Hormone replacement therapy such as estrogen therapy (ET), may be used to "transition" through perimenopause and/or treat menopause. New data implies that hormones should be used short term (no longer than 3, 5 or 10 years.) Alternatives such as vitamins and herbs are available, but many are unproven or less effective than hormones in relieving the symptoms of perimenopause and menopause. Other prescription medicines may be beneficial.
Ask yourself why you are on the hormone, then find the lowest dose of this hormone to take or an "alternative." Remember that "natural/bioidentical" and "synthetic" are NOT mutually exclusive. For example, estrogens are "naturally" occurring hormones in our bodies which are made in a laboratory possibly from plant sources. While many vitamins, herbs, and alternative medicines are extremely beneficial, they also may have side-effects (e.g., weight changes, cholesterol alterations, liver injury, allergic reactions), complications, drug interactions, or be taken too long. All choices should be individualized and discussed with a healthcare provider.
"Bioidentical" hormones mean essentially the same thing as "natural" and/or "physiologic" hormones. Many "bioidentical" products are already available as prescriptions or over-the-counter (e.g. estradiol patches, cremes and pills.) Salivary testing for these hormones is expensive and unproven. My opinion is that compounded hormone formulations may be helpful if FDA-approved products are unavailable or are ineffective. All hormones should be used in the LOWEST possible doses in order to be used safely.
For further information: www.menopause.org, www.ASRM.org, www.ACOG.org, www.4woman.org