Tel. 586-739-0531      Fax. 586.739.4217

Tell A Friend Program

Newsletter Sign-Up

Female & Male Hormone Restoration Conventional HRT vs Bioidentical Natural Hormone Replacement

Updated: 01/20/2006

Few topics have attracted as much attention in recent years as hormone replacement therapy (HRT) among postmenopausal women. For decades, physicians have been prescribing HRT to combat the symptoms of menopause as well as protect patients against osteoporosis and heart disease. The rationale behind heart disease prevention was simple: during their reproductive years, women enjoy lower rates of heart disease than men do, primarily because of the protective effect of estrogen hormones. It seemed only logical that by replacing the estrogens lost at menopause, women would retain some of their protection against heart disease. To offset the increased risk of certain cancers caused by unopposed estrogen therapy, doctors frequently added progestins to the therapy (Andrade et al 2002; Formby 1998). Progestins are synthetic chemicals designed in a lab to mimic natural progesterone.

Unfortunately, the logic of conventional HRT turned out to be faulty. In 2002, the results of the Women’s Health Initiative were released early. This landmark study followed more than 16,000 women and assessed the effects of conventional HRT, including estrogen-only therapy and therapy that combined estrogen and synthetic progestin. The findings were shocking: the estrogen/progestin arm of the study was discontinued early because the hormone therapy not only failed to protect against heart disease but was shown to increase the risk of heart attack and breast cancer (La Vecchia et al 2001). Long-term conventional HRT also increases risk for uterine cancer (Hulley et al 2002; Van et al 2002). Side effects include weight gain, premenstrual symptoms such as depression and bloating, and breast tenderness (Walsh et al 2001).

In 2004, the estrogen-only arm of the study was discontinued as well because estrogen-only HRT was found to increase the risk of stroke (Azoulay 2004). Based on these side effects, conventional HRT should not be prescribed for osteoporosis and cardiovascular disease prevention (Azoulay 2004; Rapp et al 2003).

These findings had an immediate impact on the millions of women taking conventional HRT. Up to 70 percent of women taking HRT stopped, and overall, women’s trust in the medical establishment declined significantly (Schonberg et al 2005).

This situation was unfortunate—and unnecessary. This approach to conventional HRT reflects a basic and widespread misunderstanding of female hormone replacement. Among conventional physicians, menopause is considered an isolated event that occurs around age 50, when the ovaries cease to produce estrogen and progesterone. Menopause is associated with increased incidence of heart disease, osteoporosis, and various symptoms.

While this understanding of menopause is correct, it does not do justice to the finely tuned hormone system that operates throughout a woman's life. In reality, hormone levels may begin to change in the 30s, as a woman enters a period called perimenopause. In the decades leading up to menopause, small hormonal imbalances can exist, so by the time menopause sets in, a woman may have already experienced close to 20 years of hormonal imbalance.

Furthermore, it is impossible to consider estrogen and progesterone in isolation from other hormones. All steroid hormones are created from cholesterol in a hormonal cascade. The first in the chain is pregnenolone, which is converted into other hormones, including dehydroepiandrosterone (DHEA), progesterone, testosterone, and the various forms of estrogen. These hormones are interrelated, each performing a unique biological function. True hormone replacement focuses on a woman's overall hormone health and seeks to achieve an optimal balance.

The importance of balance cannot be overstated. Physicians are just now beginning to understand the danger of having too much estrogen, a condition referred to as "estrogen dominance" (Carr et al 2001). Estrogen dominance might explain many of the conditions that confront modern Western women, from increasingly early menstruation (as early as age 10) to fibrocystic breasts (Kubista 1990), and cancer (Ashby et al 2001; Bentrem et al 2003; Bradlow et al 1995; Ghosh et al 1999; Papaconstantinou et al 2000). Estrogen dominance can occur in any woman, but perimenopausal women, who typically experience a more rapid decline in progesterone than in estrogen, are especially at risk.

Considering the dangers of estrogen dominance, it is a wonder that it took conventional medicine so long to become alert to the dangers of traditional HRT. Traditional HRT relies on a very strong estrogen called conjugated equine estrogen (CEE), which is usually (but not always) given in combination with synthetic progestins. A typical dosage is .625 mg of CEE with 2.5 mg of progestin. As the name implies, CEE is synthesized from the urine of pregnant horses (Bhavnani 2003). The progestin component used a chemical version of progesterone that was invented in a laboratory and has a chemical structure different from natural progesterone.

Estrogen dominance often produces the following symptoms:

  • Menstrual cramps and migraines
  • Bloating
  • Breast tenderness
  • Hot flashes
  • Weight gain
  • Fatigue
  • Depression
  • Hair loss
  • Fibroid tumors
  • Endometriosis

We believe that women should begin to monitor and, if necessary, correct hormone imbalances long before menopause, when there is still time to reverse this imbalance by restoring youthful hormone levels. Among younger women, it may be possible to address estrogen and progesterone levels with natural hormones, such as phytoestrogens or progesterones that can be found in plants. Among menopausal and postmenopausal women, who have dramatically reduced levels of hormones, it is often necessary to turn to specially formulated hormones that are bioidentical and supplied in approximately the same ratio found in the body. These natural hormones are often taken in conjunction with supplements that have been shown to reduce the side effects of menopause.

In addition to estrogen and progesterone, it's also important to monitor levels of pregnenolone, DHEA, and testosterone. The ideal goal of HRT therapy goes beyond the suppression of side effects caused by dropping hormone levels. The real goal of a hormone restoration program is to restore hormone levels to those of a woman aged 20 to 29. Such an approach has wide-ranging benefits throughout the body, including psychological well-being and sex drive.

(Life Extension Foundation Magazine)

What is Andropause?

There comes a time in many men’s lives, usually in their fifties, but sometimes sooner or sometimes later, when they are faced by the "Male Menopause" or "Andropause". This equivalent of the menopause in the female is often less sudden in onset but can be more severe in its long-term consequences.

Fatigue, depression, irritability, and reduced libido and potency are the commonest symptoms. This change is surprisingly often overlooked or ignored, either because the man is so pressured by the rest of his life that he assumes it is an inevitable part of growing older, or because his sexual partner has lost interest as well. Besides lack of sex drive, there is often loss of drive in professional or business life. Physically there is frequently stiffness and pain in the muscles and joints, symptoms of gout and a rapidly deteriorating level of fitness. There may also be signs of the accelerated aging of the head and circulation which testosterone deficiency can cause.

Research in over 2,000 patients at the Andropause Center in England has shown over the last fifteen years that the main causes of andropause are stress, excess alcohol, overweight, lack of exercise, and vasectomy, added to the general effects of aging.

It has been shown scientifically for the first time that there may sometimes be a low absolute level of testosterone, but more often there is a relative deficiency due to a range of factors stopping it working effectively even when the level of this key hormone is normal - the engine is pushing but the brakes are on!

Testosterone Treatment

TRT - HRT for men using Testosterone - has been shown to be dramatically effective in relieving symptoms and restoring drive, health, potency, and a sense of renewed vitality and virility when given to the right patients in the right doses at the right time. Testosterone along with DHEA are anti-aging male hormones and are available in bioidentical hormone transdermal creams for men.

To ensure its safety and effectiveness however it is essential that a full assessment or a "work-up" of each patient is carried out before hormone replacement is started, and that the results of treatment are carefully monitored. For this purpose careful history-taking and a detailed clinical examination need to be carried out.
Both to establish the diagnosis and to monitor the treatment carefully, measurements of the sex hormones and the complex range of factors regulating their action, together with tests of blood fat liver, kidney, and prostate function, and changes in red and white blood cells all need to be checked before treatment and at each follow-up visit. It is a detailed general medical screen and health check, but with special attention to the factors that make testosterone treatment appropriate safe and effective for that man.

Testosterone treatment has been in use for over half a century, and has a remarkably good safety record over that time, as confirmed by the detailed studies at this center. However, every effort is made to exclude pre-existing prostatic cancer, by clinical examination, and a sensitive blood test the Prostate Specific Antigen (PSA).

(Andropause Center – UK)