Today countless men and women worried about aging and maintaining a quality of life are receiving hormone replacement therapy (HRT). Hormone-related problems- such as mood swings, PMS, infertility, endometriosis, fibrocystic breasts, weight gain, low libido, vaginal dryness, frequent bladder infection, heart disease and osteoporosis-- can be alleviated by achieving a proper hormone balance. In considering the benefit risk ratio, it is important to take into account alternatives to conventional therapy.
Why natural hormone replacement therapy?
Alternatives to conventional HRT include the use of natural plant-derived bio-identical hormones which have the same chemical makeup as those produced by the body. Synthetic hormones and hormones from animal sources do not allow the body to generate the complete range of other hormones which are needed to operate at full capacity, and thus are more likely to produce side effects.
If you have not heard much about natural hormone replacement, you're not the only one. Since natural hormones can not be patented for the same reason you can not patent natural air, water, or vitamins, there's little or no incentive for the pharmaceutical industry to invest millions of dollars to develop, test, submit to the FDA for approval, and market these hormones.
What hormones are we referring to?
Natural hormone replacement isn't just estrogens and progesterone. Natural estrogens and progesterone are just part of a complex and closely interlinked hormone system that includes many other hormones such as testosterone, DHEA, pregnenolone, and melatonin, to name just a few. Many of these hormones have been found to decline with age. Restoring them to normal levels with natural replacement versions can have an incredibly revitalizing effect on our hearts and immune systems to our moods, energy, and libido.
Estrogen is not one hormone, but a set of similar hormones with varying degrees of activity. The three most essential estrogens are estrone, estradiol, and estriol. Estradiol is the primary estrogen produced by the ovary, and estrone is formed by conversion of estradiol. The most favored kind of estrogen replacement remains conjugated estrogens (including many estrogens that are natural to horses, but few that are natural to humans). In the intestinal tract, these are converted mostly to estrone. Synthetic ethinyl estradiol is also frequently used in estrogen supplements. Estrone and estradiol are the estrogens predominantly linked to breast and endometrial cancer.
New regimens have been developed that use natural estriol in the greatest concentration together with other naturally occurring estrogens in a properly balanced ratio. Estriol generates very little endometrial proliferation and rarely causes postmenopausal vaginal bleeding. Estriol might also be successful at reducing the risk of blood clots in the veins or lungs. Estriol is produced in very large amounts during pregnancy and is thought to be protective against breast cancer. High levels of estriol are found in vegetarians and Asian women, who have a much lower risk of breast cancer.
The hormone progesterone participates in practically every physiological process, in both men and women. The stabilizing action of progesterone is particularly visible in muscle tissue, such as the uterus, blood vessel walls, the heart, the intestine, the bladder, and bone cells. Less noticeably, progesterone stabilizes and normalizes nervous, secretory, immune and growth processes.
Natural progesterone comes from yams and soybean. It matches precisely the chemical composition of the body's progesterone. Synthetic progesterone, or progestins, are chemically developed from progesterone and react differently in the body resulting in the unwanted side effects such as salt build up, fluid retention, low blood sugar, breast tenderness, weight gain, and depression. The role of natural progesterone in protecting against and treating osteoporosis, helping to clear endometriosis and fibrocystic breast, and treating vaginal dryness, infertility, and menstrual abnormalities is getting considerable attention in the medical and lay communities. In men over 55 natural progesterone is being used to increase sex drive, and to treat osteoporosis.
Sometimes, it is important to take into consideration the inclusion of the androgens, testosterone or the synthetic methyltestosterone, to a woman's hormone replacement regimen. Generally thought of as a male hormone, testosterone is also produced by the female ovaries and is necessary to normal sexual development. Testosterone plays an essential role in maintaining libido, as well as the strength and integrity of skin, muscle and bone, lowering cholesterol levels, and improving cardiovascular circulation in both men and women.
As a woman enters the transitions of menopause, circulating androgens begin to decrease as a result of age-related decreases in adrenal and ovarian secretion. After menopause, a woman's total androgen production decreases by as much as 50%. It is possible to supplement a woman's testosterone deficiency with the same natural testosterone she has produced most of her life. Synthetic hormones with even the slightest alterations can produce side effects not found with the natural hormone.
DHEA, Pregnenolone, and Melatonin
Not just estrogen, progesterone, and testosterone, but several other hormones, including growth hormone, melatonin, DHEA, and pregnenolone, reach peak levels before or during the third decade of life and then begin a steady decline of around 2% each year. Research clearly suggests that replacing insufficient levels of these essential hormones can, among other positive effects, help protect the heart, improve mental awareness, make bones stronger, and revive a lagging sex life. We are only starting to know the health benefits that can be achieved by restoring levels of these essential hormones to their youthful peak.
Since steroid hormones play such a crucial part in maintenance of health, knowledge of an imbalance in any one or more hormones can help illuminate the cause of health problems and offer a rational basis for fixing the imbalance through diet, exercise, or hormone supplementation.
Steroid hormone levels can be determined with blood and saliva testing. When the various glands manufacture the steroids they are released into the bloodstream bound to carrier proteins. Only a small fraction (1-5%) of a given amount of steroid hormone breaks loose from the carrier protein in the bloodstream and is free to enter target tissues. Blood testing measures both the bound and unbound steroid hormones. Studies show that there is a strong connection between the levels of steroid hormones in the saliva and the bioavailable (unbound) levels of steroids in the bloodstream.
Levels of all steroid hormones can be determined one by one by both blood and saliva testing. Blood testing requires a prescription from your physician. Saliva testing kits can be acquired through compounding pharmacies associated with natural hormone replacement.
Customize, Don’t Compromise
As many as two-thirds of women who start HRT stop within two years. One main reason they quit is because of side effects, especially the irregular bleeding that can last anywhere from a few months to a few years.
So how do you get the benefits of HRT and bypass the side effects? Customize. HRT needs to be carefully started by your physician after a personal history, family history, and current medical situation are reviewed. Everybody is unique and will respond to therapy in their own way: therefore the selection of hormone(s), dose and dosage form needs to be specific to each individual. Close observation is important to ensure correct dosage adjustments and prevent unnecessary side effects. Compounding pharmacists can make natural hormones in a variety of doses, regimens, and preparations developed to make you more comfortable with your therapy while receiving long-term benefits.
For further information about Dr. Stengler’s practice and his clinic in La Mesa, California, please visit our website at MarkStengler.com or give us a call at (760) 274-2377.