Menopause

I prefer not to prescribe hormone replacement therapy. There are risks associated with it, though I think it's a good idea for the right patient. Gynecologists are much more familiar with the risks, and can counsel a woman about them in detail, so that the patient can make an informed decision. Hormone replacement therapy is an option for those women who are menopausal, have hot flashes, and do not have any conraindications to hormones (such as cigarette smoking, a first-degree relative with breast cancer or ovarian cancer, and a tendency to form blood clots). For those patients of mine who wish to explore this option, I refer to a gynecologist.

The risks and benefits of hormone replacement therapy are detailed nicely in the link below.

Recently it was proven that Neurontin (gabapentin) treats hot flashes equally as effectively as estrogen.

I do not prescribe so-called bio-equivalent hormones. I think they're a great idea, I just haven't learned how to do it. This involves checking blood levels of a patient's various hormones, and replenishing those which are low with supplemental hormones which are bio-equivalent. Some day perhaps I'll find a good course to take which would teach me how to do this, we'll see.