Customized hormone replacement therapy has improved the quality of life for millions of women who suffer from hormonal imbalance. The ideal process for achieving hormonal balance includes an assessment of hormone levels and complete evaluation of signs and symptoms, followed by replacement of the deficient hormones in the most appropriate dose via the most effective route for each person, and monitoring to fine tune the therapy.

When using customized hormones for replacement therapy, the discussion should be based on physiology (i.e., how the body responds to hormonal stimuli, or too much or too little of a given hormone) versus pharmacology (the study of how drugs affect the various body systems, including side effects) – because Hormone Replacement Therapy (HRT) is the replacement of deficient hormones with hormones that are chemically identical to those that the body naturally produces, but which have declined due to aging or illness.

Mayo Clinic researchers surveyed 176 women taking natural micronized progesterone who had previously taken synthetic progestin (medroxyprogesterone acetate, or MPA) to see if progesterone improved the women’s overall quality of life, menopausal symptoms, and satisfaction with HRT. After one to six months, the women reported an overall 34% increase in satisfaction on micronized progesterone compared to their previous HRT, reporting these improvements: 50% in hot flashes, 42% in depression, and 47% in anxiety. Micronized progesterone was also more effective in controlling breakthrough bleeding. In other studies, women using micronized progesterone had specific improvements in the areas of cognition, sleep, and menstrual problems.

Typically thought of as male hormones, androgens are a class of hormones that include DHEA and testosterone, which are normally produced in a young healthy woman, and are important for libido as well as integrity of skin, bone, and muscle. When women enter menopause, testosterone and DHEA levels may decline. Experts now recognize the importance of supplementing androgens for women who are deficient.

While women have benefited from therapy with estrogens, progesterone, and androgens that are “chemically identical” to the hormones produced naturally by the human body, researchers and health care professionals realize that this is just the “tip of the iceberg” when it comes to achieving hormonal balance. Thyroid and adrenal function, as well as nutritional status, should also be evaluated and treated when indicated.

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