If a patient does not feel better on alternatives, I start with low dose bio identical hormones. I like to start patients on low dosages because they don't have symptoms from the hormones. Studies have shown that women on standard hormones will stop within 3 months because of terrible symptoms such as breast soreness, bleeding, weight gain. If you start a patient on low-dose hormones, they will stay on them, they will get the benefits, their symptoms will improve. If the symptoms are not controlled, they are more willing to go up slowly because they feel ok.
Nothing is written in stone.
It has to be reevaluated by the doctor as the person ages. Menopause is defined by not having a period for more than a year. When you're on hormones and you stop getting a period, you can pretty much say that it's post-menopausal. If it's sequential pills, you may not be able to tell when you're postmenopausal. Dr. Corio, thanks so much for visiting with us in Power Surge tonight.