Today millions of men and women concerned about aging and preserving the quality of life are receiving hormone replacement therapy (HRT). Hormone-related problems- such as mood swings, PMS, infertility, endometriosis, fibrocystic breasts, weight gain, low sex drive, vaginal dryness, frequent bladder infection, cardiovascular disease, and osteoporosis-- can be relieved by reaching a proper hormone balance. In considering the benefit-risk ratio, it is important to consider alternatives to conventional therapy.
Alternatives to conventional HRT include using 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 full range of other hormones which are required to operate at full capacity, and therefore are more likely to cause side effects.
If you haven't heard much about natural hormone replacement, you're not alone. Because 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 spend millions of dollars to produce, test, and submit to the FDA for approval, and market these hormones.
Natural hormone replacement isn't just estrogens and progesterone. Natural estrogens and progesterone are just part of a complex and closely interlinked hormonal system that includes lots of other hormones such as testosterone, DHEA, pregnenolone, and melatonin, to name just a few. A lot of these hormones have been found to decrease with age. Restoring them to normal levels with natural replacement versions can have an incredibly revitalizing result on our hearts and immune systems our moods, energy, and sex drive.
Estrogen is not one hormone, but a set of similar hormones with varying levels of activity. The three most vital estrogens are estrone, estradiol, and estriol. Estradiol is the main estrogen produced by the ovary, and estrone is formed by the conversion of estradiol. The most favored kind of estrogen replacement continues to be 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 commonly used in estrogen supplements. Estrone and estradiol are the estrogens predominantly linked to breast and endometrial cancer.
New regimens have been established that use natural estriol in the greatest concentration along with other naturally occurring estrogens in an appropriately balanced ratio. Estriol produces 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 made in very large quantities 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 almost every physiological process, in both men and women. The stabilizing action of progesterone is especially noticeable in muscle tissue, such as the uterus, blood vessel walls, the heart, the intestine, the bladder, and bone cells. Less visibly, progesterone supports and normalizes nervous, secretory, immune, and growth processes.
Natural progesterone comes from yams and soybean. It matches precisely the chemical structure of the body's progesterone. Synthetic progesterone, or progestins, are chemically developed from progesterone and react differently in the body triggering unwanted side effects such as salt build-up, fluid retention, low blood sugar, breast tenderness, and weight gain, and depression. The role of natural progesterone in preventing 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, as well as to treat osteoporosis.
Sometimes, it is important to consider the addition of the androgens, testosterone, or synthetic methyltestosterone, to a woman's hormone replacement regimen. Typically considered a male hormone, testosterone is also produced by the female ovaries as well as is necessary for normal sexual development. Testosterone plays an important part 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 changes of menopause, circulating androgens begin to decline 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 smallest alterations can produce side effects not found with the natural hormone.
Not just estrogen, progesterone, and testosterone, but many 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% per year. Research clearly indicates that replacing insufficient levels of these essential hormones can, among other positive effects, help protect the heart, improve mental awareness, make bones stronger, and rejuvenate a lagging sex life. We are just starting to know the health benefits that can be accomplished by restoring levels of these vital hormones to their youthful peak.
Because steroid hormones play such a vital role in the maintenance of health, knowledge of an imbalance in any one or more hormones can help clarify the cause of health problems and provide a rational basis for correcting the imbalance with diet, exercise, or hormone supplementation.
Steroid hormone levels can be determined through blood and saliva testing. When the different glands produce the steroids they are released into the bloodstream bound to carrier proteins. Only a small portion (1-5%) of a given amount of steroid hormone breaks loose from the carrier protein in the bloodstream and is able to enter target tissues. Blood testing measures both the bound and unbound steroid hormones. Studies show that there is a strong correlation 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 measured individually by both blood and saliva testing. Blood testing requires a prescription from your doctor. Saliva testing kits can be obtained through compounding pharmacies associated with natural hormone replacement.
As many as two-thirds of women that begin HRT quit within two years. One main reason they stop is because of side effects, particularly 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 has to be carefully initiated by your doctor after a personal history, family history, and current medical situation are reviewed. Everyone is different and will respond to therapy in their own way: therefore the selection of hormone(s), dose, and dosage form must be specific to each individual. Close observation is necessary to guarantee correct dosage changes and prevent unnecessary side effects. Compounding pharmacists can make natural hormones in a variety of doses, regimens, and preparations designed to make you more comfortable with your therapy while receiving long-lasting benefits.
For further information about Dr. Stengler’s practice and his clinic in Encinitas, California, please visit our website at MarkStengler.com or give us a call at (760) 274-2377.
