Bioidentical Hormone Replacement Therapy (BHRT)

Further clarification is essential regarding the use of menopausal hormone therapy when teaching our clients. Primarily due to the fact that there are misperceptions about the risks and benefits of hormonal therapy, APRNs carry the role of teaching not only their own clients, but of teaching other nurses, new nurses, physicians and the public in general. APRNs must weigh the risks alongside of the benefits when prescribing ET or EPT to any of their clients having severe symptomology in order to promote short-term medication for symptom relief, but also, long-term relief from the potential threat of breast cancer (NAMS, 2012). The focal point of the standard of care is to manage menopausal symptoms, educate on possible potential risks in the future, and advocate for patients based on the latest evidence based practice.

There is nothing more important in your journey to have the proper support. And I do not mean the family and loved ones support - we will get to them very soon in a later sections. What I really want to talk about is your psychological support from a therapist and finding the right Endocrinologist to medically help you start the transition journey. I found myself really lucky by finding Dr. Michael Caruso in Denver, Colorado, who has served both as my therapist and someone who saw me right away for who I am and helped me in a way I couldn't even imagine a single person could.

Mary is a 50 year old female admitted with shortness of breath and chest pain that started early this am. She is overweight, takes hormone replacement therapy. Her right lower leg is edematous and is diagnosed with deep vein thrombosis and pulmonary embolus. She is given an infusion of Activase in the emergency room and then started on a heparin drip at 1200 uints per hour intravenously once she arrives to the floor. She is going home on Coumadin . The following are the things I will teach Mary to do or observe while taking Coumadin at home.

The process of transitioning into the opposite sex has made leaps and bounds over the last twenty years. Social transition is a more traditional approach to the transition process. Social transition is modifying how you are seen by society by dressing like the opposite sex, using opposite sex pronouns, acting in such a way that matches your gender identity, etc. Next is legal transition, this is when a person changes legal documents or records to identify with their gender identity. Lastly is a medical transition, this is when the body is physically changed through hormone therapy and/or surgery. (“One Step at a Time”, 2015)

With menopause estrogen defiency occurs which is associated with increased severity and incidence of OA in women. Estrogen therapy reduces the risk of OA compared to those who are not taking it.(21)

If you are a 50-year old woman who is not taking medication, you have a 50% chance of having a bone fracture during the remainder of your life that is related to osteoporosis. You have a 20% to 30% chance of developing a spinal deformity known as dowager’s hump. ( CAM, 2001) Even though it is beneficial to increase their intake of calcium and vitamin D, women will still experience bone loss due to the decrease in estrogen. Although more research is needed some recent studies have found that Alzheimer’s disease may develop in women with a family history of said disease with the onset of menopause. Cardiovascular disease is the major cause of death in post-menopausal women. This is believed to be due to postmenopausal women being estrogen-deficient.

In recent years the field of medicine has begun to use hormonal therapy as a form of treatment for cancer patients. Through hormonal therapy the growth of a specific tumor is interfered, as the tumor’s growth is sensitive to the amount of hormones present (1). Since hormonal therapy appears to be a great treatment for cancer, it can also be used as a treatment for menopausal women. Around 2.2 million women in the United States reach menopause each year (2). Menopause is a natural event experience by women; it is the final menstrual period due to the loss of ovarian follicular function and usually occurs around the age of 51 (2). In menopausal women hormonal replacement therapy is not used to continue the function of the ovarian follicle, on the other hand, the therapy is used to manage the symptoms commonly encountered by women.

Menopause and the risk for breast cancer are interrelated in the sense that if a woman undergoes late menopause after the age of 55 years then her risk for ovarian, breast, and uterine cancer rises. This risk is even greater if menstruation occurred early prior to 12 years of age. This can be attributed the longer exposure to estrogen and also exposure to more ovulations. Other risk factors are late age at first live birth or not having given birth.

Estrogen is a steroid hormone which plays a crucial role in growth and maturation of both sexes. In the female reproductive system, estrogen targets tissues such as mammary glands, uterus, and ovaries. Bone formation has a significant positive relationship with estrogen from puberty to maturation and beyond (Clark et al., 1992). Post puberty estrogen is mainly synthesized and released from the ovaries in females. Through binding proteins or estrogen receptors (ER) found within the nucleus, estrogen is retained and affects specific target tissues throughout the body. Binding of estrogen to its receptor causes conformational change which in turn allows binding to chromatin and proceed with transcription of specific target genes (Murdoch

A woman’s body is remarkable with an interplay of hormones that works with the body to provide the perfect place for the conception of and the development of an unborn child. Just as increased hormone levels trigger puberty and the onset of menses, their decline and cessation bring on peri-menopause and eventual menopause.

Also once you have low progesterone then the risk of estrogen going high is there .

When estrogen levels decrease, a woman’s chances for developing osteoporosis increases following menopause. Studies have shown that women who receive HRT during menopause have had a greater bone density in the early and late postmenopausal stage.

Biologically, sex is determined by chromosomes, (XX = female and XY = male). That is primarily how one is determined male or female. However, Daniela Crocetti (2013), argues that chromosomes are not the only determining factor, that instead some people can be born with an imbalance in their hormone and testosterone system, this imbalance attributes to qualities that are more commonly seen in the opposite sex. This trait is most commonly seen through transexuals. Hormonal therapy is an option for those who experience these certain types of imbalances, it focuses on the “gendered presentation of the body and behavioral components…”. As a result, the therapy tends to make one feel “like how they're supposed to feel”. However, what if one prefers

If you living a healthy life it is pretty simple to spot signs that you have hormonal imbalance. Hormones play an important role in ensuring that your body performs all the functions well.

Doctors prescribe hormone therapy for females who have had their ovaries removed, stopped having periods at a young age, or are currently menopausal. Women who are menopausal typically experience hot flashes, irritability, vaginal dryness, or other symptoms of menopause. Males typically receive hormone therapy to treat low testosterone levels; however, recent research has led to hormone therapy being used to treat men with prostate cancer. This entry will explain the psychological implications of hormone therapy for men and women by comparing the biochemical effects