Wellness Center of Door County

MENOPAUSE & MID-LIFE
SERVICES

As with most things the decision to use hormone replacement therapy is one that
should not be made lightly. A few years ago, the Women's Health Initiative (WHI)
published results which resulted in the sudden stoppage of hormones by women
all around the United States. As is often the case people were led to believe that
there was a huge number of negative outcomes for women who used hormones
simply because of the way the results were reported.

Upon closer inspection the actual increases in certain conditions were relatively
small (i.e. less than 20 per 10,000 women). The long and short of this study was
the recommendation that women use hormone replacement therapy only if
needed and for the shortest amount of time. For further information please refer
to the links on this website. It should be noted that quality of life issues were not
evaluated during the WHI ---which can be a major issue for women as we
progress through this phase of our lives.

As with any medication there can certainly be risks which are influenced by one's
personal and family health history. One of the great things that came out of the
WHI is that providers now prescribe much lower doses of hormone
replacement therapy than had been done for decades and that decreases
the risks of adverse effects.

Prior to starting hormone replacement therapy we recommend
the following:

Monitoring and actually charting the frequency of the symptoms that you
may be experiencing over the course of a few months
Reflect on how these symptoms are affecting the quality of your life
Schedule an appointment with your medical provider so that a thorough
review of your medical history & physical exam can be completed.
Schedule a discussion appointment with a medical provider who
understands your concerns and can discuss your personal risks
Choose to become an informed consumer of health care---do lots of
research on your own

		Women who have a uterus must use a combination of estrogen and
		progestin which is typically called Hormone Therapy
		Women who do not have a uterus do not need progrestin-typically referred
		to as ET or Estrogen Therapy
		Hormone Replacement Therapy comes in the following forms:

		pill/capsule
		cream that is applied on the skin
		vaginal cream or vaginal ring
		patch
		topical spray that is rubbed onto the skin

Bio-identical hormone replacement therapy is

		frequently perceived as "natural"
		available in a capsule or cream form
		compounded from plant sources versus urine of horses
		NO SAFER to use than chemically manufactured hormones;
		they carry the same risks

		Bio-identical hormone therapy can be compounded/mixed to provide an
		individualized medication dose
		Blood or saliva tests are NOT needed for a provider to prescribe hormone
		replacement therapy. Some women desire this to be done and some providers request these tests to be completed prior to prescribing. This is an individualized decision that each woman and/or provider makes

It may be difficult to decide if the benefits of taking HT/ET are worth the
risks. Every woman is different and has different risks. To limit the risks
involved with hormone replacement therapy, the Wellness Center will
provide you with a thorough examination and prescribes the lowest dose
of hormones to alleviate your menopausal symptoms. Your initial visit will
include a health history, physical examination, laboratory tests, and
counseling.

To make your decision, be sure to discuss your personal risks with your
medical provider who will prescribe the lowest doses for the shortest
period of time needed to relieve your symptoms.

If you choose hormone therapy, be sure to return for regular checkups to
make sure the treatment is working well for you. Return sooner or call
your provider if you have problems. Your health and wellness is
important to us

It's inevitable that you'd reach this stage sooner or
later---so welcome! Mid-life is one of those stages
that we all go through and learn that there is a new
meaning to being "HOT"! The average age when
most women will stop having regular menstrual
cycles is typically around 52. When a full year
without any menstrual bleeding occurs---a woman is
said to have completed menopause.

The period of time before a woman reaches menopause is called the
perimenopause and can last anywhere from 2 to 10+ years. During this time it is
quite common for a woman to experience any or all of the following:

Disrupted sleep
Not feeling rested in the morning
Feelings of warmth and/or hot flashes during the day and/or night
Night sweats
Vaginal dryness

We do know that the following things can influence the presence of the above
vasomotor symptoms:

Alcohol - and sometimes it takes only one glass of beer or wine
Consumption of caffeine
Emotional issues/stress
Lack of steady state physical activity ---in particular aerobic exercise

HORMONE REPLACEMENT THERAPY:
IS IT RIGHT FOR YOU?

	Increased Risk	Decreased Risk
Osteoporis		X
Colon Cancer		X
Breast Cancer NOTE: HRT has not been proved to cause breast cancer; may result in its appearance/detection sooner	X
Stroke	X
Heart Disease	X

HORMONE REPLACEMENT THERAPY & THE
WOMEN'S HEALTH INITIATIVE RESULTS

"The choice to use hormone replacement therapy is always a personal
decision for each woman and should occur after a thorough exam and
discussion of her personal risk factors with her medical provider."

SOME KEY POINTS YOU NEED TO KNOW

Benefits of HT/ET may:

Relieve hot flashes and other perimenopausal

symptoms

* Relieve vaginal dryness associated with

menopause

* Improve a woman's feeling of well-being during

perimenopause

menopause

* Reduce the risk of osteoporosis

* Reduce the risk of colon cancer

Side-effects of HT/ET can include:

Breast tenderness

* Nausea

* Water retention and/or bloating

* Symptoms of PMS

* Headaches

* Acne

* Minor side effects usually require no treatment and may

resolve

three months

If side effects persist return to your medical provider who may
change your dose or the combination of hormones.

WHAT ARE MY OPTIONS?

Remember that our nutritional and activity needs change as we
get older! Pay attention to these things as they can help you feel
vital and energetic throughout life.

		EXERCISE, EXERCISE and EXERCISE!!!! Walking 10,000 steps
		every day will keep you filled with vitality, maintain a healthy weight and most importantly maintain the density of your bones!
		DIET: Increase whole grains, fruits and vegetables while you
		decrease sweets, high-fat foods, caffeine and alcohol

		Once you're post menopausal your need for calcium
		increases and it is recommended that you take 1500 mg daily either through your diet and/or calcium supplementation

		HERBAL PRODUCTS: Providing you have no risk of blood
		clotting problems (previous history of stroke, or blood clots in your legs, lungs, etc. Many women report symptom relief when using over the counter products such as

Black Cohash, Soy, Vitamin E, Dong Quai, etc.

Studies do not really demonstrate that these are universally
effective---but each woman is different

Remifemin or Estroven

For some women, a simple change in lifestyle may be all that's needed to prevent menopausal symptoms. But a thorough
examination and discussion about menopause with the caring
clinicians at the Wellness Center can help you choose the best
option(s) for you!

LIFESTYLE CHOICES

If you'd like to make an appointment for an exam and/or to discuss
perimenopause or menopausal issues at the Wellness Center
simply call (920) 746-9444

SAVE YOURSELF SOME TIME BY DOWNLOADING AND
COMPLETING PATIENT FORMS PRIOR TO COMING IN FOR YOUR
FIRST APPOINTMENT!

Order a copy of the 6th Edition of The Menopause G uidebook
published by the North American Menopause Society