To treat or not to treat?
Highly individualized.
•Debilitating symptoms.
•Mild symptoms.
Goal of treatment:
Improved quality of life
One approach to treatment of these
symptoms is Hormone Therapy (HT)
•“Natural” or “Bioidentical” Hormone
regimens
•Traditional Hormone regimens
Much confusion among consumers
and clinicians about the terms
“natural,” “bioidentical” and
“synthetic.”

If a hormone is chemically identical to
that found in the human body it can be
said to be “bioidentical.”

If a substance originated in plant or
animal, one can say it is “natural.”

1.
If a substance originated in plant or
animal, one can say it is “natural.”
Many drugs in clinical use today
originate from plants.

1.
2.
If a substance originated in plant or
animal, one can say it is “natural.”
Many drugs in clinical use today
originate from plants.
Just because a substance is “natural”
does not mean it is always safe.

Hormones that are chemically altered in
the laboratory can be termed
“synthetic.”

1.
Hormones that are chemically altered in
the laboratory can be termed
“synthetic.”
A substance can be made that has
hormone activity but is different
chemically than the hormone it mimics.
Hormones that are chemically altered in
the laboratory can be termed
“synthetic.”
1. A substance can be made that has
hormone activity but is chemically
dissimilar to the hormone it mimics.
2. A substance can be altered to become
bioidentical.


Therefore, it’s possible for a
”bioidentical” hormone to be both
“natural” and “synthetic.”

Many commercially available products
made by pharmaceutical companies
are, in fact, “bioidentical.”
Bioidentical hormones for the
treatment of menopause
symptoms include estradiol, estriol,
estrone, progesterone and
testosterone.
Hormone levels constantly change due to
normal physiologic variations.
Symptoms should be managed with the
lowest effective dosages.
Monitoring hormone levels through blood
or saliva testing is therefore less important
that the successful management of
menopause symptoms.
Bioidentical hormones can be
administered as pills, topical sprays,
creams, gels, lotions, patches, vaginal
tablets, creams or inserts, injectables and
implants.
Compounding is defined as “combining,
mixing or altering of ingredients to create a
customized medication for an individual
patient in response to a licensed
practitioner’s prescription.
US FDA
The Women’s Health Initiative (WHI) Study
•Widely publicized in 2002
•Many women and physicians decided to
immediately stop HT
A consumer book recommends
bioidentical hormone therapy (BHT)
as a safer alternative to
commercially prepared hormones.
Some smaller more recent studies have
suggested very reasonable safety and even
health benefits to early onset HT.
All women experience some degree of
menopause symptoms for some period of time
in their lives.
The decision to treat menopause symptoms is
highly individualized.
Hormone therapy (HT) is a reasonable and
perhaps even healthy choice for many
women.
Bioidentical hormones are available and make
sense for the treatment of menopause
symptoms.

Menopause is defined as:
2 or more irregular periods after age 40
B) The start of hot flashes
C) No menstrual period for 12 consecutive
months
D) An increase in mood swings
A)

The average age of menopause is:
51
B) 60
C) 55
D) 49
A)

Menopause increases health risks
like:
Heart disease
B) Sexually transmitted diseases
C) Osteoporosis
D) A & C
A)

Women going through menopause
should take:
Hormone therapy
B) It depend on the woman, her symptoms
and her medical history
C) Bio identical hormone therapy
D) Estrogen therapy
A)

A)
B)
C)
D)

A)
B)
C)
D)
The most accurate test to determine
if a woman is in menopause is:
Follicle stimulating hormone (FSH) blood
test
Complete blood count (CBC)
Urinalysis
None of the above
Which of the following are proven
alternative therapies for
menopause symptoms:
Black cohosh
Plant estrogens
Herbals
None of the above

During menopause, some doctors
may prescribe which treatment?
Hormone therapy (HT)
B) Birth control pills
C) Benzodiazepines
D) A or B
A)

Which is not a symptom of
menopause?
Night sweats
B) Back pain
C) Headaches
D) Anxiety
A)

A)
B)
C)
D)

If Menopause occurs in a woman
younger than ____ years, it is
considered to be premature.
40
45
50
30
Which factors can affect the timing
of menopause?
Surgical removal of the ovaries
B) Chemotherapy and radiation
C) Medication
D) A & B
A)

Hot flashes can last from a few
minutes to a few hours.
True
B) False
A)

A)
B)
About 15-28% of post-menopausal
women can still bear children.
True
False

As a result of menopause, which of
the following is least likely to occur.
Decreased estrogen levels
B) Vaginal atrophy
C) Osteoporosis
D) Osteoarthritis
A)

A)
B)
Menopause decreases a woman’s
risk for depression.
True
False