If you are a women over the age of 40 (for a rare few before the age of 40) you may have wondered if you need to take hormones. There is so much misinformation surrounding the risks, benefits and use of hormone. It can be overwhelming, so most people just choose to stay away from them all together which results in needless suffering and decreased sense of well being, not to mention poor sleep and for some painful sex. In this blog I hope to clear up some of the misconceptions of hormone therapy.
First let me explain the difference between synthetic and bio-identical hormones. Synthetic hormones are generally commercially available. In the major studies that resulted in so much confusion regarding hormones, like The Women’s Health Initiative, they used synthetic hormones, mainly Premarin and Provera. Bio-identical hormones on the other hand are chemically identical to what the body makes and have not been found to increase the risk of cancer or blood clots in any study. The problem is studies use the term progesterone or estrogen when what they tested was a progestin (synthetic) or Premarin (synthetic) which is made from horse urine and is chemically altered to be similar but not identical to what the body naturally makes. When reading the research it can be tricky when drawing conclusions and it’s important to establish what products were actually being studied when you read and draw conclusions from research.
Estrogen is thought of as a primarily female hormone. However, estrogen is also beneficial for men and women and can help improve memory, cognition and increases bone mineral density. In women I use oral estradiol which protects against heart disease, osteoporosis, fractures, vaginal atrophy and urinary incontinence. Signs of low estrogen include sagging breasts, insomnia, depression, fatigue, mood swings and decreased libido. Women who are pre or peri (before or nearing menopause) should not be taking estrogen. Some doctors will given women who have had a hysterectomy but the ovaries remain estradiol. I question this choice as removing the uterus does not mean you are in menopause and taking estradiol before menopause is generally not helpful. Menopause is defined as not having a period for twelve consecutive months.
Progesterone is the hormone that balances estrogen. When a women has a uterus if she takes estrogen alone it can lead to a thickening of the uterine wall which is concerning. However, even for those who don’t have a uterus there are many benefits to taking progesterone. Progesterone improves sleep, mood, protects against breast and ovarian cancer and stimulates osteoblasts (bone growth). Progesterone is used to help treat symptoms of PMS in pre/peri menopausal women and is very important for women who have poly cystic ovarian syndrome.
Testosterone, generally thought of as a male hormone, is also beneficial for women. Testosterone increases muscle mass and decreases visceral fat by decreasing insulin resistance, improves collagen (thickness of skin), decreases cellulite, improves exercise endurance, improves lipid profile (decrease in risk for heart disease) as well as sexual function, desire and pleasure. I prefer a testosterone cream to injections or pellets as the absorption is more predictable and constant. There are no high peaks and valleys that are seen in injectables and pellets. There is a side effect of hair growth at the site of application which is generally direct to the labia.
Whoa! That felt like a lot and I didn’t even go over thyroid, melatonin and DHEA! Obviously hormones are complex and there is no one size fits all for anyone person. If you have ever wondered if you would benefit from taking bio-identical hormones or have questions or concerns about them, please feel free to call and discuss it with me. Or if you are ready to jump in feet first we can schedule your hour long initial consultation. My passion is to help you feel and look your best and keep you healthy throughout your lifetime!
