What to know about Hormone Therapy

A blonde female physician offering hormone replacement therapy

Hormone therapy is a medical treatment that can help relieve the symptoms of menopause and perimenopause. Hormone therapy also is called “hormone replacement therapy” or “menopausal hormone therapy.”  The average age that women go through menopause is 51. Usually beginning in your mid-40s, you enter a transition phase called perimenopause.

Your hormone levels can go up and down during perimenopause. This can cause symptoms such as hot flashes, vaginal dryness, pain during sex, sleep problems, and night sweats.

How does Hormone Therapy work?

As you approach menopause, your ovaries get smaller and gradually stop making estrogen. The goal of hormone therapy is to replace and balance your body’s supply or estrogen. Estrogen can relieve symptoms of menopause in two ways:

  • Systemic estrogen therapy. Estrogen is released into the bloodstream and travels to the organs and tissues where it is needed. Examples include pills, skin patches, gels, and sprays.  
  • Local estrogen therapy. Women who only have vaginal dryness may take local estrogen therapy in the form of a vaginal ring, tablet, or cream. These forms release small doses of estrogen directly into the vaginal tissue.

You and your ob-gyn can talk about what form may work best for you. You can decide based on your symptoms, medical history, and lifestyle.

Traditional hormone replacement therapy is a form of medication that contains female hormones- estrogen and sometimes progesterone. Hormone replacement therapy aims to help treat various issues, including sexual discomfort, hot flashes, bone density, and sex drive. Some basic forms of hormone therapy include systemic options (that come in various options such as a pill, patch, or ring) as well as low-dose vaginal products that help minimize the amount of estrogen absorbed in the body. For women experiencing hypoactive sexual desire disorder, specific versions of bio-identical hormones known as pellets may serve as an effective treatment. 

What are alternatives to Hormone Therapy?

Many women are interested in options other than hormone therapy to treat menopause symptoms such as:

  • Over-the-counter vaginal moisturizers and lubricants
  • Non Hormonal medications
  • Plant and herbal supplements, including some soy products

It also is important to know that few plant and herbal supplements have been studied for safety or effectiveness. Talk with your ob-gyn about which type of treatment is right for you.

What are Bioidentical Hormones?

Bioidentical hormones come from plant sources and are similar to hormones produced by the body. They include commercially available products that are approved by the U.S. Food and Drug Administration (FDA) as well as compounded drugs that are not regulated by the FDA. 

Customized compounded hormones pose more risk because they vary in strength and purity. That means you can take too little or too much of a hormone without knowing it. The American College of Obstetricians and Gynecologists (ACOG) recommends FDA-approved hormone therapy over compounded hormone therapy.

What Hormone Therapies are available to patients of TP4W?

In addition to the traditional estrogen and progesterone therapies, TP4W is proud to use an FDA-approved bioidentical hormonal pellet called “Testopel.” 

Testopel pellets deliver consistent, healthy levels of testosterone for 3-5 months in women avoiding the fluctuations of hormone levels seen with other methods of delivery. Further, these pellets do not increase the risk of blood clots as can occur in rare cases with estrogen replacement therapy because they do not contain estrogen.

In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be excellent for relief of menopausal symptoms and improvement in sex drive, libido, sexual response, and performance.

Next Steps

For questions about any of our Hormone Therapy services, we recommend the following pages:

Patient FAQs from The American College of Obstetricians and Gynecologists

Triangle Physicians for Women-  Bioidentical Hormone Replacement

Triangle Physicians for Women- Menopausal Management

To schedule an appointment to speak with our physicians for these are any of our services, please call our office at (919) 678-6900.

I think Dr. Grana and her assistant (Mandy) are the best. I have been going to TP4W for years – at least 20, and I have never been disappointed with the level of care I have received. I can be a challenge as my level for pain tolerance is low and they put up with me! I can’t help but highly recommend the practice to anyone looking for exemplary women’s healthcare.

Love love love Dr. Grana and her crew. Love going to Holly Springs office. The girls are the best from Lisa at the front desk to all the girls in the back. Your music and atmosphere is great. Thanks for making these appointments fun!! Yes believe it or not, fun!!!

Dr V and the office staff were all very professional, understanding, caring and very efficient. I would be happy to recommend this practice to friends, family and associates. – Barbara M. Lucas

My visit was great! & my past visit have all been great.Kristy helped me even with me being a bit stressed & in a hurry because I had to be seen & my job is super strict. Her urgency to get me seen was phenomenal. I even got to see Heather, she’s awesome & amazing. She helped deliver my baby girl a year ago. My whole family loves her and Dr Sheshadri. We actually can’t wait to get pregnant again hahaha. Everyone treats you with respect and always makes sure your okay & answers whatever questions you have before you leave. Even leaving a message for the nurses,they get back to you so quickly.  This practice really makes you feel taken care of.  We appreciate you all!  – Erika Hooks

My experience with the TP4W staff has been top of the line.  They helped me through three pregnancies and coached me through every step of the way.  Eternally thankful I chose TP4W.  – Britney

TP4W have such amazing doctors, midwives and nurses.  I cannot say enough about Dr. Grana and the rest of the staff for all the help, advice, guidance and medical care they provided me with all of my kids.  She made me feel safe and calm through both c-sections.  My routine care and pregnancy care have always been top notch and I would recommend them to anyone looking for an OBGYN.  – Brooke

We were honored to receive a hand written note..

Dr. Grana, Angie, Jessica, Heather, April, Sarah and the rest of the staff –

Thank you all so much for taking such good care of me through both of my pregnancies and births, especially my latest one on 10/29! most of yall know how nervous I was from having gone through a lot (to say the least) with my first in 2016. You all made me feel so comfortable and at ease before, during and after. And going through a touch year with my dad, you guys always asked how he was doing at every appointment, which was so thoughtful and beyond your job description. I know that you all see many women go through what i did each and every day and deliver many babies and perform many c-sections. But I hope you know how special Ruby’s delivery was to me. You all have amazing jobs! I cannot thank you all enough. Merry Christmas!

Love, Lucy

I have been going to TP4W since 2010/11 and could not be happier.

The staff, nurses, midwives, and doctors are all amazing. I have 2 sons, both delivered via cesarean by Dr. V. Every visit and every provider did everything in their power to give me the birth experience I wanted, and also ensure that myself and my babies were safe and healthy. Dr. V even did everything in his power to help me avoid my first c-section and VBAC with the second, but that turned out to be out of his hands and he was the absolute best surgeon. With my two pregnancies, I experienced a few scares and some unusual circumstances that would be too long and too private to write in a review, but every single hurdle was handled with grace, honesty, and professionalism. I am so thankful for the recommendation from a friend to come to this office. I can’t imagine ever going to another practice.

TP4W is amazing and I am so very thankful I found them 9 years ago!! Amazing partnership between midwives and doctors, sweet nurses and front end staff, and relaxing environment. I literally recommend them to all my friends! I look forward to my appointments and feel like I’m going to catch up with old friends.

I’ve always had wonderful experiences at TP4W. Everyone is friendly, knowledgeable, and thorough in their care. April delivered my son and I can’t say enough wonderful things about her. She is patient and compassionate. I had the best labor and delivery experience thanks to her. I do and will continue to recommend them to my friends and family!