Hormone Q & A

 

What are hormones and why do I need them?

Hormones are messengers that communicate with the cells of the body. Hormones are an essential part of the metabolic process of living. Hormones are necessary for cells, organs, and metabolism. Our hormone levels decline through aging, menopause, disease, and exposure to toxins or trauma. When this happens, we begin an accelerated aging process. Decline in hormones is one of the major reasons for our deterioration as we get older, both physically and mentally.

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What hormones are typically prescribed?

Synthetic estrogen (i.e.; Premarin®) and progestins (i.e.; Provera®) are produced in a laboratory. They are chemically altered so that the pharmaceutical companies can patent them. They are not identical to human hormones. They are designed to try to elicit the same responses in the body as your natural hormones. Because synthetic hormones are not identical to human hormones, they might adversely stimulate the cells and lead to side effects or cancer. Premarin® is an estrogen obtained from pregnant horses and is not human estrogen. Provera® is a progestin and not identical to human progesterone. Both have been implicated in causing problems in some women, including breast cancer.

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How are natural estrogen and progesterone produced?

Hormones that are identical to human hormones are found in yams and soy. We call these "natural" because they are natural to the body. The hormones are extracted from these and then processed by a specialty compounding pharmacy into a prescription dose and form. The body accepts these hormones as if it made them.

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What are the problems with synthetic hormones, which are not identical to human hormones?

When first developed, synthetic hormones were well received because they provided some of the benefits of hormonal replacement: controlling the symptoms of menopause and fighting osteoporosis. However, the long-term results have shown that synthetic hormones often elicit a negative metabolic response. Some women can't tolerate synthetic hormones, often suffering with side effects such as bloating, bleeding or mood swings. In some patients, synthetic estrogens and progestins can contribute to the development of breast and uterine cancer.

Synthetic hormones are not a perfect match in the body and try to trick the body. A natural hormone does not have to trick the body. Synthetic hormones produce abnormal metabolites that cause the side effects and the cancer risk.

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Why doesn't my gynecologist prescribe natural hormones?

Natural supplements, such as vitamins and hormones, are protected by federal regulation and may not be patented. Major pharmaceutical manufacturers are interested only in patentable drugs that are exclusive and profitable. A lot of what physicians learn is from the drug companies who are promoting their products. Therefore, your doctors are primarily taught only about synthetic products. Natural hormones do not come under specific brand names. Your physician must be self-educated and experienced to prescribe and monitor natural hormones. They probably just don't know a lot about them or must prescribe within the constraints of your health insurance.

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What is the truth about the recent publicity about the risks of taking hormones?

The Women's Health Initiative (WHI) was a study that evaluated the use of Premarin® and Prempro®. There were different "arms" of the study using different drug combinations. The arm of the study using Premarin® and Provera® (Prempro) was discontinued before completion because an increased risk of breast cancer was detected. This risk is attributed to the Provera® (medroxyprogesterone) portion of the regimen. This is not the first time progestins have been implicated in increasing risks for women. The arm of the study using Premarin® only was also stopped due to increased risk of stroke. These synthetic hormones are generally not well tolerated or accepted by a woman's body.

Unfortunately, the media has misrepresented the facts of this study by targeting ALL hormone therapy. THIS IS WRONG! Again, the culprit is synthetic progestin, Provera® and synthetic estrogen, and not natural estrogen or natural progesterone. There are numerous studies showing the long-term benefits of hormone therapy. You just need to make sure you are receiving the right hormones (that have the same chemical structure as and are physiologically identical to human hormones) in the right balance. It is also important to begin hormone replacement as soon as you begin to lose the hormones to avoid any length of time without their protective benefits.

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What are the signs of low Progesterone and what are the health benefits?

Progesterone is responsible for balancing estrogen and the female reproductive cycle. Deficiency results in symptoms of PMS, bloating, headaches, cramping, mood swings, breast tenderness, and irritability. A deficiency in progesterone can be a factor in frequent miscarriages.

Research shows that natural progesterone stimulates bone-building osteoblasts, thus providing protection against osteoporosis. Progesterone reduces the mitotic change in breast and uterine tissue, thereby protecting against cancer (Provera® does the opposite). Progesterone protects against heart disease. Progesterone is necessary for adequate sexual response, lubrication and vaginal vasodilatation. Progesterone is responsible for the physiologic equilibrium with estrogen. At menopause, women lose both estrogen and progesterone and both should be replaced. Progesterone replacement is important, even if you have had a hysterectomy, because it does much more than just protect the uterus.

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What if I have been taking synthetic hormones?

You need hormones, but you need the right kind, the natural hormones, in the right balance. Don't tolerate the risks of the synthetic hormones when an alternative is available. Find a physician who will prescribe natural hormones and then make the switch.

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Should I take estrogen and progesterone or not?

The risks of not taking hormone replacement therapy include elevated cholesterol, increased risk of heart disease, strokes, osteoporosis, tooth loss, depression, Alzheimer Disease, and menopausal symptoms. The side effects of the synthetic hormones -- such as bleeding, swelling, weight gain and breast cancer -- can be almost eliminated by using the natural estrogen and progesterone. Overall, health and well-being are improved, long-term survival is greatly improved, and quality of life is greatly enhanced. The risks of not taking hormones are tremendous. Just don't take the synthetic hormones.

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What about over-the-counter creams and saliva tests?

Products purchased over-the-counter are not usually of sufficient strength to produce a long-term therapeutic difference. A sufficient dose requires a prescription. Over-the-counter products might give you some symptomatic relief, but it is necessary to maintain certain hormone levels to achieve the long-term protective benefits.

Because free hormones are soluble in the saliva, we rely on saliva tests to determine accurate and optimal levels. Saliva testing has consistently been shown to be an accurate indicator of hormone levels.

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How does one know whether they are receiving adequate amounts of replacement hormones?

Blood tests determine deficiencies. Blood tests also determine whether adequate replacement has been prescribed. All people will absorb, assimilate, and respond to hormones differently than others. If the proper level (and therefore tissue level) is not achieved, then the full benefit of hormone replacement is not realized. We want hormone levels to be optimal and protective.

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What about Evista® and Fosamax®?

Evista® (Raloxifine) is in a class of drugs known as designer estrogens. Studies show that these compounds are somewhat effective in increasing bone mass although not as effective as estrogen and progesterone. Designer estrogens do not relieve any of the side effects of menopause and might even increase them. Fosamax® is a non-hormone treatment to block bone loss and prevent osteoporosis. It has been associated with a multitude of side effects, especially gastrointestinal problems. Neither designer estrogens nor Fosamax® are as effective as natural estrogen, progesterone and testosterone in preventing osteoporosis.

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Are there other hormones I should replace? What about hormones for men?

Other natural hormones that should be part of an optimal hormone replacement program are testosterone, thyroid and DHEA. Both men and women need these hormones.

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What exactly is natural progesterone and how does it differ from synthetic progestins?

Natural progesterone, a cholesterol derivative, comes from both wild Mexican yam and soybeans. It has the same chemical structure as the body's own progesterone. Synthetic progesterone derivatives, called progestins, was designed to simplify any treatment that called for progesterone. Dr. Niels Lauersen, author of PMS and You, said that, "Progestagens are chemically formulated from progesterone, however they do not duplicate the properties of natural progesterone. These synthetic hormones react differently than natural progesterone. When a woman is treated with progestins, her body becomes confused and causes salt retention, hypoglycemia and fluid retention...synthetic progestins generally make PMS symptoms worse. So if a woman is to be treated with progesterone, she should be sure that it is NATURAL progesterone."

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Are there any side effects from using natural progesterone?

Most frequently, any side effects from natural progesterone are associated with usage and can be easily alleviated by changing the amount, time, and frequency of dosage. When treating PMS, using too much progesterone over a long time can delay the period a day or two. Stopping the progesterone will cause the period to start and progesterone can be resumed after 7 days, but at a slightly lower dose. Women with irregular periods might notice some spotting at ovulation when starting progesterone treatment. This means that the period is trying to regulate to a 28-day cycle. With continued usage, periods will become regular and the spotting will be alleviated. Women beginning menopause might also notice some spotting when they begin using natural progesterone. This will be alleviated with continued use. Progesterone may also cause a feeling of relaxation or drowsiness. This is perfectly normal and can be alleviated by changing the time of dosing. Post-menopausal and osteoporosis age group women should not have any side effects.

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Do I need a prescription for natural progesterone?

Generally, natural progesterone in a cream is considered a non-prescription supplement. Progesterone in capsules, sublingual tablets, or high potency creams does require a prescription.

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Can I use natural progesterone without estrogen for the prevention of osteoporosis?

Absolutely. Many physicians feel that supplemental estrogen is not generally necessary for menopause and post-menopausal women who still have their ovaries. If flushed or hot flashes are occurring, the use of natural progesterone is effective in relieving them. It is generally recommended to use natural progesterone daily and then every 15 minutes during a hot flash. If after one month hot flashes are still occurring, some natural estrogen is suggested, in addition to natural progesterone. Estrogen use should continue until the hot flashes have stopped completely; then, natural progesterone alone can continue indefinitely.

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Can men use natural progesterone?

If men under the age of 45 use very much, it will cause the testicles to shrink and decrease libido. However, older men (over 55) can use natural progesterone to increase libido. Older men with rheumatoid arthritis have gotten relief from pain and swelling after rubbing natural progesterone cream to their joints. Natural progesterone can even help men diagnosed with osteoporosis.

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Will natural progesterone help achieve pregnancy?

Progesterone plays a crucial role in reproduction. It prepares the uterus for the implantation of the fertilized egg. Without adequate progesterone in the uterine wall, the egg cannot attach itself and is expelled. If a woman is having trouble getting pregnant, she may be experiencing luteal phase deficiency, which results when there is an inadequate amount of progesterone after ovulation. In these cases, progesterone therapy would be very effective. Adequate progesterone levels allow the implanted fertilized egg to remain in place. Women having unexplained miscarriages in the first trimester may suffer from progesterone shortage.

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How do I know if I am using enough natural progesterone?

Each woman's need for natural progesterone is different. For menstruating women, natural progesterone is usually used for 21 days each month, skipping the last 7 days (during the menstrual period). Amounts used might increase in the 7-10 days before the period, dependent on PMS symptoms. After several months of usage, the amount of progesterone used may be decreased, as well as the days used.

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I am menopausal. Will I start menstruating again if I use natural progesterone? What if I have breakthrough bleeding?

Occasionally upon beginning use of natural progesterone, a post-menopausal woman could experience some breakthrough bleeding or a period. This is a perfectly normal response and is nothing to cause alarm. The progesterone is simply causing the body to rid itself of excess stored estrogen that can sometimes stimulate uterine shedding; a.k.a., breakthrough bleeding. If this continues for longer than several months, she should consult her pharmacist or physician.

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I have amenorrhea. Can natural progesterone and estrogen help?

Amenorrhea can be the result of prolactin producing pituitary tumors, anorexia nervosa, intense exercise or undernourishment. These conditions cause cycle irregularities and ovulatory disturbances that affect the levels of circulating estrogen and progesterone. If a woman is not ovulating, she will most likely develop an estrogen deficiency, which can be controlled by natural progesterone. If the time between ovulation and menstruation (luteal phase) becomes less than 10 days, a progesterone deficiency can develop. The body produces progesterone during the luteal phase. The use of natural progesterone can help normal menstruation to resume. If it does not, it is strongly recommended that progesterone therapy be continued to prevent accelerated bone loss associated with estrogen deficiency.

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If all women always stop making progesterone after the childbearing years, why do we have to add any hormones when we are no longer fertile?

A young girl (age 11), just before she starts making hormones, has very low hormone levels but physically and emotionally is functioning well. Ideally, a menopausal woman would return to a similar state where her hormone levels are low, but they are in balance. But, take that low hormone level and add a poor diet and obesity. Both create more estrogens. Add xenoestrogens from the environment, stress (which blocks progesterone, lack of sleep or sleeping in a room not dark enough: These all increase estrogen in women (and men). You can see why menopausal women tend to have hormone imbalances.

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These statements have not been evaluated by the FDA. None of the products listed or mentioned should be used as a substitute for medical advice, or to diagnose, treat or cure any illness. Always consult your personal physician before consuming any new supplements and never change any medications without his/her expressed permission.