Friday 31 May 2013

Bioidentical Hormones - How Can They Work For Me?

Our hormones are responsible for many critical functions in the body.  They are the body’s messaging system – they communicate between the brain and the individual glandular cells, as well as between cells, and they feed back information to the brain.  As we “mature” our glands do not function quite as well as when we were young.
We do not function optimally when our hormone levels decline or are not balanced. 

It’s all about balance.  Reproductive hormones are a good example.  In women who are in their twenties, ovulation occurs with most menstrual cycles.  This results in progesterone production in the second half of the cycle.  Oestrogen and progesterone are well balanced.  An orchestra in harmony.  When a women is in her thirties and forties ovulation decreases progressively to once every 4-6 cycles and by fifty she is lucky to ovulate once to twice a year.  This means that between the ages of 35 and 50 progesterone production falls by 75% while oestrogen production falls by 35%. 

The result is called oestrogen dominance.  It has a host of symptoms most of which most women – and their families - do not particularly like.  They include premenstrual depressive symptoms, anxiety, fatigue, and irritability, insomnia, breast tenderness and swelling, shorter cycles with heavier bleeding, weight gain, fluid retention, and premenstrual headaches.  These symptoms  will be worse in cycles where women do not ovulate so some months they will feel awful, where in a cycle where they ovulate they will feel normal.  When women are between 40 – 50 and ovulation decreases in frequency the symptoms become increasingly frequent and increasingly severe.  Add in stress and increased cortisol production, and decline in thyroid function and it starts getting messy - you have an orchestra where the instruments are not synchronised at all.  When this coincides with having teenage girls who are oestrogen dominant (because they are not yet ovulating every cycle) the family dynamics can become rather interesting.

In addition we all have to activate our hormones.  One of the processes involved in this activation process is called methylation.  The gene that governs this process is one of the most important genes in the body and we all vary enormously in our ability to methylate/activate our hormones.  People who do not methylate well will experience symptoms of oestrogen dominance earlier and their symptoms will tend to be more severe.

If that isn’t enough to deal with, when women come to the end of their reproductive years, oestrogen levels start to drop as hormone production from the ovaries declines.  This is menopause and is accompanied by a long list of symptoms including psychological and physical symptoms - hot flushes, sweating, palpitations, weight gain and loss of libido. 

Hormonal symptoms are not simply something you have to live with.  These symptoms may be normal but they are certainly not optimal. You can choose to correct the imbalance.  There are many ways you can take control of these hormones.  What’s more, by restoring hormones to balanced, youthful levels and optimally activating them, the rate of ageing is slowed and many people report dramatic improvements in health and wellbeing. 

Keep in mind we are the only animals that live longer than our ability to reproduce.  We do so because of advances in everything from sanitation to modern technology in medicine.  We can choose to use advances in hormone replacement to feel better, be healthier and enjoy the extra years that we now live.

What are ‘bio identical’ hormones?
Bio identical hormones are manufactured in the lab to have the same molecular structure as the hormones made by your own body.  Often referred to as ‘natural’, these aren’t actually found in their pure form in nature,  but are made or synthesised from plant chemical extracts ( wild yam and soybeans) which are rich in precursor molecules.  These are easily converted by biochemists into other molecules that are identical in all aspects to our own naturally occurring hormones and will act in the body just like the hormones we produce.  The treatment with bio identical hormones is often referred to as Bio identical Hormone Replacement Therapy (BHRT), Bio identical Hormone Therapy or Natural Hormone Therapy. 

BHRT differs from pharmaceutical HRT in that pharmaceutical preparations contain ethinyl oestrodiol which, while relieving many symptoms of menopause, does not act like oestrodiol which is a component of BHRT.  The major difference however is with progesterone. Pharmaceutical preparations contain progestogen which is VERY different to bio-identical progesterone.  Progestogens are associated with many of the symptoms of menopause (weight gain, psychological symptoms, fluid retention) and are thought to be responsible for the increased risk of breast cancer found with the Women’s Health Initiative study.  Bio identical preparations are not associated with an increased risk of breast cancer and there is increasing evidence to suggest they may in fact be protective against breast cancer.
Conditions responsive to BHRT…
Hormones can influence every aspect of your body . BHRT can successfully treat hormone imbalance associated with pre-menstrual symptoms, perimenopause, women’s menopause and andropause (male menopause), as well as issues associated with nutritional medicine and anti-aging of the body.  Other conditions associated with hormonal imbalance include thyroid conditions, infertility, postnatal depression and weight loss. 

The major aims of this therapy administered by a successful practitioner are summed up below…
  • This treatment aims to relieve or reverse the ageing process in a way that it mimics the body’s system as it was created.  In light of this, only hormones that are the same structure as those produced by the human endocrine system should be used.
  • Hormones used in treatment should be introduced to the bloodstream in a way that imitates the glands as closely as possible, without having to go through the digestive system and creating stress on the liver.
  • Treatment should involve a broad spectrum of hormones at lower doses based on hormone test results and careful monitoring.  This approach will offer a more complete, physiological balance.
  • The dose must be individualised to the patients needs after a complete medical assessment while considering specific needs and goals of treatment. 
               
In practise a Practitioner will use an individualised, patient-centred approach.  This should involve testing hormone levels and prescribing the precise dose based on test results.  Compounded bio identical hormones can be matched to a patients needs which include oestrogen (oestrogen, oestradiol and oestriol), progesterone, testosterone, pregnenolone, thyroid extract, melatonin and DHEA.  These formulations are prepared at a registered compounding pharmacy and each patient is monitored carefully through regular follow-ups to ensure symptom relief is achieved at the lowest possible dose.  Bio identical hormones are available as troches (lozenge), transdermal creams, capsules, pessaries and suppositories.  These plant derived bio identical hormones have fewer side effects than synthetic or semi-synthetic HRT drugs commonly prescribed. 

Bio identical hormones can work wonders, but they aren’t necessarily the first place to turn when there is a hormonal imbalance.  In the great majority of cases patients can find relief through a natural approach that combines dietary and lifestyle change, endocrine support and nutritional supplements prescribed personally for the individual.  We recommend that you work with an understanding doctor who believes in the value of hormonal testing to use as a tool in the treatment of your health.  It is not recommended that hormones be used long term unless essential for symptom relief and quality of life, and only then alongside a complete risk assessment.

Dr Jackie Forrester MBChB, BSc (Med)Hons, MRCP, FRACGP  is joining our team at The House of Healing.  Jackie’s main area of interest is women’s health, bio-identical hormone replacement therapy, and methylation. 
Dr. Jackie believes in using Naturopathy and traditional Western Medicine in combination to optimise your health and wellbeing.  Appointments are now available.  Please note Dr. Jackie does not Bulk Bill.