It is important to understand that there are significant controversies in the medical community regarding the best ways to diagnose and treat symptoms related to perimenopause and menopause, as well as the safest and most effective methods to monitor hormone therapy.

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Key Risks to Be Aware Of:

• Hormone-Sensitive Tumors:
  Hormones such as estrogen, progesterone, and testosterone can promote the growth of hormone-dependent tumors, including breast, endometrial, and ovarian cancers.
  Women with a history of these cancers must be in remission for at least 3 to 5 years or longer before BHRT may be considered.
  There is no guarantee that cancer will not recur with or without hormone therapy.

  • Note: Research on breast cancer risk with hormone therapy is mixed. Some studies show no increased risk with topical estradiol plus oral progesterone, while others suggest oral estrogen alone may decrease risk. However, no definitive conclusions can be drawn.
     

• Growth of Existing Tumors:
  If hormone-sensitive tumors are present, hormone therapy can promote their growth.
   

• Pregnancy Risks:
  Testosterone therapy is not safe during pregnancy or nursing due to potential birth defects. BHRT is contraindicated in pregnant or nursing women.
   

• Medication Interactions:
  Use of antidepressant medications may reduce or delay symptom improvement from BHRT, but you should not discontinue prescribed antidepressants without medical advice.
   

• Topical Cream Transfer:
  Hormone creams applied to the skin can be accidentally transferred to others, causing unintended hormone exposure or local skin reactions.
   

• Uterine Effects:
  Estrogen without progesterone can cause abnormal uterine bleeding, fibroid growth, or uterine cancer if you have a uterus. Progesterone is recommended to help balance estrogen.

  • Contraindicated for undiagnosed vaginal bleeding.
     

• Blood Clot Risks:
  Oral estrogen increases the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE).
  This risk has not been observed with transdermal (skin-applied), SubQ, or vaginal estradiol.
  Oral estrogens are not recommended.
   

• Testosterone and DHEA Side Effects in Women:
  Rarely, testosterone or DHEA may cause: increased facial hair, acne, scalp hair loss, clitoral enlargement, lowered voice, increased sex drive or mood changes
   

These effects are uncommon at prescribed low doses and are usually reversible.
 

• Other Possible Side Effects:
  Early treatment may cause cramps, headaches, migraines, breast tenderness, nausea, bloating, irritability, fluid retention, weight changes, or other unknown effects.
  
  These often improve after the first few weeks.

By proceeding with BHRT, you acknowledge these potential risks and understand that your treatment plan will be tailored to your individual health status and monitored closely to maximize benefits and minimize risks.