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Natural Hormone Therapy - FAQ

How do I know if I’ve entered menopause?

You have entered menopause when you have had no menstrual periods for one full year. Health care professionals also define it by the elevated levels of FSH (follicle stimulating hormone) in your blood and/or significantly decreased levels of estradiol.

What happens during the perimenopausal period?

The perimenopausal time is characterized by fluctuations in estrogen production often coupled with decreases in progesterone production. These hormone fluctuations create symptoms that may include altered menstrual cycles, heavier flow or cramping, missed cycles, weight gain, depression, mood swings, hot flashes and night sweats. Perimenopause is defined as the period beginning with the first missed cycle and continuing until no cycles for one year.

How are “natural hormones” different from “bio-identical hormones”?

In the broadest sense, any hormonal agent that occurs in nature could be called natural. This broad definition of natural includes hormones produced by horses, plants, and people. There are, however, significant chemical differences among these natural hormones. Phytoestrogens, or plant hormones, are commonly used in natural hormone therapy. Bio-identical hormones are plant hormones that have been converted to be chemically identical to those produced in your body. A growing number of medical professionals consider bio-identical hormones to be safe and effective in preventing or controlling menopausal symptoms.

Which hormones should I take?

Whether you are considering “natural hormones” or “bio-identical hormones”, you should discuss your options with your physician, nurse practitioner, or pharmacist. Ask questions and request study materials. Your decision should be made only after an evaluation of three factors: your symptom history, your medical history, and in most cases your lab work for current hormone levels. The potential risks associated with hormone therapy should be evaluated with the potential benefits. The choices will become clear, and the ultimate decision is yours.

Are saliva or blood tests more accurate when determining hormone levels?

Although blood testing is currently the most popular, both tests are accurate and useful. Blood tests measure levels of protein-bound hormones (inactive) and saliva tests measure free hormone levels (active). Since the inactive protein-bound form is present in much higher levels it has historically been easier to measure. Only in the last several years has saliva testing become more common. Many studies have been published about the value of saliva testing methods and it has become a mainstay of hormone research.

If I have had a hysterectomy, do I still need progesterone?

Historically, progesterone was considered the “pregnancy hormone”, so many health care professionals felt it was not needed by a woman with no uterus. Now we know that progesterone plays many important roles in your body. Breast health, bone health, fluid balance, cognitive function, libido, and emotional stability all are influenced by progesterone. So, the absence of a uterus should not be a deciding factor when examining your need for progesterone.

How do our bodies make hormones?

Steroid hormones including DHEA, pregnenolone, progesterone, testosterone, estradiol, estrone, and estriol are produced in the body from cholesterol which is manufactured in the liver. Most of this hormone production occurs in the adrenal glands and ovaries; some estrogen is produced and stored in fatty tissues. Each of these hormones has specific functions in the body and some, like DHEA and progesterone, also serve as intermediate precursors for testosterone and the estrogens. Progesterone is also a precursor of aldosterone, which helps regulate fluid and sodium balance.

Are all estrogens the same?

Many chemical compounds have estrogenic activity in the body. Since estrogens stimulate proliferation of sensitive tissues, some of these estrogenic agents are associated with increases in uterine and breast cancers. Greater levels of activity and/or greater hormone exposure equate to greater risk. Humans produce three primary estrogens: estrone, estradiol, and estriol. Estrone and estradiol are relatively strong estrogens; each normally represents about 10% of the estrogen in your body. Estriol is a very weak estrogen and represents about 80% of the estrogen you produce. Many studies have indicated higher levels of estriol to be associated with reduced rates of breast cancer. Research in recent years has identified variances in estrogen metabolism to play a significant part in long term risk. Bio-identical estrogens are metabolized in two primary pathways: a 2-hydroxyestrone pathway, considered protective, and a 16-alpha-hydroxyestrone pathway, considered carcinogenic. In the human body equilins (horse estrogens) are primarily metabolized in a 4-hydroxyestrone pathway, considered carcinogenic.

What roles do hormones play in bone health? What are osteoclasts and osteoblasts?

Bone is living tissue and throughout life your body continually replaces old bone with new bone. Osteoclasts are special cells that resorb (dissolve) old bone. Osteoblasts are the special cells that build new bone. Diet, exercise, mineral balance, vitamin D status, and hormone balance all affect the rates of resorption and bone building. Estrogens slow the action of osteoclasts. Therefore, increasing estrogen slows your bone loss. Progesterone , testosterone, androstenedrone, DHEA, and growth hormone all increase the action of osteoblasts. Therefore, increasing the levels of any of these hormones increases the rate at which you build new bone. Hormones play extremely important roles in maintaining your bone health.

Will progesterone help with PMS?

The primary culprits causing PMS symptoms are a pattern of relatively excessive estrogen or reduced progesterone levels during the two weeks before menstruation. Numerous studies have demonstrated benefits using supplemental progesterone. Be aware that PMS symptoms may also be caused by other factors such as reduced thyroid activity or adrenal exhaustion,and nutritional factors such as mineral imbalances are also implicated.

Why do Asian women have lower cancer rates than American women?

Although not completely understood the primary difference appears to be dietary. Asian women living in the U.S. who maintain their cultural diet have similar cancer rates to Asian women in Asia. Those who adopt an American diet have similar rates to American women. The Asian cultural diet is much higher in fish, vegetables and fiber, and much lower in red meat. One difference that has been studied extensively is the significantly higher intake of dietary iodine, which enables metabolism of estrogens into protective pathways.

Are there other benefits to iodine?

Studies in recent years show the importance to our health of increasing iodine intake. Iodine enables appropriate estrogen metabolism, increases the excretion of toxic halides (chlorine, fluoride, bromates, and bromides), and is required for healthy thyroid function.

My grandmother never took hormones. Why do I have problems?

Some factors contributing to your symptoms are beyond your control: your age at puberty, your age during childbirth, and breastfeeding rather than bottle-feeding. Other factors influencing the way you feel are within your power to change. Major areas we can influence are exercise, diet, and to some extent reducing exposure to environmental estrogens. Daily physical activity reduces stress, improves digestion, improves mood and emotional health, strengthens bone, increases metabolism, reduces body fat, and reduces menopausal symptoms. Your diet, however, will probably have the greatest impact on your health. The American diet includes too little dietary fiber, too many inappropriate fats and trans-fatty acids, too much sugar and other simple carbohydrates, and an imbalance of necessary minerals. Instead, let the bulk of your diet come from fresh vegetables, fruit, nuts, poultry, and fish. Use healthy oils (olive, coconut), reduce sugars, reduce processed foods, and drink lots of water. Studies also show considerable benefits from supplemental vitamins and minerals.

Are progesterone creams and wild yam creams the same?

In the lab the plant hormone from wild yam can be converted to progesterone, however your body cannot convert it. Although wild yam cream has some progestin-like activity, it is not an effective substitute for progesterone. Only if a wild yam cream contains adequate amounts of natural progesterone, will it be beneficial as a progesterone source.

Do women need testosterone?

Testosterone is predominantly thought of as a male hormone but small amounts are necessary for women as well. Testosterone helps build bone, maintain muscle tone, increase energy, and maintain libido (sex drive). After menopause, women produce testosterone primarily through adrenal pathways (conversion from DHEA). Testosterone also serves as a precursor for estrogen production. When supplements are necessary, only very small amounts are used to prevent masculine effects.