Bio-Identical Hormone     Replacement         Julie Gorman, PharmD          D’Lisa Haas, PharmD        Kristen Riddle, Pha...
“The Triad”              PH       IAN                AR    IC                   M  YS                   ACPH              ...
What is “Natural”?        Bio-identical hormones that are              derived from plants• Bio-Identical:   – Hormones th...
What is “Synthetic”?   “Patented,” “Conventional,” or “Artificial”• Usually not found in nature, at least not in humans• C...
Progesterone vs Progestin                        Medroxyprogesterone acetate                        (Provera)•Bio-Identica...
Life StagesPRE-MENOPAUSE• Begins with first menstrual period• Monthly fluctuations of LH, FSH, estrogens &  progesterone• ...
Life StagesPERI-MENOPAUSE• Time between onset of changes in hormonal secretions and  onset of menopause• Fluctuating hormo...
Signs & Symptoms of            Hormone Imbalance•   Depression           •   Irritability•   Fatigue              •   Hair...
Estrogen Benefits & Risks        Benefits of Adequate Estrogen                      Risks of Excess Estrogen•   Increase m...
Promoting         Healthy Estrogen Levels•   Conservative, customized dosing•   Diet high in grains & fiber•   Moderate ex...
Progesterone & TestosteroneProgesterone                           Testosterone•Helps balance estrogen                 Inc...
Cortisol•   Only hormone that increases with age•   Made by the adrenal glands (on top of the kidneys)•   Supposed to brie...
Cortisol Imbalance             High Cortisol                       Low Cortisol•   Fatigue                                ...
Balance is Key!           CO      D   OI              R   YR             T IS TH   SEX HORMONES  OL
Our Goals• Symptom improvement within 2 months• Improved overall health & quality of life• Hormone balance through:  – Con...
Consult Webinar
Consult Webinar
Consult Webinar
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  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • BHRT Education Seminar Presentation
  • Consult Webinar

    1. 1. Bio-Identical Hormone Replacement Julie Gorman, PharmD D’Lisa Haas, PharmD Kristen Riddle, PharmD Becca Mitchell, PharmD Pamela Sampson, Pharmacy Technician
    2. 2. “The Triad” PH IAN AR IC M YS ACPH IST PATIENT
    3. 3. What is “Natural”? Bio-identical hormones that are derived from plants• Bio-Identical: – Hormones that are identical to those made in the human body – Same exact chemical structure as hormones produced by our bodies• Plant-Derived: – Chemically processed from precursors found in yam or soy plants
    4. 4. What is “Synthetic”? “Patented,” “Conventional,” or “Artificial”• Usually not found in nature, at least not in humans• Chemically altered from human hormone• Not identical in structure or activity to the natural hormones they emulate
    5. 5. Progesterone vs Progestin Medroxyprogesterone acetate (Provera)•Bio-Identical, Human •Synthetic analog•Increases fertility •Contraceptive
    6. 6. Life StagesPRE-MENOPAUSE• Begins with first menstrual period• Monthly fluctuations of LH, FSH, estrogens & progesterone• Most common problem is PMS – Neurotransmitter profile affected by fluctuating hormones (endorphin, serotonin) – Often successfully treated with stress reduction, diet, exercise – Treated with progesterone, SSRI’s
    7. 7. Life StagesPERI-MENOPAUSE• Time between onset of changes in hormonal secretions and onset of menopause• Fluctuating hormone secretions due to intermixed normal & abnormal cycles• Sometimes referred to as period of “Estrogen Dominance”MENOPAUSE• Termination of menstrual periods – Defined as missing 12 consecutive periods – Surgical hysterectomy
    8. 8. Signs & Symptoms of Hormone Imbalance• Depression • Irritability• Fatigue • Hair loss• Poor concentration • Fibroids• Hot flashes • Water retention• Breast tenderness • Cholestasis• Insomnia • Weight gain• Anxiety • Decreased libido• Painful menses • Breast & uterine cancer• Irregular bleeding
    9. 9. Estrogen Benefits & Risks Benefits of Adequate Estrogen Risks of Excess Estrogen• Increase metabolism • Depression• Increase insulin sensitivity • Fluid retention• Maintain muscle mass • Headaches• Improve sleep quality • Poor sleep• Prevent Alzheimer’s • Irritability/mood swings• Reduce cataracts • Fatigue• Reduces overall risk of heart disease by • Increased risk of auto-immune diseases 40-50% • Weight gain• Numerous cardiovascular benefits • Increased risk of breast & uterine cancer• Maintain collagen in skin• Decrease blood pressure• Maintain memory• Improves concentration• Maintain bone density• Increases energy & sexual interest• Decreases wrinkles
    10. 10. Promoting Healthy Estrogen Levels• Conservative, customized dosing• Diet high in grains & fiber• Moderate exercise• Stress reduction• Vitamins B2, B6, B12, Folic Acid• Omega-3 fatty acids (fish oil)• Healthy body mass index (BMI)
    11. 11. Progesterone & TestosteroneProgesterone Testosterone•Helps balance estrogen  Increases sexual interest•Improves sleep  Increases sense of emotional well-•Natural calming effect being•Lowers high blood pressure  Increases muscle mass & strength•Helps the body use & eliminate fats  Helps maintain memory•Lowers cholesterol  Helps skin from sagging•Increases metabolism  Decreases excess body fat•Natural diuretic  Helps maintain bone strength•Natural antidepressant•Antiinflammatory Natural Ways to Improve Libido•Stimulates new bone production • Decrease calorie & increase protein•Enhances action of thyroid hormones intake•Improves libido • Exercise • Get enough sleep • Lose weight • Reduce stress
    12. 12. Cortisol• Only hormone that increases with age• Made by the adrenal glands (on top of the kidneys)• Supposed to briefly increase during times of stress• Adrenaline is the “run from a bear” stress hormone while cortisol is our “stuck in traffic” stress hormone• Should start highest in the morning and gradually fall throughout the dayFunctions:• Balances blood sugar• Weight control• Immune system response• Stress reaction• Sleep
    13. 13. Cortisol Imbalance High Cortisol Low Cortisol• Fatigue (Adrenal Fatigue)• Irritability • Fatigue• Insomnia • Low blood pressure• Sugar cravings & binge eating • Insomnia• Increased osteoporosis risk • Decreased sexual interest• Decreased immune system • Decreased immunity• Low energy • Emotional paralysis• Night sweats • Allergies• Increased cholesterol • Unresponsive hypothyroidism (does• Insulin resistance not respond to treatment)• Thin skin • Feeling of being overwhelmed• Muscle weakness • Emotional imbalances• Easy bruising • Lack of motivation• Weight gain around the middle • Digestive problems• Impaired thyroid function
    14. 14. Balance is Key! CO D OI R YR T IS TH SEX HORMONES OL
    15. 15. Our Goals• Symptom improvement within 2 months• Improved overall health & quality of life• Hormone balance through: – Conservative dosing – Adequate, appropriate nutrition – Regular exercise – Stress management

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