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제목 What to expect when
작성자 비타메딕스 (ip:)
  • 작성일 2011-06-22
  • 추천 추천하기
  • 조회수 428
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What to expect when
you're stopping HRT.

by Marcy Holmes, NP, Certified Menopause Clinician

Almost overnight, the government HRT study published in July, 2002 created a national recognition of the health risks and side effects of hormone replacement therapy. Since then, women by the millions have stopped their HRT — sometimes just as suddenly. Ironically, it's often the doctor who prescribed the hormone replacement therapy in the first place who is urging his or her patient to stop HRT.

Unfortunately not many of these doctors have much advice for patients who are dropping their hormone therapy. A woman came to me recently for help when her menopause symptoms returned after she stopped her estrogen replacement. She said her doctor flatly told her he didn't know how to help her, and that if she wanted relief she needed to go back on her HRT or get help from someone else.

This may seem surprising, but remember that doctors have been taught until recently to consider HRT a near-perfect solution for symptoms of perimenopause and menopause. The American College of Gynecology is just now developing guidance for gynecologists on HRT withdrawal. But there is a great deal of knowledge among complementary practitioners, and it will help you make better health choices for yourself. Here's an overview of HRT alternatives and what to expect when you transition off HRT.

Expect HRT withdrawal problems if you quit "cold turkey"

Many women stop HRT suddenly, which is very stressful for your body. That's because it's grown dependent on this external supply. Your body could make its own hormones — right through perimenopause and menopause — but it cut back when you began HRT. Your body can resume its estrogen production, even developing secondary estrogen sites to compensate for the decline in estrogen from your ovaries. But your body needs time and support to develop those sites.

In addition, we believe the stronger forms of HRT drugs, such as Premarin and Prempro, actually modify the estrogen receptors in your cells so they only accept these synthetic hormones. It takes time for those receptors to resume their original form and accept natural HRT, whether your body's own or bioidentical HRT supplements.

As a result, which synthetic hormones you've taken and how long you've been on them are important factors in your response to stopping HRT. A third factor is how severe your symptoms were before you started hormone replacement therapy. In sum, the more severe your original symptoms, the stronger your HRT, and the longer you used it, the more likely it is you will have symptoms of HRT withdrawal when you quit.

Many women are surprised that their symptoms are worse when they stop HRT than they were before they started. This is often due to the "rebound effect", which is common to prescription drugs. The second major reason is they may be taking less care of themselves now than before.

Of course, each woman is unique. Some stop HRT abruptly and have no symptoms of hormone imbalance whatsoever. We call them the lucky few. Our waiting room is full because the majority of women experience anew all the symptoms of menopause when they stop their HRT, and they have nowhere else to turn.

Expect a soft landing if you take care of yourself

The underlying cause of hormonal imbalance is what we call the Inverted Ratio. That's when the demands you put on your body far outweigh the support you give it. If you have symptoms of hormonal imbalance, you have the Inverted Ratio. The truth about HRT is that it can fix the symptoms but it never eliminates their underlying cause.

Your body has the power to make and balance its hormones at every stage of your life. But to do so, it needs adequate support. That means rich nutrition, a well-functioning digestive system so your nutrition is really absorbed, a robust metabolism, and a program of exercise and stress reduction. (Sounds impossible? Then you just need a little help to make it happen. Click here to learn more >>.)

Understand that your body will need extra support during your HRT withdrawal. The more severe your hormonal imbalance, the more support you'll need. After you've weaned off HRT completely, the maintenance phase requires less support.

You need to put this program of support in place before you begin to wean off HRT. We advise everyone to allow 2-4 months to do so. If you do it right, you'll feel better than you ever have in your life.

Expect to be successful even if you failed the first time

We see many women in the Personal Program who stop HRT "cold turkey", couldn't deal with the eruption of symptoms, and went back on HRT. They're not happy, but at least they're functional.

We counsel these women to learn from the setback and make another attempt. They need to put their support program in place first, and then wean off HRT gradually.

Expect success if you're willing to work at it

Over 80% of the women who enroll in the Personal Program have problems that are obstacles to restoring their health after getting off HRT. Most common are digestive problems (floral imbalance, leaky gut syndrome, etc.) and endocrine problems (insulin resistance, adrenal exhaustion, hypothyroidism, etc.). Not surprisingly, these problems all interfere with hormonal balance.

Problems like these have taken years to develop and can't be resolved overnight. Their effect can be discouraging to women seeking an alternative to HRT. After making exciting progress in the first few weeks of weaning off HRT, women often stop improving, finding themselves with too many symptoms remaining. They may blame the lack of hormone replacement and say, "This isn't working". But in fact, the natural alternative to HRT is working — it's gradually healing the years of damaging health habits that created the conditions in the first place.

For many women, stress appears to be unsolvable. Stress can trigger hot flashes, insomnia, weight gain and other menopause symptoms. For many women the sources of stress in their lives seem beyond their control. But we've seen over and over again that women can make their lives less stressful. Once you begin to take care of yourself you'll get your strength and energy back. Then making additional changes seems easier. And it will be.

Don't be surprised if you need help, especially in the beginning

Most women know there are natural alternatives to HRT, and lots of them spend months self-prescribing soy, dong quai, black cohosh, and so on. Each of these can have positive effects, but they are a solution only if your symptoms are few and mild. We count those women in the lucky few. Most women who self-prescribe get discouraged and then don't know where to turn.

We designed our Personal Program to provide women with an at-home version of the methods developed at our medical clinic over the last 20 years. Besides getting the same medical-grade, doctor-formulated supplements and herbs, we offer you personalized attention, including access to our Nurse-Educators.

Expect to feel great!

We view the whole of menopause as a great awakening. Nature intends for you to begin to take better care of yourself now. Time and again we've seen a woman find her voice, learn more about her miraculous body, and begin making choices that work for her. We believe you lay the foundation here for decades of health and happiness ahead.

FAQ's

Question: "I haven't had hot flashes for 5 years, now I'm 60 and experiencing them again as I try to get off HRT. Why is this happening, am I going thru menopause again, will it last forever?"

Answer: The use and weaning off HRT is similar to dependence and withdrawal from drugs like pain medications, opiates or alcohol after long periods of use. The stronger the formula or dose, and the longer the period of use, the more likely we are to see intense symptoms during withdrawal. The Personal Program is designed to help the foundation of hormone balance for your body. In the Program you may have a consultation with the Nurse-Educator who will help devise the best combination approach. In extreme cases a brief period on bioidentical hormones may be recommended.

Question: "I'm going back on my estrogen therapy a while until things calm down, is the progesterone cream all I need to take with it?"

Answer: If you have your uterus, and you are on any form of prescription estrogen, you need to also take prescription strength progestin/progesterone, not just the non-prescription strength Natural Progesterone Cream in our Personal Program. If you have had your uterus removed, or you are not on prescription estrogen, then our Cream is usually enough to complement the estrogen you take.

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