Looking for safe Alternatives
Hormone production declines with age. Sex hormones drastically fall off with the onset of menopause. Imbalances or deficiencies of sex hormones are the main culprit for many female symptoms and complaints, like:
- Hot flashes and night sweats
- Vaginal dryness
- Low sex drive
- Depression or anxiety
- Weight gain
- Heart palpitations
- Premature aging
Until some years ago it was common medical practice to treat menopausal symptoms with synthetic estrogens and progestins, which were believed to be safe and provide the additional benefit of protecting against heart disease. These assumptions came crashing down when in 2002 the results of the Women’s Health Initiative were published. Women taking Prempro, - a combination of estrogen derived from pregnant mares and a synthetic progestin – showed a small increased risk of breast cancer after five years of usage.
Consequently, many women stopped taking their synthetic hormones and preferred to deal with their symptoms, and many physicians were searching for safer therapies.
What is a woman to do?
Our current approach is to individualize hormone replacement therapy so that it addresses each woman’s specific complaints. It’s all about selecting safe or low risk therapies, weighing the potential risks and benefits and making the choices that are right for you. Here are some of the strategies we apply:
1. Evaluating your hormones: In order to understand your hormonal needs, we will test the levels of your sex hormones (Estrogens, Progesterone, Testosterone, FSH). As hormones positively or negatively interact with each other, we often determine the strength of your adrenal glands (DHEA, Cortisol and Pregnenolone), your thyroid function and your fasting insulin level. Hormone testing can be done through blood, 24 hour urine or saliva.
2. Phytoestrogens: These are plant derived substances have been traditionally used to treat various female symptoms. They consist of soy isoflavones, black cohosh, licorice extract, vitex extracts, clover extracts, Dong Quai and others.
3. Bio-identical Hormones: Contrary to synthetic hormones, these hormones are biochemically identical to the hormones the body produces. Often these formulas are compounded as skin creams or sublingual drops, but are also available as prescription medications. They might contain Estradiol (E2), the main estrogen produced by the ovaries and Estriol (E3), a weaker form of estrogen, which is released in high amounts during pregnancy and is believed to be cancer protective. They also contain progesterone and if necessary testosterone. To date the safety of bio-identical hormones has not been evaluated by a big scale American study. A newer French study with 40000 women does not show an increase cancer risk over 15 years but significant benefits for the prevention of Alzheimer's, heart disease, colon cancer and osteoporosis.
4. Retesting: After a treatment program has been initiated we determine its effectiveness in regards to symptom relief and tolerance. If necessary we retest hormone levels and make the necessary adjustments. We also recommend regular gynecological exams including a pelvic ultrasound..
5. Lifestyle changes and Nutrition: Many hormonal symptoms and complaints are aggravated or sometimes even caused by various lifestyle and nutritional factors:
- Food allergies can trigger hot flashes, irritability, bloating and fatigue.
- Lack of exercise promotes osteoporosis, weight gain and low sex drive
- Stress can be the reason for hot flashes, fatigue, insomnia, weight gain, depression, anxiety, irritability and heart palpitations.
- Smoking can promote osteoporosis and cervical dysplasia.
- Insulin resistance often results in weight gain, fatigue, yeast infections and sugar cravings.
6. Choose a program that is right for you: An individualized approach leads to the best results. Integrating hormone replacement into a comprehensive nutritional and lifestyle program is essential. Besides addressing hormones I often recommend a dietary program, exercise plan, stress management and supplementation with Antioxidants, Minerals and Omega 3 fatty acids.