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#275 - AMA #52: Hormone replacement therapy: practical applications and the role of compounding pharmacies

The Peter Attia Drive

Sun Oct 15 2023



Hormone Replacement Therapy (HRT) for Women:

  • HRT has been misunderstood and demonized by the mainstream medical community, largely due to the misinterpretation of the Women's Health Initiative study.
  • The demonization of HRT has led to a lack of understanding and misinformation about its benefits and risks.
  • Contrary to popular belief, there have been no additional deaths due to breast cancer from HRT.
  • Menopause is diagnosed retrospectively based on 12 months of amenorrhea without any other obvious cause.
  • Blood tests can be used to measure follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol levels to determine where a woman is in her trajectory towards menopause.
  • FSH is considered the most important hormone in determining menopausal status, with levels around 20 or 25 indicating menopause.
  • Anti-mullerian hormone (AMH) can also be measured to assess ovarian reserve and predict menopause, especially for women considering fertility.

Perimenopausal Symptoms:

  • Vasomotor symptoms such as hot flashes and night sweats are common symptoms that precede other menopausal symptoms like vaginal dryness and loss of bone mineral density.
  • Hormonal changes, including increased FSH and LH levels and decreased estradiol levels, contribute to these vasomotor symptoms.

Compounding Pharmacies:

  • Compounding pharmacies play a significant role in hormone replacement therapy as they provide custom prescriptions tailored to individual patients' needs.
  • They are essential because FDA-approved formulations may not meet every patient's specific requirements.
  • However, concerns exist regarding the quality and sterility of compounded drugs, making it crucial for patients to find trustworthy compounding pharmacies.