Continuous Estrogen/progestin Hormonal Therapy
Medications containing a combination of an estrogen and a progestin can be used to control your periods and suppress the activity of endometriosis. The most common combination of estrogen and progesterone is in the form of the birth control pill, but hormones can also be delivered by a vaginal contraceptive ring that lasts 3-4 weeks or a patch that you wear on your skin and change weekly. All hormonal medications appear to be most effective against endometriosis when used in a continuous fashion. This means that you use an active pill, ring, or patch daily, and skip the hormone-free week when you would normally have your period.
Instructions on How to take ContinuousCombined Hormonal Therapy
- Birth Control Pills – Take one active pill every day at the same time
- Vaginal Ring – Insert a new vaginal ring every 3-4 weeks
- Patch – Change your patch weekly
Continuous use is as easy as skipping the inactive pills in your pill pack or replacing your ring/patch as soon as it would normally be time to remove the old one. In doing so, you will decrease the number of bleeding days that you have and prevent pain associated with your period.
Are Birth Control Pills Considered Hormone Therapy
No, birth control pills arent used as hormone therapy . The hormones in birth control pills are used to stop ovulation, so theyre at a much higher dose than the amount of hormones you find in HT.
The goal of HT is to get your postmenopausal hormone levels close to what they were before menopause. Typically, lower doses of hormones are used during HT. And the dose of hormones given during each HT session often varies depending on your individual needs.
Bioidentical Hormone Therapy Changes Lives For The Better
For women who are starting menopause or are in menopause, its common to suffer from the following symptoms:
- reduced libido or pain during sex
- vaginal dryness
- loss of energy and fatigue
- hot flashes
- night sweats and problems sleeping
- weight gain and foggy thinking
Bioidentical hormone therapy effectively eliminates those menopausal symptoms, resulting in a happier, healthier you.
Even men are helped when they use bioidentical hormone pellets. Men go through andropause as they age, just like women go through menopause when they age. Men also suffer from:
- loss of energy and fatigue
- problems sleeping
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Does Blue Cross Blue Shield Cover Bioidentical Hormone Therapy Does Insurance Cover Bioidentical Hormones
Blue Cross Blue Shield does not cover bioidentical hormone therapy or bioidentical hormone pellets, and its far from being the only health insurer that wont cover bioidentical hormone therapy. In fact, no insurance covers bioidentical hormones, bioidentical hormone pellets, but will cover the lab work necessary to calculate the optimum dose of the bioidentical hormones.
When Can I Go Off Birth Control

Because the Pill can mask menopause symptoms â including causing âwithdrawal bleedsâ during the sugar-pill week â a woman on mixed-hormone oral contraception may not know sheâs completed the transition to menopause. There are many hormone menopause tests availble. Getting an FSH test during a break from taking the Pill may help a woman and her OB/GYN determine where she is in her menopause journey. The Gennev Menopause Assessment can also help her determine her place in the perimenopause to menopause transition during this break.
When a woman goes off the Pill to get a sense of her cycles , some research indicates that may be a good time for her to transition from oral contraceptives to HRT , if she decides to go that route.
There are natural ways to manage menopause symptoms that are highly effective for some women. There are lifestyle choices or foods to eat for a healthier gutthat can make life during this challenging time easier for others. If you prefer not to take the hormonal route, or can’t because of an increased risk of breast or other cancers, you’re not out of luck. We highly recommend you talk with a Gennev Health Coach/Dietitian. Our coaches get special training in ways to mitigate menopause symptoms through nutrition, exercise, stress management, sleep hygiene strategies and more.
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Why Should You Use Birth Control Pills For Perimenopause
NOTE: As Dr. Sherry told us about birth control delaying menopause, if youâre still having periods, erratic or otherwise, you can still get pregnant. So if you engage in intercourse with men, some sort of birth control is called for. After teens, perimenopausal women have the second highest rate of unintended pregnancies. Remember, however, that the Pill does NOT reduce your risk of sexually transmitted diseases like herpes, so please continue to use condoms.
Hormone Levels During Your Period
You likely know bleeding associated with getting your period is actually the shedding of the lining of a womans uterus. As the bleeding ends, FSH and LH peak above their normal levels, leading to a thickening of the uterine lining and maturing of the egg-containing follicles in the ovary. Meanwhile, estrogen is steadily rising and peaks a few days before ovulation, after which FSH and LH peak once more.
For the next two weeks, levels of progesterone go on the rise to prepare the uterine lining for implantation of an embryo. If no implantation occurs , levels of both estrogen and progesterone drop sharply, triggering menstruation.
Your hormonal cycle is so delicate that simply altering one or two hormones can affect the entire cycle. Increasing your bodys levels of estrogen and progesterone suppresses the need to release FSH and LH, causing the entire sequence of events that lead to ovulation to come to a screeching halt.
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Cardiovascular Disease And Hrt
Women over 60 have a small increased risk of developing heart disease or stroke on combined oral HRT. Although the increase in risk is small, it needs to be considered when starting HRT, as the risk occurs early in treatment and persists with time.
Oestrogen used on its own increases the risk of stroke further if taken in tablet form, but not if using a skin patch. Similarly, tibolone increases the risk of stroke in women from their mid-60s.
Women who commence HRT around the typical time of menopause have lower risks of cardiovascular disease than women aged 60 or more.
Defy Medical: Your Concierge Clinic Specializing In Hormone Restoration
Now that you have a foundation of knowledge on BHRT, its time to take your next step.
Defy Medical has been offering hormone restoration and integrative wellness therapies for more than a decade via convenient telehealth. Our care team is up to date on the latest advancements in hormone restoration and has worked with thousands of patients to help them rediscover their best selves.
When you become a Defy Medical patient, you access:
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What To Expect From Estrogen Therapy
Most people first start noticing changes from estrogen like chest development and nipple tenderness at around 2 to 3 months after starting . Mental health, especially anxiety and depression, can also improve soon after starting estrogen. Some of the other changes that occur more gradually can include:
-
Body fat redistribution to the outside of the body
-
Softer and less oily skin
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Thinning and slowed growth of coarse body and facial hair
Most folks will max out on physical changes after taking estradiol for 2 to 5 years, but they continue taking it beyond that point to maintain the changes that have occurred and to maintain bone health.
Regarding the risks of estrogen, there has historically been a controversy over a possible increased risk of blood clots. Certain forms of estrogen like Premarin and ethinyl estradiol are known to cause blood clots.
One final risk of estrogen therapy is infertility. Over time, estrogen causes the levels of testosterone in the body to drop, which then causes changes to other body parts that are important in allowing pregnancy to occur. If preserving fertility is important to you, a reproductive specialist can help you freeze genetic material that can be used for a pregnancy later.
Menopause Symptoms And Hrt
Menopause symptoms that may be relieved by HRT include:
- hot flushes and night sweats
- vaginal dryness
- hair loss or abnormal hair growth
- dry and itchy eyes.
Other therapies, including vaginal oestrogen products, antidepressants or other medications, may be used depending on the symptoms and risk factors. Seek advice from your doctor.
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The Effectiveness Of Birth Control Pills
One way to manage many perimenopausal symptoms may be a treatment you thought you were done with: the Pill.* Because hormonal birth control provides estrogen at an even, predictable rate, the Pill can smooth the dips and peaks of fluctuations and balance out the hormones you’re losing.
For many women, hormonal birth control is an escape from some of the more disruptive symptoms of perimenopause and menopause. If you’re having a hard time of it, and are a good candidate for hormonal birth control , a few years on the Pill might be a good way to go.
What Does Perimenopause Mean

When your periods stop completely, it’s called menopause. Perimenopause means around the time of menopause. The peri-menopausal years are the few years before your periods stop. The timing of menopause is different for each woman. Although some women stop having periods in their 30s, the average age is the early 50s. So, peri-menopausal women are usually in their 40s or early 50s.
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What Causes Hormonal Imbalances In Women
The most common cause of hormonal balance in women is perimenopause when your body is transitioning into menopause and menopause itself.
Menopause occurs when a womans body stops producing Progesterone and Estrogen, the two main female hormones. During this time, women also stop experiencing menstruation. Menopause usually starts when a woman is in her 40s to 50s, although perimenopause can begin years before and cause similar symptoms.
You can typically tell youve entered menopause if you havent experienced a period for a full twelve months. Perimenopause is a little more difficult to identify and is usually diagnosable through symptoms, which are very similar to the symptoms of menopause.
Perimenopause can last for years and greatly affect your quality of life, even if you have not yet entered menopause. If you are experiencing symptoms consistent with perimenopause, you can take steps now to reduce those symptoms and regain your drive and passion for life.
Can Hormone Therapy Be Used To Prevent Breast Cancer
Yes. Most breast cancers are ER positive, and clinical trials have tested whether hormone therapy can be used to prevent breast cancer in women who are at increased risk of developing the disease.
A large NCI-sponsored randomized clinical trial called the Breast Cancer Prevention Trial found that tamoxifen, taken for 5 years, reduces the risk of developing invasive breast cancer by about 50% in postmenopausal women who were at increased risk . Long-term follow-up of another randomized trial, the International Breast Cancer Intervention Study I, found that 5 years of tamoxifen treatment reduces the incidence of breast cancer for at least 20 years . A subsequent large randomized trial, the Study of Tamoxifen and Raloxifene, which was also sponsored by NCI, found that 5 years of raloxifene reduces breast cancer risk in such women by about 38% .
As a result of these trials, both tamoxifen and raloxifene have been approved by the FDA to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for this use regardless of menopausal status. Raloxifene is approved for use only in postmenopausal women.
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Hrt And Birth Control: What You Need To Know Explained By Folx
Make no mistake: birth control is not exclusively a women’s health topic. Cisgender women are not the only people who utilize or need birth control. Plenty of people across the gender spectrum, including transgender men, transgender women, non-binary and intersex people, and many other people of varying genders belong in conversations about reproductive health, wellness, and access.
While there are many other uses for birth control other than pregnancy prevention, it should be noted that hormone replacement therapy is not and cannot be a replacement for birth control as a method of pregnancy prevention. This is true regardless of whether you’re on a high or low dose of testosterone or estrogen. In this article, we will be specifically referring to the type of sex where sperm can enter the uterus of a person with ovaries. If this is the type of sex you might be having, and you are on HRT or considering HRT, keep reading for necessary sexual health information regarding this topic.
If youre using birth control to prevent pregnancy, determining which route to take depends on your preference.
Birth control options
Immediate methods of birth control that are only needed at the time of sex include:
*It should be noted that this is a method with low efficacy
Short-acting methods, to be taken daily, that have other added benefits beyond preventing pregnancy include:
Medium-acting methods that require weekly or monthly attention include:
What about menopause?
The Complete Guide To Bhrt For Women
Many women experience a hormonal imbalance. Often, these imbalances can be caused by perimenopause and menopause but women of any age can experience hormonal deficiencies for a variety of reasons, including pregnancy, chronic medical conditions, and certain medications.
Bioidentical Hormone Replacement Therapy, or BHRT, can help address these hormonal deficiencies in women.
Throughout this guide, we will provide a comprehensive overview of BHRT, hormonal imbalance symptoms, available treatment options, frequently asked questions, and more.
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Can You Have A Period While On Hormone Replacement Therapy
Menopausal women who start a BHRT protocol will not begin having regular cycles again. A woman is considered to be in menopause if she has gone at least 12 months with no period. Menopausal women are typically prescribed a frequent dose of Progesterone to keep the uterus from growing a lining which would need to be shed through menstrual bleeding.
It is possible for menopausal women to experience spotting while they adjust to their protocols and as their provider finds the right dosage of hormones. It takes a careful balance of Estrogen and Progesterone to relieve hormone imbalance symptoms while avoiding the buildup of tissues in the uterus that causes menstruation. This spotting is typically nothing to worry about and will clear up as patients reach hormone optimization.
Perimenopausal women who still experience periods but who also have hormone imbalance symptoms will continue to have periods. These periods may become more regular and predictable as a result of balanced hormone levels. Because changes in Estrogen during perimenopause can lead to more difficult periods, BHRT may make menstruation easier.
Hrt Vs Birth Control Pills: The Ultimate Guide
Birth control pills or HRT?Whats the Difference? Why are they prescribed? And which one is right for me? This helpsheet provides the best in-depth comparison of birth control pills and hormone replacement therapy , answering these questions and more.
Some of us going through early menopause or premature ovarian failure are put on birth control pills others on hormone replacement therapy.
Both act as hormone replacement in other words, in both cases, youre taking them to replace the hormones your body used to make. But there are significant differences between the two.
So, inevitably, questions come up: What are the differences? Is one better than the other? Why am I on one and not the other? As youd expect, there are really no simple answers!
That said, though, weve set about explaining this issue, the pros and cons of each and the reasons your doctor may have prescribed one or the other of these for you.
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Continuous Progestin Hormonal Therapy
Progestins, or progesterone-like hormones, are one of the components found in combined estrogen/progestin treatments, like the birth control pill . Progestins alone are also effective in treating endometriosis. When taken in a long-term continuous fashion, progestins tend to thin the lining of the uterus which stops regular periods and lessens the chance for break-through bleeding or spotting and has similar activity against endometriosis lesions themselves.
There are various forms of synthetic progesterone called, progestins that are used to treat endometriosis. When treating young women, we prefer to start with a daily pill, such as a progesterone birth control pill sometimes referred to as a mini-pill or norethindrone acetate . These medications should be taken at the same time every day to lessen the chance of unscheduled breakthrough bleeding and pain. Setting the alarm on your cell phone can be a good reminder to take your medication at the same time each day.
The mini-pill is considered a slightly less effective contraceptive and Aygestin is not considered a contraceptive and may not protect against pregnancy. There are at least two long-acting progestin-only contraceptive methods, which may be useful in treating endometriosis: injectable medroxyprogesterone and the levonorgestrel intrauterine device .
Progestin-only treatments
Whats The Difference Between Perimenopause And Menopause

Perimenopause is menopauses opening act. Its the time leading up to menopause when your hormones begin to change. Youll still have periods during this time, but they become more irregular. Perimenopause usually begins about 4-8 years before menopause. For most women, perimenopause starts in their 40s, but some women experience perimenopause in their late 30s.
Menopause is the final period you have its the curtain closing, so to speak. When you havent had a period in 12 months, youre in menopause. The average age women experience menopause is 50, though some women may go into menopause in their late 40s. Everything after that is post-menopause.
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