialist Clinics of Australia who have undergone the treatment have reported improved sexual activity.

Although hot flushes are one of the most common symptoms experienced by women going through menopause, not all women get them. Its still not clear exactly what actually causes hot flushes but its estimated that four out of five postmenopausal women will experience them. The usual treatment for these is using oestrogen tablets and patches, however these have potential side effects and there are alternative treatments.

Decreased oestrogen levels can impact on your bodys metabolic rate but this doesnt necessarily mean youll gain weight post-menopause. Keeping a balanced diet and exercising regularly will help you manage your weight. If you notice a sudden change in your weight, despite maintaining a healthy lifestyle, talk to your doctor.

Read more:
Top five misconceptions about menopause - Starts at 60

If youre looking for relief from menopause symptoms, knowing the pros and cons of hormone replacement therapy (HRT) can help you decide whether its right for you.

HRT (also known as hormone therapy, menopausal hormone therapy, and estrogen replacement therapy) uses female hormones -- estrogen and progesterone -- to treat common symptoms of menopause and aging. Doctors can prescribe it during or after menopause.

After your period stops, your hormone levels fall, causing uncomfortable symptoms like hot flashes and vaginal dryness, and sometimes conditions like osteoporosis. HRT replaces hormones your body no longer makes. Its the most effective treatment for menopause symptoms.

You might think of pregnancy when you think of estrogen. In women of child-bearing age, it gets the uterus ready to receive a fertilized egg. It has other roles, too -- it controls how your body uses calcium, which strengthens bones, and raises good cholesterol in the blood.

If you still have your uterus, taking estrogen without progesterone raises your risk for cancer of the endometrium, the lining of the uterus. Since the cells from the endometrium arent leaving your body during your period any more, they may build up in your uterus and lead to cancer. Progesterone lowers that risk by thinning the lining.

Once you know the hormones that make up HRT, think about which type of HRT you should get:

Estrogen Therapy: Doctors generally suggest a low dose of estrogen for women who have had a hysterectomy, the surgery to remove the uterus. Estrogen comes in different forms. The daily pill and patch are the most popular, but the hormone also is available in a vaginal ring, gel, or spray.

Estrogen/Progesterone/Progestin Hormone Therapy: This is often called combination therapy, since it combines doses of estrogen and progestin, the synthetic form of progesterone. Its meant for women who still have their uterus.

The biggest debate about HRT is whether its risks outweigh its benefits.

More:
Hormone replacement therapy (HRT) - webmd.com

The natural steroid hormone dehydroepiandrosterone (DHEA) was first introduced to Life Extension supporters four decades ago at a time when the medical community was largely unaware of the scientific data supporting this hormones multifaceted benefits. Fast forward to today, when more than 3700 papers have evaluated the scientific effects of DHEA upon many different cells and tissues of the body. This multifunctional hormone and its metabolite dehydroepiandrosterone sulfate (DHEA-S) provide critical hormonal benefits in both men and women (Traish 2011; Savineau 2013). As a precursor to androgens (male hormones) and estrogens (female hormones), DHEA plays a fundamental role in the maintenance of hormonal balance and youthful vitality. It also modulates a variety of pathways throughout the body involved in various aspects of health and disease via direct actions independent of its role as a precursor to androgens and estrogens (Samaras 2013; Traish 2011; Savineau 2013).

Aging disrupts hormonal balance, with the levels of several critical hormones dramatically reduced in comparison with youthful levels, and DHEA is no exception. By age 80, levels of DHEA fall by as much as 80%90% compared to what they were during young adulthood (Samaras 2013). The gravity of this becomes clear after understanding the roles DHEA plays in supporting healthy, youthful physiology across several body systems. Studies have shown that reduced levels of DHEA-S are linked with the pathophysiology underlying numerous age-associated disease states, including cognitive decline, cardiovascular disease, bone loss, cancer, depression, sexual dysfunction, and various inflammatory disorders (Samaras 2013; Traish 2011; Savineau 2013; Dong 2012; Zaluska 2009; Labrie 2009; Straub 2000; Krysiak 2008; Lopez-Marure 2011).

Restoring youthful DHEA levels provides a unique opportunity to mitigate the consequences of dwindling hormones. Unlike direct administration of androgens (ie, testosterone replacement therapy) or estrogens (ie, estrogen replacement therapy), bolstering DHEA levels provides a reservoir of this hormone precursor that various tissues can convert into androgens and estrogens (Traish 2011; Arlt 1998; Morales 1994; Aldred 2010; Samaras 2013; Panjari 2007). However, DHEA administration cannot supplant the need to measure and restore other hormones because the rate at which it is converted to androgens and estrogens varies among individuals and with gender (Samaras 2013; Arlt 1999; Schulze 2013; Fitzpatrick 2001; Miller 2004). Therefore, restoring DHEA levels should be viewed as an integral part of a comprehensive hormone restoration regimen rather than an alternative to testosterone replacement in men and estrogen replacement in women.

In addition to its role as a hormone precursor, DHEA also modulates inflammation, which is a driving force in many diseases. This multifunctional hormone also promotes the production of the cell-signaling molecule nitric oxide within the delicate lining of blood vessels by activating an enzyme called endothelial nitric oxide synthase (eNOS). Nitric oxide is a pivotal regulator of blood flow via its ability to stimulate blood vessel dilation. Thus, it is not surprising that low DHEA levels have been linked to cardiovascular disease in the medical literature (Samaras 2013; Traish 2011).

Upon oral administration, DHEA is mostly converted to DHEA-S, which circulates in the blood far longer than DHEA. Circulating DHEA-S acts as a reserve upon which tissues can draw. Once taken up by tissues, DHEA-S is converted back to DHEA, which can then be locally converted to androgens and estrogens or exert direct action (Samaras 2013; Traish 2011).

Since DHEA-S is more abundant in the bloodstream than DHEA (Traish 2011; Savineau 2013), simple blood tests to measure DHEA-S concentrations can be integrated into any healthy aging strategy for both men and women. With regular monitoring of blood levels of DHEA-S and other hormones, individuals are provided with specific feedback about the state of their hormonal milieu (Traish 2011). This allows for development, implementation, and optimization of individualized regimens that can help maturing individuals lead full, active, healthy lives (Samaras 2013).

Bioidentical hormone replacement therapy is a method of administering hormones that are structurally identical to those produced by the human body. Treatment with DHEA, which is also bioidentical, is an integral component of any comprehensive hormone restoration regimen. On the other hand, some forms of conventional hormone replacement therapy utilize hormones that are not identical to those produced by humans and are either derived from animals or synthesized. Evidence suggests that bioidentical hormone replacement therapy may be safer and associated with greater patient satisfaction than conventional hormone replacement therapy (Holtorf 2009). Life Extensions Male Hormone Restoration and Female Hormone Restoration protocols provide a thorough overview of bioidentical hormone replacement therapy and should be referred to in conjunction with this protocol.

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DHEA Restoration Therapy - Hormone Replacement, Estrogens ...

If youre looking for relief from menopause symptoms, knowing the pros and cons of hormone replacement therapy (HRT) can help you decide whether its right for you.

HRT (also known as hormone therapy, menopausal hormone therapy, and estrogen replacement therapy) uses female hormones -- estrogen and progesterone -- to treat common symptoms of menopause and aging. Doctors can prescribe it during or after menopause.

After your period stops, your hormone levels fall, causing uncomfortable symptoms like hot flashes and vaginal dryness, and sometimes conditions like osteoporosis. HRT replaces hormones your body no longer makes. Its the most effective treatment for menopause symptoms.

You might think of pregnancy when you think of estrogen. In women of child-bearing age, it gets the uterus ready to receive a fertilized egg. It has other roles, too -- it controls how your body uses calcium, which strengthens bones, and raises good cholesterol in the blood.

If you still have your uterus, taking estrogen without progesterone raises your risk for cancer of the endometrium, the lining of the uterus. Since the cells from the endometrium arent leaving your body during your period any more, they may build up in your uterus and lead to cancer. Progesterone lowers that risk by thinning the lining.

Once you know the hormones that make up HRT, think about which type of HRT you should get:

Estrogen Therapy: Doctors generally suggest a low dose of estrogen for women who have had a hysterectomy, the surgery to remove the uterus. Estrogen comes in different forms. The daily pill and patch are the most popular, but the hormone also is available in a vaginal ring, gel, or spray.

Estrogen/Progesterone/Progestin Hormone Therapy: This is often called combination therapy, since it combines doses of estrogen and progestin, the synthetic form of progesterone. Its meant for women who still have their uterus.

The biggest debate about HRT is whether its risks outweigh its benefits.

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Hormone replacement therapy (HRT) - WebMD

This material must not be used for commercial purposes, or in any hospital or medical facility. Failure to comply may result in legal action.

What is it? Hormone replacement therapy (HRT) is a treatment for women who have low hormone levels, like a woman going through menopause. HRT is also called estrogen (es-tro-jin) replacement therapy or ERT. With HRT a woman takes estrogen, and often progestin (pro-jes-tin), to help the symptoms caused by low hormone levels in her body.

What are hormones and how do they work?

What are the reasons I may not have enough estrogen?

What are the signs and symptoms of a low estrogen level? You can have physical and emotional changes when your estrogen level is low.

Will HRT help these symptoms? You may choose to take HRT to help or prevent the symptoms of low estrogen. Hot flashes and night sweats will occur less often and may possibly go away if you take estrogen. Estrogen helps prevent vaginal dryness and thinning of the tissue inside the vagina. Your chances of breaking a bone are much lower if you take estrogen. HRT may also improve your mood and memory. HRT may reduce your risk of heart disease.

Is HRT safe?

Are there side effects with HRT? Following are possible side effects of HRT.

How long do I need to take HRT? Bone loss is highest during the early years after menopause. To get the best results, HRT should start soon after the beginning of menopause. You should continue with HRT for at least 7 to 10 years. You and your caregiver can decide how long you should take HRT. You will need long-term treatment if you are trying to prevent heart disease or osteoporosis. Bone loss will begin right away when you stop taking HRT.

How do I take HRT?

Are there other ways to prevent bone loss or heart disease without HRT? Eating foods that are rich in calcium and low in fat is one way to control bone loss and heart disease. Caregivers may give you medicine to prevent bone loss or heart disease. Other ways to prevent bone loss and heart disease are to exercise regularly and to limit the amount of alcohol that you drink. You should not have more than 1 drink a day. A drink is 1 1/2 ounces of whiskey, 5 ounces of wine, or 12 ounces of beer (regular or light). If you smoke, you should quit.

How often should I see my caregiver if I take HRT? Call your caregiver if you are bleeding from your vagina or have other side effects that are bothering you. You should see your caregiver every year for a check up. Your caregiver may want you to have the following tests.

Where can I get more information about HRT? You can call or write the following organizations for more information.

You have the right to help plan your care. To help with this plan you must learn about hormone replacement therapy. You can then discuss the treatment options with caregivers. Work with them to decide what care will be used to treat your decreasing estrogen levels. You always have the right to refuse treatment.

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Hormone Replacement Therapy - What You Need to Know

Lets put menopausal estrogen use in an historical perspective: Throughout history and as women have become over-nourished, the age of puberty has become younger. The age of menopause, however, has stayed the same, on average about 52. When the ancient Egyptians were going through menopause, the average age of death was ten years before menopause. Now the average age of death for women is 78 to 80. We live nearly half our lives past menopause. In the 1960s, scientists discovered hormone replacement and its benefits: improved cognition, less arthritis, stronger bones, better sleep, and better sex.

For decades now, millions of women entering menopause in America were prescribed Premarin or Prempro without much question. Premarin, a mixture of estrogens derived from the urine of a pregnant horse, and Prempro, a combination of horse estrogens and synthetic progesterone, served to replace female hormones that naturally dissipate in peri-menopausal and menopausal women, primarily estrogen and progesterone.

Healthcare providers and their female patients were shocked to learn that hormone replacement therapy was not as safe as they had once thought after receiving the data from the Womens Health Initiative. The results of the study suggested that this type of hormone replacement therapy did not protect a woman from getting heart disease, and actually increased her risk of breast cancer, blood clotting and possible stroke. A reanalysis of this study was completed in 2007 further suggesting that actual heart disease risk factors was dependent upon what age a woman was when she began hormone replacement therapy. These results still remain controversial. Again, in 2008 the study underwent a reanalysis which concluded that hormone therapy is associated with an increased risk of stroke, regardless of when hormone replacement therapy is initiated.

There were major problems with the study. Sponsored by Wyeth, a major producer of HRT, the WHI looked at whether hormone replacement could prevent heart attacks, since estrogen is protective for heart disease. They set up the study as a placebo-control, double-blind study. The problem is, women who are on HRT know it, so they specifically chose women who werent having night sweats or hot flashes. The only women who fit that criterion had an average age of 63, more than 10 years passed menopause. By that age, permanent changes from estrogen deprivation, such as hardening of the arteries, have already occurred. Giving HRT at that point is too late to prevent it and can actually make it worse, so people had more heart attacks and strokes. If supplemention starts early in the mid-40s when menopausal symptoms first start, it has the potential to prevent heart disease. The recent increased concern about HRT is from following women in the original study who were on average ten-plus years beyond menopause, taking oral HRT for at least 15 years, in higher doses than are prescribed today, and taking a combination of estrogen and progestin. Even given that, the increase in breast cancer and death are very slight. None of the non-oral delivery systems or current age and dosage recommendations was studied.

Unfortunately many practitioners often label all hormone replacement therapy the same. What this means is that many women are often advised that the risks apply regardless of the type of hormones. The reality of the study and the reanalysis showed associated risks only for oral conjugated equine estrogens and synthetic progestins, not bio-identical hormones.

Bioidentical, non-oral estrogen supplementation is a different animal. Bioidentical hormones are made in the lab, and once they get into the body, your body recognizes them as their own. The only way that is likely to happen is via a non-oral route. Taking any estrogen orally requires processing in the liver before it goes to the rest of the body. That processing changes the oral medication into something else, a by-product not recognized as the youthful estrogen your body likes: estradiol. Transdermal creams bypass the liver.

Objectively, HRT is the best way to protect bones. Osteoporosis treatment is only second-best because while it increases the density of bones, it makes them very brittle. Its a different architecture.

Meanwhile, women continue to come to us every day, completely confused and even scared about hormone replacement. We have always been dedicated to clearing up misconceptions about hormone replacement therapy, and . providing women with alternatives to conventional hormone replacement, including bio-identical hormones Because there havent been many definitive studies done on bioidentical hormone replacement therapy, we do not know exactly what the risks are for every woman taking it. What we do know is that from the results of studies that have looked at bio-identical hormone replacement therapy, and from what has been seen in the clinical practice of prescribing bio-identical hormone replacement to patients, bio-identical hormone replacement therapy does not appear to have the same side effects consistent with conventional hormone replacement therapy, in particular transdermal forms.

Bio-identical hormones have been shown to share the exact same molecular structure with those found in our bodies. Unlike conventional or synthetic forms of hormone replacement therapy, they are not patented and sold by pharmaceutical companies. That is the main reason why there have been very few studies to evaluate their risks and benefits. Bio-identical hormones are not as profitable as the conventional synthetic forms. In the future, more studies will be done to help clarify the benefits or disadvantages associated with bio-identical hormone replacement therapy.

There has have been serious efforts made to shut down compounded bio-identical hormone replacement therapy as an option for women. The belief of our office is that women deserve to know all of their options and alternatives surrounding hormone replacement therapy. They need to be fully informed of everything we have learned and have access to these options when they need them.

In order to find answers to your questions about bio-identical hormone replacement therapy and how to decide if that could be a better choice for you, please call our office at (314) 292-7080 to set up a consultation with one of practitioners. We here at Womens Health Specialists of St. Louis are dedicated to your complete healthcare needs. Educating yourself as much as possible will always lead you to better health. Being informed is the only way you can decide the right decision for yourself.

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Hormone Replacement Therapy - Teresa knight

RejuvinAge, a Virginia Beach Bioidentical Hormone Replacement Center, focuses on Individualizing Hormone Therapy for Women and Men. RejuvinAge specializes in Hormone Replacement for approved indications of Menopause for women and Low Testosterone Replacement Therapy for men.

Women and men are very comfortable and confident in our boutique setting for hormone replacement. Programs are individualized; one size does not fit all. Every program is physician managed; appointments are always on time with our hormone replacement doctor, Jennifer Krup, M.D. Personalized care is our focus; we recognize the importance of one on one attention.

Focusing on menopause for women, Dr. Krup encourages every woman to embrace this phase of their life.Understanding BHRT empowers women with the knowledge to make the right decisions and successfully manage menopausal symptoms. Understanding appropriate dosages, appropriate routes of administration and the appropriate length of treatment for each woman keeps RejuvinAge in the forefront

Offering Low T options for men, Dr. Krup will help determine ifTestosterone Replacement Therapyis right for you. Making the right choice for TRT is an important decision for men today.

The RejuvinAge approach to Bio Identical Hormone Replacement for women and men is based on sound medicine. Hormone optimization takes patience, compliance, great communication and a partnership with you. Our Virginia Beach Hormone Replacement center is easily accessible to the surrounding cities of Norfolk, Chesapeake, Hampton Newport News, Williamsburg and beyond. Make your appointment today-meet Dr. Krup in her Virginia BeachBio-Identical Hormone Center.

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Bioidentical Hormone Replacement Therapy | Menopause Doctor ...