Hormone Replacement Recommendations
For Menopause - By Joseph Serio R.Ph. Registered Pharmacist

I recognize that all women are unique, and there is no treatment protocol that will work for everyone. However, I can provide you with my general recommendations, which you can use to develop your specific hormone replacement strategy with your doctor:

1. Never use unopposed estrogen if you have a uterus; balance it with progesterone.
   
   
2. Never use conjugated or synthetic estrogen's. Instead, use estriol or a balanced formulation which contains primarily estriol, such as bi-estrogen or tri-estrogen.
   
   
3. If you are already on a hormone replacement program with a synthetic estrogen hormone such as Premarin, consider replacing it with estriol, bi-estrogen or tri-estrogen.
   
   
4. Estriol, bi-estrogen and tri-estrogen must be obtained through a doctor's prescription. Many doctors think estrogen means only Premarin, so you may need to provide your physician with information for further research. If your doctor will not work with you on this, find another doctor. You can contact the American College for the Advancement of Medicine for a referral, 714/583-7666 or 800/532-3688.
   
   
5. If you are already on a hormone replacement program with progestin (synthetic progesterone) such as Provera, consider replacing it with natural progesterone.
   
   
6. If you're experiencing menopausal hot flashes and night sweats, either take estriol, bi-estrogen or tri-estrogen orally on a regular basis or use topical estrogen cream, such as Ostaderm, on an occasional basis as symptoms require. Estrogen creams, applied vaginally, can help alleviate vaginal dryness. Natural progesterone cream can help with hot flashes and night sweats as well. Pransdermal estrogen and progesterone creams are available from health professionals. You can also get progesterone cream in a few health food stores and by mail order. Call Healthy Directions, 800/722-8008, ext. 655.
   
   
7. Regardless of your age, if you've gone through menopause, preventative use of estrogen and progesterone replacement therapy makes sense. This is particularly true if you are at risk for heart disease and osteoporosis.
   
   
8. Estrogen replacement requires active participation on your part. Your doctor cannot know how you feel and thus you must take the lead in suggesting or implementing slight changes in your dose and schedule until you find the program that works best for you.
   
   
9. Don't give up your hormone replacement therapy after a month. Be willing to spend three or four months being tuned in to your body and experimenting with different combinations. With a doctor's help, you should be able to devise your own personal hormone replacement therapy program.
   
   
10. If you're adamantly against using estrogen replacement therapy, perhaps because of a history of cancer or just on general principle, consider supplementing your diet with 1 to 3 mg of boron per day. Boron has been shown to have some of the same effects as supplemental estrogen in postmenopausal women.
    
    
11. Exercise has a decidedly beneficial effect on hormonal balance, and women who participate in regular physical activity have an easier transition through menopause with notably fewer hot flashes. I recommend at least 3 to 4 hours of moderate exercise per week.