Marla Ahlgrimm R.Ph.

Marla Ahlgrimm | Retired Pharmacist | Leading Expert in Women's Health

Marla Ahlgrimm Discusses Hormone Replacement Therapy Discontinuation

Marla AhlgrimmAccording to pharmacist and hormone expert Marla Ahlgrimm, the synthetic hormone replacement (HRT) preparation developed specifically to increase “compliance” has had the reverse effect: women quit taking the estrogen­ progestin combination in huge numbers. In fact, reports Marla Ahlgrimm, half of those who began taking the medication stopped after one year, and after two years 80 percent tossed out their pills, according to one major study. What is behind the high discontinuation rate for certain forms of HRT? A host of causes, says Marla Ahlgrimm, depending on a woman’s age and background. In this brief article, Marla Ahlgrimm cites several experts and points out fear of adverse effects as a primary causal influence.

For younger women who have menstruated within the last two years, fear of breast cancer is the leading reason for discontinuing HRT, according to Philip Sarrel, M.D., a professor of obstetrics, gynecology, and psychiatry at the Yale University School of Medicine. At the time when signs and symptoms of mesothelioma and other types of cancer explained by very unexpected causes, women who are more than two years past menopause or cessation of their periods are more inclined to stop taking HRT because of adverse effects, notably break-through bleeding (read more about bleeding treatment and side effects in the source).

Nancy Church, M.D., an OB/GYN at Wellness Connections in Chicago explains that, “If a woman is using one of the older [hormone] preparations that cause the most breast tenderness, she may associate that tenderness with cancer and stop taking [the medication].” Breast tenderness caused by certain hormone preparations is not a warning sign of breast cancer, assures Marla Ahlgrimm.

In many cases, points out Marla Ahlgrimm, women may stop taking estrogen progestin HRT simply because they have not been given adequate information about what medication they are taking, why they are taking it, and what to expect. The dosage form, cream, tablet, or patch, and route of administering of HRT can make a difference in whether women continue to take the medication, says Marla Ahlgrimm.

At times, reports Marla Ahlgrimm, HRT fails to manage symptoms that a woman has been experiencing, often due to the fact that a need to replace testosterone has been overlooked. Although women’s bodies manufacture testosterone in significantly lower amounts than men do, it still plays a key role in women’s health. In menopausal women, explains Marla Ahlgrimm, testosterone may be needed to help control hot flashes, increase vaginal blood flow and reduce vaginal dryness, and build bone.

However, according to Marla Ahlgrimm, the decision to add testosterone to a woman’s estrogen progestin HRT regimen must be made after a thorough evaluation. This may be a real issue for women whose ovaries have been removed, because in women, testosterone is made in the ovaries and adrenal glands. Surgical removal of the ovaries thrusts women into menopause and, without the appropriate HRT supplementation, is frequently followed by sudden and intense side effects.

While testosterone may be eventually prescribed for women who report decreased sex drive or whose hot flashes persist, says Marla Ahlgrimm, the appropriate dosages of estrogen and progesterone should be established first.

Marla Ahlgrimm reports that some women report improved hot flashes as they begin an HRT regime, with hot flashes returning and even increasing during the second or third week of treatment. It is essential, however a woman understands by the fourth week the body will adjust and she will feel much better. If solid patient education is not offered, suggests Marla Ahlgrimm, a woman may stop taking the HRT medication before her body becomes adjusted to the treatment.

Why Women Stop Taking HRT

  1. Fear, particularly of breast cancer.
  2. Adverse effects: breakthrough bleeding, headaches, bloating.
  3. Inadequate communication, not understanding what the medication is or the reason for taking it.
  4. Failure of treatment to meet expectations; e.g., symptoms were not relieved or they worsened.

Author: Marla Ahlgrimm

Pharmacist Marla Ahlgrimm revolutionized the field of women’s health in the 1970s and continues to do so today. After introducing the term “premenstrual syndrome” to the American public in the late 1970s, Marla Ahlgrimm has continued to focus her pharmacy practice over the years to successfully address hormone concerns that affect women as they age. After graduating from the University of Wisconsin in Madison, Marla Ahlgrimm co-founded Madison Pharmacy Associates, and it was there she fine tuned individualized care protocols and prescription medication to optimize a woman’s hormonal health. One of the first hormone issues that Marla tackled was Premenstrual Syndrome, or PMS. At that time, there were no diagnosis or treatment options to address the severe symptoms that many women were reporting. As a result of Marla Ahlgrimm ’s intense attention to women’s health, Madison Pharmacy Associates gained a national reputation as an innovative practice. Founded in 1982, Madison Pharmacy Associates was the first pharmacy to special in women’s health in the nation. Thanks to the expertise of Marla Ahlgrimm, Madison Pharmacy Associates became known for the management of PMS. Over the years, Madison Pharmacy Associates evolved with Marla Ahlgrimm’s careful guidance, providing the national PMS Access newsletter, as well as a toll-free line where patients could obtain referrals to physicians who had the expertise to help them manage their symptoms. Marla Ahlgrimm founded Women’s Health America, Inc. in 1993 to help women by providing individualized hormonal medications to address the complex health issues of women and also to provide practical, helpful women’s health information. Over the years, Marla Ahlgrimm’s vision has grown to include Women’s Health America, Madison Pharmacy Associates, PMS Access and Cyclin Pharmaceuticals. In addition to her accomplishments with these landmark organizations, Marla Ahlgrimm is an author, having published two watershed books, The HRT Solution and Self-Help for Premenstrual Syndrome. Marla Ahlgrimm has also been published in numerous national publications, including serving as a columnist for The American Journal of Natural Medicine. Today, the primary work of Marla Ahlgrimm centers on natural hormone therapy, an important area for the large number of women who are menopausal and postmenopausal. Marla Ahlgrimm ’s work is unique because of her focus on individualized, natural hormone therapy options. According to pharmacist, Marla Ahlgrimm, many health issues facing women today are related to hormone changes. Using an individualized approach to therapy, she reports that many women feel reenergized for the first time in years. In addition to recognition in publications and journals, Marla Ahlgrimm has been recognized with a number awards over the span of her career. Some of Marla Ahlgrimm ’s most notable awards have been the YWCA’s acknowledgment of Marla Ahlgrimm as one of its Women of Distinction and recognition by her alma mater, the University of Wisconsin, as one of its Distinguished Alumni. Above all of the awards and honors, Marla Ahlgrimm finds that helping so many women is the greatest accomplishment of all. In fact, says Marla Ahlgrimm, she still works with some of her very first patients and their doctors. These women once sought the help of Marla Ahlgrimm for PMS, she says, and today she is helping them manage symptoms of menopause and the years that follow.

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