Dr. Peter, you talked about menopause in your last article. I’ve been hearing a lot about bioidentical hormone therapy, why is it called bioidentical? -Kymm, La Quinta

Kymm, bioidentical hormones are hormones that are identical in molecular structure to hormones that we make in our bodies. These hormones aren’t “harvested” from our bodies, but actually synthesized or made from a plant chemical extracted from yams.
When a female becomes menopausal, many of her symptoms are due to lowered levels of estrogens and progesterone. A more “natural” method of treatment can be with bioidentical estrogen and progesterone.
Bioidentical hormone replacement therapy (BHRT) is often called natural hormone therapy because bioidentical hormones act in the body just like the hormones we produce. The goal in BHRT is to mimic nature, thus not have the adverse side effects that can occur when using a synthesized hormone that is not bioidentical. Many of the commercially available hormones that are prescribed are not bioidentical, they are molecular structures that your body has not seen before, which may be the reason they may cause unwanted side effects.
BHRT is usually applied in creams, gels or patches. There are commercially bioidentical hormones that can be prescribed or they can be made by a compounding pharmacist.
A full evaluation by a physician familiar with BHRT is needed to see if one is a candidate for treatment. Even though BHRT is considered “natural”, patients still need to be carefully monitored and have regular follow ups with their physican.

Hey Doc, I was just diagnosed with high blood pressure and my doctor wants me to monitor my blood pressure at home. Are those wrist blood pressure machines good? -Robert, Rancho Mirage

Robert, I frequently encounter the use of wrist blood pressure (BP) machines by some of my patients. I don’t like them because they are very sensitive to body position, your arm and wrist have to be at heart level when checking blood pressure with a wrist cuff. Wrist BP machines usually give a higher reading and are more inaccurate compared to the traditional arm cuffs. Unless there is a physical reason why you can’t take your blood pressure in your arm, I generally do not recommend the wrist blood pressure monitors.
I also very often recommend that my patients bring in their home blood pressure machines to my office to compare it with the office BP machine, so that the monitoring can be consistent. So, Robert, invest in a good blood pressure unit that goes on your arm and not your wrist.

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