#275 - AMA #52: Hormone replacement therapy: practical applications and the role of compounding pharmacies
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Oct 16, 2023
Dive into the world of hormone replacement therapy as the discussion highlights its vital role in women's health during menopause. Discover the signs and symptoms to watch for and learn about FDA-approved HRT options. Explore the challenges of testosterone replacement therapy for women and the essential role of compounding pharmacies. Gain insights on testing for menopause and how hormones like AMH affect fertility awareness. It's an informative session that debunks myths and provides practical guidance for navigating hormone health.
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insights INSIGHT
HRT Misconceptions
Hormone replacement therapy (HRT) is important for women's health, but has been misrepresented.
The mainstream medical community's misinterpretation of the Women's Health Initiative led to the demonization of HRT.
volunteer_activism ADVICE
Tracking FSH Levels
Track follicle-stimulating hormone (FSH) levels to understand menopause trajectory.
An FSH level of 20 or 25 is a strong indicator of menopause.
insights INSIGHT
AMH as a Predictor
Anti-Müllerian hormone (AMH) can predict menopause and ovarian reserve.
A high AMH suggests menopause is likely six or more years away.
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In this "Ask Me Anything" (AMA) episode, the discussion zeroed in on the practical application of hormone replacement therapy in women. Peter walks through the signs, symptoms, and hormonal changes in women approaching – and going through – menopause. He provides an overview of the FDA-approved HRT formulations and explains how women might go about choosing the right option for themselves. Peter also describes the significant changes in testosterone levels in women over time and the options, as well as the considerations and challenges of testosterone replacement therapy (TRT) for women. Lastly, Peter highlights the necessary role of compounding pharmacies in HRT, underscores concerns regarding the quality and sterility of compounded drugs, and offers guidance on locating a trustworthy pharmacy.
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We discuss:
Why hormone replacement therapy is such an important topic [2:00];
The onset of menopause: symptoms, blood tests, and when to consider HRT [6:00];
Tests that may provide indications of perimenopause and their implications for fertility [9:15];
Vasomotor symptoms: hormonal changes that cause hot flashes/night sweats, and HRT therapies that can help [13:45];
The role of estrogen in menopausal HRT [17:30];
The limited role of progesterone in HRT protocols [25:15];
What is a “bioidentical” hormone? [28:30];
Overview of the FDA-approved HRT formulations [31:45];
Determining HRT dosing and considerations for perimenopausal women [37:45];
Choosing the right HRT formulation: pros and cons [43:30];
Examining the link between certain forms of estrogen and breast cancer [46:45];
Changes in testosterone levels in women over time and why it matters [50:00];
Recognizing low testosterone in women: common symptoms and diagnosis [53:45];
Testosterone replacement therapy for women: options, considerations, and challenges [57:30];
The long-term use of testosterone in women: examining the limited data [1:00:15];
What is a compounding pharmacy? [1:09:30];
Reasons to opt for a compounding pharmacy over a pharmacy that adheres to stricter regulations [1:16:00];
The tragic incidents that heightened concerns about compounding pharmacies [1:20:45];
Tips for finding a reputable compounding pharmacy [1:27:45]; and
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