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Road to Healthy Aging “We Age Because We Lose Our Hormones” Beginning with puberty, a woman’s spends a significant percentage of her life in a state of hormone imbalance. In the U.S. alone, 36 million women have entered menopause and many of those women experience uncomfortable, if not debilitating symptoms long before and during “the change.” Symptoms encountered include hot flashes, night sweats, insomnia, memory loss, irritability, mood swings, and loss of libido. The best way to treat these symptoms is with Bio‐identical Hormone Replacement Therapy (BHRT). Celebrities like Suzanne Somers and Oprah Winfrey have brought BHRT onto center stage. So what are Bio‐identical Hormones? These are hormones made in compounding pharmacies from wild yam, to be identical in chemical structure to hormones that are naturally produced by the human body: it is an exact replacement. Examples of bio‐identical hormones include estradiol, estriol, progesterone, and testosterone. These hormones work like a symphony in that they are all designed to work together. If one is altered or deficient, it will affect the actions of all the other hormones. Consequently, bio‐identical hormone replacement requires a customized approach for each individual in order to achieve optimal health and balance. Contrary to synthetic hormones, one size does NOT fit all! Why is there so much controversy about BHRT? This began with the Women’s Health Initiative, (WHI), a large poorly designed study by the NIH, looking to answer questions about the benefits of hormone replacement therapy using synthetic hormones, e.g. premarin and provera. This study was stopped prematurely due to experts stating that these hormones not only increased the risk of breast cancer, but also threatened the heart, increased the risk of stroke and dementia as well. Many physicians have responded by avoiding any form of HRT, because they believe that there are no other options only created confusion and concern. Sensationalized reports of the WHI findings changed the face of hormone replacement therapy forever. Thus came the growth of BHRT. Had BHRT been used in the study, there might have been a very different outcome. Let’s look at some of these hormones individually and how they affect our lives. Common symptoms of spotting, irregular menses, PMS, mood swings, irritability and insomnia are all signs of progesterone deficiency. This is the first hormone that we lose as we get older. Because it is a “calming” hormone, progesterone is best taken at bedtime. It must be balanced with estrogen in order to avoid “estrogen dominance.” Studies have shown that bio‐identical progesterone can protect the uterus from uterine cancer, decrease the risk of heart disease and breast cancer especially when added to estrogen therapy. It is the synthetic progestin that increases the risk of breast cancer. Contrary to popular belief, bio‐identical progesterone IS needed, even if you don’t have a uterus. Low estrogen levels, which follow the progesterone decline, are associated with accelerated aging. Replacing hormones that we have lost over time will help to slow the aging process. We are not looking for you to be a 25 years old again, however the goal is to help you achieve optimal health, sense of well being, improved memory and bone density. Hot flashes, night sweats, vaginal dryness, memory loss are all signs of estrogen deficiency and can be easily treated with the use of bio‐identical hormones. The best method to replace estrogens is by using transdermal estrogen. Many people are still taking synthetic estrogens, or oral estrogens which can have many negative side effects. Transdermal estrogens bypass the liver, which if taken orally are associated with more inflammation, increased incidence of blood clots and has metabolites that are often associated with increased cancer risk. I never recommend oral estrogens for this reason. Estrogen balanced with progesterone and testosterone is what the body needs. So what about testosterone? This is one of the most under‐appreciated hormones we have. It is not just a male hormone. Women need this as well. Benefits of testosterone include increasing sexual desire, protecting the heart, improving bone health and has anti‐cancer properties. Putting this into the mix makes a happy and balanced body. “I just want to get through menopause.” Most people believe that you use hormones just to minimize symptoms of menopause. It is what happens AFTER menopause that is of equal importance. Thinking clearly, continuing to have a productive life, feeling good, looking good, and improving bone health are some of the benefits of continuing small doses of BHRT. The common question is how long do I take these hormones? The answer is, as long as it is needed. This varies from person to person depending on the medical history and individual needs. The basic question is “Are they for me?” Using bio‐identical hormones is a personal choice, and may not be for everyone. Regardless of your decision, there are other options that can significantly improve hormonal imbalances as well as your overall health. A healthy and balanced diet is crucial for hormonal health. Reducing overly processed foods, (especially refined sugars), and eating organic foods with plenty of fruits and vegetables will help overall health. Meditation and yoga can alsoreduce the stress caused by hormonal imbalances as well. Exercise has tremendous benefits. Exercise promotes the production of 17 beta estradiol, another form of estrogen. This hormone helps to burn fat and increase energy. As you approach menopause, your body produces significantly less 17 beta estradiol. If you continue to exercise, you can maintain good levels of this hormone through menopause, and you continue to feel and look good. Other natural remedies can include Black Cohosh which is a plant that contains phytoestrogens that bind to estrogen receptors and can relieve many menopausal symptoms including night sweat, anxiety and depression. This is only a temporizing agent and should not be used longer than 6 months. Dong Quai increases blood flow, helping to relieve hot flashes and vaginal dryness. It is most effective when used in combination with black cohosh. Lastly, Maca Root, a plant used for centuries in South America, is thought to be an aphrodisiac. People today still use it for its sexual benefits. It encourages the production of hormones, helping to reduce menopausal symptoms. There are other alternatives as well. In conclusion, bio‐identical hormones are safe and effective, and they can significantly improve your quality of life. It is a customized approach to health, and one size does not fit all. If you want to feel better, look better and think more clearly, this is a great option. Dr. Deborah Sainer received her medical degree from UMDNJ, New Jersey Medical School and is Board Certified in Internal Medicine and Emergency Medicine. She has been practicing for over 20 years, including the past 7 years at the Fibromyalgia and Fatigue Center in Centennial, CO., using an integrative approach to health. She is an active member of the American College of Anti‐Aging Medicine and the Institute of Functional Medicine. Dr. Sainer has recently opened a new practice in Evergreen, New Spring Integrative Medicine, and she can be reached at (720) 328‐8784.