Estrogen Replacement in NYC

Estrogen Replacement in NYC

When I see my patients for their annual medical exams, so many complain of exhaustion, insomnia, sexual dysfunction, getting up at night to urinate. Plus these women look so much older than the had the year before. They may become part of our weight loss practice and many begin receiving cosmetic treatments. But before seeing me, they had all seen their Gynecologists who did not deal with their issues. Maybe one out of fifteen women have been started on Hormone Replacement Therapy and most often its not bioidentical.

The outdated dogma said only treat severe hot flashes and night sweats. If a patient has minimal symptoms, don’t treat them. For vaginal dryness, prescribe an estrogen cream. Treat for as short a time as possible. Only prescribe progesterone if a women has a uterus. If she has had a hysterectomy there is no need for progesterone.

What we feel at Hormone Replacement Doctor is to make sure the patient maintains youthful pre-menopausal levels of estrogen, progesterone and yes even testosterone replacement for women. (see testosterone replacement for women).

Estrogen replacement treats the following symptoms:

  • night sweats
  • hot flashes
  • Estrogen Replacement in NYCdizziness
  • unexplained anxiety and depression
  • poor short term memory
  • fatigue
  • insomnia
  • increase in belly fat
  • sudden increased weight gain
  • crying easily
  • vaginal itchiness and dryness
  • painful sexual intercourse
  • decreased libido
  • increased wrinkles and dry flaky skin
  • shortness of breath
  • palpitations
  • increase in blood pressure and cholesterol
  • headaches
  • frequent urination
  • loss of anal sphincter tone

Clearly the secondary changes that occur due to a loss in estrogen are not good. Patients tell me they feel that they’ve become someone else.

Therapy consists of replacing the deficient hormones with bioientical hormones. After a careful history, physical exam and complete blood work up we will decide what is best for you. After one month, testing will be repeated until hormone levels are where they need to be. The goal is to have you feeling your best. It is also important to reduce osteopenia, risk of heart disease, lower cancer risk, help you with weight management and skin care.

Your prescriptions will most likely be obtained from a very high quality compounding pharmacy, but there are acceptable bioidenticals produced from large pharmaceutical companies as well.   Especially compounded hormones can come in a variety of forms. For estrogen; Estradiol.

E2 is the strongest estrogen. It also imparts the cardioprotective aspect,  especially if it is given orally. Other estrogens such as E3 estriol can also be added to the compounded Rxs.  Transdermal estrogens can be used as well.

There has to be a high degree of compliance meaning if they are not rubbed in really well over a large area of soft skin it is harder to attain therapeutic blood levels with creams.    For Progesterone the oral method is great for those having trouble sleeping. Also, sublingual and transdermal work well.

What’s amazing about this is that we’re  finally beginning to do it! Prior thinking was hormones are bad, dangerous things to be avoided.  Especially, after the WHI study that used nonbioidentical hormones, physicians were not usually recommending Hormone Replacement Therapy.  If they were to be given at all it wouldn’t be until after periods had stopped for a year. Meanwhile the individual woman felt awful. Some women were given and are still getting birth control pills ( non bioidenticals) and having many expected side effects.

Forever Health – Bioidentical Hormones and Wellness
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Sue Decotiis, MD | 120 E 46th St., #1201 | New York, NY 10017 | Phone: (212) 685-3640