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The Doctor's Corner: The why and how of hormones

May 30, 2013|By Dr. Jane K. Bening

This is the second of two articles updating women of all ages on the use of hormones.

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I had to bite my tongue while sitting at Zinc Cafe & Market in Laguna Beach (one of my favorite places) the other day. Two beautiful young women who looked to be in their early twenties sat across from me, both with bad acne, which can leave permanent scars. I doubted they could be using birth control hormones, now available as pills or via a nifty vaginal ring. In addition to reliable contraception, use of these hormones is a great strategy for clearing up skin problems and smoothing out a myriad of other hormonal challenges in women, paving the way for an easier menopausal transition.

In my experience, use of a spectrum of hormones can safely improve women's lives from puberty into menopause and beyond. What to prescribe, and when, is a clinical judgment call. There are many well-researched Food and Drug Administration (FDA)-approved choices on our treatment palette. (To disclose, I have been a medical speaker for manufacturers of FDA-approved bioidentical menopausal estrogen products.)

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The American College of Obstetricians and Gynecologists published a practice bulletin elucidating the myriad non-contraceptive benefits of birth control hormones in January 2010. These include reduction of acne and facial hair, improvement in menstrual bleeding and pain, control of endometriosis and premenstrual syndrome, improvement in bone density and a marked reduction in the lifetime risk of ovarian and uterine cancer. Just think — all that, and contraception to boot! It is simple to recommend extended pill usage, reducing the frequency of menstrual periods. We can help women control their cycles for more carefree beach days. These are fantastic benefits, with minimal risks for women with healthy lifestyles.

As a transition strategy for non-smoking women, we may continue birth control hormones, including the vaginal ring, right up to the age of 54. This can mask the menopausal transition, again smoothing over the perturbations of hot flashes, irregular bleeding and moodiness.

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