Uterine fibroid, or leiomyoma, is a common condition of the uterus that can occur in at least 50% of women who are of reproductive age. The presence of fibroid is benign and they are usually asymptomatic so not all women may be aware that they have this condition. Hormonal imbalance can affect fibroid growth in women but the good news is that most signs of fibroids are said to improve after menopause.
So how will hormone replacement therapy for menopausal women with history of leiomyoma work, and is it safe to take? Many women take hormone therapy to help with their menopausal symptoms, and those with a history of leiomyoma may safely take HRT to manage severe symptoms of fibroids like abnormal bleeding. There are available low-dose HRT medications and those that can inhibit estrogen production to prevent new growths or shrink the fibroids.
Uterine fibroids, also called uterine myoma or uterine leiomyomata, are noncancerous growths of muscular tumors that form on the walls of the uterus. Often, fibroids can appear as small and tiny as a seedling but in some cases, they can grow unusually large and put pressure on the other body organs and affect the size of the uterus.
Fibroids can be further classified depending on the area where they grow. The common types of fibroid growth are:
Fibroids are a complex medical condition and it is often hard to pinpoint the exact cause of these growths. There are certain risk factors that are said to contribute to the development of fibroids such as age, genetics, family history, obesity, and high blood pressure.
There are few cases of fibroids that come with symptoms, and it is usually affected by the size and location of the growth. The common signs of uterine fibroids in a perimenopausal or postmenopausal woman are:
Fibroid symptoms can be similar to other medical conditions that can affect a woman’s reproductive organs such as ovarian cyst (fluid-filled sacs in the ovary) and endometrial polyp (tissue growths). In some cases, the growth of fibroids may attach themselves to the uterine lining and affect the endometrial thickness, resulting in endometrial hyperplasia.
Most of women’s reproductive organs and functions are influenced by the presence of estrogen and progesterone. These female hormones affect the lining of the uterus and uterine fibroids, which grow on the walls of the uterus, are also believed to be caused by these two hormones.
There are studies that show how fibroids are hormone-sensitive growths in the uterus. For one, women who are pregnant usually have high hormone levels. The estrogen and progesterone during pregnancy prepare the uterus to be a suitable environment for the developing baby. In the same way, this increase in hormones can affect the size and growth of uterine fibroids.
Leiomyomas can also develop or worsen their symptoms every menstrual cycle where estrogen levels tend to fluctuate. Most experiences of painful periods or menstrual cramps can be attributed to the presence of uterine fibroids. However, many doctors believe that fibroids can improve once a woman reaches menopause.
Menopause is a normal life stage where a woman stops having her period. During this transition, it’s common to have hormonal imbalance since the body experiences significant drops in the female hormone levels.
Women approaching menopause may experience worsening symptoms of fibroids for a period of time. But after menopause, the chances of developing new fibroids are low since the decrease in estrogen levels is not enough to support its growth. Some doctors also say that fibroids can shrink in size during the menopause or postmenopause stage.
Hormone replacement therapy has long been used by many women for relieving common menopausal symptoms such as vaginal dryness, hot flashes, night sweats, irritability, sudden mood swings, aches and joint pains, and menopausal hair loss.
It is a treatment that is known to significantly improve the quality of life for many older women who are menopausal or postmenopausal. In fact, HRT can also lessen the risk of chronic conditions that can affect postmenopausal women such as osteoporosis, colorectal cancer, and even diabetes.
Hormone replacement therapy is a treatment that allows women to replace the essential hormones that their body stops producing at menopause. Women who have had undergone a hysterectomy to remove their ovaries are also given hormone therapy to alleviate symptoms of early menopause.
Hormone therapy medications are available in a variety of forms and deciding on which HRT type to take will depend on the doctor’s recommendation, your preferences, and your current condition. Generally, HRT can be classified into different kinds according to what hormone type is given:
Hormone therapy can also be considered as an effective treatment for uterine fibroids. However, when choosing the right medication, menopausal patients with a history of leiomyoma should avoid taking pure estrogen therapy alone. As much as possible, the doses of hormones in HRT medications for patients with leiomyoma should be low to avoid complications with the fibroids.
The types of hormone treatments that can help with uterine fibroids are hormonal agents, progestin-releasing intrauterine devices, contraceptives or birth control pills, and GnRh agonists. These hormone medications can relieve discomfort from fibroid symptoms and may help shrink their size by preventing the effects of estrogen and progesterone.
Hormonal medications include selective progesterone receptor modulator (SPRMs) drugs such as medroxyprogesterone, mifepristone, and androgen drugs like Danazol can be prescribed to treat abnormal bleeding or heavy menstrual periods. These medications can work to block the activity of progesterone and control the growth of fibroids.
Intrauterine devices are a type of contraception device that is directly inserted into the womb or uterus. These usually contain progestin which is the synthesized and artificial form of progesterone hormone. When placed in the uterine cavity, the device will continuously release progestins that can prevent the uterine lining from building up and reduces uncontrollable heavy bleeding induced by fibroids.
Using intrauterine devices can cause certain side effects such as breast swelling or tenderness, acne, spotting between periods, headaches, nausea, and skin conditions like acne.
Birth control or oral contraceptive drugs are medications used to prevent possible pregnancies. It works by preventing the ovaries from producing eggs that can be fertilized during ovulation period. Birth control pills may contain both estrogen and progesterone hormones or progesterone alone.
While it primarily serves to control pregnancies, women with heavy flow of blood during menstrual cycles may also take these contraceptives to reduce the heavy bleeding. They may not have a direct effect on shrinking fibroids but they can provide short-term relief from its unpleasant symptoms.
The common effects of taking birth control pills are headaches, nausea, fluid retention, weight gain, and high blood pressure. These drugs may also increase risk of blood clot or deep vein thrombosis in older women. In some cases, taking contraceptives may increase the size of uterine leiomyoma so patients are usually advised to discontinue the medications and see a doctor if this happens.
Gonadotropin-releasing hormones, also known as GnRh agonists, are medications that can impede with the production of estrogen hormone in the ovaries. Since estrogen can influence the development of uterine leiomyoma, taking GnRh agonists can temporarily block the activity of estrogen which in turn can help reduce the size of the fibroids.
One of the common drugs in the GnRH agonist family is leuprolide (Lupron). This is usually administered via injections and it is prescribed for women who have serious heavy and abnormal uterine bleeding every menstrual period. Long term use of these medications is usually not recommended because of its side effects. It can cause severe menopausal symptoms such as hot flushes, night sweating, vaginal dryness, and may increase chances for bone loss or osteoporosis.
These medications can help decrease the growth of the symptomatic fibroids before undergoing surgery. Stopping GnRh agonists will trigger the uterine leiomyomata to grow back and return to their original size. If you’re taking these medications, it’s best to have regular check-ups and exams with a doctor to see if your fibroid condition worsens.
Hormone therapy is a safe treatment as long as it is regulated and taken under a doctor’s advice. Menopausal women with history of leiomyoma can safely receive HRT and benefit from its effects since there are available medications with low concentrations of estrogen and progestin and those that can suppress its effects.
However, there are certain cancer risks that come with taking long-term HRT. Women who take estrogen therapy for prolonged periods may have increased endometrial cancer risk, breast cancer, cardiovascular disease, and ovarian cancer. While in some women, combination therapy may reduce the risk for endometrial cancer and colon cancer.
To be on the safe side, taking HRT for treatment and relief of menopause symptoms should only be taken for two to three years. If you’re prescribed with HRT and you have fibroids, you will need to have regular examinations to see how your fibroids are responding to the hormone treatment.
When you decide to quit hormone therapy, you need to discuss with your healthcare provider about lowering the dose before completely stopping the medications. This is done to help the body adjust to the low levels of hormones and stop depending on the medications.
Uterine fibroids are commonly diagnosed during a pelvic exam where a doctor will examine for any abnormalities inside the uterus. An endometrial biopsy or hysteroscopy may also be performed to confirm any cancerous growths and take out the fibroids.
Most of the time, surgery for uterine fibroids are considered for severe cases that don’t respond to medications. Here are the possible medical procedures for uterine leiomyomata:
For myoma that causes abnormal uterine bleeding, an endometrial ablation may be performed to reduce its symptoms. During this procedure, a surgeon will remove or destroy the uterine lining to stop the bleeding. It usually uses radiofrequency energy to damage both the lining and shrink the fibroids. However, there are some doctors that may use the cryomyolysis technique to freeze the fibroids instead of heating them.
This procedure is usually assisted with a laparoscopic ultrasound tool to help locate the fibroids. Once the fibroids have been detected, another device will insert tiny needles that will emit the radiofrequency waves to destroy the myoma. It’s still considered a minimally invasive treatment since it doesn’t require any large incisions and recovery will only take a few days.
A myomectomy surgery removes the fibroids while keeping the uterus intact. This is an ideal option for younger women who want to improve their symptoms but still want to have children in the future. There are different approaches to performing a myomectomy:
Another major surgical procedure to remove the fibroids is a hysterectomy. During this procedure, the whole uterus is removed and this makes sure that the fibroids are gone for good. One downside to this operation is that a woman can no longer try to get pregnant. For menopausal women, the ovaries may also be removed during the hysterectomy to stop menopause symptoms.
Depending the size of the uterus, the procedure may be performed via taking out the uterus from the vagina (vaginal hysterectomy), through an incision on the lower abdomen (abdominal hysterectomy), or laparoscopically. Generally, women with a large uterus are not be eligible for the laparoscopic approach.
This procedure is also known as uterine fibroid embolization. This technique completely hinders the flow of blood to the fibroids, stopping their development and eventually causing them to decrease in size.
This is usually done in a radiology room rather than an operating room since it’s less invasive compared to the myomectomy and hysterectomy. This treatment only needs injections of small particles called polyvinyl alcohol into the arteries that supply the fibroid. The injected substance will block the blood supply so that the fibroids will stop growing.
Menopause and fibroids are two common occurrences for a woman. In fact, they may go hand-in-hand since fibroid growth becomes more prevalent as you near the menopause stage. And while most fibroids are not dangerous, it doesn’t mean that you have to endure the discomfort from its symptoms.
Get safe and effective hormone replacement therapies to help with your menopause and fibroids symptoms at Revitalize You MD. We are committed to helping you achieve overall health and wellness by restoring the balance to your hormones. Consult with us today and receive a personalized HRT plan for your needs.
Menopause symptoms can be managed with hormone replacement therapy (HRT), also called menopausal hormone therapy, which is a treatment that replaces hormones that are at a lower level. The treatment’s current role is to relieve menopausal symptoms. These symptoms include hot flushes, mood swings, night sweats, reduced sex drive, and vaginal dryness.
So what’s the safest natural female HRT? The two main types of natural HRT are bioidentical hormone replacement therapy and traditional natural hormone replacement therapy, and those two are the safest ones. The former is derived from plants and is chemically identical to the hormones that our body produces. The latter involves the consumption of supplements or plants that have compounds that could alleviate hormonal symptoms.
The average menopausal woman could have concerns about conventional HRT and would rather go for natural options. Bioidentical hormone replacement therapy and traditional natural hormone replacement therapy would be the safest and best options to treat hormonal imbalance.
Bioidentical hormone therapy or bioidentical HRT can treat hormonal imbalances and depletion with a synthetic hormone that originated from plant estrogen. With that, you can say that bioidentical hormones are like hormones that have the same molecular structure as the ones that the human body can produce naturally. Moreover, the majority of BHRTs have plant hormones that mimic estriol, progesterone, dehydroepiandrosterone (DHEA), and melatonin.
The two types of BHRT are United States Food and Drug Administration (FDA)-approved BHRT, which are quite similar in terms of safety as the standard HRT medications, and custom-compounded BHRT medications, wherein a pharmacist would mix according to what the doctor prescribed.
The benefits of bioidentical HRT include the following:
Traditional natural hormone replacement therapies essentially mean consuming supplements or plants that contain compounds that could alleviate hormonal symptoms. These supplements and plants include:
When it comes to their benefits, some experts don’t believe that BRHTs are any safer or more effective when compared to the traditional natural HRTs.
When it comes to comparing the two natural HRTs, it’s important to note that bioidentical hormones differ from those in traditional HRT in the sense that they’re chemically identical to those that our bodies naturally produce. They’re also made from plant oestrogen.
According to bioidentical HRT supporters, it’s a lot safer because it’s identical to the hormones that the body produces, but experts believe that the risks of HRT and bioidentical HRT are similar. Compounded bioidentical hormones or compounded bioidentical hormone therapy may have more risks, but there has been no reliable evidence proving that BHRT is more effective when compared to HRT.
The conditions that natural HRT treats are hormonal imbalances, symptoms of perimenopause, and symptoms of menopause.
Hormones are produced in the endocrine glands and tell your organs and tissues what to do. They help in controlling your body’s major processes such as reproduction and metabolism, but when you have a hormonal imbalance, you have too little or too much of a certain hormone. In general, your normal hormonal cycle could change during stages of puberty, pregnancy, breastfeeding, and menopause.
Hormonal imbalance symptoms that are specific to females include:
By definition, perimenopause is “around menopause.” It’s essentially the time wherein your body naturally transitions to menopause and marks the end of your reproductive years. When you’re at your perimenopause stage, you’ll begin to notice signs of progression to menopause such as irregular menstruation.
During perimenopause, the estrogen level in your body rises and falls unevenly and your cycles may shorten or lengthen. The perimenopause stage ends when you’ve gone through 12 whole months without a menstrual period. That’s when you know you’ve already reached menopause.
As you transition to menopause, there may be some changes and symptoms such as:
Menopause marks the end of your menstrual cycles and is a natural biological process. However, you have to be ready for both physical and emotional symptoms. It’s also important to note that conditions that affect the health of the ovary, such as ovarian cancer and endometrial cancer, can increase the severity of menopause symptoms.
Apart from menstruation changes, the symptoms for perimenopausal, menopausal, and postmenopausal women are generally the same.
Other common symptoms of menopause are:
Any treatment we go for will always have its pros and cons. It’s important to take note of the pros and cons of BHRT so we know what to expect.
| Pros | Cons |
| BHRT helps increase the lower levels of hormones. It improves symptoms such as: Sleep problemsHot flashesWeight gainMood swingsNight sweatsLoss of sexual arousal or desirePain during sex | Even though the FDA has already approved the preparations of progesterone and bioidentical estradiol, it’s yet to approve compounded bioidentical hormones (Natural progesterone is a hormone that naturally occurs in the body, and micronized progesterone is FDA-approved for use with estrogen as an element of HRT. According to NCBI, micronized progesterone and progestogen are recommended as part of combined HRT in women who have an intact uterus). |
| Hormone replacement reduces the risk of diabetes, tooth loss, and cataracts. | Hormone replacement therapy can increase breast cancer risk and the risk of the following: Blood clotsStrokeHeart diseaseGallbladder disease |
| Hormone replacement can improve the thickness, hydration, and elasticity of one’s skin. | The common side effects of BHRT include: FatigueMood changesAcneBloatingIncreased facial hairWeight gain |
Bioidentical hormones can be given through patches, pills, creams, gels, implanted pellets, and shots. Your doctor is the best person to decide which one is best for you, but you can try more than one way before you find what works best.
If you worry about your safety with the treatment, it’s comforting to know that those on hormone treatment are watched closely by their doctors. They also adjust the doses according to a patient’s needs. Your doctor may also adjust your dose according to your changing hormonal needs. According to the International Journal of Pharmaceutical Compounding, bioidentical HRT is a more natural and safer alternative to synthetic progestin.
The FDA-approved bioidentical hormones have been tested for safety, so you’re sure that you’re getting reliable treatment. They have also passed the FDA’s strict standards. However, the compounded hormones haven’t gone through FDA testing yet, and only a little research has been done. They also haven’t been proven safe or unsafe. A recent report from the National Academies of Sciences, Engineering, and Medicine also says that the use of compounded bioidentical HRTs should be limited to only a small number of patients — specifically patients who aren’t able to benefit from a hormone therapy product that has already been approved by the FDA.
Alternative treatment options can help menopausal women manage the physical and psychological symptoms related to hormonal imbalance and depletion, such as:
Before trying alternative remedies, talk to your doctor first because some supplements may interact with prescription medications or harm people with certain medical conditions.
Treatments such as conjugated equine estrogen (commonly sold under the brand name Premarin) and estrogen therapy are used to treat menopausal symptoms, but the best one you can go for is bioidentical HRT. And there’s no better place to perform bioidentical HRT than Revitalize You MD. Here at Revitalize You MD, our medical staff will first assess your needs before treating you with bioidentical HRT products. We value our patients’ safety, so we also treat them depending on their specific imbalance.
Our team consists of certified and licensed staff who have a wealth of medical knowledge and experience to serve you. Call us now at (678) 304 – 1850 or send us an email at info@revitalizeyoumd.com to schedule your appointment.
Hormone replacement therapy (HRT) or menopausal hormone therapy is a treatment used to relieve menopausal symptoms such as mood swings, night sweats, vaginal dryness, and hot flashes. An average menopausal woman who experiences menopause symptoms and hormonal imbalance/hormone imbalance (defined as either hormone deficiency or high hormone levels) would ideally take HRT to relieve her symptoms.
But can HRT actually be a benefit to senior women? Any treatment will always come with its share of pros and cons, but with HRT, it’s better to start early so the benefits will outweigh the risks. Hormone therapy must therefore start before the age of 60 or within a decade of menopause to avoid blood clots, breast cancer, heart disease, and stroke.
Hormone replacement therapy is believed to improve the quality of life and prolong the life of elderly women regardless of whether it was started at menopause or later, but it comes with some risks, and many reports claim that it’s better to start HRT early. Postmenopausal women should be properly oriented and educated about hormone replacement therapy, especially the fact that estrogen can lower the chances of death and disability from osteoporosis and cardiovascular disease.
Cleveland Clinic reported that one study has shown that hormone therapy that began early in postmenopausal women reduced death rate, heart failure, and heart attacks by a significant amount. These women who began taking hormone therapy early and used it for more than a decade were not at risk of stroke or breast cancer.
Hormone replacement therapy that had an estrogen-progestin pill (Prempro) increased the risk of blood clots, breast cancer, heart disease, and stroke. In addition, those who start hormone therapy at age 60 or older, or more than a decade from the onset of their menopause, are at greater risk of the mentioned conditions. This is why hormone therapy must begin before the age of 60 or within a decade of menopause.
When it comes to bone health, hormone therapy has a lot of bone health benefits for women up to 60 years old. In some cases, they may continue HRT after 60 depending on their bone density and general health, among others. But one must note that it’s not very common to begin hormone therapy for bone health at 60 or after that. This is because, by the time we reach 60, our arteries become stiffer and women are more at risk of cardiovascular disease.
In general, HRT for women above 65 years old is still quite controversial. While there are still limited data about this, some research claims that women shouldn’t start HRT after they turn 60.
When you approach menopause, your ovaries produce less progesterone and estrogen. Progesterone is a hormone that occurs in the body naturally, and estrogen is a hormone that’s responsible for reproduction (Micronized progesterone is approved by the FDA for its use with estrogen as an element of HRT).
These hormones can affect the condition of your heart, your bones, and your vagina. Thankfully, it’s possible to replace these hormones with ones made in a lab — which is what we know as hormone replacement therapy or menopause hormone therapy.
While HRT can ease menopausal symptoms, we must first understand its benefits and risks.
HRT can:
More than this, HRT can also be beneficial to your health after menopause. HRT can also:
However, a document published by the American College of Obstetricians and Gynecologists explains that HRT shouldn’t be used for the prevention of coronary heart disease. This is because there isn’t enough evidence to confirm that long-term estrogen therapy/estrogen replacement therapy or hormone therapy use can improve cardiovascular-related outcomes.
On the other hand, a 2009 publication by NCBI reported that oral HRT has been associated with a 63% relative reduction in colorectal cancer risk in postmenopausal women after necessary adjustment for other known risk factors.
The Women’s Health Initiative’s findings in 2002 show that HRT may slightly raise the chances of breast cancer, stroke, and heart disease in women who went through menopause and took a combination of estrogen and progestin (a form of progesterone).
It’s important to note, though, that many of the women in the study were above the age of 60 and the results weren’t clear. The publicity of this still caused many women to stop or not begin doing HRT.
Research has since shown that the benefits of HRT can be greater than the risks, but HRT can still heighten the risk factor of:
When researching HRT, you may come across the term “bioidentical hormones” or “bioidentical hormone replacement therapy.” Bioidentical hormones are man-made estrogen and progesterone, so chemically, they’re the same as your hormones. While some of them are made by drug companies and are FDA-approved, others are produced by pharmacists according to doctors’ orders. They’re called compounded, and compounded bioidentical hormones haven’t been tested by the FDA for safety.
When you hear that bioidentical hormones are “natural,” it means they come from plants or animals, but they still need to be processed.
Here are some measures you can take so hormone therapy will be less likely to cause issues:
Your doctor may recommend against HRT if you have or have had:
If you wish to start HRT, be sure to first discuss the benefits and risks with your doctor, and be sure to consider your medical history, age, personal preferences, and risk factors. For most women who use HRT for short-term treatment of menopausal symptoms, the benefits usually outweigh the risks.
HRT is a licensed treatment for osteoporosis prevention and can also be the choice of treatment for those starting treatment below 60 years old, especially those with premature or early menopause (Early menopause, or menopause before you’re 45, could mean that you don’t have enough estrogen that will protect the body, so you may need HRT to prevent disease). When you begin to feel menopausal symptoms, you could see a doctor to discuss what to do and how to proceed.
HRT can usually begin as soon as you start noticing symptoms of menopause. Let your doctor explain the different types of HRT available so she could also help you choose the best one for you (some options for treating menopausal symptoms include conjugated equine estrogen and systemic hormone therapy or systemic estrogen).
Hormone replacement therapy is an effective and safe way to treat your symptoms, but some people still like to rely on home remedies to help them with their symptoms. Some alternatives include:
Always remember that even though some alternative therapies have been backed by research, others have only anecdotal evidence as their support. Be sure to discuss with your doctor or healthcare provider before trying alternative treatments.
Treatments such as vaginal estrogen are commonly used to treat menopausal symptoms (e.g., vaginal dryness, itching, and burning), but the best and safest treatment you can go for is bioidentical hormone replacement therapy — especially with Revitalize You MD.
At Revitalize You MD, our reliable medical staff will first do an assessment of your needs before they treat you with bioidentical hormone replacement products. We also treat patients depending on their specific imbalance, and we guarantee excellent and quality care. If you’re interested in receiving BHRT from us, contact us now at (678) 304 - 1850 or info@revitalizeyoumd.com.
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