Summary:

• Symptoms of menopause
• BHRT to treat menopausal symptoms
• Estrogen Treatment
• Progesterone Treatment
• Testosterone, Dehydroepiandrosterone (DHEA) & Pregnenolone Treatments.

Symptoms of Menopause

Women are often told that they must ‘be strong’ and endure the many physical discomforts that come with being a woman. From painful menstrual cramps to the various PMS symptoms, women face it all and often have to do so without complaining.

One phase of life that can also be a challenging experience for women is menopause. Menopause occurs between the ages of 35 to 55. Essentially, it’s a process where a woman’s menstrual cycle begins to stop. The reproductive cycle doesn’t shut down overnight. Rather, the female hormone levels gradually decrease and menstruation becomes increasingly irregular, before halting altogether. This may take up to a decade to fully happen.

While the levels of female hormones like progesterone, estrogen and others start decreasing, all sorts of uncomfortable symptoms start appearing, including:

• Hot Flashes, where the body feels like it’s heating up and you start sweating profusely
• Mood swings
• Dizzy Spells
• Panic attacks
• Indigestion and increased feeling of bloatedness
• Joint pain
• Breast tenderness or soreness
• Frequent urination
• Hair Loss
• Chest palpitations
• Weight gain
• Night sweats

Bio-Identical Hormone Replacement Therapy (BHRT) to Treat Menopausal Symptoms

One of the best scientifically proven ways to treat the gradual decrease of hormones in women’s bodies is to replace the lost hormones. This is called BHRT and is a safe and secure way to manage the symptoms of menopause, especially when they interfere in one’s quality of life. With medical sciences advances, now we have a better option than the conventional HRT, which is bio-identical hormones, these are the hormones that are molecularly similar to what our body produces.

Estrogen Treatment

Estrogen plays many important roles in the body, including regulating lipoproteins, preventing heart disease, maintaining the health of your muscles, maintaining bone density and maintaining the health of your blood vessels. Additionally, the presence of Estrogen helps prevent Alzheimer’s disease. In the reproductive cycle, Estrogen is a main regulator of the menstrual cycle.

However, if there is an excess of Estrogen in the body, they can have negative effects on the body. These effects can include, but are not limited to depression, headaches, tenderness in the breast, panic attacks, heavy periods, fatigue, mood swings and bloating. Your risk of developing cervical dysplasia, uterine fibroids, breast cancer and auto-immune diseases can be significantly increased.

How do women have excess estrogen in their bodies?

This can be due to the body’s inability to eliminate artificial estrogen that has been consumed. It can be compounded by lack of exercise and a diet poor in grains and fibers. Environmental estrogens play a crucial role too, as does the increase of a certain type of estrogen called 16-OH Estrone in the body.

In Menopausal women, Synthetic Estrogen can be prescribed in a drug form known as Premarin. The main component in Premarin is Estrone, as well as Sodium Equilin Sulfate. The ability of the body to metabolize Sodium Equilin Sulfate is limited which can lead to accumulation of these synthetic hormones   in the body and this may cause harm in the body in the long term.

There are three main types of natural estrogen, namely Estrone, Estradiol and Estriol.

Estrone(E1): Estrone is the main estrogen made by the body. However, if they are present in too high concentrations, they have been found to increase the risk of breast cancer. 16-OH, 4-OH and 2-OH Estrones are the two types of Estrones in existence. 16-OH Estrone have a stronger activity and has been associated with increased risk of breast cancer, obesity, hypothyroidism, toxicity, excess of omega-6-fatty acids and inflammation.

4-OH Estrones also have negative effects in high amounts. They directly damage your genes and cause mutations, and they cause methionine and folic acid deficiencies. Artificial hormones like Premarin actually increase the rate of 4-OH Estrones. There’s also proof they’re linked to uterine fibroids too.

2-OH Estrones are safe and you can increase them by consuming cruciferous vegetables, flax, soy, kudzu, Rosemary, turmeric, broccoli and anything with proteins. Taking Vitamin B and Omega-3 fatty acids as supplements, as well as moderate exercise and weight loss is beneficial too. Estrogen metabolism in the body can be increased when someone is obese, leading to a decrease in good 2-OH Estrone and increase in bad 16-OH Estrones.

Estradiol (E2): Estradiol is important in regulating cholesterol and lipoproteins, particularly HDL (high density lipoprotein) and LDL (low density lipoprotein). Other lipids and fats like triglycerides are also controlled by Estradiol. Additionally, it maintains the health of bones, increases serotonin, decreases fatigue, is an antioxidant, maintains memory and increases absorption of calcium, magnesium and zinc.

Estriol (E3): There is evidence to show that E3 protects against breast cancer and has been used in trials to treat breast cancer. Apart from that, it’s important during pregnancy as it benefits the vaginal lining. Most importantly, it controls the symptoms of menopause. The vaginal balance of bacteria is controlled by Estriol, as it prevents the overgrowth of bad bacteria.

An excess of Estrogen can also be caused by Xenoestrogens, which are chemicals that can imitate estrogen in the body. These chemicals are toxic and can come from pesticides, synthetic hormones for animals, plastics and cosmetics. Similarly, alcohol and antibiotics have been shown to elevate certain estrogen levels in the body.

Estrogen can also affect memory, focus and other brain functions in a significant way. Maintaining the correct estrogen levels helps to increase blood flow to the brain, increase the supply of oxygen, increase neurotransmitters, maintain dexterity, increase focus, decrease the risk of Alzheimer’s and many others.

The best way to treat Estrogen loss is through transdermal HRT, which means that the Estrogen is given via application on the skin. Transdermal estrogen is usually paired with oral Progesterone. Oral route is avoided because when Estrogen is given orally, it can increase the risk of side effects, such as increase in blood pressure, increased triglycerides, risk of gallstone, decreased testosterone, lowered levels of growth hormones and increased cravings for carbohydrates.

Progesterone Treatment

Inadequate progesterone can lead to a variety of symptoms in the body, like anxiety, depression, irritability, mood swings, insomnia, osteoporosis, excessive menstrual flow, allergies, weight gain and nervousness. This lowered progesterone levels are mainly caused by impaired production, stress, a high sugar diet, problems with other hormones and vitamin A, B6 and C deficiencies.

Synthetic Progesterone is called Progestins. However, they do not have all the functions of natural Progesterone, like the ability to lower cholesterol and improve sleep. As such, the use of Progestin usually results in certain side effects like increased appetite, insomnia, depression, acne, hair loss, nausea, decreased libido and increased risk of coronary artery spasms.

Progestins are able to interfere with the body’s own natural ability to produce the hormone, and can stop natural Progesterone from protecting the heart against diseases. It also increases LDL and decreased HDL, leading to an increased risk for heart attacks and stroke. Progestins also increase the risk of uterine cancer and blocks natural estrogen from increasing serotonin, a hormone linked to happiness and wellbeing.

Natural progesterones are able to accomplish certain things that Progestins can’t. They’re able to help balance Estrogen, they leave the body quickly, improve sleep, improve moods, lowers high blood pressure, lowers cholesterol, prevents breast cancer and has anti-inflammatory effects.

In HRT, Progesterone must always be given with adequate Estrogen. This ratio mimics the one that exists naturally.

Testosterone

Although Testosterone is mainly a male reproductive hormone, women need it too, but in lower amounts. Testosterone is important in maintaining the female libido, emotional well-being, decreasing body fat, bone strength, overall health of brain cells, muscle strength and more.

In women that have testosterone deficiencies, their body will begin experiencing muscle wasting, weight gain, fatigue, low self-esteem, decreased HDL,  decreased health of the skin and hair, sagging cheeks and anxiety. A low testosterone level is often seen in women who are experiencing menopause and after childbirth. Chemotherapy, stress, endometriosis, depression, birth control pills and even psychological trauma can cause low testosterone.

Testosterone replacement is best done through the skin using a bio-identical form.

Beside replacement therapy, Testosterone levels can also be increased naturally through adequate sleep, exercise, weight loss, stress reduction and an increase of amino acid intake, particularly arginine, leucine and glutamine.

Dehydroepiandrosterone (DHEA)

DHEA is a hormone produced in the adrenal glands of the body and is not specifically a reproductive hormone. However, it does make estrogen and testosterone in both men and women. DHEA production can decrease by about 75% by the age of 70, which is why it’s one of the hormones that should be replaced by bio identical HRT. Low DHEA can be caused by stress, aging and smoking, in addition to menopause.

In the body, DHEA decreases cholesterol, prevents the formation of fatty deposits, prevents blood clots, increases bone health, increases muscle mass, helps with stress and decreases allergies. Women tend to be more sensitive to the decrease of DHEA compared to men.

It’s important to replace DHEA in your body, as it helps increase muscle mass, decrease fat cells, improve general emotional wellbeing, improves sleep and helps with joint pain.

Bio-identical DHEA eliminates the risk of artificial DHEA. If there is an excess of DHEA in your body through the consumption of artificial DHEA, it can lead to things like fatigue, anger, deepening of voice, mood changes, insomnia, sugar cravings, acne, weight gain and more.

Pregnenolone

This hormone is a precursor for DHEA, Progesterone, Estrogen and Testosterone. This hormone is responsible for nerve functions, inflammation and sleep regulation amongst others. Individuals with low cholesterol may not be able to produce this hormone effectively, which leads to the need for replacement. Additionally, Pregnenolone production decreases with age, and individuals 75 years and above have been found to have 65% less Pregnenolone compared to individuals in their 30s.

In the body, Pregnenolone regulate the nervous system and helps deal with stress. It improves mental and physical energy, as well as brain functions. It can also reduce pain and inflammation, help you sleep better and repairs nerve damage.

HRT with Pregnenolone helps treat depression, arthritis, insomnia, fatigue, memory loss and autoimmune diseases resulting from hormone level decline.

No ‘One Size Fits All’

The decline of hormone levels as a result of menopause affects the entire body. The hormones in the body work together and the decline of one hormone affects the function of all.  Therefore, HRT has to be tailored and customized to fit each individual as each person’s experiences is different

Written by Dr. Lai Jun Min