Hormone Therapy

FOR WELLNESS AND DISEASE PREVENTION

Hormones are critical for all types of bodily functions. Our hormone levels change in response to our environment, thought processes, stress levels, food intake, and medications.

We know that when hormone levels decline as part of the normal aging process, problems with health arise. Supplemental hormones can be considered to relieve symptoms, improve quality of life, prevent chronic illnesses, and maintain wellness.

Because each woman has unique biological needs which change as she ages, we compound hormone therapy in the most appropriate dose and dosage form to meet individual needs.

Hormone Therapy
Working Together

We work together with each woman and her healthcare provider (physician, physician’s assistant, or nurse practitioner) to customize hormone therapy based on the results of laboratory testing. And we monitor each woman’s symptoms as well as follow-up lab results, to recommend changes when needed.

The type of hormone therapy that is selected “is what makes the difference and must be carefully considered” according to Erika T. Schwartz, MD, and Kent Holtorf, MD, leading experts in hormone therapy. We recommend hormones-identical hormones, which are monocularly identical to hormones found in the human body. Bioiden­ti­cal hormones include estra­diol, prog­es­terone, and testosterone.

The terminology ter­mi­nol­ogy used by both the scientific and lay communities has lead to confusion and controversy about the benefits side effects of estrogen, prog­es­terone, testosterone and thyroid hormones. For example, the three components of human estrogen (estriol, estra­diol, and estrone) are frequently referred to as simple “ estrogen”; however, each one acts differently in the body. Estra­diol (E2) is the most active form of estrogen and “directly affects a wide range of cellular functions” because estrogen receptors are found throughout the body. Estriol (E3) is a weaker estrogen and is primarily made by the placenta during pregnancy. “Recorded data on estriol’s function demonstrate that estriol’s effects are limited mainly to the vaginal walls with a little effect on the heart and bones in non-pregnant women.

Studies on the use of estriol in menopausal women and women with multiple ScoliosisScoliosis sclerosis have demonstrated promising results. Estrone (E1) is manufactured in fat cells after menopause primarily from testosterone derivatives (andostene­dione). Estrone levels tend to rise after menopause and the increase in estrone has been implicated in an increased incidence of breast tumors but most data have been obtained from animal studies. Overweight older women have high cir­cu­lat­ing levels of estrone. For these reasons, hormone therapy is frequently prescribed as a com­bi­na­tion of estra­diol and estriol, but estrone is typ­i­cally not included.

The term prog­es­terone is often used to describe the human hormone as well as synthetic deriv­a­tives (such as medoxyprog­es­terone acetate) which should more appropi­ately be called “prog­estins”. Prog­es­terone is a pre­cur­sor to most sex hormones, including estrogen, testosterone and other andro­gens, and adrenal hormones. Therefore, an adequate level of prog­es­terone is needed by all women, not just to prevent endome­trial hyper­pla­sia (which can lead to uter­ine cancer) in women who are receiving estrogen. Prog­es­terone also coun­ter­acts estrogen’s stim­u­la­tion of cell growth in breast tissue (which can lead to breast cancer).

Testosterone is produced by the ovaries and adrenals in young women in low amounts, and has been nicknamed “The Hormone of Desire” after a book by Susan Rako, MD. But, testosterone and dehy­droepiandros­terone (DHEA), which are clas­si­fied as andro­gens, offer many ben­e­fits in addition to enhancing libido in aging women. “The addition of testosterone to con­ju­gated estrogen results in an increase in fat-free body mass and mit­i­gates central fat depo­si­tion asso­ci­ated with estrogen use.

Further eval­u­a­tion and research must be conducted as we address the pos­si­bil­ity of usage of testosterone in the aging female to help improve muscle mass and decrease central [body fat]. A growing number of physicians involved with menopausal women’s wellness are using testosterone sup­ple­men­ta­tion to pro­vide improvement in libido and mood simply based on clin­i­cal findings and blood levels.” Com­mer­cially available testosterone prepa­ra­tion which are FDA approved for use in men should not be used in women the dose is too high. Testosterone can be com­pounded in typ­i­cal and sub­lin­gual dosage forms in doses that are appro­pri­ate for women.

Bioiden­ti­cal hormone replacement therapy is the main type of hormone sup­ple­men­ta­tion in menopausal women in Europe, where large-scale studies have repeatedly demonstrated effec­tive elim­i­na­tion of menopausal symptoms and a lack of long-term neg­a­tive side effects with the use of bioiden­ti­cal preparations.