By Dr. Kirsten Singler NMD
Hormone balancing and hormone replacement can be a controversial and confusing subject. Lately, I have had an influx of patients experiencing detrimental effects of unbalanced hormones and hormone therapy. I am surprised and worried that so many women remain uneducated about some very important aspects of hormone therapy. If you or someone you know is thinking about hormone therapy, please make sure to read and share the list below.
Abnormal bleeding is not okay.
If you are post-menopausal and begin to bleed after starting hormone therapy, that dose is not right. I have seen many menopausal patients who are anemic due to bleeding induced by poorly and wrongly prescribed hormones. I have also seen this happen in pre-menopausal women who are prescribed excess estrogen which causes them to bleed excessively for months. Women, please know that the only normal bleeding is from day 1-5 of your cycle during your fertile years. If you are bleeding more than that, you need to have your hormones tested and modulated.
Extra body hair, acne, irritability is likely a sign of excessive testosterone.
This is another sign of wrongly prescribed hormones that I see far too often. Women are presenting to the clinic on testosterone doses that put their blood levels in the same range as a young man. Oftentimes, blood levels had not been tested. Please know that even though we need this important hormone, if too much is given it will result in problems listed above as well as polycythemia vera, risk of stroke and breast cancer. Women need very little testosterone and should always have the serum levels tested when undergoing hormone therapy.
Test your hormone levels.
Ladies, this is a must. For starters, if you go to a doctor with hormone-type symptoms it is only prudent that you get the proper work-up to determine the origin of the symptoms. For example, I had a patient who came to our clinic because she had hormone-centered symptoms, and desired hormone therapy. It turned out, however, that after we ran her blood work her hormones were fine but her thyroid had serious problems. Before seeing me, she had been prescribed hormones by her OBGYN (without testing) that were obviously not working, because her problems were in the thyroid.
Another reason you must get your hormone blood levels tested is to know if you are in a normal range or spiking outside the norm. For example, my patient, who had been getting testosterone injections and had blood levels as high as a young man, had not had her hormones tested, so was unaware that she was so far out of range. What’s more is that the high testosterone had caused her to develop a condition called polycythemia vera that was also undetected until we ran her blood labs.
If you are having symptoms of hormone imbalance you need labs to confirm and diagnose exactly what is going on. If you are pre-menopausal, you need labs run between days 3-5 of your cycle and then again between days 21-25. You doctor should be checking to ensure your estrogen and progesterone are at or above specific numbers for health, fertility, or to reduce risk of cancer. If you are menopausal and decide to undergo hormone therapy, you need to have labs run regularly to confirm that your serum levels are in a healthy and protective range.
Know the difference.
Hormones are all different and have different actions in the body. Let’s start with the estrogens. There are three different estrogens in women: estrone, estradiol, estriol. Each has different structure, function, and associated risk. Note that the difference is in the ending of the word, so they are easier to differentiate as E1, E2, and E3. Studies implicate estrone with increased cancer risk, while estriol has been associated with decreased cancer risk. Now, here’s the complicated part; the most common hormone replacement used in the US is Premarin. Premarin is made out of horse urine and is not the same as the estrogens found in a human’s body. Premarin is estrone sulfate, equilin sulfate and equilenin sulfate and studies show that it can increase risk of cancer. For the most part, naturopathic doctors use bio-identical estradiol and estriol while avoiding estrone and Premarin. The bio-identical estrogens are typically made from plants.
Now let’s talk progesterone. The most commonly prescribed progesterone is not actually progesterone, but is a progesterone look-alike called progestin. Progestin is synthetically derived and studies show that it can induce a proliferative effect on cancer, in other words, increase cancer risk. In fact, the Women’s Health Initiative found increased risk of cancer when using conjugated horse estrogens with progestin. Meanwhile in Europe, bio-identical progesterone is used and studies have shown that it may be protective against cancer. Bio-identical progesterone is made from yams or soy beans and has the exact same structure as the progesterone found in a woman’s body and that is why they call it by the same name.
Know the risks.
Your doctor should educate you about the risks associated with hormone replacement that includes breast cancer, heart disease, polycythemia vera, and stroke. Your personal risk factors should be assessed before starting such a therapy. Risk factors include history of cancer, family history of cancer, age, diet, lifestyle, and weight. Your doctor should also educate you about the risks of hormone deficiency such as reduced bone density, reduced muscle mass, increased risk of type II diabetes, reduced mood and memory, increased risk of dementia. If your doctor has not informed you of these risks and answered all of your questions, then you likely need to find a better doctor.
Know your options.
If you have symptoms of hormone imbalance, you have many options. Rather than taking hormones, you may choose to use botanicals that help to heal the endocrine (hormone) system. In this way, you get your glands and organs to function optimally again. You may also choose to make educated diet and lifestyle changes to eliminate harmful chemicals from your body. These pollutants have special affinity for the hormonal systems in the body. Once removed, the body regains its natural ability again. Additionally, acupuncture has been used for thousands of years to naturally balance the body’s hormones. Finally, as a last resort, bio-identical hormone therapy can be prescribed at the safest dose, based on the research.
Signs and symptoms that warrant hormone evaluation:
Premenstrual syndrome (PMS)
Premenstrual dysphoric syndrome
Fibroids, endometriosis, pelvic cysts
Excessive menstrual bleeding
Swelling and bloating
Polycystic ovarian syndrome (PCOS)
Share with others.
If this article has been helpful to you, please share it with your friends and family. My goal in writing this is to bring awareness to women’s health and to get women talking and asking the right questions so that we can live happy and healthier lives.