Bioidentical Hormone Therapy for Menopause in Turkey

Bioidentical Hormones in Menopause

Menopause is a major turning point in a woman’s life. During this period, hormonal changes can lead to a wide range of physical and emotional symptoms. Hot flashes, night sweats, insomnia, mood swings, and bone loss can make daily life challenging. Considering the increased health risks after menopause, hormone therapy becomes an option for many women. However, traditional hormone replacement therapy (HRT) may cause side effects or may not be suitable for everyone. This is where bioidentical hormone therapy (BHT) comes into play.

Many of my patients come to me saying, “Doctor, I’ve entered menopause. Should I take hormones or not?” Understandably, there’s a lot of confusion about this topic — some doctors insist it’s essential, while others say it should never be used. So what should we do? Although menopause is a natural process, it has become a more destructive phase in the modern era as human life expectancy has increased. During menopause, the body’s production of estrogen, progesterone, as well as testosterone and DHEA, decreases significantly. Among these, estrogen and progesterone play vital roles in protecting a woman’s heart, blood vessels, bones, and brain — giving women a unique advantage over men. When these hormones decline during menopause, the body experiences rapid aging, physical decline, and increased susceptibility to illness.

In menopause, the key is to use bioidentical hormones — molecules that are identical to those naturally produced by the ovaries. These natural hormones bind to the same carrier proteins and reach the target cells just as the body’s own hormones do. We can restore lost estrogen (E2: estradiol and E3: estriol) through patches, creams, or gels, and use micronized natural progesterone either vaginally or orally.

As experienced and well-trained gynecologists in this field, we first evaluate whether our patient is suitable for hormone replacement therapy through detailed medical history and examination. When appropriately prescribed, Bioidentical Hormone Replacement Therapy allows a woman who respects and cares for her body and health to regain vitality — and the benefits can be truly transformative.

Bioidentical Hormone Therapy in Menopause: Restoring the Natural Balance

So, what exactly are bioidentical hormones, and how do they benefit women during menopause? Let’s take a closer look.

What Are Bioidentical Hormones?

Bioidentical hormones are compounds that are chemically identical to the hormones naturally produced by the body, such as estrogen, progesterone, and testosterone. It’s similar to taking natural thyroid hormone or insulin when your body’s own production is insufficient — you are simply restoring what your body already knows and recognizes. These hormones are either naturally synthesized or derived from plant sources and are recognized by the body’s hormone receptors as identical to endogenous hormones.

Unlike synthetic hormones, bioidentical hormones do not cause receptor misrecognition or increase cancer risk. While conventional hormone therapies are standardized and the same for everyone, bioidentical hormone therapy is personalized. The formulation can be adjusted based on blood hormone levels, allowing for a more balanced and natural effect in the body.

These hormones — primarily estrogen, progesterone, and in some cases testosterone — are administered to the body to help restore hormonal equilibrium. Estrogen is one of the most effective hormones for relieving menopausal symptoms, while progesterone plays an essential role in maintaining the health of the uterus, breasts, and bones.

Benefits of Bioidentical Hormone Therapy in Menopause

Bioidentical hormone therapy (BHT) is a treatment approach designed to improve women’s quality of life during and after menopause. The key benefits of this therapy include:

1. Reduces Hot Flashes and Night Sweats

The sudden fluctuations in body temperature caused by declining estrogen levels can make daily life difficult. By balancing estrogen levels, bioidentical hormone therapy can significantly reduce hot flashes and night sweats.

2. Improves Sleep Quality

Sleep disturbances are common during menopause due to hormonal fluctuations. Night sweats and anxiety can disrupt sleep patterns. Estrogen and progesterone supplementation have relaxing and stabilizing effects that can improve sleep quality.

3. Supports Mood and Emotional Well-Being

The drop in estrogen levels can also affect the production of serotonin, the “happiness hormone.” This can lead to depression, anxiety, and mood swings. Bioidentical hormones help restore hormonal balance, stabilize mood, and reduce irritability and tension.

4. Protects Bone Health

The positive effects of estrogen on bone density are well-known. After menopause, decreased estrogen levels increase the risk of osteoporosis. Bioidentical hormone therapy helps slow bone loss and reduce the risk of fractures.

5. Supports Skin and Hair Health

During menopause, women may experience dry skin, loss of elasticity, and hair thinning. Estrogen supplementation stimulates collagen production, leading to healthier, more radiant skin and stronger hair.

6. Enhances Sexual Health

Decreased estrogen and testosterone levels during menopause can cause vaginal dryness, low libido, and discomfort during intercourse. Bioidentical hormone therapy helps restore vaginal moisture and elasticity, improving sexual comfort and desire.

7. Supports Cognitive Function and Brain Health

Recent research has shown that estrogen receptors exist in the brain. Estrogen stimulates nerve cells in the hippocampus and positively affects cognitive functions such as memory and concentration. The decline of estrogen during menopause can cause “brain fog,” forgetfulness, and increase the long-term risk of Alzheimer’s and dementia. Therefore, bioidentical hormone therapy can play a protective role in maintaining brain health after menopause.

8. Promotes Heart and Vascular Health

Before menopause, women have a lower risk of heart attack compared to men, thanks to the protective effects of estrogen. After menopause, as estrogen levels drop, this risk rises to match that of men. Studies have shown that bioidentical hormone therapy may have beneficial effects on cardiovascular health, reducing this increased risk. Women with a family history of heart disease, heart attack, or severe hot flashes should be evaluated by a cardiologist and considered for bioidentical hormone therapy.

9. Relieves Vaginal Dryness and Restores Sexual Function

Vaginal dryness is a common symptom of menopause that can make intercourse painful and decrease sexual desire. Bioidentical hormone therapy, especially with localized vaginal applications of estradiol (E2) and estriol (E3) in gel, cream, or suppository form, helps restore natural moisture, reduce pain and burning, and revive libido.

How Is Bioidentical Hormone Therapy Administered?

Bioidentical hormone therapy can be administered in various forms. The most common methods we use include:

• Creams and gels: Applied directly to the skin for absorption.
• Oral capsules or tablets: Taken daily, although this route is not suitable for every woman due to the liver’s first-pass effect and potential side effects such as embolism.
• Transdermal patches: Provide a steady and balanced hormone release for up to a week.
• Nasal sprays or sublingual drops: Offer rapid absorption and can be more comfortable for some patients.

The choice of formulation depends on individual needs and medical recommendations. Hormones absorbed through the skin bypass the liver, which reduces the risk of blood clotting — making this method significantly safer, especially for women in higher-risk groups.

Hormone replacement therapy is a serious medical treatment and should always be managed under medical supervision. I do not recommend synthetic oral hormones. Instead, opt for bioidentical hormones applied through the skin. Additionally, it is important to have your carotid arteries and breast health evaluated to ensure there are no underlying concerns for your safety.

Lastly, if there are chronic inflammatory conditions in your body, they should be addressed before starting therapy to ensure the treatment can be initiated safely and effectively.

Nutrition and Lifestyle Recommendations During Menopause

In addition to bioidentical hormone therapy, making certain lifestyle adjustments can help you experience a smoother and more comfortable menopause transition:

• Stay hydrated: Dehydration can worsen hot flashes.
• Incorporate plant-based estrogens: Foods such as soy, flaxseeds, and chickpeas contain natural estrogen compounds.
• Avoid sugar and processed foods: Sudden fluctuations in blood sugar can trigger mood swings.
• Exercise regularly: Resistance and weight-bearing exercises help maintain bone density and prevent muscle loss. Walking, Pilates, yoga, or light strength training are excellent options.
• Manage stress: Meditation, breathing exercises, and social activities can help lower stress levels.

Possible Side Effects of Bioidentical Hormone Therapy

Like any medical treatment, bioidentical hormone therapy may have some side effects. These are generally mild and can be managed by adjusting the dosage or form of administration:

• Headaches
• Mild stomach discomfort
• Breast tenderness
• Slight weight changes
• Spotting or irregular bleeding

If these side effects persist, consult your doctor to review and modify your treatment plan as needed.

In Conclusion

Bioidentical hormone therapy can be an effective option for relieving menopausal symptoms.

Menopause is, of course, a highly individual experience — some women go through it with minimal discomfort, while others may find the symptoms more challenging. By restoring the body’s natural hormonal balance, bioidentical hormone therapy offers a more natural and comfortable way to navigate this stage of life.

If you are struggling with menopausal symptoms, consider consulting a specialist to determine the most suitable treatment for you. Remember: being a woman means embracing change and transformation, and with the right guidance, a healthy and balanced menopausal journey is absolutely possible.