Dr. Holley is a member of the American Menopause Society and stays up to date with the research being done in this field. For many years we thought that hormone replacement was the best thing since sliced bread. Hormones could cure everything from hot flashes to dementia.
Then in 2003 the Women’s Health Initiative found that hormones are not all they had been cracked up to be. The risks and adverse events associated with hormones made national headlines and the use of hormone replacement plummeted.
Many studies since then have reanalyzed the 2003 data and conducted additional research, and found that hormone replacement is not just a black and white matter, but there are many shades of gray. Many factors go into your decision regarding the use of hormones. Your age now, your age at menopause, your family history, body weight, breast density, cholesterol level, bone density, and the severity of your symptoms all contribute to your risk profile for hormone replacement.
Symptoms of menopause vary greatly from one person to another. Some women are disabled by their hot flashes and the resulting insomnia, irritability, mood swings, and the general misery they cause. After menopause many women experience a loss of energy, weight gain, and loss of sex drive that threatens their marriage. Others have vaginal dryness that causes pain with intercourse, vaginal odors, or urinary urgency.
There are many non-hormonal methods of coping with these symptoms, including relaxation training, anti-depressants such as Zoloft, and neuromodulators such as Neurontin. Some patients do well on herbal preparations containing black cohosh.
After menopause, women are deficient in several hormones, estrogen, progesterone, and testosterone. We can test your levels of each of these hormones and help you determine which, if any, you want to replace. Various preparations are available to replace the deficient hormones, including tablets, vaginal creams, patches, and pellets, involving either natural bio-identical hormones or artificial hormones. We will help you find the preparation that is right for you.
Menopause care also includes monitoring of your bone density and treatment or prevention of osteoporosis. This can be done with a DEXA bone density measurement done every 2-5 years to assess your bone health, and then informed decisions can be made about treatment. A variety of medications, both hormonal and non-hormonal are available, in tablets or injections, to prevent fractures and pain as you grow older.
Sexual problems are common after menopause, and usually have to do with pain during intercourse, or a loss of sex drive, or both. We will help you determine the cause of your sexual problem, and plan an approach that works for you.
Doctor Holley can also help you manage your other medical problems in the context of menopause, including cholesterol screening, diabetes screening, thyroid replacement, and more. Menopause marks a golden time in your life, and with proper care you can enjoy it to the fullest.