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There has been much confusion and misinformation in the web and other media about natural hormones, and what makes a hormone "natural." Popular books and shows on menopause generated a surge in demand for bioidentical hormones over the last two decades.


There is much relief to be gained from hormone balancing measures, and hormone replacement therapy is one strategy for doing so, though it is not appropriate for every woman with a hormone imbalance.  It is essential that the whole clinical picture be considered and underlying conditions addressed.  Fortunately, most of the time hormonal balancing measures are sufficient without adding any exogenous hormones to relieve the symptoms of perimenopause and menopause. Bioidentical hormones have significant benefits over conventional synthetic hormones and fewer side effects when administered appropriately, and this includes treating underlying conditions to get relief from menopausal symptoms. 

Dr. Hoppins is highly skilled in hormone balancing and will help you determine whether hormone replacement therapy is appropriate for you.

Bioidentical Hormones have the exact chemical structure to the hormones the body makes and have the identical effect. Conventional synthetic hormones, Ethinyl estradiol in particular, have a much more potent effect on the liver in relation to their estrogenic effect. Ethinyl estradiol, for instance, is derived from the urine of pregnant mares- hence the old trade name Premarin: Pre- (pregnant) -mar (mare) -in (urine).  Progestins are ubiquitous in oral birth control pills, hormonal based IUDs, Depo shot and mini-pill as norgestimate, levonorgestril, and medroxyprogesterone to name a few of the over 20 progestin drugs that are not bioidentical.  Progesterone is the only natural progestin.

Prescriptive therapy of Premarin has largely fallen out of usage in favor of Estradiol (natural estrogen), though it is still the main hormone used in birth control pills.  It is two molecules of horse estrogen joined together (conjugated equine estrogen) and is difficult to metabolize out of the body. Menopausal symptoms can therefore temporarily reoccur while the body clears the remaining CEE before feeling the effects of bioidentical hormone therapy.  More frequently though in the last several years, women present to the clinic already on BioHRT, but it is no longer working or the side effects are problematic.  

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