The good news about a woman’s new lifespan is that you’ll probably live until you’re 80! The bad news is that your habits and choices must support that new longer life. Exercise, excellent eating, and regular check-ups are the basics, but the hormone question comes up when there are problems with hot flashes, energy, sleep, mental focus, and osteoporosis. The headlines about hormones have caused many women – and their doctors – to pitch any consideration of hormone replacement out the window without investigating the facts behind the headlines.

On his informative website www.alanaltmanmd.com., Making Love the Way We Used To author Dr. Alan Altman likens this reaction to an auto recall gone crazy: “Imagine, if you would, the following scenario. The Ford Explorer has been recalled by the manufacturer due to a rear-wheel defect. This is big news in all the media outlets. You are not concerned because you drive a Chrysler Newport. But, to your surprise, you receive a call three days later from your family doctor telling you that you should immediately stop driving your car because the problem with the Explorer means that all cars are dangerous to your health and well-being. Sounds ridiculous, but, in fact, it’s happening all over America with respect to hormone replacement therapy (HRT) since the publication of the Women’s Health Initiative (WHI) . . .”

The Women’s Health Initiative was not a study of HRT, but a study of Prempro, the horse-derived estrogen/synthetic progestin combo that is totally different from the many “bioidentical” HRT products available today. Unlike Prempro, these forms of HRT are identical to the natural hormones of the body, the kind that decline with age.

For symptoms starting in perimenopause, when you’re still menstruating and could get pregnant, a low progestin birth control pill is probably your best choice. I started a Vivelle DOT estradiol patch/Prometrium regimen in my late forties for my perimenopause symptoms because I had a tubal ligation at 35, and didn’t need the higher-dose birth control pills for contraception. Some of the other estradiol patch brands were larger and kept falling off, so I became an expert at covering them up with extra band-aids to keep them on (not very attractive). But the Vivelle DOT just hung in there, helping me feel like myself again in so many ways. The beauty of Vivelle, Climara, Estrace, Prometrium, Prochieve, and other brand-name bioidenticals is that you can buy them through any pharmacy, your doctor has probably heard of them, and they are FDA-approved and standardized, so they’ll likely be covered through your insurance.

Blood tests reveal the perfect dose for you, but a typical starting bioidentical low-dose regimen might be:

1. Vivelle DOT .0375 patch, changed twice a week, with Prometrium 200 mg – 12 days a month.
2. or the patch plus Prochieve vaginal gel 4% every other night for 12 nights of the month.
3. Estrace tablets 0.5 daily with Prometrium 200 mg for 12 days of the month.