Women's Hormone Health

The Informed Woman's Guide to Hormone Health

Your hormones have you on remote control. They act as chemical messengers communicating to all the tissues in your body, including your brain. When hormone production is optimal and levels are balanced, you feel great, have tons of energy, easily maintain your ideal weight, desire and enjoy sex and have a disposition that is not easily flustered. Remember those days? That was you in your 20’s!

The 20’s, aptly called the reproductive years, is typically the decade in a woman’s life when the delicate balance of all the three sex hormones produced by the ovaries - estrogen, progesterone and testosterone - is ideal. During these years, your internal remote control works perfectly. Estrogen and progesterone work within the female body to drive the menstrual cycle: estrogen rises in the first half of the cycle, peaks at ovulation, then falls in the second half as progesterone rises. Progesterone is released by the rupturing egg follicle (the corpus luteum) following ovulation. If the egg is not fertilized, then pregnancy does not occur and the cycle begins again. When a woman begins to menstruate, and up until she is approximately thirty years old, her normal ratio of estrogen to progesterone is meant to be in perfect balance.

In this scenario of balance, estrogen works to:

• develop female sex organs and secondary sex characteristics such as breasts and pubic hair,
• maintain the menstrual cycle,
• support the growth and function of the uterus, specifically creating the blood-rich lining of the uterus preparing it for pregnancy; and
• stimulate cell growth

During these same years, progesterone works within the body to:

• maintain the uterus and prepare it for pregnancy during the reproductive years
• promote survival of the ovum (egg) once fertilized
• support bone density and slow bone loss to prevent osteoporosis
• act as a natural diuretic to prevent bloating and water retention
• serve as a natural anti-depressant
• foster a calming effect on the body
• maintain libido
• promote regular sleep patterns; and
• oppose or check estrogen's predisposition to promote excessive cell growth in order to provide protection against uterine, breast and/or ovarian cancer

Testosterone also plays a vital role within the female body. It helps to:

• boost sex drive
• support feelings of arousal
• promote muscle strength and bone building
• enhance outlook on life and sense of wellbeing, and
• increase stamina and energy levels.

As you move past your 20s and into your 30s, hormone imbalances and/or symptoms related to stress, lack of sleep, synthetic birth control, etc., can start to appear. As you reach your ‘forty-something’ years it is not uncommon to find that symptoms now begin in earnest as your aging ovaries gradually lose their ability to produce steady amounts of each sex hormone. Progesterone is the first hormone whose production declines. Typically beginning in your early to mid-30s, progesterone levels drop 120 times more rapidly than does estrogen production. The reason for this is explained by natural science - as ovarian function wanes we no longer ovulate regularly, and when we don’t ovulate - we don’t make progesterone. Lack of ovulation is the defining feature of menopause (although it can happen much earlier) as overall hormone production slows. During these years while estrogen levels decline by forty percent or more, progesterone levels can drop to nearly zero! It’s all about physiology: the follicle that ruptures to release an egg at ovulation, becomes the “corpus luteum” that pumps out progesterone for the second half (“luteal phase”) of the cycle. If ovulation does not occur and the corpus luteum is not formed, production shuts down and the body cannot make enough progesterone to keep estrogen levels in check.  This disruption of the ideal ratio between estrogen and progesterone triggers negative responses throughout your body and brain. The medical term for this phenomenon is “estrogen dominance."

Estrogen dominance can short-circuit your internal remote control physically, emotionally and mentally. Symptoms include fatigue, depression, low libido/poor sex drive, mood swings/increased irritability, hot flashes, night sweats, headaches/migraines, abdominal weight gain, insomnia, osteoporosis, irregular bleeding, bloating and increased risk of breast, uterine and prostate cancers.

Why Bioidentical Hormones Are Safe and Synthetic Hormones Are Dangerous

Bioidentical hormones have exactly the same molecular structure as the hormones produced within the human body. Consequently, they also have a 100 percent RBA for the hormone receptor sites within the body. In other words, they fit perfectly. Because the body recognizes, accepts and uses bioidentical hormones just as it would naturally occurring human hormones, bioidentical hormone replacement is both safe and effective.

Unfortunately, synthetic hormones, such as the commonly prescribed Premarin, Prempro, Premphase, Prempac and Premelle (e.g. the Premarin family of products), have a very different molecular structure from the hormones produced within the human body. Premarin is actually a drug made up of conjugated estrogens obtained from the urine of pregnant mares. As the late John Lee, M.D. used to say:  “Premarin is only ‘natural’ if your ‘natural’ food is hay!” It is important to note that minor chemical changes in the molecular structure of a hormone can cause striking alterations in biologic activity. Because synthetic hormone molecules fit very poorly within the body’s hormone receptor locks, their RBA is less than 100 percent. The ramifications of this poor fit can include sometimes lethal side effects and health risks.

In the words of women who first used synthetics

We often hear from women who are relieved to discover that they have an alternative to synthetic hormone drugs. Consider Diana’s case:

I took Prempro for 3 months, but I didn’t feel good on it. It only partially relieved my hot flashes and mentally I didn’t feel right on it. I had what could only be described as “foggy thinking.” After reading Dr. Randolph’s book “From Hormone Hell to Hormone Well,” and taking bioidentical hormones..the benefits were quite unexpected! My hot flashes and night sweats were relieved, but also I noticed other benefits that I didn’t even imagine could be addressed.

• For the last 10 years or so I gained 5 lbs. every winter, which would take 3 months to lose. This is the first time I didn’t gain any weight over the winter months.
  
• My mood improved, I felt a lot happier and more carefree.
  
• I used to drink three cans of diet cola every day for the last 15 years. I no longer have any cravings for pop and now I rarely drink it.
  
• My total cholesterol decreased 20 points in 30 days without any changes to my diet and exercise programs.
  
• I used to feel tired and groggy in the afternoon. I’m now surprisingly alert.
  
• After the addition of DHEA to my hormone replacement regimen, my metabolism increased tremendously. Now I consume more calories, and I’m a few pounds lighter.
  

I’m 52 years old. I feel like I’m in my early 30’s and my metabolism acts like it belongs to a much younger person. Thanks so much Dr. Randolph! – Diana Lowe

Many medical studies have substantiated the dangers of synthetic hormone replacement. In July of 2002, the National Institutes of Health (NIH) halted in progress, the first large randomized study of its kind to examine the effects of a widely used type of synthetic hormone replacement therapy called Prempro, which combines the altered molecular structures for both estrogen and progesterone. (Note: Synthetic progesterone is referred to as progestin.) The study, which was one of five major studies that comprised the large clinical trial called the Women’s Health Initiative (WHI), was discontinued when the risks among HRT users proved to be greater than the benefits: synthetic hormones were found to increase a woman’s risks for breast cancer as well as heart disease, blood clots and stroke. Later findings also linked synthetic hormone replacement to an increased risk for Alzheimer’s disease. The findings were published in JAMA, the Journal of the American Medical Association.

In addition to WHI’s momentous findings in 2007, The New England Journal of Medicine published powerful evidence linking the significant drop in breast cancer rates to the sharp drop in synthetic hormone use by menopausal women. Unfortunately, for those women who participated in WHI, a 2008 study published in The Journal of the American Medical Association (JAMA) reported that, three years after they stopped taking their drugs, women who had used the synthetic estrogen plus progestin combo drug Prempro during the WHI trials evidenced a 27 percent higher risk of developing breast cancer than those in the trial who took the placebo. Post WHI- discussion centers primarily on the fact that the average age of those in the study was 63 years old; naysayers point to lower cardiovascular risks among younger women in the study and take exception to the overall findings.  But even prior to the WHI, a review of existing trials with HRT users (Hemminki and McPherson 1997; HERS 1998) showed no benefit in terms of protection against heart disease and the increased risks for stroke and blood clots that surfaced within the first one to two years of the WHI cannot  be underplayed. Nor can the overall finding that the most popularly prescribed form of HRT (PremPro) was shown to be increasing risks for the very diseases it claimed to be protecting us against. The final recommendation from the principal investigators of the WHI was that PremPro should be discontinued.  Yet it remains on the market under proviso that it be prescribed for short duration symptom relief only, and at the lowest possible dose. At this writing, there is little information as to what extent this recommendation is being followed, nor is there evidence that lower dose HRT is any safer or more effective.

In the United States, a black box warning appears on the package insert for prescription drugs that may cause serious or even life-threatening adverse effects. It is so named because a black border surrounds the text of the warning. The FDA can require a pharmaceutical company to place a back box warning on the labeling of a prescription drug, or in the literature describing it. It is the strongest warning required by the FDA. The following is the black box warning included in the package insert for the Premarin family of drugs.

Why Hasn’t My Doctor Told Me About Bioidentical Hormones Before Now?
Although Dr. Randolph has been prescribing and recommending bioidentical hormones for years, the word has been slow to get out about their effectiveness until recently, when celebrities like Oprah, Suzanne Somers and Robin McGraw started singing their praises. It’s important to note that pharmaceutical companies cannot patent a bioidentical structure, so they’ve invented synthetic hormones that ARE patentable - and thus, are more profitable and easier to market. Women and men are now becoming more educated and they face an array of options - from “fountain of youth” approaches to those based on restoring hormones to balanced “physiological” levels and “looking good at any age”. Of course what works for some does not work for everyone, so it’s important to inform yourself about the in’s and out’s of restoring hormone balance, and how it can work for you. That should mean discussing your preferences with your doctor, but unfortunately, many physicians have been slow to acknowledge the safety and efficacy of BHRT because they were trained in medical school to prescribe synthetic hormones.  And, though medical research across the globe validates that BHRT should be the medical treatment of choice for symptoms of hormone imbalance, independent medical scientists do not have the marketing budgets nor the research funds supplied by large pharmaceutical companies to conduct ongoing studies. However, through the work of forward-thinking providers like Dr. Randolph, Dr. John Lee, and other pioneers of the natural hormone movement, progress is being made. Women are beginning to take charge of their hormonal health. The Natural Hormone Institute applauds and supports these efforts through education, information and safe solutions for detecting and correcting hormonal imbalances. Take the hormone health quiz to get started managing your hormone health.