Reflections Wellness and Spa - Hormone Replacement Therapy

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Hormone replacement therapy (HRT) is a medical treatment designed to alleviate menopausal symptoms by replenishing diminishing hormone levels. As women approach menopause, the production of key female hormones, such as estrogen, progesterone, and testosterone, significantly decreases.

This hormonal imbalance often leads to discomforts like hot flashes, night wears, vaginal dryness, and mood swings. HRT restores hormonal balance, improving the quality of life for individuals experiencing these challenges.

There are various forms of hormone therapy, each tailored to address the specific needs of every individual. These include estrogen therapy (used for postmenopausal women), combined hormone therapy (a mix of estrogen and progesterone for those with a uterus), and testosterone therapy (for those needing additional support for libido and energy levels).

According to a study published by the JAMA Health Forum in 2024, the prevalence of menopausal hormone therapy (MHT) use among postmenopausal women in the U.S. declined from 26.9% in 1999 to 4.7% in 2020. This significant decrease underscores the importance of understanding HRT’s role and benefits in managing menopausal symptoms.

This article explores the types, benefits, and considerations of HRT, providing a comprehensive guide for those considering hormone replacement options.

 Hormone replacement therapy (HRT) is widely used to manage various health conditions resulting from hormonal imbalances. Its primary applications include alleviating menopause symptoms and addressing other hormone-related deficiencies. HRT provides a tailored approach to improving quality of life by restoring female hormones like estrogen, progesterone, and testosterone. 

1. Menopausal Symptoms: HRT effectively reduces menopausal symptoms of

• Hot Flashes
• Vaginal Dryness
• Night Sweats
• Mood Swings
• Muscle Loss
• Abdominal Belly Fat
• Poor Sleep
• Fatigue
• Low Energy
• Depression
• Anxiety
• Irritability
• Lack of Focus
• Low Libido
• Foggy Thinking

1. Low Testosterone Levels: In both men and women, testosterone therapy helps improve energy, muscle mass, and libido.
2. Premature or Early Menopause: Women undergoing premature menopause due to medical conditions or surgeries, such as hysterectomy, benefit from hormone supplementation.
3. Bone Health: Estrogen therapy plays a critical role in preventing bone loss and reducing the risk of osteoporosis.

1. Symptom Relief: HRT alleviates uncomfortable vasomotor symptoms like hot flashes and night sweats, improving daily life.
2. Sexual Function: Addresses vaginal dryness and discomfort, enhancing sexual health and intimacy.
3. Improved Cognitive Function: Research published in Alzheimer’s Research & Therapy indicates that hormone replacement therapy (HRT) may positively influence cognitive health, especially in women carrying the APOE4 genotype, which is linked to a higher risk of Alzheimer’s disease. The study found that HRT is associated with enhanced memory performance and increased brain volumes when initiated during early menopause.
4. Improved Bone Health: Menopause accelerates bone loss by up to 20% during this stage, leading to a higher incidence of osteoporosis and fractures. HRT has been shown to help maintain bone density and reduce the risk of fractures in postmenopausal women. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) reports that estrogen loss during menopause is linked to decreased bone mineral density, increasing fracture risk.

EvexiPEL is the flagship therapy of EVEXIAS Health Solutions. This method delivers life-changing bioidentical hormone therapy. EVEXIAS achieves this exclusively through strategic partnership with a leading compounding pharmacy and FDA-registered 503B outsourcing facility. This comprehensive approach combines physiological principles with innovative techniques to optimize hormone levels in both women and men.

If you experience a combination of fatigue, depressed mood, and lower/absent libido, you may have Androgen Insufficiency Syndrome (AIS). Hormone Replacement Therapy (HRT) is a highly effective treatment for AIS. Additionally, if you prefer a minimally invasive procedure every 3-4 months (4-6 months for men), you are an ideal candidate.

Other symptoms that often improve with bio-identical hormone optimization include insomnia, early waking, anxiety, lack of energy/drive, lethargy, joint pain, and daytime sleepiness.

To confirm a suspected diagnosis of AIS and begin your evaluation, your physician will order lab work to assess your hormone levels. These results will be discussed during your initial consultation.

Initial bloodwork is performed to establish baseline hormone levels, aid in diagnosing AIS, and assess any imbalances in other major hormone systems (e.g., adrenal, thyroid). These values will help determine your initial dosage.

Four weeks after your first pellet insertion, you will have repeat labs (a smaller panel). These results will be reviewed at your six-week follow-up visit.

Thereafter, a full panel of labs is drawn annually. If you experience any significant changes in symptoms related to hormone therapy, your nurse practitioner will recommend reassessment at that time.

The EvexiPEL method features the patented - pellet that is plant based and derived from yams and designed to be an exact replication of what the body produces in contrast to synthetic

hormones. This pellet is specifically designed to improve patient comfort and deliver sustained, steady dosing throughout the treatment cycle

The individual ingredients within the pellets are FDA-approved, and the distribution of these pellets is regulated by the FDA. However, the pellet insertion procedure itself is not FDA-approved. It's common for physicians to prescribe medications or therapies for uses not explicitly approved by the FDA (off-label) if they believe them to be safe and effective for their patients. The reason bio-identical hormones (compounded drugs) are not FDA-approved is due to their individualized dosing nature.

Pellets are inserted using a very minor surgical procedure, performed in the office setting and requiring only local anesthesia. Using a very small incision (~ 1-2 cm in women, ~ 3-4 cm in men), they are inserted subcutaneously below the belt and above the buttock in women, and in the posterior flank in men. Recovery is very quick and uncomplicated; exercise restrictions for 3 days in women and 5 days in men are simply to avoid complications.

There are no serious or permanent side effects. In some cases, nuisance side effects can occur, such as hair growth or acne, both of which are very treatable.

There is no direct causative link between bio-identical estrogen, progesterone, and breast cancer. The Women's Health Initiative (WHI) study in 2003 raised concerns about "hormones and breast cancer," but a long-term follow-up study published in JAMA in 2017 by one of the original WHI authors found no increased mortality from breast cancer in the subjects over an 18-year period.

The number of patients receiving HRT 5 to 10 years after breast cancer treatment and remission is increasing. However, hormone use in patients with a history of hormone-receptor-positive tumors is not yet considered standard care. The decision to use hormones in this situation is an informed one that the patient must make for herself.

Finally, patients with or recently recovered from breast cancer can receive testosterone alone to help manage both AIS and menopausal symptoms.