Q: What do women use under HRT?
A: Women’s Hormone Replacement Therapy (HRT) is more complicated than men’s.
During menopause, women have lower estrogens that cost in several issues.
Hot flushes at night, vagina dryness, painful intercourse, lack of libido, dry skin and hair, gain in weight, depression, osteopenia.
Estrogens are administrated in the morning as cream (bioidentical), but progesterone is another hormone with has to be used at night, in order to provide balance. Progesterone helps endometrium and also calms down nervous system, provided at night.
Dehydroepiandrosterone (DHEA) is another hormone to be used, as secondary androgen coming from adrenals.
It is metabolized mainly to testosterone (T) in women, while it is safer option, rather than using testosterone itself.
The main androgen encloses the risk of hirsutism and virilisation effects (voice
deepening, clitoric enlargement, acne and hair thinning).
Pregnenolone is an optional neurosteroid, metabolized to progesterone can help memory.
Testosterone is occasionally used in the form of cream, under small concentration, that has to be monitored.
Excessive aromatization out of estrogen and testosterone administration, can be managed by the use of DIM, a substance found in brocholi and has anti-estrogenic effects.
During follow up labs, we assess same hormones as with men’s HRT, so Total Testosterone (TT),
Free-Testosterone (FT), Estradiol (E2), Prolactin (PRL), Sex Hormone Binding Globulin (SHBG), Dehydroepiandrosterone sulphate (DHEA-S) is the panel.
The use of calciferol is mandatory (D3/K2) and levels are verified by blood work of the active form 1,25(0H) D3.
Estrogens, DHEA, Testosterone and Vitamin D will ensure there is no osteoporosis any longer.