As women and people with uterus transition through the natural phases of life, menopause often emerges as a challenging chapter filled with uncertainty. The physical and emotional changes can feel overwhelming, leaving many seeking answers and support. Hot flashes disrupt sleep, mood swings cast shadows over daily activities, and energy levels fluctuate unpredictably. In this moment of transition, the search for balance can lead to frustration and discomfort. 

 

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We spoke to Dr. Anuradha Panda, an experienced Obstetrician and Gynecologist (MBBS, MD, DGO, FICOG), Distinguished Clinical Tutor (AHERF), and Laparoscopic and Robotic Surgeon at Apollo Hospitals, Jubilee Hills, Hyderabad, about menopause and the role of bioidentical hormone replacement therapy. Menopause can be complicated, but there's hope with bioidentical hormone replacement therapy.   Bioidentical hormone replacement therapy is used to  restore hormonal balance in the body that is not producing adequate levels of key hormones, such as estrogen, progesterone, and testosterone. 

 

Related story: Menopause: What You Need To Know

What are bioidentical hormones?

Dr. Panda explains bioidentical hormones are processed hormones that closely resemble the ones naturally produced by the human body. Some of these hormone replacements are custom-made hormones including estrone, estriol, pregnenolone, testosterone, and their various forms. This treatment is designed to match the hormones in a woman's body more naturally and meet individual needs. Also read An Ob-gyn’s Guide to 5 Female Hormones and Their Impact on Your Health

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How do they differ from traditional hormone replacement therapy (HRT)?

Dr Panda: The main distinction between bioidentical hormone replacement therapy (BHRT) and traditional hormone replacement therapy (HRT) lies in the origin and composition of the hormones used. Traditional HRT often utilises synthetic hormones or hormones sourced from animals, which may not match the human body’s hormones as closely as bioidentical options.

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How does bioidentical hormone replacement therapy address hormone imbalances?

Dr Panda: Hormonal imbalances in women during menopause can cause symptoms like hot flashes, mood swings, trouble sleeping, fatigue, weight gain, low sex drive, and difficulty concentrating. To address these issues, doctors start with a detailed hormone level test to understand your unique hormonal needs. Based on the results, they create a personalised treatment plan tailored to your symptoms and health history.
BHRT uses bioidentical hormones, which are almost identical to the ones your body naturally produces. This makes them easier for your body to accept, reducing side effects and improving effectiveness. Regular follow-ups are crucial to track progress and adjust the treatment as needed. 

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Are there any side effects associated with BHRT?

Dr Panda: As with any medical treatment, bioidentical hormone replacement therapy (BHRT) carries potential risks and side effects that patients should be aware of.

• Some individuals may experience water retention, leading to a sensation of fullness or swelling in the abdomen.
• Hormonal fluctuations can cause discomfort or sensitivity in the breast tissue, which may vary in intensity.
• Besides, this treatment may trigger mild headaches in some. This happens  because the body is adjusting to the new hormone levels. 

Related story: 10 Ways to Ease Menopause Symptoms

 

How long does it typically take to see results from BHRT?

Dr Panda: The timeline for experiencing results can differ significantly from person to person, influenced by individual factors and the specific symptoms being addressed. For many, initial improvements may be observed within a few weeks; for instance, individuals might notice enhanced sleep quality, reduced nighttime awakenings, or a decrease in the frequency and intensity of hot flashes. 

However, for others, the journey to optimal symptom relief may extend over several months, as it often takes time for hormone levels to balance and stabilise effectively.

Related story: Doctor Answers 5 Questions on Perimenopause

Are there any lifestyle changes one should consider alongside BHRT?

Dr Panda: Absolutely. Hormone therapy works best when combined with a healthy lifestyle.
A balanced diet is essential for supporting hormonal health. Focus on whole, nutrient-rich foods such as fresh fruits, vegetables, lean proteins, whole grains, and healthy fats. These foods provide the vitamins, minerals, and antioxidants your body needs to function optimally. Minimising processed foods, added sugars, and unhealthy fats can also help stabilise blood sugar levels and reduce inflammation, both of which are important for hormonal balance.

Regular physical activity is another cornerstone of a healthy lifestyle. Exercise not only helps manage weight but also boosts mood, improves energy levels, and supports better sleep—all of which are often disrupted by hormonal imbalances. Aim for a mix of cardio, strength training, and flexibility exercises to get the most benefits.

Stress management techniques, such as mindfulness, yoga, meditation, or even simple deep-breathing exercises, play a crucial role in keeping cortisol (the stress hormone) levels in check. Chronic stress can disrupt your hormonal balance, so finding ways to relax and unwind is necessary.

Adequate sleep is equally important, as the body does much of its hormonal regulation and repair during rest. Create a consistent bedtime routine, avoid screens before bed, and ensure your sleeping environment is conducive to quality rest.

Supplements can be a helpful addition to your routine but should be approached carefully and under medical guidance. For instance, vitamin D is essential for bone health and hormone regulation, while omega-3 fatty acids can help reduce inflammation and improve mood. Other supplements, like magnesium or probiotics, might also support hormonal health, depending on your specific needs.

These lifestyle changes not only enhance the effectiveness of bioidentical hormone replacement therapy but also contribute to better overall health and well-being. Hormones don’t work in isolation—they interact with every system in your body, so taking a holistic approach can lead to the best outcomes.

 

Related story: 6 Lifestyle Changes to Prepare For Perimenopause

 

How is bioidentical hormone replacement administered?

Dr Panda: There are different forms of bioidentical hormones available to suit individual needs and preferences. The method of delivery is chosen based on your symptoms, medical history, and convenience. Here are the most common ways bioidentical hormones are administered:

• Creams and Gels: Creams and gels are applied directly to the skin, usually on areas like the arms, thighs, or abdomen. The hormones are absorbed through the skin and enter the bloodstream. 
• Patches: Hormone patches are applied to the skin and deliver a steady dose of hormones over a specific period (usually a few days). They are convenient and reduce the need for daily application.
• Pills or Capsules: Oral forms of bioidentical hormones, such as progesterone or estradiol, are taken by mouth. However, these may have a slightly higher risk of side effects due to how the liver processes them.
• Injections: Hormones like testosterone are sometimes given via injections, which deliver the hormone directly into the muscle for gradual release into the bloodstream.
• Vaginal Forms: For localised symptoms like vaginal dryness or discomfort, bioidentical hormones (creams, suppositories, or rings) can be applied directly to the vaginal area.

 

During menopause, it's essential to maintain regular follow-up appointments with your healthcare provider. These check-ins are crucial for assessing your progress, making necessary adjustments to your treatment plan, and ensuring that you are on the right track towards managing your symptoms effectively. Your doctor can provide insights into expected timelines and help guide you through any challenges that may arise as you work toward achieving your health goals.

 

Need all your wellness solutions in one place? A whole new world awaits just a click away.