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The purpose of this blog post is to give you information.  Please read through all material and make an informed decision.  It’s your health.

A week ago, Oprah featured a segment on her show regarding hormone replacement therapy and the controversy between synthetic and bioidentical.  You can go to Oprah.com to read some of the show’s excerpts.  I can understand the controversy from the stand point of lack of knowledge on both sides (pro and con).  I’ve made my decision to stick with BHRT with my patients based upon the Women’s Health Initiative Study.

On May 31, 2002, the WHI study of conjugated estrogens 0.625 mg/day, plus medroxyprogesterone acetate 2.5 mg/day in postmenopausal women was stopped after a mean of 5.2 years of follow-up because the test statistic for invasive breast cancer exceeded the stopping boundary for this adverse effect and the global index statistic supported risks exceeding benefits.

Three years after stopping hormone therapy, women who had taken study pills with active estrogen plus progestin no longer had an increased risk of cardiovascular disease (heart disease, stroke, and blood clots) compared with women on placebo.

Source: FDA website

The estrogen-alone study was stopped at the end of February 2004 because the hormone increased the risk of stroke and did not reduce the risk of coronary heart disease, a key question of the trial. The study was to have ended in March 2005.

Source: National Institute of Health website

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Hot flashes can really suck.  Ask any woman going through menopause (men experience the same symptoms as well).  Aging can really be annoying and people will do anything to slow down its progress.  Many women who suffer from menopausal symptoms such as hot flashes will usually seek out the advice of their OB/GYN who will usually point them in the direction of hormone replacement therapy (HRT).

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Think back to your early teen years where your voice began to change and bodily hair began to grow in uncharted regions.  You began to take interest in the opposite sex and acne became a huge social deterrent.  This is the phase we all came to love called puberty.  The time when your hormonal system was kicked into high gear.

Years have passed now and you begin to enter into a new hormonal phase.  Something I call: The Second Puberty (or commonly known as Menopause and Andropause).  As much as men will not admit they go through this, well…we do (it’s usually put off as a ‘mid-life’ crisis).  Menopause is actually the cessation of menses, meaning there’s no eggs being released!  Andropause, on the other hand, basically means that there’s a moderate decrease in testosterone production.  But males still produce sperm through this time.

So here’s what’s happening:

Essentially your body begins to make less of the primary sex hormones: Estrogen (females) & Testosterone (males).  So physically speaking, women begin to form more male characteristics and men begin to form more female characteristics. You know the saying, “the longer you’re married to a person, the more you begin to look like them.”

Menopause usually dominates the scene, because women are more attune to their bodies and men just shrug it off.  But both usually are afflicted with hot flashes, night sweats and usually a decrease in libido.  Here’s the kicker: you can actually prevent this from happening.

How Doc?

Well we have to step back and give you a brief schooling on your hormonal system.  Your sex hormones are primarily produced in the gonads (ovaries and testes) and also your adrenal gland cortex.

When you go through these phases, the drop off in sex hormones produced by the gonads should be buffered by the production of sex hormones in the adrenal glands.  The majority of the time the culprit tends to be decreased levels of progesterone.

The common treatment for menopausal symptoms has been hormone replacement therapy, specifically synthetic estrogen.  Most women are given Premarin.

What is premarin?

Hold on to your seats when I tell you this, but premarin is actually horse urine.  Yes, they get premarin from pregnant mares (hence the name Pre (gnant) Ma (res) u(Rin)e.  Every time I tell patients this, they look at me in disbelief and shock that their OB/GYN didn’t disclose this information.  We’ll leave this topic for a discussion at another time.

What’s the solution to hormonal balance:

  1. You need to have your hormones levels properly tested.  I highly recommend salivary hormone testing which looks at the bioavailable forms of estradiol, progesterone, DHEA, testosterone, and cortisol.  I work with Labrix, which specializes in salivary hormone testing.
  2. Once you get your test results your treatment plan may include support for your adrenal glands (glandulars, adaptogens and supportive nutrients), topical bio-identical progesterone, dietary change and exercise.
  3. Other tests may be warranted such as a liver detoxification capacity test and thyroid panel.

If you would like to have these tests run, please call my office at 949-559-7999 and request these tests and I can help devise a treatment plan for you.

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