As we age, our hormones naturally change. However, this drop in sex hormones can affect our health. We typically think of female menopause, which can impact weight, energy, and bone and heart health.

Estrogen and progesterone replacement medications are commonplace. However, hormone replacement therapy (HRT) is not only for women. Men can also participate in HRT.

In this article, we’ll explore women’s menopausal transition, different female hormone types, the safety considerations for HRT, and a comprehensive solution.

What Is the Hormonal Transition?
For women, menopause begins between 45 and 55 years of age with changes in the menstrual cycle. The process is gradual as mature eggs diminish and monthly ovulation becomes irregular. Simultaneously, there’s a decline in estrogen and progesterone levels, which is also experienced after a hysterectomy.

These dropping hormone levels can affect women’s physical and mental health. Symptoms vary in severity for each person, including:

• Hot flashes
• Insomnia
• Dry skin
• Mood swings
• Vaginal dryness and pain
• Cardiac issues
• Relaxed pelvic muscles
• Hair growth

If you are experiencing menopausal symptoms, there are several therapies to help. Let’s take a look.

HRT Treatments for Menopause
Most commonly, HRT for women consists of estrogen supplementation. Yet, there are differences between conventional HRT and bioidentical hormones.

Bioidentical hormones are, by definition, exactly the same molecule that your body produced in your youth. Sometimes people believe that “bioidentical” and “natural” are the same thing. However, they are not. “Natural” simply means that the hormones were obtained from a natural or animal source. For instance, the conjugated equine estrogens that are commonly prescribed to menopausal women are extracted from the urine of pregnant horses. These are natural, but they are not what our own bodies produced. Two-thirds of the estrogens found in conjugated equine estrogens are only found in equine species, never in a human. Horses, donkeys, and zebras have a very different mix of hormones than human beings do.

On the other hand, the only natural source for bioidentical hormones would be to grind up healthy young humans to obtain them. This is clearly not an acceptable method. Consequently, bioidentical hormones are made from plant substrates that are then modified in the laboratory to exactly reproduce the molecules that are naturally made by young human beings.

Is HRT Safe?
When done properly, HRT significantly lowers the risk of several health issues for women. These include breast cancer, heart disease, osteoporosis, and colon cancer.

What created concerns about HRT? In 2002, findings from the Women’s Health Initiative (WHI) study initiated in the early 1990s led to the belief that estrogens caused breast cancer. Over the next 10 years, the study was carefully re-examined and found the following:

• Estrogen alone actually lowered the risk of breast cancer by about 30%.
• What caused the rise in breast cancer was not the estrogen, but medroxyprogesterone acetate—the synthetic replacement for progesterone—that was used in the study.
• Medroxyprogesterone acetate—sold under the brand name Provera— raises the risk of breast cancer by about 67%.
• Estrogen, which lowered the risk of breast cancer by 30% was coupled with the use of Provera, raising the risk by 67%, giving a net rise in breast cancer of about 27% in the study.
• Real progesterone—the hormone that young women make naturally—does not raise the risk of breast cancer.

A simple observation is that women in their twenties have the highest levels of both estrogen and progesterone that they will have in their lifetime. And yet, these women have the lowest risk of breast cancer that they will have during their lives. As the levels of progesterone and estrogens drop, the risk of breast cancer rises. In many ways, it appears that for most women, breast cancer is effectively an estrogen deficiency disease.

The Pros and Cons of HRT
As we discussed, women’s bodies change when estrogen and progesterone levels decline. This can result in:

• Dry and wrinkled skin
• Thin bones to the point of osteoporosis
• Muscle mass loss
• A slow metabolism
• Waning brain and memory function
• Decreased tolerance for stress
• Increased anxiety and depression

Replacing female hormones to youthful levels can overcome all of these deficits.

What are the signs that you need HRT?
For women, if you find that your drive, ambition, and stress tolerance are fading, there's a good chance that you would benefit from HRT. If your menstrual periods have become unstable or have stopped completely, this indicates that your progesterone levels are too low to induce a cycle. In this case, you need HRT.

Before and After HRT
When hormone levels are properly replaced, you should notice a significant improvement in your sense of well-being. You will likely experience improved memory and mental processing, as well as smoother more attractive skin and hair. The key is when your hormone levels are properly replaced.

Since every woman's level will be somewhat different, your metabolism is not the same as anyone else’s. And since age, weight, diet, and lifestyle all impact hormone levels, it sometimes takes three to four or even six months for the proper replacement. While we have laboratory data and many years of experience to help us, there is a degree of trial and error based on the individual’s unique metabolism to permit us to find the ideal level.

Longevity Medical Clinic Can Help
Most commonly, HRT consists of some form of estrogen supplementation for women and testosterone supplementation for men. While this is the way it's usually done, we believe it to be grossly inadequate.

At Longevity Medical Clinic, we utilize comprehensive, bioidentical hormone supplementation. We begin by measuring at least eight different hormones.

• Pregnenolone: A steroid hormone that plays a role in the production of other hormones and affects mood, sleep, immune function, and cognition.
• Dehydroepiandrosterone (DHEA): A hormone that produces testosterone and estrogen for women and declines with age. Low levels are linked to breast cancer, heart disease, osteoporosis, and cognitive decline.
• Testosterone: Plays a key role in maintaining muscle mass, bone density, cognitive function, mood, energy, sexual drive, and ovarian function.
• Estradiol: A type of estrogen that regulates the menstrual cycle, affecting the reproductive and urinary tracts, heart, blood vessels, brain function, blood sugar levels, and collagen production.
• Progesterone: Regulates menstruation and supports pregnancy. Post-menopause, progesterone supplements are important to reduce menopausal symptoms, the risk of cervical, uterine, and vaginal cancers.
• Follicle-stimulating hormone (FSH): Controls the menstrual cycle and stimulates egg growth. Women after menopause have a higher level of FSH.
• Dihydrotestosterone (optional): A hormone that stimulates the growth of male characteristics, and a high level in women increases body and facial hair.

With male patients, we test the levels of:

• Pregnenolone:A steroid hormone that plays a role in hormone balance, and is important for stress management and cognitive function.
• Dehydroepiandrosterone (DHEA): A hormone that produces testosterone and estrogen in men. Low levels are associated with osteoporosis, memory loss, depression, and erectile dysfunction.
• Testosterone: Plays a key role in maintaining muscle mass, bone density, cognitive function, mood, energy, and sexual drive.
• Estradiol: Plays a key role in maintaining muscle mass, healthy bone density, sperm production, and sexual drive in men.
• Progesterone: A hormone that produces sperm, maintains muscle mass, regulates mood, reduces stress, and maintains prostate health.
• Dehydroepiandrosterone sulfate (DHEAS): Important in producing testosterone and regulates heart rate and blood pressure.
• Luteinizing hormone (LH): Stimulates testosterone and sperm production in men. As testosterone decreases, LH increases.
• Dihydrotestosterone (optional): Converted from testosterone, too much DHT can enlarge the prostate, promote heart disease and prostate cancer, and accelerate hair loss, while too little DHT can cause gynecomastia and prostate tumors.

Our goal is to restore all eight of these hormones to the robust youthful levels that allowed you to function at your best, and we never use Provera for our female patients. Finding the right hormonal balance is a somewhat complex process and best approached by specialists, such as our physicians at Longevity Medical Clinic.

Schedule your consultation with one of our doctors today!