BHRT Part 3: Solve Troubling Symptoms

Prerequisites:

1. Part I: Discover the Power of BHRT and
2. Part II: Expand Treatment Options

The educational process for BHRT education workshop in Part III is both didactic and interactive, with workshop sections devoted to Q and A. Some of the exciting topics to be discussed include:

• Vitamin D – Its function as a prohormone, best form and ideal levels, how to prescribe, monitor, and adjust. 
• Part “B” – PCOS  “atypical” presentations of PCOS and how to diagnose. Alternative insulin sensitizers for PCOS patients. PCOS and thyroid (T3 deficiency) dysfunction connection. PCOS and Nonalcoholic fatty liver disease connection.
• Treating Vaginal atrophy
• Perimenopausal transition & early menopause 
  
• Prophylaxis of postpartum depression with progesterone
  
• Aromatase inhibitors and cognitive decline 
  
• Male insulin resistance issues (corresponds to PCOS) – effects on SHBG, prostate cancer risk; diagnosis and treatment. 
  
• Deep dive into prostate cancer (Understanding PSA and free PSA, harm of ADT, and new research on alternatives to treating prostate cancer.

Only the most interesting, complex, and convoluted cases that Dr. Neal Rouzier has experienced over the last ten years will be presented. Many concepts taught in other academies are contrary to the medical literature presented in this workshop, but this is only because the attendee will decide therapy based on evidence-based guidelines rather than public opinion or popularity. 

Clinical cases will be analyzed to decide upon the appropriate treatments and level of care provided to patients. In BHRT Parts I & II, the cases and studies are simple and straightforward. However, a thorough understanding of BHRT Parts I and II are necessary to understand many of the more complex cases presented in the Bioidentical Hormone Training Part III. 

Extensive literature summaries that provide credence and support are presented so that providers have all the available data to defend their practice if necessary. There are many examples of studies that justify BHRT. For example, one study showed that standard statin treatments for cholesterol caused more cancer occurrence than PremPro®. Progesterone causes decreased absorption of estrogen, yet it can be anticipated and prevented. Each of these controversial topics and more will be thoroughly addressed in the Bioidentical Hormone Training Part III.

Access: This workshop is offered in-person and/or virtually. You can choose if you would like to be shipped printed educational materials. We will also post a recording for each day that same evening. The recording will be available until Thursday of the week after the event to re-watch or catch up on anything you may have missed, but it will not be available after this time.

Accreditation: 20 AMA PRA Category 1 Credits | 20 Nursing Contact Hours (20 pharmacologic hours) | 20 Hours Pharmacy Credit (knowledge based)

Upon completion of this workshop the health care professional will be able to:

• Identify CFS/Fibromyalgia in addition to, diagnosing, testing, and treating it to improve patient outcomes.
• Describe the data demonstrating that androgen suppression therapy, as well as estrogen deprivation, is associated with poor survival in men in comparison with placebo.
• Identify the inverse relationship between estrogen and prostate cancer and the two mechanisms by which estrogen treats and protects against prostate cancer.
• Examine literature reviews as to what level of Vitamin D helps protect against cancer, CAD, osteoporosis, dementia, type II DM and AMD as well as how to treat Vitamin D deficiency and how much is too much
• Determine current management strategies for preventing loss of pregnancy in Polycystic Ovary Syndrome (PCOS) as well as improving pregnancy rates with aromatase inhibitors and the importance of maintaining low levels of aldosterone with PCOS.
• Discuss the pathophysiology of vaginal atrophy and the use of rings, tabs, troches, creams, and DHEA.
• Determine the risks and benefits of transdermal estrogen vs. oral estrogen, why one vs. the other one, and review the statistics that claim HRT increases blood clots, or does it?
• Describe how thyroid replacement therapy does not cause osteoporosis and how it can be protective against heart disease and dyslipidemia.
• Recognize the data demonstrating that only certain types of estrogen increase the production of fatty acid esters that result in protection against atherosclerosis and plaque deposition at the blood vessel wall.
• Examine current policy statements for hormone replacement therapy by the North American Menopause Society (NAMS) and American College of Obstetricians and Gynecologists (ACOG), with a critique and review of their recommendations.
• Discuss the most current literature for bio-identical hormone replacement therapy (BHRT), thyroid, testosterone, DHEA, estrogen, and progesterone.
• Describe the difference in clotting between Premarin®, Provera®, esterified estradiol, and micronized progesterone as per JAMA.
• Discuss the importance of sex hormone binding globulin (SHBG) in men and women and why it is predictive of CAD, MS and cancer.
• Examine the medical literature to understand how hormones affect cardiovascular disease for both men and women and how Testosterone can both increase and decrease CVD in women by interpreting the correct approach.
• Discuss new therapies for prostate cancer as well as better diagnostic sensitivity and specificity of MRI-S scan in addition to treatment rationale for prostate cancer survivors through case presentations and literature review.
• Recall how estrogen therapy can be beneficial in the treatment of prostate cancer and reversing the side effects of ADT.
• Demonstrate skills in multiple case studies with interactive discussion to ensure interpretation and treatment protocols are as demonstrated in our evidenced based scientific literature.
• Describe rational approaches for the use of progesterone in treating PMS and PPD.
• In addition to the clinical skills learned in this course group discussions contribute to the collaborative nature of pharmacists working with physicians and nurse practitioners and their patients to determine a personalized approach to prescribing HT. This collaborative provides a continuum of care for patients in ensuring improved patient outcomes and consistency in care.