Using personalized medicine in your approach to menopause is the safest way to use hormone replacement therapy to support your body through menopause. It allows you to use the least amount of HRT in the safest way possible based on your unique needs, genetics and body systems. Taking a naturopathic-functional medicine approach allows you to go beyond focusing on symptom relief. It allows you to strategize health long-term with the goal in mind to reduce your risk of chronic disease and thrive into menopause
Navigating Through What Hormone Approach is Appropriate for You.
As discussed in Part 1 There’s no question that Bioidentical Hormone Replacement Therapy (BiHRT) is preferred over Synthetic HRT if hormone therapy is indicated in a woman’s situation. If you’ve done any research into BiHRT you’ve probably come up with many different and confusing opinions.
When physicians work with BiHRT, there are different approaches to prescribing. Some apply the research results of the Women’s Health Initiative study (WHI Study) and in some instances it’s not even considered since the hormones used in that study were synthetic hormones.
Allopathic Mainstream Approach
The Standard Allopathic approach at one extreme advocates following the same safety guidelines recommended for prescribing Synthetic HRT since that’s the only large study we have on any HRT. They advocate the same protocols that began in 2002 after the preliminary outcomes of the WHI study. Its use is discouraged in women with a positive family history of breast cancer and heart disease, they recommend using only half of the dose of what was used in the WHI study and they caution its use over 5 years. They are prescribing natural hormones as if Premarin (horse estrogen), and synthetic progesterone are the same as natural hormones (BiHRT). In addition to this, all women are treated the same regardless of age and how long they’ve been without a period. They don’t consider the uniqueness of the woman in front of them, as there is no personalized approach to their prescribing
Longevity approach
On the other hand, the Longevity approach sits at the opposite end in the philosophical approach to prescribing hormones. This approach aligns itself more with the WHI study data that shows that HRT is beneficial in younger menopausal women. In terms of the increased disease risk in older women, they don’t believe the research data on synthetic hormones applies to natural hormones. They also believe because we are living longer, we should mimic the hormone levels we had when we were younger to help support the body’s long-term vitality and prevent disease Some of these physicians are creating hormone protocols that use such high doses of natural hormones women may begin to cycle again.
In between these two camps lay an infinite number of approaches that vary according to the beliefs of the practitioner and the personal beliefs and goals of each woman.
So how does one safely navigate this terrain to discover the most effective and safest way to use hormones? Personalized Medicine holds the key.
Personalized Medicine Approach and Bioidentical Hormone Therapy.
Each woman needs to create her own personalized approach when navigating the best way to thrive into Menopause regardless if she uses BiHRT or not. Using a one size fits all standard prescription, crossing your fingers and hoping for the best, is negligent at this time in your life. Each woman needs their own customized approach, not a protocol based on the beliefs or the opinions of famous movie stars or talk show hosts, or a group class where all woman are treated the same
It’s important to base health decisions on solid relevant research that is aligned with each woman’s risk benefit ratio, personal health history, disease risk, genetics, current health status, symptoms, lifestyle, health goals and beliefs on aging.
How to Begin to Initiate Your Personalized BiHRT Approach
If you choose to support your menopause transition with BiHRT there are important tools to have on board to personalize your approach.
A Partner Physician: You need a physician to partner with who specializes in women’s medicine and is familiar with Bioidentical hormones, Personalized medicine, and Functional and Naturopathic medicine principles to help you customize the most effective and safest prescription for you. If your physician is dismissive, doesn’t address your personal risk factors and concerns, or makes a blanket statement that all hormone therapy is dangerous I would advise you seek a practitioner aware of the final outcome of the WHI study and one who is well versed in personalized or functional medicine
Motivation: You must be willing to do the work to make the lifestyle changes required to optimize your thrive on BiHRT. This isn’t just about taking a medication; it’s about you taking responsibility and doing as much as you can to optimize your body to achieve a healthy hormone balance while on hormones.
Key Principles Of Personalized BiHRT
Ultimately the goal of Personalized BiHRT is to use hormones in the safest possible way to achieve both the short-term health goals as well as the long-term vitality of each woman. How this is achieved is going to be different for each woman based on her past health history, lifestyle factors, biochemistry, genetics etc.
There are many ways to do this when you work with your physician. Below I outline how I apply these goals when working with women in my ‘Restore the CORE Approach’ to Thriving in Menopause to give you an idea of what areas need to be focused on. The program involves a detailed history and is based on each woman’s risk factors. We do a variety of functional medicine lab tests if indicated; imaging like vaginal ultrasounds and bone density testing, genetic testing, urine and salivary hormone testing and screenings for breast health, heart health, bone health, mental health and brain health.
Dr. Plazas Restore the Core Thrive in Menopause Program
The Restore the Core Program is for women whether they choose to do hormones or not. We spend one-third of our lives in menopause. At this time, it is vital to achieve symptom relief whether it is with hormones, herbs, supplements, diet, or lifestyle interventions. It is important to design a personalized program to achieve the health goals of each woman in a way that alleviates symptoms but also prevents chronic disease so a woman can thrive as she ages.
Creating Hormone Balance
It is essential to optimize hormone metabolism. Each woman is unique in how they process hormones in their body. Pouring active hormones into a system that may not be able to handle them correctly is irresponsible and careless. If a woman has had a history of hormone imbalance due to dysfunctional hormone metabolism the same thing may occur on hormone replacement.
1. Hormone History: It’s vital to take a detailed menstrual and gynecological hormone history to gain insight into how each woman metabolizes and utilizes her hormones. This helps us choose the best combination, form and dosage to help a woman balance her hormones.
2. Urine Hormone testing is necessary usually once on BiHRT to give us deeper insight into how a woman is detoxifying and metabolizing her hormones. It also allows us to see if hormone levels are in the targeted therapeutic range to match a woman’s health goals. At this time Urine testing is the most accurate way to look at the metabolism of hormones in the body, but depending on the form of HRT serum or salivary may be added as well. goals.
Optimize Genetics and Nutrition
Each woman is different biochemically and genetically. There are a number of genes and nutrient deficiencies that affect how we detoxify our hormones. These need to be addressed as they can have a profound effect on how we metabolize our hormones and can put us at risk for chronic disease if left untreated long-term. It is also important to look at the whole body for deficiencies or genetic tendencies that put a woman at higher risks for other diseases associated with aging like heart disease, dementia, stroke, osteoporosis, diabetes or breast cancer etc. This needs to be incorporated into the overall treatment plan when considering hormones and designing a long-term dietary lifestyle and supplement protocols tailored for each woman
Revitalize Metabolism and the Biochemistry of Body Systems
The body’s systems need to be revitalized to ensure they are all working optimally so the body is able to process hormones in the most effective and safest way when they are introduced into the body
The endocrine system which involves all the glands that secrete hormones like the adrenals, and thyroid as well as the digestive system and the liver’s detoxification system all play a role in hormone metabolism. We do a detailed dive into testing and optimizing Digestion, Liver health, and Adrenal and Thyroid function.
Energize diet and lifestyle
There are also many dietary and lifestyle factors, that affect our biochemistry and affect the balance of female hormones.
A woman’s diet and lifestyle play a huge role in her hormone balance and risk of chronic disease. Diet, stress, exercise, and mental state all play a huge role in optimizing your hormone balance and disease prevention. All of these can be optimized to help our hormone balance and chronic disease prevention
Conclusion
It’s is vital to your long term thrive to receive ongoing personal prescribing based on your unique biochemistry and health goals to create the safest way to thrive on BiHRT.The ‘Restore the Core’ program primes your body to be more receptive to hormones and removes anything that is standing in the way of their efficacy.
This allows you to achieve the key principle of personalized BiHRT: to use the least amount of hormones in the safest way possible to achieve the health goals of each woman, alleviate symptoms and prevent chronic disease so a woman can thrive as she ages
