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When it comes to the question of whether to use hormone replacement
therapy the answer is always one of personal choice. This is part 2 of a 3 part series.
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1 | | Part 2 | | Part 3 |
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PART 2 - HRT IS A PERSONAL CHOICE
When it comes to the question of whether to use hormone replacement therapy
the answer is always one of personal choice.
The key to making the appropriate decision is based on both the knowledge of
what menopause represents in terms of its potential impact on health, quality of life and sexuality and an understanding
how hormone replacement options differ in their potential benefits and risks.
Without this knowledge, a woman cannot effectively participate in her own healthcare
decisions. In essence, she becomes the passive recipient of her doctor’s store of knowledge and individual bias.
Acquiring the necessary information may be difficult for most women as the
physician is the source she usually turns to for information. Doctors may have only scant knowledge of the menopausal
process, its global nature, or the extent of its potential impact on health and quality of life. In addition, most
physicians are not aware of what constitutes an optimum hormone replacement regimen.
Menopause 101
A “natural menopause” is characterized by cessation of the monthly menstrual
cycle and occurs because of an expected age-related failure of the ovaries to continue to produce estradiol, the
biologically-active form of estrogen. Most often, this will occur between the ages of 48-52. It is the rise in
the estradiol level at puberty that is responsible for the physical and mental metamorphosis from a young girl
to an adult female. This includes all the changes that that we characterize as “secondary sexual characteristics.”
An early or “premature menopause” is one that occurs prior to age 40 and can
be the result of genetic factors or autoimmune processes. An “induced menopause” can be due to surgical removal
of the ovaries with or without a hysterectomy, by chemotherapy or radiation.
After menopause, estradiol concentrations in the blood fall to their prepubertal
level. The aging process is accelerated as the hormonally-dependent tissues that have relied on estradiol for their
support begin to regress and their ability to function optimally is compromised. Virtually every organ system is
affected including the vagina, bladder, brain, skin, skeleton and cardiovascular.
Hormone Deficient
Many women think in terms of “going through menopause.” What they usually mean is that they have stopped having
symptoms such as hot flashes, sweats and insomnia. However, unless a menopausal woman chooses to use hormone replacement
she will spend the remainder of her life in a hormone-deficient state. The central issue for most menopausal women
is whether to use hormone replacement.
Menopause - assuming it is a “natural menopause” - is normal. There is no “right
choice” for everyone. Whether a woman chooses to live in a hormone-deficient state or use hormone replacement is
a personal decision. In most cases, menopausal symptoms such as hot flashes, sweats and insomnia will disappear
within 2 years. However, long-term consequences of estrogen deficiency cannot be predicted on an individual basis,
but many women on the surface do not seem to be affected.
If a woman has experienced a premature or induced menopause the effects are
magnified. Those who have had their ovaries removed are at greatest risk of osteoporosis, cardiovascular disease
and atrophic changes of the vagina, urinary system and skin especially when this occurs prior to an expected natural
menopause.
Women who choose to use hormone replacement have a better quality of life according
to a recent pole conducted by The Gallup Organization. This is not meant to imply that postmenopausal women who
are not on hormone replacement are incapable of a fulfilling life and sexual experience. They are capable of both.
We have all heard about “Aunt Sadie” who never touched a hormone, or any other medication for that matter, yet
lived to age 94, remained “sharp as a tack,” had a sexually satisfied boyfriend thirty years younger, drove a car
every day and mowed her own lawn. However, the point is that it is unlikely that anyone, regardless of gender,
can function optimally in a hormonally deficient state.
Part 1 - Hormone
Replacement Therapy, Panacea or Poison?
Part 3 - What Is Optimum Hormone Replacement?
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Dr Nosanchuk is currently in practice in Southeastern Michigan
and is accepting new patients. His office is located in Bingham Farms, a suburb of the Detroit Metropolitan Area.
Dr N specializes in the care and treatment of menopausal women and has a special interest providing treatment to
women whose lives have been altered by their menopause, hysterectomy, or both. This includes strategies to restore
quality of life, by resolving problems, such as persistent symptoms, loss of libido and disturbances of sexual
function.
Appointments with Dr Nosanchuk can be scheduled by calling (248) 644-7200
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IMPORTANT
This web site is for educational purposes only. It is not intended to suggest
a specific therapy for any individual and must not be construed to establish a physician/patient relationship.
Website By Athena
All Contents Copyright © 2000-2005 menopausehysterectomy.com/drn4u.com
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