The Hormonal Nightmare

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When To Take Bio–Identical Hormones

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Some health practitioners believe that a woman should take biologically identical [bio–identical] hormones daily. On the other hand, many health practitioners believe that the most logical way for a woman to take biologically identical [bio–identical] hormones would be cyclically. This means that biologically identical [bio–identical] hormones are taken in the same beautiful regular rhythmical pattern that the sex hormones are made in a woman’s body every monthly cycle.

During the time a woman is having her period, her hypothalamus stimulates the anterior pituitary gland to release follicle-stimulating hormone [FSH]. This causes an egg [or follicle] to ripen during the follicular phase, a woman’s uterine lining to start becoming plush, and for more estrogen to be produced. This is shown in the following illustration.

Flow Phase

As more estrogen is produced, some of it acts as a feedback message back to the hypothalamus to decrease the production of follicle-stimulating hormone [FSH] by the anterior pituitary gland. This is shown in the following illustration.

Follicular Phase

On the other hand, some of the estrogen triggers the hypothalamus to get the anterior pituitary to make luteinizing hormone [LH]. This leads to the production of progesterone, in preparation for the fertilization of an egg and to maintain a pregnancy if it occurs. This is shown in the following illustration.

Ovulation

If no pregnancy occurs, the progesterone being made by the woman’s body sends a message back to the hypothalamus to make follicle stimulating hormone, a period occurs and a new cycle begins. This is shown in the following illustration.

Luteal Phase

There is some disagreement among health practitioners as to when a woman is in menopause. Many say it is when a woman has not had a period for 12 months. Others say that a more objective way of determining if a woman is in menopause appears to be not only to look at what is happening with her periods, but also to check her follicle stimulating hormone level [FSH] and leutinizing hormone level [LH]. When a woman’s follicle stimulating hormone level [FSH] is very high, that indicates that the body is trying to stimulate a follicle in the ovary to ripen, and for ovulation to occur. However, at menopause, this is no longer possible as a woman no longer has any follicles [eggs] left to ripen.

Although a woman in menopause no longer has follicles in her ovaries to stimulate and ovulate, many practitioners will recommend that a woman take her biologically identical [bio–identical] hormones in a way that mimics how they were produced during a woman’s reproductive years. By doing this, it is believed that a woman’s hormone receptors will be turned on and off properly and in the same way that they were during her reproductive years.


Daily Dosages

Daily baseline doses of some of the biologically identical [bio–identical] hormones may need to be given, especially if a woman has had both of her ovaries surgically removed. This should be only done on an individual basis.

For most women, on the other hand, giving daily doses of biologically identical [bio–identical] hormones is opposite to the way in which a woman’s body naturally makes her hormones. Giving daily doses of bio–identical hormones appears to disturb the natural pattern in a woman’s body of turning on and off the hormone receptors and the ability of a woman’s body to use the biologically identical [bio–identical] hormones that she is taking.


Cyclical Dosages

Prescribing biologically identical [bio–identical] hormones in a cyclical fashion more closely mimics the pattern in which the sex hormones are released in a woman’s body during a menstrual cycle.

If a woman no longer has a menstrual cycle, it is necessary for her to plot 28 day months on her calendar. Estrogen is usually prescribed from Day 1 to Day 25 of the 28 day cycle, and then the woman stops taking her estrogen for three days before she starts a new 28 cycle. Progesterone is usually prescribed from Day 10 or Day of 11 to Day 25 of the 28 day cycle, and then the woman stops taking her progesterone for three days before she starts a new 28 cycle. If testosterone is prescribed for a woman, it is usually taken during the first 25 days of the 28 day cycle, and is usually not taken during the three days before she starts a new 28 cycle.


Cyclical Dosages in Titrated Amounts

Prescribing different amounts of biologically identical [bio–identical] hormones at different times throughout the 28 Day cycle is done to more closely mimic the amount of hormones that are produced in a woman’s body during the regular menstrual cycle. This is called the titration of a dose and is considered to be the most natural way for a woman to take her biologically identical [bio–identical] hormones.

Some birth control pills attempt to mimic this type of dosing by providing two or three different strengths of the synthetic hormones at different times during the 28 Day cycle of taking the birth control pills.

Prescriptions for titrated doses of biologically identical [bio–identical] hormones are particularly important if a woman needs bio–identical hormones during her reproductive years, when she has infertility problems, when she has problems with miscarriages, or if she is very sensitive to changes in the levels of her hormones.

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