With aging, injury, surgery and through the disease process, endocrine organs which synthesize and secrete hormones decline. Therapeutic replacement of these hormones is known as hormone replacement. Using meta-analytic data pooling results from thirty studies involving 26,708 postmenopausal women, menopausal hormone replacement has been shown to reduce mortality by 39% in women who initiated hormones prior to age 59 (PMID 15209595). Hormone replacement in women has been a specialized area of clinical focus for Dr. Parker for ten years. Patients generally seek out her guidance for secondary or tertiary opinions regarding hormonal treatment options for perimenopause, menopause and, less commonly, post-menopause. Each case is considered on an individual basis. Safety and efficacy of care guide her hormone prescribing standards, and is consistent with the treatment goals and evolving risk assessment of the individual woman. She employs a prevention-based holistic approach for timely initiation and continued use of hormone replacement as an integral part of the whole-person approach to women in menopause.
Dr. Parker does not rely on a particular protocol for hormonal prescribing practices. Rather, she reviews and critiques primary medical literature using an evidence-based perspective in order to serve the unique needs of each individual within in clinical setting. She has undergone extensive hormonal prescribing studies through the Age Management Medicine Group, the North American Menopause Society, the American Academy for Restorative Medicine, and has also trained with the American Academy of Anti-Aging Medicine with specific emphasis in hormonal replacement in men and women. She has had the distinct honor of clinical tutelage and mentorship with thought leaders in hormone replacement over several years of study, and she continues to refine her craft with ongoing education and research.
Dr. Parker practices the principle of Primum non nocere (Latin meaning First, Do No Harm, as listed as the first edict of the Hippocratic Oath of physicians) with conscientious prescribing techniques for all medications. She uses molecularly exact hormones, commonly known as bio-identical hormones, with a preference for FDA-approved versions of these applications. Conjugated equine estrogen hormones are not prescribed because they are predominantly comprised of estrone sulphate, and estrone is metabolized into 4-OHE1(E2), a carcingenic metabolite. She sources alternatives to paraben-based hormone prescriptions, since parabens have been associated with breast tumors in women (PMID: 31918794). She does not use or recommend pellet therapy based on the uncontrollable side effects which can occur with their use, but she does work with women who have used pellets with other providers and need to recover from their use.
Potential Benefits of Hormone Replacement Therapy include:
Contraindications to Menopausal Hormone Therapy include:
Hormonal assessment of menopausal women (as well as hypogonadal men) is a specialty that is under-recognized by conventional as well as even 'anti-aging' clinics. We routinely review lab work which has been run using inappropriate assays, which contributes to improper assessment and care of patients facing hormonal imbalances.
Amin MM, Tabatabaeian M, Chavoshani A, Amjadi E, Hashemi M, Ebrahimpour K, Klishadi R, Khazaei S, Mansourian M. (2019) 'Paraben Content in Adjacent Normal-malignant Breast Tissues from Women with Breast Cancer', Biomed Environ Sci., 32(12):893-904.
Rosner, W., Hankinson, S.E., Sluss, P.M., Vesper, H.W., Wierman, M.E. (2013) ‘Challenges to the measurement of estradiol: an endocrine society position statement’, Journal of Clinical Endocrinology and Metabolism, 98(4), pp. 376-87.
Salpeter, S. R., Walsh, J. M., Greyber, E., Ormiston, T. M., & Salpeter, E. E. (2004) 'Mortality associated with hormone replacement therapy in younger and older women: a meta-analysis' Journal of general internal medicine, 19(7), 791–804.
Stanczyk, F.Z., Jurow, J., Hsing, A.W. (2010) ‘Limitations of direct immunoassays for measuring circulating estradiol levels in postmenopausal women and men in epidemiologic studies’, Cancer Epidemiology, Biomarkers & Prevention, 19(4), pp. 903–906.
Find out whether you are an ideal candidate for Dr. Parker's precision medicine approach to hormone replacement therapy by scheduling an initial appointment with us.
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