Tracking and titrating hormone supplementation will give your patients the confidence they deserve and minimize unwanted side effects sometimes associated with hormone replacement. It is now widely accepted that minimizing the hormone dose and the exposure duration is ideal to minimize possible risks.

How do you help alleviate your patient's menopausal symptoms while still giving some assurance that the dose is controlled?

Saliva testing is a simple and convenient way to test the bioavailable portion of sex-steroid and adrenal hormones (estradiol, estrone, estriol, progesterone, testosterone, DHEA, DHT, and cortisol). Home collection allows you and your patient to precisely time collections to correspond to menstrual cycle and diurnal variations. Pre and postmenopausal, age and sex specific, and supplemented ranges are provided for comparison.

One of the first indications of a need for estrogen is an increase in the rate of bone turnover. The Dpd urine assay measures the deoxypyridinoline crosslink, which is a byproduct of bone breakdown. This assay should be done on all women as they enter perimenopause - even asymptomatic patients can exhibit a high rate of bone loss and be at risk for Osteoporosis.

Comprehensive hormone replacement program

1. Baseline testing to identify deficient hormone levels that are often the cause of unwanted symptoms. Low estradiol or low progesterone can often be associated with the same set of symptoms and testing can help identify which hormone or hormones need replacement.

2. Once treatment has started, monitor hormone levels to adjust dosing to the lowest possible level.