What is Hormone Replacement Therapy and Who Needs it?

Hormone Replacement Therapy

Like it or not, as we age our bodies don’t always keep up with our needs for even keel hormones. As a result, we reach the “fun” part of trying to get the correct balance. Breezy Mama turned to our favorite OB, Dr. Gafori, of IGO Medical Group, to explain exactly what is hormone replacement therapy, signs to watch for that it’s time you need it, how long it takes to get right and more.

1. What exactly is hormone replacement therapy?

Hormone replacement therapy is treatment that replaces the estrogen that women in perimenopause and menopause are lacking. Specifically, in women that do not have a uterus, this means unopposed estrogen treatment, while in women with a uterus, it means both estrogen and progesterone treatment. The progesterone is given to protect the uterus and prevent the development of uterine cancer.

2. At what age can women expect to need it?

Menopause is defined as the time when a women has gone through 12 consecutive months without menses without any other biological cause. The mean age for menopause is 51. Some women, though, will begin having symptoms of perimenopause well before they consistently skip menstrual cycles.

3. Do all women need it at some point?

No, all women do not need it, but many women may benefit from it.

4. What are some signs it’s time to start adjusting hormone levels?

Once a woman actually begins skipping menstrual cycles, they may develop symptoms from the erratic changes in their hormone levels. The most talked about symptoms are probably hot flashes, but women may also suffer from vaginal dryness, mood lability including depression, insomnia because of hot flashes, loss of focus and memory changes.

5. What’s involved?

The most important thing is that a woman keeps a record of what her symptoms are, and what symptoms are actually bothering her. This way, when she comes into the office to see her doctor, she has a good description of the changes and how she has been affected by them. I ask my patients to fill out a calendar for the two weeks or so before they see me so that I can use it as a baseline to compare to once I begin treatment. In general, it is not useful to check blood hormone levels because they can be different on different days.

6. How long does it take to get the correct balance?

For some women, it is as simple as one visit to the doctor. Depending on the patient’s age, time from menopause, frequency of symptoms, and level of discomfort from these symptoms, we develop a hormone replacement regimen. We then adjust the dosing based on the woman’s response to the hormones.

7. I’m scared of becoming crazy moody… how can this be avoided?

Many woman do experience mood changes and lability when they are menopausal and many of them respond to hormone replacement therapy. Women with a history of depression may find that their symptoms are aggravated or that the medicine that has worked for them forever, now no longer does. I always emphasize that lifestyle is very important to our sense of well being… exercise, healthy eating, and living all help us respond better to the physiologic changes related to menopause. Most patients feel an almost immediate relief of many of the emotional symptoms once they are started on a hormone regimen that works for them.

breezy_deal1Have a question you’d like Dr. Gafori to answer? Email it to: info@breezymama.com!

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About Dr. Gafori:
Valerie Gafori MD, FACOG is a board certified obstetrician/gynecologist. She completed her undergraduate degree in Physics at MIT, her masters degree in Biology at Stanford University, and medical degree at UMDNJ: New Jersey Medical School. She completed her residency in OB/GYN at George Washington University and joined a private practice in Washington DC for one year before she moved to La Jolla. She is now in private practice in La Jolla, California with IGO Medical Group. She has special interests in minimally invasive surgery and gynecology.

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