Fast Facts About Estrogen Therapy

Hello! I am Cindy Franklin, one of the pharmacists at John Hollis Pharmacy, and I am currently on hormone replacement therapy. I asked John if I could start our series on Hormone Replacement Therapy (HRT) because I have such a strong personal interest in the topic! At John Hollis Pharmacy, we believe that an informed patient has the best outcome. We will be exploring HRT in depth, so know that this week will simply be a quick overview!

Topical estrogen is a better choice for most women.

It will take time to find the best hormone combination.

There are options.

Finally, yes, going through menopause can make you feel like you are losing your mind.

First, when taken orally, estrogen goes through a "first pass effect" in the liver. This means that the liver quickly metabolizes estrogen; so higher doses must be given to reach the desired level of estrogen in the body. Estrogen is well absorbed through the skin so using topical estrogen through a cream or transdermal patch avoids the liver and lower doses of estrogen can be used to achieve the same result. We want to always use the lowest dose possible to get the desired response as this lowers the chance of side effects.

Everyone is unique. There is no "one size fits all" in hormone replacement therapy. Make sure that you have a physician who will work with you, and know that your pharmacist is there to help. Communication and patience are the two keys in this process.

For some patients, a patch is the perfect solution. Another patient may have an allergy to the adhesive, or for others, the amount of estrogen is simply too strong or too weak. The beauty of compounding pharmacy is that your therapy can be customized to fit your needs. The important thing to know is that there are options that can be explored, including sublingual forms of hormones to avoid the first pass effect.

And finally, changes in hormone levels can wreak havoc with your mental state. One patient described it as "I can hear your words, but they feel like bricks that are bouncing off my head." Another talked about her thoughts racing to the point of incoherence prior to estrogen therapy. And this is in addition to the hot flashes, vaginal atrophy and bone loss!

Know that there is relief available, but it does take a working relationship with your physician and pharmacist to obtain the best results. Stay tuned for more information next week!

Making healthy choices for life with John Hollis Pharmacy!