hormone replacement therapy Archives - Laura G Owens ~ Writer. Raw. Real. Chronically ambivalent.

On July 28, 2011

(Photo credit: Renjith Krishnan’s)

hormones,bioidentical hormone replacement, compounding pharmacist, hormone replacement, progesterone, testosterone, estrogen, vivelle-dot, climara

Consider using a compounding pharmacist for bioidentical hormones

Have you talked to your doctor because you think you might be in peri or full menopause?

Are you feeling off, forgetful, sweaty? Are you waking up in the middle of the night, increasingly anxious, unfocused, irritable and have little sex drive? Perhaps you’ve had a complete hysterectomy and your doctor wants you on hormone replacement therapy.

The first step is to measure your hormones. Saliva testing is preferable to serum blood tests, in some instances.

(Click image for hormone testing kit)

Click for list of ZRT Labs hormone tests)

And, if based on your test results you decide to start hormone replacement therapy (HRT), consider bioidentical HRT over conventional, synthetic forms. It’s important to get your bioidentical hormones (BH) from a reputable pharmacy who dispenses with a prescription from your doctor. (Ask your doctor what your state requires as this varies).

Find a compounding pharmacist nearest you.

While over the counter (OTC) progesterone creams are available, I don’t recommend these because of the potential for inconsistency in the active compounds and dosing. Dr. Lee however, the HRT guru I follow, recommends a few OTC formulas in his book.

(click image for more information)

One of Dr. Lee’s OTC progesterone cream recommendations is Emerita. Yet, I order my progesterone and testosterone from a local compounding pharmacy. I mail or fax the pharmacy my Ob & Gyn ordered prescription and the staff fills my script through the mail upon request.

So what exactly is a compounding pharmacy?

Writes Wikipedia:

Compounding pharmacies use commercially-available bulk drugs to create new formulations which differ (in form or dosage) from those manufactured on a large scale by pharmaceutical companies.

Custom-compounded BHRT is (bioidentical hormone replacement therapy) almost wholly restricted to the United States, where pharmacy compounding is governed at the state level while the FDA has regulatory authority over the compounded product. Some internet-based compounding pharmacies understate harm and claim benefits of compounded BHRT beyond what can be proven by evidence-based medicine, and many of their claims exceed those made by other, more mainstream, BHT practitioners.

Find a compounding pharmacist nearest you.

In the United States, compounding pharmacies are licensed and regulated by their respective state like all other pharmacies. National standards have been created by Pharmacy Compounding Accreditation Board (PCAB). Compounding pharmacies were the subject of the United States Supreme Court decision Thompson v. Western States Medical Center (535 U.S. 357, 2002).

I pay a small extra fee to have my compounding pharmacy dispense my creams in a dose-monitored pump to ensure I easily apply the exact amount of progesterone and testosterone cream my doctor prescribed. (Note: Testosterone is a controlled substance and is not available over the counter).

Syringes with tick measurements on the side are often given to customers. These work fine and usually don’t cost more.

Verify your pharmacy and the pharmacist is legitimate. I won’t mention the name, but a certain pharmacy in our area was charged (okay the pharmacists were, not the local chain) for dispensing steroids in and out of state, without a prescription.

Find a compounding pharmacy nearest you.

Before I bought my prescription from the pharmacy I now use I met with the doctor on staff (a former Ob & Gyn who specialized in hormone and brain balancing) and the compounding pharmacist.

I order my bioidentical estrogen patches, Vivelle-dot (I used to use Climara but the bi-weekly Vivelle is offers a more continuous delivery of the active ingredient because you change the patch twice a week) from a Canadian Pharmacy. Because Vivelle is not a compounded substance, it IS FDA approved. I order mine from a verified Canadian pharmacy.

Will insurance cover bioidentical hormones?

Many insurance companies don’t cover compounded medications, it’s important to ask if they pay some, all or none of the cost. Some insurance plans will cover bioidentical estrogen patches (e.g. Climara, Vivelle-dot) because these biodientical estrogen patches are regulated by the FDA.

I have a health savings plan and pay out of pocket, so I price my hormones all the time. For years I’ve found that even if my estrogen patches were covered under my insurance, it was (usually) less expensive to order them out of pocket from my Canadian pharmacy, even after including the shipping charges.

I use Smart Choice Pharmacy and have been nothing but pleased over the years. Their customer service is polite, efficient and prompt.

Hormone replacement therapy decision checklist:

Track symptoms for several months before and after starting HRT
Get tested (saliva preferable in many cases)
Consult with open minded doctor who understands or specializes in women’s medicine, natural hormone and mood balancing.
Start hormone therapy if applicable. Monitor your symptoms over time, realizing that your body may feel worse the first week or two before you feel better as you adjust ot the hormones.
Use bioidentical hormones, BHRT (my preference), using the least amount to achieve desired results (reduced or no symptoms).
Use a compounding pharmacist for your BHRT creams and compare your health insurance and pharmacy plans for bioidentical estrogen patches if applicable. Many women find they don’t need estrogen HRT, only progesterone.

Obtaining your BHRT creams from a compounding pharmacist rather than over the counter increases the likelihood that the progesterone and/or testosterone cream you use is formulated to the dosing and purity your doctor prescribed, which is critical to relieving your menopausal symptoms.

Hormone Fears Cloud Benefits of Bioidentical Hormone Therapy over Conventional

Click here for a few of my favorite natural hormone balancing products

(Photo credit: Sally Howard)

For women who need hormone replacement, bioidentical hormones can offer a safe alternative to synthetic estrogen and progesterone.

Traditional hormone replacement therapy has become the standard protocol for women as they approach menopause or for women who have a total hysterectomy. Yet not every peri or full menopausal woman has low estrogen, progesterone or suffers from hormone deficiency symptoms. Prescribing hormones to women who don’t need them may elevate their levels and produce unwanted side effects.

Yet for women who do experience the symptoms of estrogen deficiency or estrogen dominance (due to low progesterone) bioidentical hormone or natural hormone replacement is a safer alternative to synthetic.

The Controversy Over Hormone Replacement

Hormone replacement therapy became controversial after a report suggested there was a link between breast cancer and estrogen. In July 2003 The Women’s Health Initiative, the largest government study on synthetic hormones, was halted when early results showed that women using conventional hormone replacement (specifically PremPro), had a much higher risk of invasive breast cancer, heart disease and stroke. Women began to weigh the risks of using HRT against learning to live with the unpleasant symptoms of menopause

Yet critics of that study point out that the WHI study was NOT representative of women in their 40’s and 50’s, women who were likely in the early years of peri or full menopause. In fact the average age of the women involved in the study was 63 with an average time into menopause of 12 years.

Controversy exists over bioidentical hormones (BH).

But because I worked with a natural hormone mood balancing doctor who understood BH, my Ob & Gyn writes the prescriptions, adjusting my dosing after we consult about my symptoms, and I get my prescription through a reputable compounding pharmacy I have zero concern about BH, but grave concerns about synthetic BH.

I’ve been using BH for several years.

Suzanne Somers has been the bioidentical hormone poster child, and while she may or may not use levels higher than some, her message is still the same: do what works for you.

The key is to get tested, track your symptoms, and re-test. IMO, and Dr. Lee’s, replace only to levels that alleviate or eliminate your symptoms, no higher. As you age, your requirements change. But don’t accept feeling crappy as “the way it is when you age” or “what menopause feels like.”

Don’t be afraid of hormones, be afraid of not doing your hormone homework and of accepting that feeling crappy is part of aging.

Click here for a few of my favorite natural hormone balancing products

I’ve greatly benefited by getting off 20 years of synthetic HRT (I had to be on HRT since age 19 due to my pituitary disorder, empty sella syndrome). Those prescriptions had levels of estrogen far higher than my body required, not to mention that bioidentical and synthetic hormones in most regards, act quite differently in your body.

Natural Hormone Replacement vs. Conventional

Although traditional hormone replacement has been shown to be safe in women entering peri or full menopause, synthetic hormones are radically different than bioidentical or natural hormones in how the body synthesizes them.

So what is bioidentical? Hormones are deemed bioidentical if they are exact duplicates of what your body makes.

Click here for a few of my favorite natural hormone balancing products

Advantages of Bioidentical HormonesFirst, bioidentical hormones such as estrogens, progesterone and testosterone are administered transdermally, via a patch or cream and in much lower doses than oral estrogens. Transdermal delivery methods avoid the “first pass metabolism” by the liver that occurs with oral dosing.

Second, bioidenticals mimic what your own body naturally produces.

Dr. John Lee, a pioneer in women’s health and author of “Hormone Balance Made Simple” is an advocate of bioidenticals for hormone replacement therapy, explains, “Hormones do very complex and specific jobs in the body by fitting into part of your cells called receptors, much the same way that a key fits into a lock. Once the hormone is in the receptor, it gives the cell instructions. If the molecular structure is different, even by ONE atom, the instructions given to the cell are different.”

So, comparing synthetic hormones to bioidenticals is like comparing processed white bread to all natural unprocessed multi-grain. Both share similar properties but once consumed their by-products and how the body uses them can be very different.

Flaws With Conventional Hormone Replacement Therapy

1. Doctor’s often don’t measure hormone levels prior to starting conventional hormone replacement therapy.

2. Synthetic hormones, because they are not duplicates of what the body makes on it’s own, often produce unwanted side effects.

3. The dosing level of synthetic hormones isn’t physiologic, the level your body would naturally produce on it’s own. Instead, the synthetic dose is usually much higher than what is necessary for the body to produce a desirable effect.

Click here for a few of my favorite natural hormone balancing products

Dr. Lee’s “3 Rules For Hormone Replacement”1. Use hormones only if you need them (e.g. if they are measurably low and/or you have clear symptoms)

2. Use bioidentical hormones rather than synthetic hormones

3. Use the least amount required to reduce or eliminate symptoms.

Work with Open-Minded Expert in Hormone Replacement Therapy

It’s best to consult with your Ob/Gyn or a specialist in hormone balancing with a background in endocrinology and/or gynecology. Be sure to find a physician who listens to your symptoms, is open-minded and is knowledgeable in both synthetic and natural / bio-identical hormone replacement.

They should be well-informed regarding the latest research findings. Unfortunately, hormone replacement therapy has become a profitable industry for doctors practicing in fields completely unrelated to female endocrinology. Buyer beware.

Hormone replacement has become quite common place but in reality it is a complex and specialized field. In the hands of a trained professional who understands the intricacies of a woman’s endocrine system (and more notably, the benefits of bioidentical hormones), hormone replacement therapy is safe and effective for many women.

Most doctors prescribe bioidentical hormones via transdermal delivery systems such as patches, creams, gels and sublingual (under the tongue). Some physicians however, offer hormone pellet therapy, a process of inserting concentrated pellets under the skin to provide continuous delivery of bioidentical estrogen or testosterone. Although pellets offer patients some advantages, once inserted they cannot be easily removed unlike transdermal methods.

If you’re experiencing cyclical or on-going symptoms of menopause or a hormone imbalance, ask your doctor about getting a saliva test which for some hormones is more accurate than blood. Click here for saliva hormone testing kits

Armed with accurate information and a doctor knowledgeable in bioidentical hormones, hormone replacement therapy can alleviate a number of hormone imbalance symptoms, safely and with minimal or no side-effects.

Click here for a few of my favorite natural hormone balancing products

Hormone Testing – Saliva or Blood? Depends.

Click here for saliva hormone testing kits
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer

hormone testing, blood test, saliva testing, blood work

Saliva test more accurate to measure certain hormone levels

Photo credit: Ambro

Head to your doctor because you’ve been feeling off, forgetful, sweaty, waking up in the middle of the night, increasingly stressed, unfocused, irritable and she might tell you you’re in peri or in full menopause. Or perhaps you’ve had a complete hysterectomy and your doctor wants you on hormone replacement therapy.

Or, maybe your cortisol (the stress hormone) levels are way off the charts, a condition that is all too common today, that and adrenal fatigue. Cortisol in small doses as the fight or flight reactive hormone alerts you to take action. And, like all hormones it’s just doing its proper job. But, at chronically high levels, as in the case of chronic stress, cortisol can harm your sleep and your health.

Whatever is going on your doctor (or you) may want to test your hormones along with a number of other factors.

How? Likely via a blood test. Yet, while not invalid, conventional blood serum tests are not as accurate as saliva to measure certain hormones.

Saliva testing

According to ZRT labs:

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.

This free or unbound hormone is what we want to measure, since it is active or bioavailable to the target tissues such as the breast, uterus, brain, and skin. Many studies in the scientific literature have shown that there is a strong correlation between the levels of steroid hormones in saliva and the bioavailable (free) levels of steroids in the bloodstream.

Click here for saliva hormone testing kits
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer

ZRT labs also offers at home blood spot testing which is convenient and at times less costly than the blood serum tests your doctor orders.

Blood spot testing

The development and application of blood spot testing allows monitoring of hormone levels, cardiometabolic markers and Vitamin D. The convenient collection of blood from a tiny nick of the finger, allows for flexibility of testing at the right time of day, month or following hormone therapy. Blood Spot testing provides results on par with those from serum tests but without the cost and inconvenience of conventional blood draws, making it beneficial for both patient and practitioner.

ZRT labs offers saliva, blood spot and combo tests. This ZRT labs chart compares which tests are done in saliva and/or blood spot.

Hormone or Analyte	Saliva	Blood Spot
Estradiol (E2)
Progesterone (Pg)
Testosterone, free
Testosterone, total
DHEA-S (DS)
Cortisol, AM (C1)
Cortisol, Diurnal (C1, C2, C3, C4)
Estriol (E3)
Estrone (E1)
Follicle stimulating hormone (FSH)
Luteinizing Hormone (LH)
Insulin-like Growth Factor (IGF-1)
Insulin, fasting
Triglycerides (TG)
Hemoglobin A1C (HbA1c)
High Sensitivity C-Reactive Protein (hs-CRP)
Total Cholesterol (CH)
LDL Cholesterol
HDL Cholesterol
VLDL Cholesterol
Prostate specific antigen (PSA)
Sex hormone binding globulin (SHBG)
Thyroid peroxidase antibodies (TPO)
Thyroid stimulating hormone (TSH)
Triiodothyronine (T3), free
Thyroxine (T4), free
25-hydroxy vitamin D2
25-hydroxy vitamin D3

So, you have choices depending on what you want to measure:

Go to your doctor. Doc orders standard blood to test hormones, etc, (ideal for measuring cholesterol, vitamin D etc, but not all hormones as you can see from above).
Depending on what you want to test, you can order your own saliva and/or blood spot test from ZRT labs either directly or through a provider (depends on what is cheaper, if your insurance covers the labs if ordered by a doctor or you buy the kit directly and bring the results to your doctor).

But, if you want saliva and/or blood spot testing and your doctor won’t order them for you, take all this into your own hands.

Order your own from ZRT, bring the results to her, or ideally to a physician who understands saliva testing and will discuss options to re-balance your hormones, cholesterol and/or vitamin D levels.

The Truth About Progesterone For HRT – Bioidentical Progesterone Isn’t The Same As Synthetic Progestin.

Photo - Sally Howard

The term progesterone has been used to describe the synthetic progestins found in birth control pills and hormone replacement therapy, progesterone is not the same as progestin.

Your body knows the answer.

Conventional hormones are synthetic forms of hormones, they’re molecularly altered and as a result they don’t react in the body like your own hormones or their near identical twin, bioidentical hormones.

What Is Natural Progesterone?

True progesterone is a steroid hormone made by your ovaries when you ovulate in the middle of your menstrual cycle. A small amount is also made by your adrenal glands and nerve cells. Progesterone is manufactured in the body from a steroid hormone called pregnenolone and it is a pre-cursor to most other steroid hormones.

While estrogen seems to get all the glory and most of the controversy, progesterone deserves some attention.

Progesterone’s most important role is to balance or oppose the effects of estrogen. Most doctors no longer prescribe an estrogen-only oral contraception or hormone replacement therapy (HRT) due to the dangers of estrogen dominance in the body. Progesterone also stimulates bone building and helps protect against osteoporosis (while estrogen helps maintain bone density).

Differences Between Natural Progesterone and Synthetic

In order for a hormone to be considered true progesterone it must either:

Naturally occur in the body

Be bioidentical

Bioidentical simply means the hormone is created in a laboratory to be an exact duplicate of what your body makes. The progesterone used for natural hormone replacement therapy (natural HRT is not the same as bioidentical HRT although bioidentical is often lumped under the term natural HRT) is often derived from plant fats and oils, usually a substance called diosgenin extracted from a wild yam that grows in Mexico, or from soybeans.The other human steroid hormones including estrogen, testosterone, and the cortisones, nearly always come from synthesized diosgenin.

The combination birth control pill or conventional hormone replacement therapy (HRT) have progestin, which is not progesterone. Provera is one of the most commonly used progestins for HRT.

Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer

Two Reasons to Consider Natural Progesterone for HRT

Safety. Consider this: In the 3rd trimester of pregnancy the placenta produces huge amounts, 300-400 mg, of progesterone daily without any risk to the developing baby. Yet even a fraction of that amount of progestin could cause birth defects. The list of side effects and warnings from progestin or “medroxyprogesterone acetate” is eye-opening.
Cost. Synthetic hormones like progestin, or Provera, are not naturally occurring in your body. Drug companies purposely make these medications different so they can patent them. This allows the drug company to sell the medications exclusively for years (until the patent runs out) and therefore charge more money because they have no competition. While natural substances like bioidentical progesterone, cannot be patented so they are less expensive to you.

If you’re considering starting HRT and are concerned about the effectiveness and safety of conventional vs natural or bioidentical hormones,Dr. John Lee, a pioneer in natural women’s health and author of Hormone Balance Made Simple suggests women consider this point first, “Synthetic hormones are not necessarily made, sold, and prescribed because they work better than natural hormones, but because natural hormones can’t be patented.”

Risks of Progesterone

The key to effective HRT is to use just the amount you need to alleviate or eliminate symptoms, no more, no less. This fine balancing can take time and require you track your symptoms, adjusting levels as necessary (with the help of a physician who understands natural and bioidentical HRT).

Natural progesterone has few risks or side effects. Initially as your body adjusts or if you use progesterone in excess, the following side effects may occur:

Sleepiness/lethargy

Edema (water retention)

Candida (yeast)

Bloating

Lowered libido

Mild depression

Exacerbates symptoms of estrogen deficiency

Most health care professionals prescribe between 10-40mg daily, once or twice a day for 15-25 days of the month. The number of days and dose depends on if you are ovulating, had your ovaries removed or are in peri or full menopause.

In some cases, patients have been prescribed as much as 100 mg per day which is in gross excess. In addition, some doctors prescribe a transdermal patch (on the skin) that includes other bioidentical hormones (estrogen or testosterone). Transdermal patches should include only individual hormones to allow you to regulate the dose and accurately monitor symptoms.

Be Sure to Get the Real Deal

Ideally you’ll want to buy your progesterone from a compounding pharmacist who will ensure you receive the proper quality and concentration of the hormone through a measured pump container or transdermal patch.

If you do buy progesterone cream at a health or drug store, check to see the amount listed on the label. Be wary of brands that claim to have wild yam but don’t, or have very small amounts of progesterone. If the label doesn’t list the exact amount of progesterone you have no way of knowing what you’re getting unless you call the company. Verify the amount (and the company’s credibility) before you use any progesterone cream.

Be sure to get your hormone levels checked begin any HRT program. A saliva test is ideal for to measure some hormones. If you’re considering bioidentical HRT be sure to consult with a reputable doctor who has vast experience in both conventional and natural hormone replacement therapy.

How Safe Is Hormone Replacement Therapy? Bioidentical or Conventional?

Click here for hormone testing kits
Click here for progesterone testing kit
Click here for testosterone testing kit
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer
Click here for DHEA products.

Photo: Sally Howard

After a large hormone study scared women, many now unnecessarily avoid hormone replacement and suffer from menopause symptoms such as hot flashes and poor sleep.

Flip through any newspaper and you might read another alarming article about the dangers of hormone replacement therapy. Dig a little deeper however, to reveal fact vs. fiction.

The uproar began in July 2003 when the The Women’s Health Initiative (WHI) during the largest government study on synthetic hormones ever conducted, halted their research after early results indicated that women using conventional hormone replacement therapy (specifically PremPro), had a much higher risk of invasive breast cancer, heart disease and stroke.

Largest Hormone Replacement Study Criticized

Critics of the study point out that the WHI study wasn’t representative of women in their 40’s and 50’s, women who were likely in the early years of peri or full menopause. In fact the average age of the women involved in the study was 63 with an average time into menopause of 12 years, and therefore more likely to have other risks related to breast cancer, heart disease and stroke.

Estrogen plays an important role in your body. It’s responsible for puberty changes in girls such as menstruation, and the development of breasts and hips. In adult women estrogen contributes to the softness of the skin and to vaginal lubrication, it helps maintain bone density, and plays a crucial role in brain function. In men, estrogen serves to assist the function of testosterone and can also influence bone density and cognitive functioning.

Estrogen however, is a double-edged sword hormone. Too much of it without the balancing effects of its bedfellow progesterone, or the wrong kind of estrogen, and it can indeed, be harmful.

When Estrogen Can Be Dangerous

Dr. John Lee, pioneer in natural women’s health and author of “Hormone Balance Made Simple,” coined the phrase “estrogen dominance” to describe what happens when the ratio of estrogen to progesterone is changed by excess estrogen or inadequate progesterone .

Ten to fifteen years before menopause, a woman may actually produce enough estrogen, but not make enough progesterone, which puts her into estrogen dominance. Over a long period of time too much estrogen may put her health in danger.

Estrogen dominance is known to cause and/or contribute to:

Cancer of the breast, ovary, endometrium and prostate (men).
PMS, mood changes, anxiety, irritability
Menopausal symptoms
Weight gain
Bloating
Mood swings
Tender breasts
Headaches
Fatigue
Depression
Hypoglycemia
Uterine fibroids
Endometriosis
Fibrocystic breasts.

**Dr. Lee advises women to use bioidentical hormones. Synthetic estrogen and progesterone hormones hormones like PremPro (combines Premarin and Provera) do not act the same in your body as bioidentical and can cause unwanted side effects or risks.

Substances that Mimic Estrogen

In addition to estrogen dominance, there is a growing concern regarding Xenoestrogens, substances that have estrogen-like and potentially detrimental affects in the body. These are found in most pesticides, plastics, acetones (e.g. nail polish remover) and in industrial pollutants such as PCBs. They can be very potent and toxic, and unlike natural hormones they don’t efficiently clear from the body. As a result, xenoestrogens tend to accumulate in the tissue over time. Even coffee can increase estrogen in the body.

Deciding If Hormone Replacement Therapy Is Right For You

Your decision regarding hormone replacement therapy should be based on clear and accurate research information, your age, health history, lifestyle, menopausal symptoms, and your individual concerns.

Read Between the Research Lines. Don’t let the WHI study scare you away from considering HRT if you’re suffering from peri or menopausal symptoms. Discuss the implications of the WHI results with your doctor.
Get Hormone Levels Checked. If you do decide to try hormone replacement therapy,measure your hormone levels first (saliva tests are more accurate than blood).Click here for hormone testing kits.
Only Consult with Experts. Only consult with a physician who is extensively trained in natural and conventional hormone replacement therapy (preferably an Ob & Gyn or endocrinologist), and who is up to date on all the research.
Consider bioidentical instead of synthetic HRT. While bioidentical hormones (BH) are not FDA regulated, a reputable, licensed compounding pharmacist can formulate bioidentical HRT creams to provide regulated, dose-accurate HRT. Dose-regulated transdermal (on the skin) bioidentical estrogen patches are also available.

What Do the Experts Say?

Bioidenticals are not safer or more effective, according Mary M. Gallenberg, M.D, Mayo Clinic gynecologist and obstetrician:

“According to the Food and Drug Administration (FDA) and several medical specialty groups, bioidentical hormones may be riskier than standard hormone therapy, and there’s no evidence they’re any more effective.

Bioidentical hormones have become popular in recent years, partly because of celebrity endorsements and partly in reaction to reports of increased health risks with standard hormone therapy. The term “bioidentical” means the hormones in the product are chemically identical to those your body produces. In fact, they are — but so are the hormones used in many FDA-approved hormone replacement products.”

But, I put my money on Dr. John Lee, author of numerous books on natural hormone replacement and the primary hormone expert I follow, and on Dr. B., a former Ob/Gyn I consulted with for three years. Dr. B left her traditional practice so she could work with women and men to naturally balance their hormones and manage their mood issues, tired of trying to treat her patients with synthetic hormones only to see their symptoms remain or get worse, Dr. B moved into natural hormone balancing.

In conversations with her and after reading Dr. Lee’s book, reviewing the research and tracking my symptoms, I gave up synthetic HRT, a regime I’d been on for 20 years (due to a pituitary disorder I have called Empty Sella Syndrome). The first thing Dr. B said to me when she saw I was on Ortho Novum for hormone replacement is “Why in the world do they (decades of doctors) have you on THIS for HRT, a birth control pill and a much too high dosage of estrogen?”

My answer back then, “I don’t know, they just did.”

That was then, this is now. Today I don’t default to doctor’s orders (nor do I ignore them if they make sense to me).

Ultimately you have to decide what makes sense for you. You have to consult with a doctor who is schooled in conventional and natural hormone balancing.

Writes Dr. Lee on his website:

“The message of steroid hormones to target tissue cells requires bonding of the hormone with specific unique receptors in the cells. The bonding of a hormone to its receptor is determined by its molecular configuration, like a key is for a lock. Synthetic hormone molecules and molecules from different species (e.g. Premarin, which is from horses) differ in molecular configuration from endogenous (made in the body) hormones. From studies of petrochemical xenohormones, we learn that substitute synthetic hormones differ in their activity at the receptor level.

In some cases, they will activate the receptor in a manner similar to the natural hormone, but in other cases the synthetic hormone will have no effect or will block the receptor completely. Thus, hormones that are not bioidentical do not provide the same total physiologic activity as the hormones they are intended to replace, and all will provoke undesirable side effects not found with the human hormone. Human insulin, for example, is preferable to pig insulin. Sex hormones identical to human (bioidentical) hormones have been available for over 50 years.

Pharmaceutical companies, however, prefer synthetic hormones. Synthetic hormones (not found in nature) can be patented, whereas real (natural, bioidentical) hormones can not. Patented drugs are more profitable than non-patented drugs. Sex hormone prescription sales have made billions of dollars for pharmaceutical companies Thus is women’s health sacrificed for commercial profit.”

So what if you want to get your hormones tested? For several hormones, saliva is ideal, but for other tests, it depends. Read more: Blood or Saliva Testing for Hormones?

Click here for progesterone testing kit
Click here for testosterone testing kit
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer
Click here for DHEA products.

Testosterone HRT for Women to Improve Sex Drive, Energy Levels, Memory and Bone Strength.

Click here for testosterone and other hormone testing kits

(Flickr, Photo credit)

Testosterone, an androgen hormone, can provide numerous health benefits including improving libido in menopausal women and women with diminished testosterone.

Click here for testosterone and other hormone testing kits

Testosterone isn’t just for men. In fact, this androgen hormone is produced in small amounts in women’s ovaries and adrenal glands.

As women approach age 40 their levels of estrogen, progesterone and androgens (testosterone) begin to decline. Once in menopause or if they’ve had their ovaries removed, testosterone levels drop even further and androgen-deficiency symptoms such as low sex drive and diminished energy may appear.

This once maligned hormone was thought to be one of the culprits behind acts of violence and rage.

Yet in controlled doses testosterone can be highly beneficial to menopausal women considering hormone replacement therapy, particularly if they’re experiencing low sex drive unrelated to physical or emotional factors.

Estrogen and Progesterone Hormone Replacement Isn’t Always Enough

Although most doctors prescribe estrogen and progesterone replacement therapy to protect women against osteoporosis, bone loss, Alzheimer’s disease, and to alleviate mood changes, hot flashes and vaginal dryness, these hormones might not improve their libido or energy levels. Dr. William Regelson, MD, and author of The Superhormone Promise, suggests that testosterone is the missing piece of the puzzle for hormone replacement therapy.

Click here for testosterone and other hormone testing kits

“For many women who feel they are not quite themselves, the ingredient missing from the blueprint is testosterone.” Dr. Regelson found that including testosterone in the hormone replacement mix, even for brief periods of time, can mimic our “normal hormonal state” and help women better tolerate estrogen and progesterone.

Benefits of Testosterone Hormone Replacement for Women:

Increases sexual drive
Maintains and builds lean mass and reduces body fat
Strengthens bone
Promotes a sense of well-being, boosts mood
Supports cognitive function (ability to focus on a task)

Testosterone has also been shown to reduce vaginal dryness, urinary incontinence, and urinary tract issues, although this might be due to the fact that much of testosterone is converted to estrogen, the hormone responsible for alleviating several urogenital symptoms.

Although few studies exist regarding the risks and benefits of testosterone hormone replacement in women, one research study conducted showed that testosterone improved overall well-being, some measures of bone density, sexual drive, mood, energy and even sleep quality.¹

Click here for testosterone and other hormone testing kits

Types of Testosterone Hormone Replacement Therapy

Most doctors won’t prescribe testosterone pills due to the risk of liver toxicity and because this form can lower levels of HDL, the “good” cholesterol in your body. Bioidentical testosterone (bioidentical means it is similar to what your body naturally produces on its own) is available in transdermal forms such as gels, creams and patches or in sublingual drops and tablets.

Deciding if Testosterone Hormone Replacement Therapy Is Right For You

The key to bioidentical estrogen, progesterone and testosterone hormone replacement therapy is to supplement if your levels are measurably low, using the lowest dose necessary to alleviate the greatest number of symptoms. If you are considering testosterone hormone replacement therapy:

Test levels. Ask your doctor to test your androgen, DHEA, estrogen and progesterone levels. Progesterone may also improve libido. Saliva testing is more accurate for some hormones because it measures “free” hormone levels (the active hormones) rather than only overall totals. ZRT labs offers home kits, saliva and blood spotting. You can then take the results to your doctor to consult.
Click here for testosterone and other hormone testing kits

Click here for testosterone testing kit
Consider DHEA. DHEA (dehydroepiandrosterone) a precursor to testosterone, is milder and in low doses can provide some of the same therapeutical effects for women. Dr. Christine Northrop, a pioneer in women’s health, recommends that if your testosterone and DHEA is depleted to take DHEA, although you need to wait about four months to feel the effect. If after four months you don’t notice any improvement, consider testosterone hormone replacement.Click here for DHEA products.
Avoid if you’re in childbearing years. Most younger women produce ample amounts of testosterone.

Although testosterone shouldn’t be prescribed across the board for all menopausal woman, it can benefit women who despite estrogen and progesterone hormone replacement therapy and DHEA supplementation, still experience low energy levels, diminished sex drive and reduced sensitivity to sexual arousal.

Footnotes:

Painter, Lisa. “Testosterone: A Major Breakthrough for Menopausal Women,” Discovery Health. July 15, 2008. http://health.discovery.com/centers/womens/testosterone/testosterone.html

K. K. Miller, B. M. K. Biller, C. Beauregard, J. G. Lipman, J. Jones, D. Schoenfeld, J. C. Sherman, B. Swearingen, J. Loeffler and A. Klibanski. Effects of Testosterone Replacement in Androgen-Deficient Women with Hypopituitarism: A Randomized, Double-Blind, Placebo-Controlled Study. The Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 5 1683-1690.

DHEA For Bone and Skin Health During Menopause – Controversial Steroid Hormone Offers Benefits for Some Women

(Flickr, photo credit)

Despite some bad press about anabolic steroids, DHEA, a hormone produced by the adrenal glands, may improve aging skin and improve spinal bone density in menopausal women.

After Orlando Magic All-Star forward Rashard Lewis tested positive for DHEA, this much touted anti-aging steroid hormone, was once again thrust into a negative spotlight.

Yet some studies suggest that DHEA hormone therapy when monitored carefully in users, provides anti-aging benefits such as improving skin collagen in post-menopausal women and increasing spinal bone density.

Click here for DHEA testing kit

DHEA Hormone Therapy: Not Just For Men

DHEA or dehydroepiandrosterone, is the most abundant steroid in humans. It is a hormone secreted by the adrenal glands (located above the kidneys) and acts as a precursor to male hormones (androgens) and some female sex hormones (estrogens). A small amount of DHEA is also produced in the brain by neurons.

After age 30, DHEA levels begin to decrease and are lower in some people with anorexia, end-stage kidney disease, type 2 diabetes (non-insulin dependent diabetes), AIDS, adrenal insufficiency or people who are critically ill. DHEA levels may also be depleted by a number of drugs, including insulin, corticosteroids, opiates, and danazol. There is sufficient evidence supporting the use of DHEA in the treatment of adrenal insufficiency, depression, induction of labor, and systemic lupus erythematosus. (National Library of Medicine, National Institutes of Health and PubMed).

Menopause and DHEA Cream for Skin Anti-Aging

In a 2008 study, sixty postmenopausal women participated in a study designed to test the affects of topical DHEA on the gene profile of human skin. Women subjects randomly received a topical application of DHEA cream with either 0% (placebo), 0.3%, 1% or 2% strength.

Results strongly indicated that DHEA may have an anti-aging effect on the skin by stimulating collagen biosynthesis through improved structural organization of the dermis while modulating keratinocyte metabolism.

DHEA For Bone Health in Older Women

Low levels of DHEA have been associated with low bone density. Researchers at Saint Louis University conducted a two year bone density study in 2009 among men and women ages 65 to 75 years old. Previous studies on DHEA and bone density showed little promise. Yet researchers believe because calcium and vitamin D deficiencies, (present in half of older adults), were not addressed during that earlier study it prevented DHEA from improving bone density. The current research included supplementation with both calcium and vitamin D.

Results differed for men and women. Women test subjects who took DHEA the first year experienced a 2 percent increase in spinal bone density compared to control subjects who took a placebo. After the second year, placebo subjects started DHEA and the test subjects continued DHEA use. Both test groups of women had a 2 percent increase in spinal bone density (a total of 4 percent in the original test group).

In the male test groups however, both DHEA and placebo groups experienced a 1 to 2 percent increase in spinal bone density, suggesting the calcium and vitamin D supplements included in the protocol, contributed, not the DHEA.

Researchers found positive results in spinal bone density but not in hip bone density. Edward Weiss, Ph.D., associate professor of nutrition and dietetics at Saint Louis University’s Doisy College of Health Sciences and lead author of the stud, suggests hips may respond more slowly to bone-enhancing therapies and require additional time to see positive effects with DHEA supplementation.

DHEA’s Additional Health Benefits

Although Weiss suggests consulting with a doctor before taking DHEA he notes, “In addition to its beneficial effects on bone, DHEA replacement may have other benefits including improvements in risk factors for diabetes and heart disease, improvements in immune function, and improvements in psychological health.”

In a 2005 review of DHEA replacement and supplementation studies, J. Bruckel found that with adrenal cortex insufficiency, where there is a definite DHEA deficiency, such as with women suffering from Addisons’s disease or pituitary insufficiency, “substitution makes good pathophysiological sense, and treatment can be useful.”

Risks of DHEA

Dr. Weiss cautions that because few studies have been conducted on the long term effects of DHEA, users should be monitored carefully. DHEA may cause higher than normal levels of androgens and estrogen and increase the risk of prostate, breast, ovarian, and other hormone-sensitive cancers.

“Therefore, DHEA supplementation should be avoided in men and women who have had cancer or who have a strong family history of cancer until further research can establish whether or not it is safe for these individuals,” said Weiss.

Results have been inconsistent on the anti-aging benefits of DHEA supplementation. In a 2009 review, “Dehydroepiandrosterone,(DHEA), review of its efficiency in improving libido and other symptoms of aging,” researchers found positive results with the metabolism of the carbohydrates increasing the efficiency of insulin, but not enough research indicating that DHEA reduces the symptoms associated with aging.

Despite the inconsistent research and negative attention DHEA has received and risks associated with any hormone replacement therapy, some individuals may highly benefit from taking monitored doses of DHEA, such as menopausal women and those suffering from adrenal insufficiency.