Bioidentical Hormones are Safe
October 1, 2008 by Candice Lane, M.D.
Filed under For Women
There is no doubt that there is improvement in the symptoms of menopause by using hormone replacement therapy. It includes elimination of symptoms such as hot flashes and night sweats, reversal of bone loss leading to osteoporosis, improved sleep, emotional stability, libido and quality of life.But extreme confusion revolves about the safety of taking hormones.
Some doctors are telling patients to get off all hormones. Some are prescribing Premarin and Provera, while others are prescribing “bio-identical hormones”. Still others are switching back and forth between the two.
Hormone replacement therapy or HRT is a broad category. Some people use this term to refer to all hormone replacement therapy. When you hear this term in the media, they are generally referring to Premarin and Provera which are not natural to the human body. These drugs are referred to as synthetic hormones because they are synthesized with molecules that do not occur in the human body in nature.
Premarin is a type of estrogen obtained from horse’s urine. Although it is natural to horses, it is a different molecule than occurs in the human body. It is a very potent estrogen that can alleviate many symptoms but has negative effects as well.
Provera is a progestin used to prevent tissue from building up in the uterine lining while taking Premarin. A progestin is NOT progesterone. It is a different molecule. Progestins actually inhibit production of progesterone by the human body and have dangerous effects on the human body.
The new classification of hormone replacement therapy is called bio-identical hormone replacement therapy or BHRT. This therapy includes estrogens and progesterone that are made from soy and wild yams obtaining a compound that has the exact same molecular structure as these substances in the human body… therefore, bio-identical.
The dangers of Synthetic HRT (Premarin and Provera) were discovered in the Women’s Health Initiative Study in 2002.
This study analyzed the outcome of women taking Premarin (conjugated equine estrogen or horse estrogen from pregnant mare’s urine) and Provera (medroxyprogesterone acetate or synthetic progesterone) and found increased rates of breast cancer and cardiovascular disease. Since the drugs used were not bio-identical hormones the results only apply to Premarin and Provera, not BHRT.
Premarin is taken orally. Any oral estrogen can be a problem for heart health. It can activate coagulation and inflammation. Descenci in Circulation in 2005, found that transdermal estrogen does not have this effect.
The main breast cancer problem is the synthetic Provera (medroxyprogesterone). When the Women’s Health Initiative patients who received only Premarin without Provera were analyzed the rate of breast cancer was not increased. (Anderson, JAMA, 2004). This indicated that it was the Provera that caused an increased incidence of breast cancer.
BHRT (bio-identical hormone therapy) does not increase the chance of breast cancer. The main danger of synthetic HRT is the non-bio-identical progestin (Provera).
In the Fournier et al. study in the International Journal of Cancer, 2005 studied 54,000 women who were taking bio-identical estrogen and either bio-identical progesterone or synthetic progestin. The women taking the bio-identical progesterone had a 10% decrease in risk of breast cancer and the women taking artificial progestin had a 40% increase in the risk of breast cancer.
The De Lignieres study from Climacteric 2002 could not show an increased risk of breast cancer with use of bio-identical hormones but showed an increased risk with the use of synthetic progestin (Provera/medroxyprogesterone). In fact, they could not justify stopping BHRT(bio-identical), which is beneficial for quality of life, prevention of bone loss and cardiovascular risk profile without activating coagulation and inflammatory protein synthesis as in users of oral estrogens.
The real problem with synthetic HRT is the synthetic progestin(Provera). In contrast, several studies document that higher progesterone levels during pre-menopausal years or during pregnancy are protective against breast cancer. (Campanoli, Journal of Steroid Biochemistry and Molecular Biology, 2005).
In any case, estrogen should not be taken without progesterone which counters the proliferative tissue effect of estrogen on breast and uterine lining.
Bio-identical hormone therapy, which is different from Premarin and Provera, is safe, effective, and proven beyond any reasonable medical and scientific doubt.
Testosterone in Women
September 21, 2008 by Candice Lane, M.D.
Filed under For Women
Testosterone is an anabolic steroid produced by both men and women. Anabolic simply means it helps to build you up. Although women have testosterone levels that are only one-tenth to one twelfth the levels of men, it is an important hormone for women.
Testosterone is usually the first hormone to decrease in women in the pre-menopause and may start to decline in your thirties even before progesterone and estrogen decline.
Testosterone has many beneficial effects in women. Its most well-known effect is restoring libido and improving the ability to orgasm. It can increase the size and sensitivity of the clitoris.
Other important benefits are improving mood, reducing depression, and increasing energy. It may help to reduce panic attacks.
Testosterone increases physical strength by building muscle and improving muscle tone. This is an important effect since many women lose upper body strength with age. It also reduces fat and cellulite and increases fat-free mass.
It can reduce aches, pains, and fibromyalgia. It also helps fight fatigue.
Testosterone increases the bone mineral density of the hip and spine preserving bone mass. It improves osteoporosis.
Testosterone is a controlled prescription medication and must be administered as a cream or gel through the skin because oral testosterone can be toxic to the liver. Testosterone should not be taken by women in the absence of adequate estrogen levels because it may increase heart disease.
Testosterone applied to the clitoris can improve sexual sensitivity. Estriol and testosterone applied to the vaginal area can improve tissue quality and treat urinary leakage. Taking hormones transdermally can help urinary leakage as well.
As with all other bio-identical hormone treatments, the effects of testosterone must be monitored by a physician. Signs of too much testosterone are oily skin, acne, over-developed muscles, excess body odor, greasy hair, exaggerated aggression, and disruptive sexual desire.
When I first started testosterone, I got two speeding tickets in one month. At that point I stopped using it for a few weeks and started again at a lower dose. I have found testosterone to be helpful in overcoming panic attacks and fears (Is this why men are brave?) and helps increase emotional shield.
Testosterone has a place in all balance hormone replacement programs.
Estrogen-Natural Bioidentical Hormone Replacement
September 21, 2008 by Candice Lane, M.D.
Filed under For Women
You need to think about starting natural estrogen bioidentical hormone replacement therapy when approaching menopause in your late 40’s and early 50’s. Why? Well, for relief of symptoms like hot flashes, night sweats, vaginal dryness, and low libido among others, nothing works better than estrogen. Long term benefits of estrogen bioidentical replacement therapy include prevention of memory loss, maintenance of heart health, prevention of heart disease, bone production (prevention of osteoporosis), prevention of Alzheimer’s disease, prevention of cataracts and macular degeneration, maintenance of mood and prevention of depression, and quality and youthfulness of your genital tissues and skin. Vitamins and herbs cannot do all these things (although they may temporarily improve some symptoms like hot flashes). Quite simply, estrogen keeps women’s cells healthy. Only estrogen in women can prevent disease and improve quality of life…and only bioidentical transdermal estrogen!
What is natural bioidentical hormone replacement? It means using hormones that are biologically identical to what your body makes. In other words, the hormones are the same chemical structure as the ones that your body makes. Customized natural hormonal therapy is the only way to replace hormones safely. One size does not fit all.
Studies have shown that women who use hormone replacement live longer than those who do not. To be effective in preventing disease, estrogen must be started in women in their 50’s. For example, you need 10 years of estrogen replacement to help prevent Alzheimer’s disease.
Estrogen has 400 functions in your body. It increases your metabolic rate, enhances energy, improves insulin sensitivity, and regulates body temperature. It prevents muscle damage and helps maintain muscle.
In the cardiovascular arena, it helps maintain the elasticity of your arteries, dilates your small arteries, increases blood flow, inhibits platelet stickiness, decreases the accumulation of plaque on your arteries, decreases blood pressure, decreases LDL (bad cholesterol) and prevents its oxidation, acts as a natural calcium channel blocker to keep your arteries open (pharmaceutical companies make alien molecules to do this in patients with heart disease), decreases lipoprotein A ( a bad fat that is a risk factor for heart disease), reduces homocysteine (another risk factor for heart disease), increases HDL (good cholesterol) by 10 to 15%, and reduces the overall risk of heart disease by 40 to 50%.
Estrogen has many benefits for your brain and nervous system. It helps maintain your memory, increases reasoning and new ideas, helps with fine motor skills, enhances the production of nerve-growth factor, improves your mood, increases concentration, helps prevent Alzheimer‘s disease, improves your mood, aids in the formation of neurotransmitters in your brain such as serotonin which decreases depression, irritability, anxiety, and pain sensitivity.
For eye health, it protects against macular degeneration and helps prevent cataracts.
For beauty, it maintains the amount of collagen in your skin increases the water content of your skin and is responsible for its thickness and softness, improves breast firmness, maintains the moisture and thickness of the genital tissues, and decreases facial wrinkles.
For bones, it maintains bone density and helps prevent tooth loss.
It increases sexual interest and decreases your risk of colon cancer
Your body has receptor sites for estrogen everywhere: in your brain, muscles, bone, bladder, gut, uterus, ovaries, vagina, breast, eyes, heart, lungs, and blood vessels, so it is needed for health is all these areas.
So with decreased estrogen you get thinner skin, more wrinkles/aging skin, decrease in breast size, stress incontinence, oily skin, acne, decreased sex drive, decreased dexterity, increase in insulin resistance and possible diabetes, vaginal dryness, decreased memory, osteoporosis, urinary tract infections, and increased cholesterol.
Perimenopause and menopause occurs in our 40’s and 50’s. Most women of that age group can expect to live to be a mean age of 83. You may spend 30-40 years without the benefits of estrogen and experience resultant and inexorable disease and decline from loss of estrogen.
With a safe and effective way of replacing estrogen with bio-identical hormones, women no longer need to bear the disease and decline of estrogen deficiency.
A few things to remember:
1. Estrogen must be balanced with progesterone (not progestins or medroxyprogesterone which are piosons), even if you had a hysterectomy. Estrogen without progesterone or not enough progesterone equals 10 pounds. Besides, progesterone also has many benefits of itself.
2. Never take any type of oral estrogen, even bioidentical. It can cause or make cardiovascular heart disease worse due to a protein that is made in the liver when a great deal of estrogen hits the liver when absorbed from the gut. Transdermal estrogen doesn’t do that because it is absorbed more evenly.
3. Take only bioidentical estrogen that has estradiol (your main estrogen) and estriol (a weaker estrogen with cancer and heart protective effects). This compound is generally called Biest (bi-estrogen). Another bioidentical estrogen compound called Triest is now considered to be outdated since it contains estrone, another one of our week estrogens. We need a little estrone for bone health, but we do not need to replace it especially since estrone can be metabolized in the body into cancer causing metabolites.
If your doctor does not know these things, seek out a doctor who is trained and specializes in bioidentical hormones replacement. And enjoy your next 40 years!
Progesterone Deficiency
September 3, 2008 by Candice Lane, M.D.
Filed under For Women
Although the traditional definition of menopause is 12 months without a period, hormone loss can start 10-15 years before this happens. Testosterone starts declining first, and then progesterone. Estrogen is the last to go and is often signaled by the infamous “hot flash” we’ve all heard about.
Most women start feeling differently from their younger selves in their 40’s when progesterone starts declining. But even young women can have decreased progesterone which can manifest as PMS (premenstrual syndrome), often associated with stress or hormonal birth control. The most common symptoms of decreased progesterone include:
- Anxiety
- Depression
- Irritability
- Insomnia
- Mood swings
- Osteoporosis
- Pain and inflammation (aching joints, back)
- Increasing HDL cholesterol
- Excessive menstruation
- Weight gain or inability to lose weight.
- Fibroids
- Fibrocystic disease of the breast
- Breast tenderness
- Bloating
- Indigestion
- Gas
- Snoring
- Migraine headaches
There are other causes of decreased progesterone besides decreased production. These include:
- Stress
- Antidepressants
- Sugar
- Saturated fats
- Deficiency of vitamins A, B6, C, and Zinc
- Decreased thyroid hormone
- Taking progestins (a synthetic progesterone) in birth control pills and birth control devices, or in Prempro (synthetic hormone replacement)
Natural bioidentical (same molecular structure as in the human body) progesterone
has many beneficial effects including:
- A calming effect
- Helps sleep
- Balances estrogen
- Lowers blood pressure
- Helps the body metabolize fats
- Lowers cholesterol
- Increases scalp hair
- Is a natural diuretic
- Is a natural antidepressant
- Increases metabolic rate
If are experiencing the symptoms of progesterone deficiency, it is important to be tested by a knowledgeable physician to see if you need replacement. Natural bioidentical progesterone replacement may be all you need to start feeling yourself again.
