When considering hormone replacement therapy (HRT), I have learned recently, there is a lot of information out there but not a lot of concrete answers. My interest in learning more about HRT began as a sort of academic interest. As part of the treatment options that Dr. Susan Mikaelian has brought to the Women's Intimate Wellness, HRT is a new addition to my aesthetic and skin care background. My intent is not educate or to state an opinion on whether HRT is the right treatment plan (as with any medical decision like this, a woman is best served by consulting with her medical team and weighing the decision that is right for her). I would like to share how my interest in learning more about HRT led to my choice to try it and what I have experienced so far.

My Reason for HRT

Every woman has their own reason for exploring HRT. For some, they could be seeking relief from perimenopausal symptoms such as mood swings, hot flashes, vaginal dryness, etc. After menopause, some women will struggle with vaginal dryness, urinary tract symptoms or sexual discomfort that can be helped with HRT. My personal interest in HRT started with a blood test as part of my yearly wellness exam. My primary care provider and I were discussing family history and other health factors that are important at my age (51) in looking ahead. I do not currently experience many perimenopausal symptoms, with the exceptions of occasional night sweats and I am not sleeping as well as I used to. This year's wellness visit started my interest in being more proactive with what's next for me...menopause. 

Image: https://www.uclahealth.org/endocrine-center/normal...

Because Dr. Mikaelian specializes in all things women's intimate health, she is a natural next step after a yearly physical and gynecological exam with your PCP or OB/GYN. As I was learning more from her about HRT, I thought it would be interesting to see what she could learn from my blood panel. This blood panel is a little different than the one used in a typical blood draw for a physical. Dr. Mikaelian looks at hormone levels that may affect a woman’s health and overall quality of life. For a more detailed explanation of these hormones and the role of the thyroid, this article was helpful for me. 

My Personalized Hormone Replacement Recommendation

After reviewing my health history, medications, blood panel results, and current symptoms, Dr. Mikaelian suggested some supplements and a testosterone pellet. WAIT...TESTOSTERONE!? That's what I thought, what I actually said was "hmmm, interesting that may be a good idea, tell me more Dr. Sue". I have since learned that there is a range for hormones and the goal is to find where I, as an individual, feel best. There are benefits to supplementing women with either estrogen or testosterone when their levels are low, and treatment needs to be individualized for each patient after reviewing the risks and benefits. My blood work indicated low Vitamin D (common in my past blood work) and I fell on the lower range for testosterone. I liked the idea of the bioidentical hormone replacement therapy (BHRT) delivered in a sustained-release pellet inserted during a quick 20 minute office visit. I also started taking a couple of supplements to help my vitamin levels. I will have a follow-up blood test 6 weeks after the pellet insertion.

What's Next?

So it has been a little over a week. I don't feel drastically different. I do wake up with more energy and am sleeping more soundly. I told Dr. Mikaelian that I am not sure yet if it is the BHRT or a placebo effect, but I'll take it! I am also more interested in adding exercise to my day than I have been in awhile. I know that could be the result of better sleep too. Ultimately, how I feel will determine if I will continue with some type of HRT after the 3 - 4 months the pellet will last. I don't expect to be on it forever and I know this is a customized treatment based on my current health, risks, and blood assessments. I will definitely be adding a yearly visit with Dr. Mikaelian to my overall health plan as I now know, this specialized look at my intimate wellness compliments my yearly exams perfectly.

Article medically reviewed by Susan Mikaelian, MD.

Dr. Susan Mikaelian sees patients for hormone replacement consultations on Monday and Friday afternoons at 9348 Grand Cordera Pkwy, Ste 120 Colorado Springs, CO 80924. For self-pay patients, the office visit is $75 and the initial blood labs are $149. Please call 719-355-3861 to schedule.