Peri-Menopause and Menopause

Atlanta Age Management Medicine offers bio-identical hormone replacement for women.

 

ESTROGEN

Estrogen is an essential sex hormone that declines in women during the peri-menopause (10-15 years leading up to menopause) and then decreases abruptly during menopause. Menopause is defined as the absence of menstrual periods for one year. Women can start having hormonal imbalances much earlier- as much as 10-15 years before menopause. When women do not initiate a prompt estrogen replacement program at the time of menopause, they undergo accelerated aging manifested by:

• osteoporosis
• senility
• heart disease
• loss of muscle mass
• loss of skin elasticity and thickness
• atrophy of the female genitalia
• depression
• mood instability
• insomnia 

Estrogen replacement therapy significantly delays or prevents this accelerated aging process seen in women following menopause. In fact, women who take estrogen replacement have half the degenerative diseases of women who do not take estrogen replacement and live an average of 3.5 years longer. What is even more amazing, is that these positive statistics are with those patients on Premarin (non-human estrogen taken from the urine of pregnant horses). Dr. Casas uses only natural, bio-identical estrogen (estradiol) replacement in the form of topical creams; measures estradiol levels and adjusts dosages to pre-menopausal levels. There is every reason to believe that the anti-aging effects of natural human estrogen will be even better than with horse( Premarin)estrogen.

Estrogen
Relives menopausal symptoms
Increases female life expectancy
Protects against coronary artery disease
Boosts brain function
Helps prevent osteoporosis
Protects against Alzheimer's disease
Improves skin and muscle quality

Estrogen

  • Relives menopausal symptoms
  • Increases female life expectancy
  • Protects against coronary artery disease
  • Boosts brain function
  • Helps prevent osteoporosis
  • Protects against Alzheimer's disease
  • Improves skin and muscle quality

Progesterone

Progesterone is also a female sex hormone that keeps estrogen in balance and is therefore absolutely necessary in the female hormone replacement program regardless of whether the female has a uterus or not.
This concept is not understood by some physicians and this has lead to an increase in cancers of the uterus and breast in women on estrogen replacement, alone. Progesterone has powerful anti-cancer properties. In addition, Progesterone facilitates the action of other hormones such as thyroid, testosterone, and endorphins. Synthetic progesterones (progestins) such as Provera lack many of the beneficial properties of Progesterone and in fact actually serve to increase LDL "the bad form of cholesterol". Provera also does not have the beneficial effect that Progesterone has in increasing bone mass, reversing osteoporosis, and burning fat. Dr. Casas uses natural progresterone replacement as indicated by the her female patient's blood levels.

Progesterone:

  • Natural antidepressant and tranquilizer
  • Improves female libido
  • Protects against cancer
  • Boosts thyroid action
  • Helps the body use fat rather than store it
  • Helps prevent osteoporosis

 

Testosterone

Both Men and Women need testosterone for optimal health. Testosterone is needed for libido, muscle strength, leanness, and sense of well being. Menopausal women have low to non-detectable testosterone levels with resultant loss of libido and increase in body fat. Return of libido and improved mood return within days of testosterone replacement by transdermal cream. Regrowth of muscle and bone occurs within months and is facilitated by a weight resistance training program.

 

Testosterone:
  • Boosts female libido
  • Facilitates a healthy heart
  • Helps prevent osteoporosis
  • Fights fat
  • Increases muscle strength and improves appearance

 

The evidence that Bio-Identical Hormone Replacement in improving symptoms of menopause, in a patient who is a candidate for replacement , is beneficial are well known. They include elimination of symptoms like hot flashes, night sweats, reversal of bone loss leading to osteoporosis, improved sleep, emotional stability, increased libido and improved quality of life.

The Fournier Study was published in 2005 in the International Journal of Cancer. It followed 54,000 women who were taking bioidentical estrogen and either bioidentical progesterone or progestin. Progestins are not bioidentical. Progestins are fake progesterone. The women taking the bioidentical progesterone had a 10% DECREASE in the RISK OF BREAST CANCER and the women taking the synthetic progestin had a 40% INCREASE in the RISK OF BREAST CANCER. An extension of this study, published in 2007 in Breast Cancer Research and Treatment, looked at 80,000 women. Those on bioidentical estrogen and progesterone had no increase in the rate of breast cancer, those on artificial progestin had an increase of 69% in the risk of breast cancer.

Another study, the de Lignieres Study from Climacteric which was published in 2002, concluded that the risk of breast cancer is not increased with bioidentical hormones but is increased with synthetic progestin. Studies consistently show that the higher the progesterone levels over the course of a woman's life, including pregnancy when progesterone is at its highest levels, the greater the protection from cancer. Real bioidentical progesterone prescribed in the proper dosage is protective.

These medical studies are documented scientific observations that the problem with synthetic (not bio-identical) hormone replacement therapy is with synthetic progestin. There are several studies that document th at higher natural progesterone levels naturally made during premenopausal years or during pregnancy are protective against breast cancer. (Campanoli, Journal of Steroid Biochemistry and Molecular Biology, 2005).

It is important to understand that the dangers of synthetic (man-made) hormone replacement therapy discovered in the Women's Health Initiative Study in 2002 does not apply to the state of the art Bio-Identical Hormone Replacement Therapy.

This study looked at the outcome of women taking Premarin (conjugated equine estrogen or horse estrogen from pregnant mares urine) and Provera (Medroxyprogesterone Acetate or synthetic (man-made) progesterone and found increased rates of breast cancer and cardiovascular disease. Since the drugs that were used- both Premarin and Provera- were not bio-identical (same as the body produces)- the results only apply to Premarin and Provera and NOT to Bio-Identical Hormone Replacement.

The Problems with the Women's Health Initiative Clinical Trial of 2002:

Women were given the wrong estrogen- Premarin is not a human hormone. Premarin is mostly Equilin. Premarin is horse estrogen. Premarin has low levels of Estradiol and it is well known that there are cardiovascular benefits from Estradiol. Premarin does not contain Estriol and Estriol is known to be protective against breast cancer.

Women were given the wrong progesterone- Provera blocks progesterone receptors and is not a human hormone. Provera or synthetic (man-made) progesterone actually reverses the benefits of estradiol (estrogen.

Women were given the medication by the wrong route- oral estrogens are known to increase inflammation. To be safe, estrogens must be given via the skin (transdermally) so that they bypass the liver. This route is associated with less risk of toxicity.

The wrong group of women were chosen for the study- the women who participated in the study were women who were older and already had established cardiovascular disease. You see, there is about a five year window after menopause begins (absence of menstruation for one year) when changes begin to happen without bio-identical hormone replacement and once they occur, they are for the most part, irreversible and the risk of heart disease for women is then just as great as it is for men.

The study by Anderson in the Journal of the American Medical Association (JAMA) in 2004 showed that again, the main problem is synthetic progesterone, Provera, since the Women's Health Initiative patients who just received Premarin and not Provera did not have an increased rate of breast cancer.

In Women's Health in 2006, Grodstein points out that beginning any hormone therapy near menopause signigicantly reduces heart disease. In 1997, the New England Journal of Medicine states that hormone users have a lower overall risk of death. Schneider concludes his study in Maturitasion 2002 by saying that cancer mortality is reduced in current or ever hormone replacement therapy users.

 

Yoga Woman on Beach

HORMONE IMBALANCE/DEFICIENCY TEST FOR WOMEN:

Read through the list of symptoms in each group. In any group where you have two or more symptoms, there is a good chance that you have the hormone imbalance or deficiency represented by that group. The only way to determine hormone imbalance/deficiencies is to have lab testing done but in conjunction with symptoms, it can help to confirm the diagnosis.

Symptom Group 1

  • Pre-Menstrual Syndrome (PMS)
  • Insomnia
  • History of Early Miscarriage
  • Unexplained Weight Gain
  • Anxiety
  • Painful and/or Lumpy Breasts
  • Cyclical Headaches
  • History of Infertility

Symptom Group 1 indicates PROGESTERONE DEFICIENCY - this is the most common hormone imbalance among women of all ages


Symptom Group 2

  • Bloating/Water Retention
  • Night Sweats
  • Memory Problems
  • Depression
  • Hot Flashes
  • Vaginal Dryness
  • Painful Intercourse
  • History of Bladder Infections

Symptom Group 2 indicates ESTROGEN DEFICIENCY - this is the most common hormone imbalance/deficiency in perimenopause and menopause


Symptom Group 3

  • Rapid Weight Gain
  • Mood Swings
  • Anxiety/Depression
  • Breast Tenderness
  • Migraine Headaches
  • Red Flushed Face
  • History of Gallbladder Problems
  • Foggy Thinking
  • Insomnia
  • Bloating/Water Retention
  • Heavy Bleeding

Symptom Group 3 indicates ESTROGEN EXCESS - this is most common in women on one size fits all synthetic hormones often prescribed for menopausal symptoms


Symptom Group 4
Combination of Symptoms from Group 1 and 3
Symptom Group 4 indicates ESTROGEN DOMINANCE - an imbalance caused by not having enough Progesterone to balance with the Estrogen. This is VERY DANGEROUS since estrogen dominance is associated with a greater risk of CANCER of the breast and uterus. Again, Progesterone is protective against cancer.



Symptom Group 5

  • Acne
  • Excessive Hair on Arms and Face
  • Thinning Hair on Head
  • Ovarian Cysts/Mid Cycle Pain
  • Polycystic Ovary Syndrome (PCOS)
  • Infertility

Symptom Group 5 indicates EXCESS ANDROGENS (MALE HORMONES) - this is most often caused by higher, unbalanced testosterone levels as well as insulin levels.