Natural Hormone Replacement Therapy
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 consider alternatives to conventional therapy.
Why Natural Hormone Replacement Therapy?
Alternatives to conventional HRT include using natural plant-derived bio-identical hormones which have the same chemical makeup as those made by the human body. Synthetic hormones and hormones from animal sources do not allow the body to make the full range of other hormones which are needed to function at full potential, and therefore are more likely to produce side effects.
If you haven't heard much about natural hormone replacement, you're not alone. 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 spend millions of dollars to produce, test, and 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 lots of other hormones such as testosterone, DHEA, pregnenolone, and melatonin, to name just a few. Many 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 to our moods, energy, and sex drive.
Natural Estrogens
Estrogen is not one hormone, but a group of similar hormones with varying levels of activity. The three most vital estrogens are estrone, estradiol, and estriol. Estradiol is the primary estrogen made by the ovary, and estrone is formed by the conversion of estradiol. The most favored form 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 commonly used in estrogen supplements. Estrone and estradiol are the estrogens primarily linked to breast and endometrial cancer.
New regimens have been established that use natural estriol in the greatest concentration together 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 effective at lowering 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.
Natural Progesterone
The hormone progesterone participates in almost every physiological process, in both men and women. The stabilizing action of progesterone is particularly noticeable in muscle tissue, such as the uterus, blood vessel walls, the heart, the intestine, the bladder, and bone cells. Less visibly, progesterone stabilizes and normalizes nervous, secretory, immune, and growth processes.
Natural progesterone comes from yams and soybean. It matches exactly the chemical make-up of the body's progesterone. Synthetic progesterone, or progestins, are chemically developed from progesterone and react differently in the body resulting in 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 preventing and treating osteoporosis, helping to clear endometriosis and fibrocystic breast, and treating vaginal dryness, infertility, and menstrual abnormalities is receiving significant attention in the medical and lay communities. In men over 55 natural progesterone is being used to raise libido, and to treat osteoporosis.
Natural Androgens
In some cases, it is necessary to consider the addition of androgens, testosterone or 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 important part in maintaining sexual desire, in addition to 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 transition of menopause, circulating androgens start to decline as a result of age-related reductions in adrenal and ovarian secretion. After menopause, a woman's overall 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 changes can produce side effects not found with the natural hormone.
DHEA, Pregnenolone, and Melatonin
Not just estrogen, progesterone, and testosterone, but lots of 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 suggests that substituting inadequate levels of these vital hormones can, among other positive effects, help protect the heart, improve mental alertness, make bones stronger, and revive a lagging sex life. We are just beginning to understand the health benefits that can be achieved by restoring levels of these essential hormones to their youthful peak.
Hormone Testing
Since steroid hormones play such an important role in the maintenance of health, knowledge of an imbalance in any one or more hormones can help illuminate the source of health problems and give a logical basis for repairing 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. Just a small fraction (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 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 individually by both blood and saliva testing. Blood testing requires a prescription from your physician. Saliva testing kits can be obtained through compounding pharmacies associated with natural hormone replacement.
Customize, Don't Compromise
As many as two-thirds of women who begin HRT quit within two years. One major 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 reap the benefits of HRT and avoid the side effects? Customize. HRT has to be carefully started by your doctor after a personal history, family history, and current medical situation are assessed. Everybody is unique 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 monitoring is necessary to ensure proper 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 gaining long-lasting benefits.
For further information about Dr. Stengler’s practice and his clinic in La Jolla, California, please visit our website at MarkStengler.com or give us a call at (760) 274-2377
