In an insightful HOT! Magazine Q&A, Dr. Simone Silver tackles a range of complex and personal questions women face during perimenopause and menopause, providing evidence-based and nuanced answers.
A significant portion of the discussion is dedicated to the topic of hormone pellets. Dr. Silver explains that while these small, implanted cylinders offer the convenience of steady hormone release for 3-6 months and are available in South Africa, they come with considerable drawbacks. The primary concern is the inability to adjust or reverse the dose once implanted, which can lead to uncomfortably high hormone levels and side effects that must be waited out. She advises that patients and practitioners must be fully aware of these limitations and the source quality before considering this non-FDA-approved method.
Dr. Silver also addresses the connection between HRT and emotional health, explaining that depression can be a direct symptom of hormonal shifts but can also indicate that a woman’s current HRT formulation or dosage is incorrect. She emphasises a holistic investigative approach, recommending tests to rule out nutrient deficiencies and assess the need for balancing hormones like progesterone and testosterone alongside estrogen.
On cardiovascular health, she clarifies the critical “window of opportunity”: HRT offers the most heart protection when started early in menopause. While this specific benefit may plateau after about 10 years, she stresses that the decision to continue therapy should be based on a broader assessment of bone health, cognitive function, symptom severity, and overall quality of life, not solely on cardiovascular metrics.
The article also provides clear explanations for managing menopause-related breast enlargement and tenderness, often through dose adjustment, and outlines what an endometrial ablation procedure entails for treating heavy periods.
Original Article: Ask The Expert with Dr. Simone Silver, published in HOT! Magazine, October 2020.
