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Hormone replacement therapy has been
increasingly researched and used in the past few years. Since the
Women’s Health Initiative (WHI) study was done in 2002, more women are
looking for alternatives to the once commonly prescribed Premarin and
Provera.
Options for Hormone Replacement Therapy
Premarin and Provera
Premarin is also known as conjugated equine
estrogen (CEE) and is produced from pregnant mare’s urine. Provera is
also known as medroxyprogesterone acetate (MPA) and is a synthetically
made progestagen. The WHI study found that there was an increased risk
for stroke, myocardial infarction, invasive breast cancer, pulmonary
emboli, and deep vein thrombosis in women who used CEE (0.625mg) and MPA
(2.5mg) during the 5 year study relative to placebo.
2004 studies by the WHI indicate that estrogen plus progestin use
doubled the risk for venous thrombosis in postmenopausal women aged
50-79 years.
Natural Hormone Replacement and
Bio-Identical Hormones
There are three naturally occurring
estrogens with the body: estrone (E1), estradiol (E2), and estriol
(E3). In women, these estrogens are produced in the ovaries and in the
adrenal gland. As menopause occurs, these levels begin to fluctuate and
decrease. An imbalance in the levels of estrogen causes symptoms such
as hot flashes, irregular menses, heavy bleeding, weight gain, and
insomnia to name a few.
Naturopathic Medicine in Conjunction with Traditional Therapies
Some women suffer from mild to severe
symptoms during perimenopause and menopause that they need immediate
relief. Menopause is defined as the cessation of menstruation, often
occurring between the ages of 45 and 55. Prior to this, physiological
changes occur in women that may create uncomfortable and sometimes
distressing symptoms such as those described above. By supplementing
bio-identical hormones with naturopathic medicine, symptomatic relief
can be achieved. Various options are available to women, including
homeopathy, nutrition, botanical medicine, and lifestyle modifications
to name a few.
Addressing Other Hormone Systems
From a naturopathic medicine perspective,
the body needs to be viewed as a whole, not just the ovaries and
uterus. This is extremely important as women enter menopause. Often we
become very focused on estrogen and progesterone levels that we dismiss
other important glands and organs in the body, specifically the thyroid
gland and adrenal glands.
The thyroid gland is located on the
front part of the neck, below the larynx (voice box). It consists of
two small glands, one on each side of the windpipe. It plays a large
role in the body’s metabolic function and calcium balance. Many women
present with “subclinical hypothyroidism” and have symptoms such as
fatigue, cold hands and feet, dry and brittle nails, hair changes,
weight gain, and “chicken skin” on their arms and outer thighs.
Although their TSH may ‘appear’ to be within normal limits (between 0.2
and 6.0 mU/L on blood work), their thyroid still needs support. T4 (thyroxine)
and T3 (triiodothyronine) levels are also important in determining
optimal thyroid function. Determining all 3 levels of hormones is
necessary in overall perimenopausal and menopausal treatment.
The adrenal glands are located on top
of the kidneys and secrete an important hormone, cortisol. Cortisol is
the stress hormone and plays a large factor in hormone balancing in
women. Symptoms such as inability to fall asleep at night, feeling
“wired but tired”, heart palpitations, and difficulty wakening in the
morning can be symptoms of altered cortisol secretion patterns. As the
ovaries begin to stop functioning, the adrenal glands take over the
production of these hormones. It is not uncommon for women to have
dealt with increased amounts of stress during their lives (work, family,
poor diet choices, lack of exercise, over-exercise, etc.) and to have
taxed their adrenal glands. When it becomes time for this gland to take
over the hormone production aspect from the ovaries, it cannot deal with
this extra burden. This is when we see symptoms of an inability to lose
weight, overwhelming fatigue, exercise and heat intolerance to name a
few. Support of the adrenal gland is crucial for women of all ages.
Oftentimes, symptoms of a low functioning
thyroid and a low functioning adrenal may mimic each other. Consulting
with your health care practitioner can help you determine which system
needs attention.
Testing Available
Conventional
blood work can be done through your family physician. Hormones
are bound by protein in the blood. With blood testing, free amounts of
hormones can not be determined. When a hormone is bound to a protein,
it is unable to perform its action at the cellular level. Your blood
work may indicate adequate amounts of bound hormone, but what is the
level of the active form?
Saliva testing is more readily
available now and is a more accurate indicator of free hormone levels
within the body. With this test, we are able to determine your levels
of available estrogen, progesterone, DHEA, testosterone and cortisol.
By interpreting these results, we can create a treatment program that
will help minimize your symptoms of perimenopause and menopause.
For women entering menopause, the route you
choose for treatment depends on you. If symptoms are unbearable, a
combination of traditional and naturopathic medicines is your best bet.
By using natural hormones, we can better balance your body so that the
transition is much easier. There are women who choose to go one way or
the other, but ultimately the choice is yours. By balancing your
hormones and seeking effective treatment for adrenals and thyroid,
menopause can be a breeze. Menopause is time to be cherished, but it
becomes a time of anguish and stress. By working with your body as a
whole, we can help this become your best time.
JAMA. 2002;288:321-333.
JAMA. 2004;292:1573-1580
Top of Page |
"For women entering menopause, the route you
choose for treatment depends on you. If symptoms are unbearable, a
combination of traditional and naturopathic medicines is your best bet.
By using natural hormones, we can better balance your body so that the
transition is much easier. There are women who choose to go one way or
the other, but ultimately the choice is yours. By balancing your
hormones and seeking effective treatment for adrenals and thyroid,
menopause can be a breeze. Menopause is time to be cherished, but it
becomes a time of anguish and stress. By working with your body as a
whole, we can help this become your best time." |
