Transcript Do I Need Hormones? - Coastal Prestige Medical Services, Inc.

Do I Need Hormones?
Dr Johnnie Ham, MD
Coastal Prestige Medical Services and Clinic
Pismo Beach, California
What are Hormones?
• Hormones are BioChemical Messengers
• Hormones control numerous functions
in the body
• One of the Two Major Controllers in
your body
Unique Targets
Where do they come from?
Focus on the Major Sex
Hormones
• Progesterone
• “pro” “gestational”
• Testosterone
• Estrogen
• Estradiol – the major player
• Estrone – less active, post-menopausal
• Estriol – the pregnancy estrogen
Estradiol
• Performs over 240 functions in the body
• In contrast, Testosterone performs about
110; Thyroid Hormone performs about 15
• Produced by the month’s stimulated
follicles in the ovary
• So, no stimulated follicles, no estradiol
Some Functions of Estradiol
• promote formation of female secondary sex
characteristics
• accelerate metabolism (burn fat)
• increase vaginal lubrication
• thicken the vaginal wall
• maintenance of vessel and skin
• reduce bone resorption, increase bone
formation
• protein synthesis
• increase hepatic production of binding
proteins
• increase circulating level of factors 2, 7, 9,
10, plasminogen
• increase platelet adhesiveness
• Lipid
• increase HDL, triglyceride
• decrease LDL, fat deposition
• Fluid balance
• salt (sodium) and water retention
• Hormones
• increase cortisol, SHBG
• Gastrointestinal tract
• reduce bowel motility
• increase cholesterol in bile
• Melanin
• increase pheomelanin, reduce eumelanin
• Lung function
• promotes lung function by supporting
alveoli
• Brain
• Stimulates endorphins, promotes seratonin
and dopamine release and production
Symptoms of Estradiol Deficiency
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Mood disturbances
Hot flashes
Night sweats
Depression
Anxiety
Dry skin
Decreased libido
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Incontinence
Vaginal dryness
Insomnia
Memory Loss
Weight Gain
Skin thinning
Abnormal lipids
Is Estradiol Safe?
• Bio-Identical Hormones – exact copies
• Bio-Similar Hormones – close,
generally function like the hormone
• Bio-Limited Hormones – a few
functions only
• Bio-Antagonists – block functions
Is Estradiol Safe?
• BioIdentical Estradiol is the same
chemical structure as what your body
produces…so was it unsafe when you
were making it?
• Of course not…..
Breast Cancer and
Estradiol
• Does Estradiol cause Breast Cancer?
• Women in China have virtually no
incidence of breast cancer….yet are
exposed to estradiol for 40 years of their
lives
• No study has ever shown a link between
bio-identical estradiol and breast cancer
But I heard it causes
Breast Cancer….
The Womens Health Initiative
• Very large study in 1997 looking for benefits
of HRT in post-menopausal women
• Average age of inclusion – 65
• No previous HRT use
• Used PremPro – then the second most
common medication 2.5 million women
Prem-Pro
• Combination of Premarin and Provera
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Premarin “pregnant mare’s urine”
Contains 12 different xeno-estrogens
Only one is “similar” to estradiol
Activity of the other 11???
Patentable
Provera – methylprogesterone – not
bioidentical
So what happened?
• Study was terminated in 2002, because
a study limit was exceeded – a
“reported” 26% increase in the risk of
breast cancer
• Actual risk of control group 2.0%
• Increased risk of study group 2.5%
• ….the change from 2.0% to 2.5% is 26%
And now for the rest of
the story…..
• Larger decrease in risk to colon cancer
• Decrease in overall mortality
• In 2009, in OBGYN News…those in the
WHI who developed Breast Cancer
AND were on PremPro survived their
breast cancer far more than those who
were in the placebo group…..
WHI Perspective
• Abnormal study group
• Abnormal hormones used – not
bioidentical
• Slight increase risk in breast ca, greater
decrease in colon cancer
• Greater survival if develops breast ca
Testosterone
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improves oxygen uptake throughout the body
controls blood sugar
regulates cholesterol
increases lean body mass
prevents osteoporosis
maintains immune function
maintains cardiac functions
Stimulates neurological function and repair
Symptoms of Testosterone
Deficiency in Women AND Men
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Decreased or absent libido
Erectile or Sexual dysfunction
Decreased muscle mass
Decreased muscle strength
Osteoporosis
Heart disease
Sleep disorders
Memory failure
Irritability
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Decreased energy level
Mood swings
Depression
Anxiety
Increased pain
Cold intolerance
Decreased self-confidence
Decreased cognition
Loss of sense of well-being
Is there anything I can do
without taking hormones?
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Exercise
Diet
Herbal Supplements
Stress Reduction techniques
Chiropractic care
Massage therapy
Managing Hormones
Basic Level
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Start with symptoms
Educate on risks, benefits, alternatives
Begin therapy, monitor the results
Incrementally add or subtract whatever is
needed for your personal desired effect
• Once everything is “perfect” then measure to
get a baseline
• Generally, using Estradiol, Testosterone, and
sometimes progesterone
How much does it Cost?
• If not covered by insurance:
• Testosterone and estradiol cream thru the
Women’s International Pharmacy is $19.50 per
month each
• Most insurance companies cover estradiol for women
and testosterone for men, including MediCare
• Most men are willing to pay $19.50 for testosterone
for their wives…
Costs?
• How much do you pay for
antidepressants, blood pressure
medication, cholesterol meds, or Viagra?
• What is your personal cost of
Osteoporosis, or Low Back Pain
• What is an improved sense of well-being
worth?
More Info?
• Strongly Recommend:
• “Perfect Balance” by Dr Robert Greene,
featured on Oprah, bestseller
• “The Life Extension Revolution” by Philip Lee
Miller, MD, Los Gatos Longevity Center
• “Natural Hormone Balance for Women” by
Uzzi Reiss, UCLA
• Caution – be careful about what you read
on the Internet!