(Part 1 of a 5-part series.)

Functional Endocrinology is a term that I have come to love. It means that there is no hormone producing organ or gland in the body that operates in isolation. It means they all work together in the context of the environment the body and mind are functioning in. Anyone who doesn’t address the thyroid, the adrenals, stress reduction, weight management, nutrition, medications AND the reproductive system when considering bioidentical hormone therapy isn’t giving you the whole picture.

Hormone imbalance is ALWAYS related to stress. 5 people having the same experience will react differently to the same stressor. There is a test for stress. It’s a cortisol saliva test that will identify how your body is responding, how you are doing in any given day. Stress promotes aging, oxidizes DNA, and is linked with almost all causes of death. In Western medicine we wait for it to create disease, and then we treat the symptoms of the disease. Stress makes us crave carbs, snap at our kids, drink cups and cups of coffee, and then have to use alcohol to calm down at the end of the day. If you go on a vacation, your life is still waiting for you when you get back. This is the cause of hormone imbalance.

Western medicine can be called Symptom-Drug Medicine. You get 6 minutes of face to face time with your doctor to get the words out about your symptoms, you get a scribbled out prescription for a medication and off you go. We all know this is not working. Declining mental sharpness and energy is NOT a normal process of aging! Antidepressants are given in lieu of real listening by your medical provider. A drop in energy, moodiness, and lack of libido are NOT due to a lack of Prozac or Zoloft in your blood stream. Insomnia is not because your blood level of Ambien is too low. One of my favorite questions I am asked is, “I don’t feel depressed, so why did I get prescribed an anti-depressant”? Why don’t we call hypothyroidism, “cold hand-ism” or “weight gain-ism”? Fibromyalgia, chronic fatigue and restless leg syndrome are all symptoms…with no known causes, but they have a drug that the pharmaceutical industry found would help. So now it is a “standard of care” in medicine. But then what about the side effects of these drugs used to treat symptoms? Why is it okay to give an antidepressant for fibromyalgia and then have our patient’s sex drive bottom out?

Never reject human physiology in favor of the latest pharmaceutical. Bioidentical hormone therapy has been called, “a fad” by the pharmaceutical companies. A fad is created by marketing giants. A “movement” is caused by grass roots. Bioidentical hormone therapy has become a normal term in society now because of our patients. This is word-of-mouth advertising; it is a movement. It has become popular because it actually works.

There is a problem though. Many medical providers are not properly trained. There has been overdosing of bioidentical hormone therapy for the past few years that many of us then have to clean up when our patients come to us in a bigger mess than when they started. Large doses of any hormone will make you feel great for about 6 months, but then it will store in your fat tissue and begin to be released randomly. I have hundreds of clients who come to me in this state and I have to begin by detoxing them and then restarting.

Myths about Female Hormones

• Pharmaceutical estrogens are the “fountain of youth” and have more benefits than risks for women.
• Estrogen levels are responsible for hot flashes and most menopausal symptoms.
• Estrogen levels drop significantly after menopause.
• The best way to test for menopause is FSH.
• Birth control pills and HRT closely mimic our natural hormones.

Facts

• Pharmaceutical estrogens can contribute to blood clots and stroke and breast cancer.
• Lack of balance between estrogen, progesterone, and testosterone leads to hot flashes and other menopausal symptoms.
• Estrogen levels normally drop only 10-20% after menopause.
• The best way to test for hormone balance is salivary testing.
• Oral contraceptives and HRT are much more potent than our natural hormones and suppress our natural production.

 

Estrogen functions as a growth and storage agent, mainly storage of fat and growth of endometrial lining (leading to an increased risk of cancer and fibroids). It decreases the effect of the thyroid hormone in the body.

Progesterone is like the yang to the estrogen yin. It promotes normal cell death, allows for diuresis, and decreases estrogen receptors.

We want balance between the two. Six-year-old girls have great balance and are never fanning themselves on the playground with hot flashes. Little girls make very little estrogen. Why do we keep giving our women estrogen and killing them off?

Symptoms of Excess Estrogen in the Body:                        

• Breast tenderness/fibrocystic changes
• Hot flashes
• Water retention
• Depression
• Anxiety
• Fatigue
• Endometriosis
• PMS
• Weight gain
• Breast and uterine cancers

Symptoms of Excess Progesterone in the Body:

• Breast tenderness/fibrocystic changes
• Hot flashes
• Water retention
• Depression
• Anxiety
• Fatigue
• Endometriosis
• PMS
• Weight gain
• Breast and uterine cancers

These lists are the SAME!

Premarin and Prempro were marketed for menopause and birth control pills for PMS. However, they do not replace hormones…they replace nothing. They were approved for treatment of vasomotor symptoms, not HRT. They actually CREATE estrogen dominance, which can cause breast cancer. There is no accurate testing for monitoring them. The FDA approved only a question to monitor HRT: “are your hot flashes better?”  These hormones come from pregnant horses. We are a little smaller than horses and our hormones should be monitored by more than how we feel on one day of our ever-changing cycles.

If you are still wondering if exogenous HRT with synthetic or horse hormones is safe, keep reading. The pharmaceutical industry was just as powerful in the 1930s when these drugs were first invented as they are now. Here is a timeline of studies and their findings:

In 1973 Harper’s Bazaar called estrogen replacement something that, “keeps you flirtatiously feminine-a real package deal that spruces up your vagina.”

In 1975 the New England Journal of Medicine reported a 14-fold increase in endometrial cancer from keeping our “vaginas spruced up”.

In 1976 the NEJM reported a link between HRT with breast cancer.

In the 1970s Provera was added to Premarin for women with a uterus. Prempro did it one pill in 1995.

 In 1989 the New England Journal of Medicine published a Swedish study that showed a slight increase in breast cancer in women on Premarin. The risk more than doubled in women on Premarin plus Provera (current standard of care).

In 1998 the PEPI trial showed that HRT does not prevent heart attacks and in fact increases the risk of second heart attacks.

In 2000 the WHI saw an increase in heart attacks in women on Prempro and gave them the chance to drop out of the study. Wyeth hired Lauren Hutton as its spokesperson and sales approached $2 billion per year in spite of the fatal findings of the study.

In 2002 the WHI study halted the use of Prempro because of:

• 26% increase in breast cancer
• 29% increase in heart attack
• 41% increase in stroke
• 200% increase in blood clots
• No improvement in overall quality of life
• Increased risk of Alzheimer’s dementia

Not taking Prempro would save annually:

• 8,000 breast cancers
• 7,000 cardiac events
• 8,000 pulmonary emboli

The take home message?

Horse urine estrogens are NOT human estrogens. Provera is NOT progesterone.

Provera balances estrogenic stimulation of the endometrium but it has side effects. Are these worth it?

• Depression, anxiety, and insomnia
• Bone loss and seizure potential
• Increased lipids profile and glucose intolerance
• Blood clots
• Acne
• Fluid retention
• Heart disease and stroke
• Breast cancer
• Decreased libido
• Inhibits production of natural progesterone

Natural progesterone does not do any of these things if given at the correct levels!

Even in the medical literature when you look at studies, Provera will be substituted for natural progesterone and be called progesterone.

Permarin got its name by putting its ingredients in the title: Pregnant Mares Urine=Premarin

Asian women have fewer reported menopausal issues. What is the difference between Asian women and American women? They are slimmer. Obesity is a huge factor in the metabolism of Estrone  (the carcinogenic form of estrogen).

Next week in part 2 we will talk about testosterone for women and men.

For now…here’s to your health!