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Bioidentical Hormones

by Barbara Simon

My Menopause Lifesaver

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For many women, going through menopause is a horrible experience. It certainly was for me. I was 49 years old when insomnia became a nightmare. Never before had I experienced trouble going to sleep or resting peacefully throughout the night. Not only was I unable to sleep but night sweats were a regular occurrence. I’d kick off the covers and lay on top of the blankets drenched in perspiration, finally falling back to sleep only to wake up cold and wet. Many times I had to change my nightgown before trying to fall asleep again. Several times during the day, I felt such intense heat rise up in me that I would stand in front of the open refrigerator door to cool off. And I was hungry, all the time. It didn’t matter how much or what I ate, my hunger went unsatisfied. Naturally I gained weight. With more weight, I felt even worse about myself and life. Every time I washed my hair, fistfuls seemed to come out. Needless to say, I was depressed. I was also fatigued, dragged myself around all day, and fought to stay awake and get work done. Everything felt like an effort. Then there were the mood swings. I would cry at the slightest thing, get angry and upset for no reason, feel self-pity, and be discouraged. My menstrual periods were erratic and had almost stopped. Unlike today, when I was experiencing menopause no well-researched information existed about how women could best deal with the incapacitating symptoms. I knew about certain herbs, which I tried, but that was like putting a Band-Aid on a large wound. Commiserating with friends who were also suffering helped a bit with support, but it didn’t make my physical symptoms easier. Nothing seemed to work. For me, acupuncture wasn’t effective. And my family practice doctor didn’t know how to help, other than the standard solution of antidepressants and synthetic drugs, which was not a route I wanted to take. By this point in my menopause experience, I had suffered for almost five years. Every year my

symptoms got worse. I was exhausted and completely frustrated by my lack of knowing what to do and how to stop the endless downward cycle. Relief started to come when I finally took my health into my own hands. I no longer wanted to be a victim of my own body and inadequate support from the medical community. In my heart, I felt there must be something out there that would help. I read any health newsletters, medical magazines, and nontraditional information I could find about menopause. From my research, I knew there was a difference between perimenopause and menopause. Perimenopause is a period of time when your body starts to transition into menopause. How long it lasts varies from woman to woman, but the average range is two to eight years. During this time, your body’s levels of the hormones estrogen and progesterone rise and fall and your periods change in some way. Menopause begins one year after your periods stop altogether. While I did not personally experience all of the following symptoms of perimenopause and menopause, I did have several.

•Hot flashes•Night sweats• Insomnia• Fatigue• Irritability•Brain fog•Urine leakage•Mood swings•Depression•Anxiety• Feeling invisible• Joint aches•Accelerated skin

wrinkling

•Heart palpitations•Weight gain• Itching•Headaches•Osteopenia/

Osteoporosis (bone loss)

•Vaginal dryness• Irregular menstrual

periods•No menstrual periods• Painful intercourse• Low libido/low sex•Hair loss

Through one of the articles I had read, I found out about an upcoming seminar in Los Angeles that would address women’s health issues. I signed up and

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•DHEA-S• Estradiol•Total Estrogen• Progesterone• Pregnenolone•Total and Free Testosterone• Sex Hormone Binding Globulin (SHBG)•TSH• Free T3

During my first appointment with the physician, he performed a pelvic exam and we had a lengthy discussion. He asked about my lifestyle, eating habits, vitamin supplementation, sex life, and family life. Then he explained in detail the results of the blood test and what they meant. Based on the results, the doctor prescribed certain nutritional supplements, as well as the bioidentical hormones estrogen and progesterone. According to the Women to Women Web site, bioidentical hormones are manufactured in the lab to have the same molecular structure as the hormones made by your own body. This makes them unlike synthetic hormones, which are intentionally made to be different. That’s because drug companies can’t patent a bioidentical structure to make it exclusively theirs, so they invent synthetic hormones that are patentable (Premarin, Prempro, and Provera being the most widely used examples). Dr. Herb Slavin, with the Institute of Advanced Medicine, says on his Web site:

“For the last 60 years, Hormone Replacement Therapy (HRT) involved using synthetic hormones to keep post-menopausal women feeling young and forever feminine. Now, women are turning to bioidentical hormone replacement therapy (BHRT) as a superior form of HRT. Bioidentical hormones are made in a laboratory, usually from the components of yams, to match exactly the molecular structure of the hormones that were normally made in the ovaries. The molecular structure of these hormones is

excitedly attended, eager to learn more about menopause. The conference was designed for health-care care professionals, so the majority of people in attendance were physicians and nurses. After listening to several speakers, one man in the audience stood up and asked questions of the panel. The statements he made and questions he asked let me know he was a physician. His comments were insightful and were made with such authority, knowledge, and compassion that I immediately knew I wanted to see him professionally. After the seminar, I asked for his card. He was a gynecologist and antiaging doctor, with an emphasis in bioidentical hormone replacement therapy. Even though I could tell there was much uncertainty among the other members of the medical community in the audience toward what he shared, it made sense to me. Finally, I felt hope that I’d found a doctor who understood and cared about women’s issues. The following Monday morning I called the doctor’s office and made an appointment. I learned that before I could see the physician, I would have to have blood drawn for the extensive tests he would need to make an accurate diagnosis. I discovered that blood testing is the single most important preventive tool you can use to help head off health problems. To get a picture of my overall health and to identify potential disease risks, this doctor tested for specific problems with comprehensive blood panels and individualized tests, such as: • Female Comprehensive Panels•Cardiac Risk Factors•Vitamin Deficiencies•Hormone and Thyroid Panels•Metabolic and Chemistry Profiles

I learned that continual assessment of hormone levels is necessary for women seeking to maintain a healthy hormonal balance. The panel below is designed for women looking to monitor their current hormone levels:

•Chemistry Panel (Complete metabolic panel w/lipids)•CBC

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indistinguishable from that of natural hormones produced in the body. Bioidentical hormones come in a variety of delivery systems, such as cream, BLA tablets, capsules or troches. A successful approach to dealing with a woman’s menopausal symptoms is to begin with laboratory tests of hormone levels, called a hormone panel. The doctor can then prescribe a precise dosage of bioidentical estrogens, testosterone, progesterone, or DHEA that can be made at a compounding pharmacy. This is contrary to treatments that are typically one size fits all.”

The physician I saw prescribed bioidentical hormones in a cream. I was to rub a prescribed amount of the estrogen cream on my hands and inner arms in the morning after showering and at night before bed. The progesterone cream was to be rubbed on the inside of my thighs in the morning and before bed. It might take a little time, but he assured me all my symptoms would disappear. He also guaranteed bioidentical hormones were totally safe, because they were the same hormones that my body made naturally. Synthetic hormones do not replicate what the body produces. There is nothing synthetic in bioidentical hormones. In addition to hormones, I was prescribed a natural, rather than synthetic, thyroid supplement. Vitamin supplements were also recommended that would help my symptoms and general health. They’re part of the natural approach to menopause that also includes good nutrition, exercise, and bioidentical hormones. I was so reassured, so excited at the prospect of getting my life back, that I left with a smile on my face and a skip to my step that I hadn’t had for a long time. I couldn’t wait to begin my new regime. I was introduced to the solution to my menopause nightmare more than two decades ago, and to this day, I take my hormones, vitamins, and thyroid supplement regularly. I sleep well and feel rested when I wake up. I don’t have hot flashes or mood swings and I don’t eat myself into a stupor. I maintain a healthy body

weight. I’m no longer in a fog or feel depressed. My skin is no longer dry, but hydrated and toned. My hair grew back, and now I experience only normal loss. What a difference in my life. I am happy again. I am a yoga teacher and practice yoga postures often, which keeps me strong, supple, and aligned. I walk 30 – 45 minutes every day, which helps my stamina and heart. I know taking bioidentical hormones helps boost my immune system and reduce my risk of diabetes, heart disease, osteoporosis, Alzheimer’s disease, stroke, and breast cancer. Life is good. What I share here is what I believe in and what worked for me. I am not a doctor, and I don’t consider myself an expert in biochemistry and bioscience, but I am an expert in my own body and consider myself to be an informed woman. This regimen worked so well for me that I want to share it with you. Nevertheless, it is very important to discuss your own personal symptoms with a doctor before taking any medications or supplements. Through my own investigation, I learned that the new approach to health, aging, and wellness is to balance our lost hormones with bioidentical hormones (estrogen, progesterone, testosterone, DHEA, and others); strengthen our major hormones (adrenaline, thyroid, insulin, cortisol, and others); and detoxify our body. Eliminating stress, valuing a good night’s sleep, and supplementing with vitamins and minerals that make up for the lost nutrients in our food are also important factors in becoming internally young, healthy, and energetic. You need to do research and arm yourself with the knowledge of what’s going on and what you can do to make yourself feel your best. And, you shouldn’t wait until perimenopause or menopause to have your hormones evaluated. Some of the problems can be overwhelming and interrupt your life, and alleviating them may simply mean increasing a hormone that you’re deficient in or balancing one that you’re dominant in. This is one reason I want to make the point that it’s not just women on the verge of menopause who need to

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educate themselves about their bodies and hormones. All women should. One of the first steps is finding the right physician. Robin McGraw, in her book What’s Age Got To Do With It? Living Your Happiest & Healthiest Life, advises us that one of the most self-loving actions we can take is that of being informed; i.e., to shop around. She writes the following: Today I’ve found wonderful doctors to help me manage my hormones, but when I was shopping around for the right expert, here are some things that helped then and still help me today: •Ask questions in advance. Since I knew I wanted to

take only natural hormones, the first question I’d ask before making an appointment was how the doctor felt about natural versus synthetic hormones.

• Prepare for the appointment. I bring a list of my concerns and symptoms and even notes on any symptoms I’ve experienced, such as when they occurred and what they felt like. Also, bring up general concern, such as why you wake up feeling sluggish (I personally like to hit the ground running in the morning and if that doesn’t happen I want to know why).

• Listen carefully. It’s important to pay attention to what the doctor says about how to use prescriptions. Sometimes the pharmacy will put as needed instead of specific directions.

•Do your research. Even if I trust the doctor immensely, I come home and research his or her suggestions. If you’re not comfortable with your doctor’s suggestions or don’t understand them, ask him or her questions, get a second opinion, and talk to other women experiencing what you are.

•Move on if it’s not a match. If you don’t like a doctor, there’s no harm in finding someone else.

To begin your own inquiry into how best to deal with the changes in your body, I have listed below a breakdown and explanation of the most important

hormones. I have also provided links to Web sites that provide new and innovative ways to stay healthy, heal various medical situations without drugs, keep our mind sharp, and help with antiaging.

Hormones

DHEA According to the Mayo Clinic Web site DHEA (dehydroepiandrosterone) is an endogenous hormone (made in the human body), and secreted by the adrenal gland. DHEA serves as precursor to male and female sex hormones (androgens and estrogens). DHEA levels in the body begin to decrease after age 30.

Testosterone The News Medical Web site describes testosterone as a steroid hormone from the androgen group. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands. Testosterone is the hormone responsible for the sex drive in both men and women. As we age testosterone declines in both sexes. This hormone is important to helping us maintain muscle mass and strength and bone density.

Estrogen and Progesterone The Life Extension Web site lists estrogen and progesterone as “female” steroid h o r m o n e s that play important roles in maintaining bone density and strength, sexual function, mental function and, in women, in countering the effects of menopause. Recent studies indicate that estrogen may be an effective treatment for age-associated memory problems. These hormones are produced in the ovaries and adrenal glands. Estrogen regulates a woman’s passage through menstruation, fertility, and menopause. It supports the growth and regeneration of female reproductive tissues, and keeps the uterus, urinary tract, breasts, and blood vessels toned and flexible. Progesterone regulates the menstrual cycle, sustains a pregnancy, stimulates bone-

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building cells and the rate of new bone formation. It promotes energy production in the brain and protects against nerve cell damage and brain aging.

Melatonin According to the WebMD Web site Melatonin is a hormone made by the pineal gland, a small gland in the brain. Melatonin helps control your sleep and wake cycles. Melatonin is important because your body has its own internal clock that controls your natural cycle of sleeping and waking hours. In part, your body clock controls how much melatonin your body makes. Natural melatonin levels slowly drop with age. Some older adults make very small amounts of it or none at all. Published studies indicate the importance of maintaining youthful levels of melatonin to help protect against age-related degenerative diseases.

Pregnenolone According to the Consumer Lab Web site Pregnenolone is often called the “mother of steroid hormones” because it is a precursor to many other steroid hormones in the body. Pregnenolone is naturally produced from cholesterol in the body and then it breaks down into other hormones including testosterone, estrogen, progesterone, DHEA, and others. It is also often a component of “natural” or “bioidentical” hormone therapies used for menopausal symptoms.

Links I Like

Life Extension Foundation - directory of alternative medical doctors throughout the country. No matter where you live you will most likely find an alternative physician not far from you.http://www.lef.org/Health-Wellness/InnovativeDoctors/

Life Extension Foundation: 800-544-4440 or website:www.lef.org

Life Extension Foundation blood testing services:

http://www.lef.org/Vitamins-Supplements/Blood-Tests/Blood-Tests.htm/

Women to Women online: http://www.womentowomen.com/bioidentical-hrt/bioidenticalhormones.aspx/

Good site for reference on bioidentical hormones, doctors, symptoms, general information:http://www.specialtycare4women.com/

Female Hormone Replacement Therapy: https://www.angelmedcenter.com/female-hormone-replacement-therapy/

California Healthspan Institute - has a very thorough hormone program run by Dr. Ron Rothenberg, antiaging specialist, specializing in advanced preventive medicine and BHRT for men and women:320 Santa Fe Drive #211,Encinitas, CA 92024(800) 943-3331 or (760) 635-1996http://ehealthspan.com/treatment-info/hormone-program-2/

Mayo Clinic Web site:http://www.mayoclinic.com/health/dhea/NS_patient-dhea

News Medical Web site:http://www.news-medical.net/health/Testosterone-What-is-Testosterone.aspx

WebMD Web site:http://www.webmd.com/sleep-disorders/tc/melatonin-overview

Consumer Lab Web site:http://www.consumerlab.com/answers/Will+pregnenolone+help+slow+down+aging%3F/pregnenolone_aging/

Herb Slavin, M.D. Web site - http://www.drslavin.com/functional-medicine/bio-identical-hormone-replacement/