Health Column: The hormone-deficient woman
INTEGRATE YOUR HEALTH
Free Press Health Columnist
“Bioidentical Hormone Replacement for WOMEN
Monday, July 7
“Low Thyroid: Misunderstood, Misdiagnosed, Missed!”
Monday, July 21
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My new patient relayed to me, teary eyed, that she “was tired and depressed, not sleeping well, frustrated with her weight, and had no sex drive.” Despite previously being in great health and continuing good diet and exercise habits, her body was in her words “out of control.” There were also new aches and pains, plus she thought her skin looked dry and lifeless.
Added to this was a host of new medications started in recent years for symptom control, including Prozac for mood, Xanax for anxiety, Ambien for sleep, and Lipitor for her newly diagnosed high cholesterol. To make matters worse, at the young age of 55 other silent aging processes occurred, such as thinning bones and artery plaque.
The stress of not feeling well, poor sleep, and medication side effects were pushing her toward adrenal fatigue. The high stress hormone called cortisol had been on overdrive for many years, causing the secondary effects of high blood sugar and high insulin (which conspire along with cortisol to put weight on especially around the midsection). In times of additional stressors, her “reserves” of cortisol were depleted leaving her emotionally labile and drained of energy.
This patient represents thousands of patients that I’ve had the pleasure of successfully helping with all of these issues. The good news is that a real solution exists, involving the replacement of missing hormones.
BIODENTICAL HORMONE REPLACEMENT THERAPY (BHRT)
Hormones are chemical messengers that help the entire body function normally. They work in concert with the nervous system by responding to neuronal commands that regulate everything from growth and development, to reproduction, to the aging process itself. Hormones control metabolism, mood, energy, sleep, and sex drive. Put simply, humans are designed to be healthy with optimal levels of hormones.
Bioidentical means identical to our biology. A bioidentical hormone has the same chemical and molecular structure as the hormone that is normally found in the body. By contrast, many drugs are similar to natural hormones and will activate hormone receptors in the body, but are not identical. Birth control pills, for example, are much stronger than our natural hormones yet not identical.
For women, the natural ovarian hormones include estrogen, progesterone and testosterone, and these hormones plummet after menopause. In the world of hormone replacement, there are synthetic “look-alike” drugs that will stimulate the natural hormone receptors, such as brand name Premarin for estrogen and Provera for progesterone. Both drugs have effects beyond that of their natural hormone equivalent, and as one would expect numerous side effects not observed with bioidentical hormones.
Unlike drugs such as Premarin, which contains 10 estrogens derived from pregnant horse urine (none of which are the same as the three naturally occurring estrogens in the human body), bioidentical hormones are derived from plant sources and synthesized into the exact same chemical found in the human body.
EVIDENCE OF SAFETY
In 2002 the Women’s Health Initiative (WHI) study shocked doctors and patients alike with the revelation and proclamation that “hormones cause cancer.” More specifically, the non-bioidentical look-alike to progesterone, called Provera, caused a 26-percent increase in the rate of invasive breast cancer. Provera also caused a 200-percent increase in blood clots, a 41-percent increase in stroke, and a 29-percent increase in heart attack or death from heart disease.
It is worth noting in a case of “missing the forest for the trees” that for the treatment group in the WHI, the decreased mortality from hip fractures and colon cancer offset the increase in breast cancer and 97.5 percent of women on treatment had no adverse events.
Bioidentical progesterone has been studied extensively, in dozens of studies head to head with Provera, and simply stated it does not have the same risks. For everything bad with Provera, progesterone does the opposite. As an example, in the largest study involving progesterone, the European EPIC study involving over 50,000 women taking hormones, it was found that progesterone actually lowered the risk of breast cancer by 10 percent.
EVIDENCE OF EFFICACY
HRT is not about treating menopausal withdrawal symptoms such as hot flashes, night sweats or mood swings. Although it does treat those symptoms quite effectively, HRT is really about preventing disease and maintaining quality of life. It’s about keeping the body operating well. Not having optimal hormone levels is like letting a fine automobile just run out of oil, then declaring it is “growing old” as the red light comes on and it overheats.
Bioidentical hormones were being used long before drug companies even came into existence. They are available in a few commercial forms, but mostly we employ the compounding pharmacist to make BHRT formulations that are specific to each patient and uniquely available in either a tablet or a topical cream. It is a well-researched and proven branch of medicine that is growing rapidly.
GJ Free Press health columnist Scott Rollins, M.D., is board certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call 970-245-6911 for appointments or more information.
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