As women, we have been riding the hormone roller coaster practically since we were born. When we are younger, it is often dismissed as PMS. As we grow older, it “must be going through the change.” Hot flashes, low libido, mood changes, irritability, inability to lose weight, increased belly fat, inability to fall asleep and stay asleep, vaginal dryness, mental fogginess and low stamina are all symptoms our body presents when there is an imbalance. But there is something you can do about it. 

Northside Woman recently asked board certified physician assistant Ferrina Sheth to discuss the basics regarding hormones and the myriad of hormone replacement therapies (HRT) available.

“When you have symptoms, your body is telling you something,” said Sheth, a bio-identical hormone and medical aesthetics specialist at Restorative Health at North Gwinnett in Sugar Hill, the Blue Med Center in Atlanta and Premier Women’s Health in Lithonia.

“Symptoms are the body’s way of communicating with us of any imbalance,” she said. “It is always important to get to the root cause of a symptom, rather than just masking it with anti-depressants or other medications.” 

For more than 30 years, bio-identical hormones have been helping pre-menopausal and menopausal women deal with symptoms related to menopause.

“It is best to visit a BHRT (bio-identical hormone replacement therapy) health care provider to determine the root cause, and if hormone therapy is the correct support the body needs,” she said.

Common hormones that are matched to help women with menopausal symptoms include estradiol (the major form of estrogen in females), testosterone and progesterone, Sheth said. While estrogen has more than 400 different functions, it helps with mood and protects vital organs including the heart, the breasts, ovaries and other major organs. It also supports mental focus and sexual health.

Testosterone is vital in the female body and helps with mood, libido and muscle mass, along with joint pain and inflammation.  Progesterone opposes estrogen, thus balancing it in the body. It also supports serotonin activity, which helps with sleep.

“Over-the-counter supplements like black cohosh, primrose and DIM (Diindolylmethane) may help relieve menopausal symptoms, but they are not hormones,” Sheth said. “Therefore, [they] do not protect or benefit your body as the BHRT.”

Bio-identical hormone therapies are plant-based and come in oral, cream, gel, vaginal inserts or pellet form. 

“Creams are applied once or twice a day to the inner arm or inner thigh,” she said. “The absorption is best on those areas of the body due to the vascular permeability (thinner skin and the visual presence of veins). [But] creams can be less effective due to application errors.” 

If applied with the palm of the hand, the hormone remains mostly on the palm, Sheth said. If applied with a device, the cream can end up just being smeared around on the applicator instead of on the skin, she said.

Pellets can be easily inserted under the skin through a small procedure done at the office by a BHRT health care provider. 

“Studies have shown that they last up to three months or longer, and release hormones as your body requires them,” Sheth said. “This takes away the burden from patient from either taking a pill or apply things to their skin; hence, giving an accurate and consistent release specific to the individual.”

As with any therapy, Sheth says there are contraindications and side effects. She cautioned it is always important to ensure the benefits outweigh any risks before you start BHRT.

  “There have not been any large studies that support that BHRT changes any risk factor of breast cancer,” she said, but “your personal risk is best assessed by your health care provider.” 

As added support, she said supplements such as DIM and micronized progesterone can be prescribed for estrogen balance and metabolism. 

According to cancerresearchuk.org, the chance for cancer is there with BHRT, but is very small. 

“The balance of risks and benefits is different for each person,” the website states. “So, talk to your health care provider about what option might be best for you. They should help you decide according to your needs for treatment. There are other things that affect cancer risk more strongly. For example, you can reduce your cancer risk by keeping a healthy weight, not drinking alcohol and stopping smoking.”

Sheth said studies show women can use bio-identical hormone replacement therapies up to 75 years of age.

“As women shift the focus to their well-being, we cannot ignore the need for hormone balancing to achieve an optimum quality of life,” Sheth said. “I hear complaints from female patients who were ‘conquering the world’ in business, and all of a sudden aren’t able to conduct a meeting due to forgetfulness and emotions. Then, some are empty-nesters and now have the time to focus on themselves. 

“I’m thankful I’ve gone into this field,” she said. “I can see a difference [BHRT makes] in a woman’s life.”

Some therapies discussed in this article are not FDA-approved. Please consult your health care provider if you have any questions or concerns.

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