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Simply Go To Our Website Home Page http://www.thehealthychoice.net and click on the FREE Hormone Analysis.

Treatment Options for Vaginal Atrophy:

What Do the Newer Studies Show?

As women enter the menopausal age, hormones start declining, and without therapy, symptoms of menopause become exacerbated. With this hormone loss, the vaginal epithelium becomes atrophic and physiological lubrication is reduced. This can lead to physical discomforts such as vaginal dryness, irritation, itching, burning, dyspareunia, all which can lead to decreased libido, causing sexual distress both to the patient and her partner.

Conventional treatments include intra-vaginal conjugated estrogen or estradiol; however, other studies have provided compounders with alternative choices. Vaginal moisturizers can improve the balance of intracellular fluids in the vaginal epithelium. Vaginal lubricants have more of a short-term action as they act as a mechanical barrier between the vaginal epithelium and the external environment, improving the dryness related to sexual activity.

In 2008, Constantino and Guaraldi published a study that utilized a vaginal suppository containing hyaluronic acid sodium salt 5 mg, vitamin E acetate 1 mg, and vitamin A palmitate 1 mg. Dosing was a suppository intravaginally every night for 14 nights, then tapering to every other night for 14 nights. Of 150 women, 126 women completed the study in full. The study assessed efficacy of the study medication in the areas of burning, itching, dyspareunia, inflammation and irritation. Results showed that any symptom that was reported as severe initially was resolved to either mild or absent at the end of four weeks.¹

Hyaluronic acid helps to form an extracellular water film, which moisturizes the skin, maintaining a water balance aiding in skin elasticity. It also facilitates the healing process and tissue regeneration. Vitamin E, which has antioxidant properties, also acts as an anti-inflammatory and healing agent. Vitamin A has been shown to increase the function of the immune local cells and the epithelium of the vagina.

Chollet et al evaluated the safety and efficacy of a vaginal suppository compound for vaginal atrophy. Estriol 1 mg and progesterone 30 mg was given daily for two weeks, then three times weekly for a total of six months. In a study group of 19 women, results showed improvement in vaginal pH, vaginal dryness, and libido. Follow-up endometrial biopsies were performed, and no hyperplasia or carcinoma were noted at six months of treatment. Serum estriol concentrations were taken at baseline, preinsertion of the dose, five hours post-dose, at week two, and at months three and six. What is interesting to note is that the estriol serum level did not differ statistically from the baseline to preinsertion dose, at week two, or months three or six, suggesting that estriol has minimal systemic accumulation, as reflected in the study.

Serum progesterone levels increased at all time points, with a median serum level that was less at month six when compared at month three. Also, preinsertion serum levels were higher at week two than at month three, indicating that absorption of intravaginal progesterone 30 mg dose during maintenance phase does not gradually increase. Side   effects noted were early vaginal spotting (which resolved, no recurrence), and vulvar and vaginal irritation.²

Although many groups have stated their positions regarding the use of progestin in women with a uterus while taking estrogen, Chollet et al mentions that other studies utilizing unopposed intravaginal estrogen had increased endometrial thickness. While the patient population was small in the estriol and progesterone intravaginal study, it confirms that the medications were well tolerated, and endometrial hyperplasia did not occur at these doses of hormones.² Estriol 1 mg/progesterone 30 mg vaginal suppository formula.

Lastly, dehydroepiandrosterone (DHEA) has been studied for libido and sexual dysfunction in postmenopausal women. Intravaginal doses studied include 3.25 mg, 6.5 mg, and 13 mg versus placebo. A parameter of this study considered the benefit of intravaginal DHEA on vaginal atrophy, dryness, and itching. Results showed that at the end of 12 weeks, all three doses had an equal benefit on vaginal dryness and no adverse events were reported. On the domain of arousal lubrication, the 13 mg dose achieved the best score, although all three doses showed tremendous benefit at 12 weeks.³ Serum steroid levels were evaluated in a separate study and found to be within the normal postmenopausal range.⁴

The Constantino and Guaraldi study provides a non-hormonal treatment for some women, in addition to intra-vaginal Vitamin E. These studies provide great marketing material for some practitioners, and you can obtain them from PUBMED (www.ncbi.nlm.nih.gov/pubmed/) for a fee.

Contact: The Healthy Choice Compounding Pharmacy for more information at: (914) 238-1700

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References:

1.         Constantino D, Guaraldi C. Effectiveness and safety of vaginal suppositories for   the treatment of the vaginal atrophy in postmenopausal women: an open, non-    controlled clinical trial. Eur Rev Med Pharmacol Sci. 2008 Nov-Dec;12(6):411-6.

2.         Chollet JA, Carter G, Meyn LA, Mermelstein F, Balk JL. Efficacy and safety of    vaginal estriol and progesterone in postmenopausal women with atrophic          vaginitis. Menopause. 2009 Sept-Oct;16(5):978-83.

3.         Labrie F, Archer D, et al. Effect of intravaginal dehydroepiandrosterone    (Prasterone) on libido and sexual dysfunction in postmenopausal women.         Menopause. 2009 Sep-Oct;16(5):923-31.

4.         Labrie F, Archer D, et al. Serum steroid levels during 12-week intravaginal             dehydroepiandrosterone administrtion. Menopause. 2009 Sep-Oct;16(5):897-906

Synthetic estrogens are used to make medicine, to fatten animals before slaughter, to get cows to give more milk, to kill bugs on our fruits and vegetables, and to produce industrial plastic and petroleum products. Over-exposure to environmental estrogens affects the balance between estrogen and progesterone – another female hormone. When progesterone levels drop off during menopause, the over-abundance of estrogen caused by the intake of chemical estrogen-like compounds increases the incidence and severity of menopause-related symptoms.

Estrogen dominance can also occur when progesterone production drops. This can occur during periods of high stress, and at any time in a woman’s reproductive life, from the time of her first period, after childbirth and especially during menopause. Estrogen dominance can cause thyroid problems, breast disease or tenderness, heavy or irregular periods, water retention, moodiness, weight gain and insomnia. Treatment can be as easy as adding Progesterone.  Some symptoms of estrogen dominance include:

Mood Swings
Irritation and Nervousness
Headaches
Breast Tenderness
Anxiety
Uterine Fibroids
Water Retention
Fibrocystic Breasts
Feels Cold
Menstrual Bleeding Changes

If you are concerned that  you may be experiencing Menopausal symptoms please click on this Link http://www.thehealthychoice.net/survey.htmand take our Free Hormone Assessment Analysis and within 48 hours we will contact you with your results and our recommendations.

Phil Altman, R.Ph.,

Compounding Pharmacist

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Estrogen is produced in several places in the body, including the ovaries, adrenal glands and fat cells. Even if your ovaries have been removed or you have gone through menopause, estrogen is still being produced in low but measurable amounts by these other tissues. There are multiple steps needed to help ensure safe excretion of estrogen from the body. These steps produce different end products or “metabolites” along the way. There are some metabolites that are “bad” because they are toxic and damage DNA, as opposed to the “good” estrogen metabolites that behave safely and are preferable. Although our genetics influence how easily we make the good and bad estrogens, it turns out (big surprise!) that food and other lifestyle factors have an enormous effect on the kinds of metabolites the liver will make. These are what we focus on for breast cancer prevention at BCH and Nutrition@BlumKitchen.

Genetic and urine testing can also be done to evaluate one’s risk for making bad estrogens. With these test results, we can determine how to use food, supplements and behavior modification to increase good estrogen levels and lower bad ones. For example, foods which support estrogen detoxification pathways include: cruciferous vegetables like kale, broccoli and cauliflower; fiber from fruits and vegetables; soy; dried beans; and ground flax seeds. Let us help you understand what you need by reviewing your personal health history and conducting one of these tests if needed. Or, go directly to Nutrition@BlumKitchen for one of our Cancer Fighting Foods classes. See Chef Marti’s list of breast-cancer-fighting foods below, along with a delicious recipe.

Supplement of the Month

Di-indolylmethane, or DIM, can be taken in supplement form to improve the good:bad estrogen ratio and decrease the risk of breast cancer. We also recommend it to reduce symptoms of too much estrogen. Research supports the use of DIM as a supplement because of its safe activity in the body and low side effect profile. DIM is poorly absorbed into the body unless it is bound to oils and fat-soluble nutrients in the same capsule. We use DIMAvail, made by Designs for Health, due to superior absorption and bioavailability in the body. DIMAvail is 10% off for the month of October.

Blum Center for Health

34 Rye Ridge Road Plaza

Rye Brook, NY  10573

Contact Us: (914) 652-7800

www.blumcenterforhealth.com

The Healthy Choice’s Second Annual BHRT Seminar

Thank you to everyone who attended The Healthy Choice Compounding Pharmacy’s  second annual BHRT Seminar.  This Seminar was for Doctors and Staff interested in learning how to better incorporate Bio Identical Hormone Replacement Therapy into their practice.

This years presenter was Dr. Pamela Smith, MD, MPH, Author of “HRT, The Answers” . 

Dr. Smith  has been featured  on CNN & PBS. 

Click Here to Learn More!

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Ingredients:
1 ½ cups of cherry or other small tomato variety; I used small, round heirloom tomatoes (yum!)
½ large cucumber
1/3 cup basil, packed
¼ tsp salt
Juice of half a lime
2 tbsp apple cider vinegar
1/8 large avocado (or a couple of slices)
1/3 cup water
3 tbsp olive oil

Directions:
Begin by blending all ingredients, except the olive oil, in a food processor or a high speed blender on high. Next drizzle olive oil in. Adjust water content to make soup as watery or creamy as you like.
Garnish with additional veggies: avocado chunks, zucchini, cucumber, tomatoes, basil, etc.

Recipe provided by: The Blum Center for Health

Foods to help hormone imbalance.
Eat plenty of phytoestrogens which include leafy green vegetables, broccoli, cauliflower, cabbage, chickpeas, beans and lentils.  Phytoestrogens provide a balancing effect by mimicking estrogen in the body’s estrogen receptors and preventing xenoestrogens–stronger, synthetic, toxic hormones–from attaching.
Garlic is a powerful antioxidant that inhibits cancer growth by flushing cells of carcinogens. It also cleans the lymph system and enhances thyroid function—all of which work to balance the endocrine system.

Culinary Rx:
Garlicky Kale Salad
This twist on the classic Caesar salad is heartier and healthier. Kale contains essential vitamins, minerals, antioxidants and anti-inflammatory compounds.  Instead of anchovies, garlic and lemon give this salad a vibrant Italian bite while the naked goat cheese gives it a parmesan-like flavor. Any of the available varieties of kale will taste delicious. If you can’t find naked goat cheese, use regular

parmesan. To make this a vegan dish, skip the cheese all together.

Serves 4
Ingredients

• 1 bunch kale, rinsed and chopped into bite-sized pieces (Lacinato works best)
• ¼-1/2 c. extra virgin olive oil
• 1.5 lemons juiced
• 2 cloves garlic, finely minced
• Salt and pepper to taste
• Pinch of red pepper flakes
• 4 oz. naked goat cheese (optional)
• Toasted pine nuts or walnuts

Directions

1. Place the kale in a large salad bowl
2. In a small bowl, whisk together the olive oil, lemon juice, salt, pepper and red pepper flakes until emulsified.
3. Stir the dressing into the kale until all pieces are coated. Add the cheese and nuts and let it marinate for at least 3 hours. (Though overnight is even better.)

Mediterranean French Lentil Salad
Serves 6-8

Ingredients:

2 cups small French lentils, rinsed, and drained
7 cups cold water
1 1/2 tsp salt
1 bay leaf

Dressing:
2 cloves garlic, mashed/pressed/chopped
zest of 1 lemon
1 tsp salt
1 tbsp Dijon mustard
1/4 cup balsamic vinegar
1/4 cup olive oil
cracked pepper to taste
1 cup fresh parsley, chopped
3 cups bitter greens – escarole, arugula, dandelion, frisee, butter lettuce

¼ cup red onion (options)

Options: tomatoes, cucumber, olives

Directions:

Combine the lentils, water, salt, and bay leaf in a medium saucepan. Bring to a simmer, and cook just below a rolling boil for 20 minutes, skimming off any foam as it appears. When the lentils are tender but still firm, drain well and discard the bay leaf.

In a salad bowl, toss the salad dressing ingredients together, whisking well.

Add the drained lentils to the dressing and the parsley and toss. Serve warm over the mixed greens and red onion, or set aside and let cool to room temperature.

Curried Cauliflower Soup
Serves 6-8

Ingredients:
1 head cauliflower, cut into florets
3 T. olive oil
sea salt
1 small yellow onion diced
2 carrots, peeled and diced small
1 cup finely chopped celery
1 t. curry powder
¼ t. ground cumin
¼ t. ground coriander
1/8 t. ground cinnamon
6 cups vegetable broth

Directions:
Preheat the oven to 400 degrees and line a baking sheet with parchment paper.
Toss the cauliflower with 1 T of the olive oil and ¼ t. of salt, then spread it in an even layer on the pan.
Bake until the cauliflower is tender, about 20-25 minutes.
While the cauliflower is roasting, heat the remaining olive oil in a large pot over medium heat, then add the onion and pinch of salt and sauté until softened, about 3 minutes.
Add the carrots, celery and ¼ t. salt and sauté until the vegetables brown.
Add the spices and another ½ t. salt and stir until the spices coat the vegetables. Pour in ½ cup of the broth to deglaze the pot and cook until the liquid is reduced by half.
Pour the broth into the pot along with the roasted cauliflower. Blend the soup with an immersion blender until smooth or work in batches if using a standing blender.
Taste for salt or a squeeze of fresh lemon juice.

Ginger Mint Green Tea
4 cups

Ingredients:

4 cups water
4 ½-inch slices peeled fresh ginger
1 green tea bag
1 peppermint tea bag
1 T freshly squeezed lemon juice
1 t. honey

Directions:

Bring the water with the ginger to a boil in a saucepan.
Lower the heat, simmer, and cover for 10 minutes.
Remove from the heat, add the green and peppermint tea bags and steep for 10 more minutes.
Remove the tea bags and ginger, then stir in the lemon juice and honey, Serve hot or chill for at least an hour before serving.

Poached Salmon with Pesto
Serves 4

Ingredients:

Juice of 1 lemon
½ t. sea salt
4 4 oz. boned salmon filets
4 cups vegetable stock

Directions:

Stir the lemon juice and salt together, then add the salmon and turn to coat. Marinate the salmon in the refrigerator for at least 20 minutes.
In a pot or straight-sided wide sauté pan, bring the stock to a slow boil over medium heat. Slide the salmon into the broth and poach for 7-9 minutes, just until the fish is tender.

Pesto Sauce
1 cup

Ingredients:

Pesto Sauce
Ingredients:
1  cup parsley
½ cup basil or cilantro
6 mint leaves
½ t. ground cumin
½ t. paprika
1 clove garlic, minced
¼ cup olive oil
3 T lemon juice
¼ t. sea salt

Directions:

Place all the ingredients in a food processor and blend until smooth. Check for salt or lemon. And if you want a thinner consistency add 2 Tablespoons water.

Kale and Cranberry Tart
Serves 8

Ingredients:

For crust:
1 1/2 cups blanched almond flour
1/2 teaspoon finely ground, unrefined sea salt
1 tablespoon minced fresh rosemary or scallions (white and green parts)
1/4 cup olive or avocado oil
1 tablespoon filtered water

For the tart filling:
3 packed cups coarsely chopped raw kale (stems removed before measuring)
2 tablespoon thinly sliced shallots
3/4 teaspoon finely ground, unrefined sea salt
4 large or 5 medium eggs, whisked
1/4 cup + 2 tablespoons dried cranberries
1/4 cup + 2 tablespoons raw pine nuts

Directions:

1. Preheat the oven to 350 degrees F. Place the baking rack in the middle of the oven.
2. Make the crust: Fluff up almond flour with a fork before measuring and mash to break up any lumps. In a large bowl, combine the almond flour, salt, and rosemary or scallions.
3. In a medium bowl, whisk together the oil and water. Stir these into the almond flour mixture until thoroughly combined. Then press the dough into a 9-inch tart pan.
4. Bake for 15 to 20 minutes, until lightly golden. Remove from the oven and let cool completely before filling.
5. Make the filling: Fill a 3 to 4 quart pot with 4 to 6 inches of water. Cover and bring to boil. Add kale (minus the stems), pressing to submerge it in the water, and boil, uncovered for 2 to 4 minutes, until bright green. Remove kale with a skimmer or pour into a colander over the sink. Run cold water over the kale or plunge it in ice water to stop the cooking and hold the color.
6. Place the kale, shallots, and sea salt in a food processor and pulse until well blended. (If you do not have a food processor, finely chop the kale and shallots then mix with the sea salt.) Transfer the kale mixture

What Are Bio-Identical Hormones?

Bio-identical hormones are an exact replica of the hormones that are naturally produced by the body.  They match your body’s hormones molecule by molecule. They are natural hormones because they are made from soy, yams and other plant extracts. They are termed “bio-identical” because they are compounded to match each individual patient.

What Is The Difference Between Bio-Identical Hormones and Synthetic Hormones?

The difference between bio-identical hormones and synthetic hormones is that, although both are created in labs, synthetic hormones are not identical to the hormones naturally created in your body, whereas bio-identical hormones match your body’s hormones molecule by molecule.
Synthetic hormones are derived from plant progesterone and animal estrogens, but are not identical to the hormones your body uses. Synthetic hormones act as toxins because their chemical makeup cannot be metabolized properly. Premarin is a non-bio-identical hormone which is obtained from the urine of pregnant horses. Provera is also an example of a synthetic hormone. It causes bone loss or osteoporosis. Their combination called Prempro has been marked with a black-box warning for causing serious health risks.
Bio-identical hormones or natural hormones are replicas of the body’s own natural hormones. Bio-identical hormones are made from soy, yams and other plant extracts. Then they are sent to the compounding pharmacy and made to match each individuals needs.

Do I Need A Prescription?

Yes, bio-identical hormones are compounded prescription medications that we produce in our specialized pharmacy.  Each prescription is made with only the highest quality ingredients and made to fit each patients individualized need.

Can You Recommend A Physician That Prescribes It?

Yes, we have a large list of participating doctors.  These doctors are highly trained and comfortable working with bio-identical hormones.  They will work closely with you, and Phil Altman, your Compounding Pharmacist.  They will customize a BHRT regimen designed especially for you.

What Are My Options?

First of all, you have to decide if you are a candidate for hormone replacement therapy, not everyone is. This is a personal choice, it is a choice that you must be educated in. Because in order to have a successful experience you have to be an active participant.

Not everyone is a candidate for estrogen, they might just need some progesterone and/or testosterone, DHEA, Pregnelone etc.. Once you decide what forms of hormones you might need restoration in, then you must decide what dosage form to use. Do you want to use a cream ,capsule or drops etc.. These are all of the basic questions that you must ask yourself, your practitioner and compounding pharmacist.  Everyone must be on the same page. Your options are as varied as there are different people. EXPLORE THEM

Are They Safe?

Everyone is concerned about safety as they should be. We feel that bio-identical hormones give you the best risk reward ratio. We feel that when ever you take any form of estrogen there is some risk involved. But bio-identical hormones, since they are structurally identical to what your body produces, they get excreted very quickly. Progesterone vs. progestins is also very important.  Progesterone opposes estrogen throughout your entire body, not just your uterus. Progesterone will also increase cell death while progestins do not. Progesterone acts as a natural diuretic to help prevent weight gain.
Estriol is the weakest of all the estrogens and has the most cancer protecting properties. Just another reason why bio-identical hormones are safer than commercially available products. Even when estriol E3 is combined with estradiol E2 the estriol will help reduce the negative benefit of estradiol.

PROGESTERONE BENEFITS
Opposes estrogen thru out your entire body
Acts as a natural diuretic
Acts as a mood elevator
Helps balance thyroid
Helps balance blood sugar
Helps build bones

When Will I Feel Better?

Everyone is different, everyone’s stress level is different, as well as there preexisting hormone level.
If you could look around a room and tell me which two people are the same then, I can tell you exactly  when it will work. People’s lifestyles all vary. You are what you eat! Are you a big meat eater or a vegan?  Are you overweight?? Estrogen is stored in fat cells.  Overweight people will release more estrogen into there system therefore, they may not need estrogen replacement therapy.

Stress also plays a large part of when you feel better.  It‘s all about balance. Balancing your hormones, lifestyle, stress etc.. The quicker you can put all of that in balance the quicker you are going to feel better.

What Forms Does It Come In?  What Dosage Form Is Best For Me?

One of the keys to bio-identical hormone replacement therapy, is the different dosage  forms it can come in. We have the ability to customize dosage forms to fit each individual patient. Using a compounding pharmacist to help you decide what dosage form to use, will be key in having a successful therapy. If you have any digestive disorders we strongly  recommend using the transdermal route. Although, the American preference has usually been to take a pill over using creams.   If you decide to go the transdermal route, there are different delivery systems, i.e. syringes, pumps, jars etc.. There are also different bases that we can use depending on  the sensitivity level of the patient. Also, when you use the transdermal route you have more dosing flexibility.  You can take 1 & 1/2 doses of a cream, whereas it’s more difficult to take 1 & 1/2 capsules. There are also lozenges you can suck on, vaginal suppositories, vaginal creams, drops etc.. The key with dosing is finding out what is going to work best for the individual patient.

How Do These Products Work?

There is a lot of misinformation about this. Physicians, as well as patients, do not always understand the structure function statement. That, if you change any part of the chemical structure of any chemical, you will change the function of that product. So what that means, is that these Bio-Identical Hormones are structurally identical to what your body produces. This is more of hormone restoration. Replacing hormones (structurally identical) to what your body is no longer producing. It is like tricking your body into thinking you are producing more hormones, thus putting  you in a pre peri-menopausal phase. The goal of these products is to put you back in balance!

Will I Gain Weight?

Hormones are chemical messages that cause the body to make changes affecting weight gain or weight loss.  When your hormones are out of balance, it can, in some cases, makes it easier to gain weight and harder to lose weight.  When your hormones are in balance you get the most out of your nutrition therefore, making it easier to lose weight.  For instance, men as they get older get less active and have a decline in testosterone.  This particular hormone boosts  metabolism which helps lower body fat. Concluding, that when testosterone levels are balanced  a man’s ideal weight is easier to achieve.

Do I Need To Take These Hormones Forever?

Not necessarily, it depends on how well your body responds to bio-identical hormone therapy. Also important, it’s how well you manage your diet, sleep patterns, exercise, and stress levels that will assist you in regaining hormonal balance. Some patients can wean off various hormones once they become balanced and have fewer symptoms of menopause or andropause. There are also patients who can wean off adrenal and thyroid support once their adrenals or thyroid glands have healed. There is no single answer for everyone, it depends on your individual hormone stability and how well your diet and lifestyle will support everything else. In the worst-case scenario, if you decided to stop bio-identical hormone therapy, your body would return to the state it was in before initiating your program.

What Is The Women’s Health Initiative?

The National Institutes of Health (NIH) established the Women’s Health Initiative (WHI) in 1991 to address the most common causes of death, disability and impaired quality of life in postmenopausal women. The Women’s Health Initiative was designed to define the risks and benefits of using synthetic hormone therapy to potentially prevent heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women.
It is important to note that the women in this study were all postmenopausal, average age of sixty-eight. This fact is significant as most of these women had 15 years since the loss of their hormones to develop diseases that estrogen, progesterone, and testosterone might have prevented. Most importantly, the study used synthetic hormones and not natural bio-identical hormones. This was a 15 year research program and the women in these studies are now participating in a follow-up phase, which will last until 2010.

Why Is There So Much Confusion About Bio-Identical Hormones?

Bio-identical hormone preparations are medications that contain hormones that are an exact chemical match to those made naturally by humans. Some bio-identical hormones are made by drug companies, are approved by the FDA, and are sold in standard doses. Other bio-identical hormone preparations are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. Those “custom-made” preparations aren’t approved by the FDA. The FDA doesn’t approve any compounded products, for any condition, because those products aren’t standardized. But, the purpose of compounding is to do it on a patient-by-patient basis, so there’s nothing that’s submitted to the FDA to evaluate, so they’re not FDA approved. And because compounded products don’t go through the FDA approval process, they don’t bear the same warnings as other hormone therapy. A woman who gets a prescription for an FDA-approved hormone therapy for menopausal symptoms is “going to get a lot of warning information,” but if she gets a compounded product instead, “you don’t get any of those warnings. There’s no requirement for them to provide that because those products are not FDA approved.”

How To Know If Bio-identical Hormones Are Right For Me?

Some women just know when they are not feeling “quite right” or “like they used to”.  To help answer this question, ask yourself:
Do I have hot flashes?
Can I not sleep at night?
Do you wake at night sweating excessively?
Is your menstrual cycle more irregular than when you were in your twenties and thirties?
Do you have alterations of heavier bleeding one cycle and lighter the next?
Do you have difficulty concentrating?
Do you have mind fog?
Do you feel more anxious now, and for no reason?
Do you have vaginal dryness or painful intercourse?
Are you more depressed?
Have lack of energy?
Depending on how many questions you’ve answered yes to will let you know if you should consider BHRT.  But, we are all individuals and someone who just has one of these problems might find it bothersome enough to seek out help.  You don’t have to feel this way, just because you are getting older.  You can do something about it.

Phil Altman, R.Ph., Compounding Pharmacist
(914) 238-1700
Email:Phil@TheHealthyChoice.net

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