SAN ANGELO, Texas —Estrogen, progesterone, DHEA and testosterone are hormones that play critical roles in women’s health. Estrogen alone performs 400 essential functions ranging from increasing our metabolic rate and decreasing blood pressure to maintaining memory and sustaining bone density. Adequate estrogen levels contribute to our skin’s youthful appearance, our energy levels and our mood.
Estrogen, progesterone, DHEA and testosterone work in concert, traveling down metabolic pathways to achieve needed balance.
In young, healthy women, these four hormones achieve a natural balance, ensuring that each hormone does its job and doesn’t cause problems. for instance, if estrogen is present without the buffering effects provided by progesterone, the “unopposed” estrogen can attach to hormone receptors in the breasts and can increase the risk of breast cancer.
Either because of aging or the influence of environmental factors such as smoking or stress, our ovaries begin producing hormones more erratically as we approach midlife. As our hormones diminish, women experience a wide variety of symptoms including foggy thinking, mood swings, weight gain, anxiety, insomnia, and heart palpitations.
This period of hormonal fluctuation and diminishment is known as perimenopause. at this stage, most women still have adequate estrogen, but are experiencing changing levels of progesterone, testosterone and DHEA. Doctors can perform a blood test that identifies the levels of circulating hormones in a woman’s body, determining shortages and excesses.
Over a period of 10-15 years, the ovaries eventually quit producing the hormones necessary for menstruation causing menopause. at this stage, estrogen supplies have diminished, too, causing symptoms such as hot flashes, night sweats and increasingly wrinkled skin. Low estrogen levels also contribute to thinning bones that can lead to osteoporosis.
For many years, the only treatment available to deal with the symptoms of “the change of life” was Hormone Replacement Therapy (HRT), a regimen that uses estrogen as the primary therapeutic tool. This estrogen’s chemical make up is different from the estrogen that occurs in our bodies, which affects the way it interacts with our cells. It also is stronger and since it is administered alone, it is unopposed. a landmark study noted that HRT increased the risk of heart attack, stroke, blood clots and breast cancer prompting the medical community to rethink the use of HRT as a long-term solution. now, HRT is prescribed only as a short-term treatment.
In recent years, an alternative, known as Bioidentical Hormone Replacement (bHRT), has become widely available. the hormones used in this treatment are synthesized in certified labs from plants and are chemically identical to the hormones that naturally occur in our bodies; therefore, they interact with our cells and follow the same metabolic pathways as our own hormones. because the hormones are identical to those produced by our bodies, they can be used for as long as the patient benefits from them.
The only women who cannot undergo bHRT are women who have a history of or are at high-risk for sex-hormone-fed cancers such as breast cancer, ovarian cancer, uterine cancer, and endometrial cancer.
BHRT strives to restore the balance between the four primary sex hormones. Doctors use the results of the initial blood test and follow-up urine or saliva tests to prescribe a mixture of hormones specific to an individual patient’s needs. for instance, if a patient’s progesterone and testosterone levels are low, her treatment will supplement only these hormones. because naturally occurring chemicals cannot be patented and the prescriptions are individualized, they can only be filled at compounding pharmacies, which are pharmacies that have the ability to create custom-made medicines.
For women, finding balance in our lifestyles is not always easy. Fortunately, though, science has provided an opportunity to restore hormonal balance. if you are plagued by the symptoms of hormone imbalance, talk with your doctor to determine whether or not bHRT offers a pathway to well-being for you.
Kathy Cubine, D.O., is a family practice physician at Community Medical Associates and a member of the medical staff at San Angelo Community Medical Center.