Once you started taking bioidentical hormones and those horrible symptoms of hot flashes, night sweats, insomnia, bloating and mood swings start to disappear, you find yourself wondering: “Do I still need the hormones or is my body no longer experiencing those symptoms?”
The question is logical and makes sense. The answer is not as straight forward as you might think.
Let’s think conventional for a minute. When the doctor puts you on medications for your high blood pressure, low thyroid or diabetes, does he ever take you off them? As a reformed conventional doctor I can tell you the answer. It is a plain and simple, NO. No medication for chronic conditions is meant to be stopped in a conventional setting.
If anything, you are bound to be placed on an ever increasing numbers of medications with each passing year and visit to your doctor. But that is what the system is about. Increased numbers of medications, increased revenues for the drug companies. Forget about what is best for you, the patient.
Now, let’s look at the same issue from the prism of the patient advocate, the doctor who is there to help you, make you better, not just push medications. The patient advocate perspective will always question the need for continuous use of any type of medication, bioidentical and naturals included., Over the past 10 years that I have been working with bioidentical hormones I have found myself quite often in a position to question when if ever I would recommend to my patients to stop the use of the hormones. After much research and evaluation of the patients I care for I have come to the conclusion that while everybody is different and the best care is totally individualized, there are basic rules that apply to every patient.
Here are the general principles that should guide you when thinking of stopping or even starting the use of bioidentical hormones.
1.As long as you are alive you can change your mind and stop or start them again.
2.If you are not 100% sure you believe in the hormones, do not take them.
3.Do not follow anyone else’s advice. Listen to your body. Make your own decisions.
4.If you are not sure you still need the hormones, stop at the end of the month.
5.Give yourself a break from the hormones if you are taking them on a continuous basis. Make sure you skip a few days every couple of months.
6.If you stop taking them see how you feel. Watch for any sign of recurrence of the symptoms that required you to use the bioidenticals to begin with.
7.While it is true that estrogen will increase bone density over time, measurement of bone density is not a good guideline for the use of the hormones. Use short term criteria that can be easily measured by you: hot flashes, night sweats, insomnia, mood swings, weight gain, migraines, palpitations, etc.
8.Change doses and see how you feel. Since the human body changes all the time, I never understood how you can be prescribed the same dose of any medication on a continuous basis. Use the bioidentical hormones to keep your body balanced and synchronized.
9.Everyone is different and all we have is one day at a time. Some of us may need the hormones forever, while others may stop after a few months or years. Trial and error is the way to figure out what is the best formula for you.
Erika Schwartz, M.D.