As people age they dry up – skin, eyes, mouth and private parts! Their bones become fragile and their brains shrink in their skulls. We’ve all seen it! The reason for this desertification is the loss of sex hormones around midlife. For women, the transition is rather abrupt and very variable. Some women simply stop menstruating and have no further problems, while some women suffer mood swings and temperature regulation issues for years. Sleep becomes a distant memory and memory itself begins to fade.
When I see a woman in her early to mid 50’s sit down in my office and bursts into tears, it’s pretty clear what is going on. She is missing her hormones. Her sex life has gone from a healthy and satisfying regular event, to a dreaded performance. It is uncomfortably dry “down there”, and she’s distressingly disinterested. And the weight gain. Oh my, the weight gain can take her from an hourglass figure to a teapot on legs.
The great news is that the science of hormone replacement has progressed hugely in the past 20 years, since the Women’s Health Initiative (WHI) came out in 2006 and everyone was scared off of hormone replacement beyond five years after menopause. Sadly, it will take time for the good news to catch up, and for the doctors to believe it.
Here’s the good news. The annual Breast Cancer Symposium was held in San Antonio, Texas a month ago. A review of the WHI done and endorsed by a dozen prestigious cancer centers vindicates estrogen as the cause of increased incidence of breast cancer! The real culprit was the patent drug progestins (medroxyprogesterone acetate, norethindrone), both invented drugs that never existed in nature.
Real hormones protect the hormone receptors from environmental toxins like pesticides, plastics, heavy metals and others that do cause damage to DNA. Real hormones send “youthifying” messages to the body, renewing old cells and lubricating joints, skin, hair and other body parts. Real hormones are brain protective too as the brain needs hormones to function at its peak. Brains can atrophy with age, but less so when on natural hormones.
For those women interested in slow, juicy aging, you must find a provider who is knowledgeable in prescribing bioidentical hormones. Most doctors – even gynecologists – are only familiar with the pharmaceutical options; not the best, as we have seen. The doctors in the know use compounding pharmacies to make a hormonal recipe that is unique to each individual’s needs, as we are all different and dosing varies throughout the life cycle. With each decade after menopause the dosing should be revisited, especially if the patient suddenly becomes symptomatic (breast soreness, hot flashes), that indicate a change in dose is in order. Here are the essential hormones needed:
Estrogen
Estrogen provides the juice. Vaginal dryness, flaking skin, dry mouth, dry eye, are usually a result of estrogen deficiency. Replacing estrogen can result in improved mental sharpness as well.
Progesterone
This is the safest hormone and helps with sleep when given in a capsule at night. It helps with mood stabilization. That woman who cries at commercials responded very well to progesterone and no longer has the urge to weep at inappropriate times.
Testosterone
Protective of heart muscle, helps prevent (and treat) breast cancer, and makes your workout more beneficial as there is a better chance of putting on muscle mass. A woman in my practice gets 2mg a day, where a man might get 100mg, so the risk of turning into the Incredible Hulk is nonexistent for a woman. It is also the hormone that supports your sex drive. For men, it’s the main event. Testosterone starts to decline around 35, and slowly disappears until he is flabby, grumpy and apathetic. Replacing testosterone really turns back the clock for a guy.
The way we dose the hormones might be different for different women. Some can use a topical skin cream and get great results, others need a vaginal formula because they don’t absorb through the skin. Giving estrogen by mouth is never a good idea. The liver is good at denaturing it and making it into potentially troublesome metabolites. Some practices use inserted pellets that slowly dissolve and release their hormones over several months. As a former surgeon, I’m not crazy about repeatedly puncturing the skin, although some doctors (and many of their patients) swear by it. It’s a matter of convenience and personal preference.
After a few weeks on the hormones, I insist on getting a urine test to see all of the influences a hormone has as it enters and exits the body in different forms. Blood tests or saliva tests miss these all important metabolites and don’t show a true picture of a patient’s actual risks.
Slowing down aging is much harder without hormones. Find a knowledgeable provider, expect some tweaking along the way, and age slow, juicy and hot!
Dr. Carol L. Roberts, MD has practiced Functional/Integrative/Holistic medicine since 1993. She has been in Naples since 2010 when she began working at the Perlmutter Health Center, now the Naples Center for Functional Medicine, where she is the Medical Director. Her specialties are hormone replacement, finding the underlying cause(s) of chronic illness, and slowing down aging.