Did you know?

Did you know?

Did you know?

Did you know?

Hormone Basics

  • Hormones are substances produced by one organ to affect a response on another organ to function appropriately.
  • Perimenopause may start as early as age 30 with the hormone progesterone declining first and foremost.
  • Menopause is the absence of hormones produced by the ovaries, specifically estrogen and progesterone.
  • Estrogen and Progesterone are sex hormones, produced by the ovary, that certainly effect a woman’s reproductive health, but also effect the functioning of brain, blood vessels, bone, vagina, bladder, to name just a few.
  • Perimenopause is the decline and imbalance of ovarian hormones (specifically estrogen and progesterone), with eventual resulting ‘menopause’ or the near absence of these hormones altogether.
  • Progesterone declines first and more precipitously, as early as age 30, and results in symptoms including poor sleep, lack of calmness or increased anxiety, mood disturbances, breast tenderness, irregular periods, to name a few.
  • Estrogen usually decreases a bit later with symptoms including hot flashes/night sweats, racing mind at night, mental fogginess, weight gain, palpitations, bloating, etc.
  • Declining hormone levels and the eventual absence of sex hormone altogether can result in increased risk for dementia, heart disease, osteoporosis, specific types of cancer.
  • Bio-Identical hormones are defined as ‘exact molecular copies’, that is, identical to the hormones our bodies previously made – They are not man-made/synthetic structures.
  • Treatment with Hormone Replacement Therapy (HRT -Using synthesized variations of hormones) or Bioidentical Hormone Replacement Therapy (bHRT – exact molecular copies of our hormones) – specifically estrogen and progesterone replenishment, is associated with a lower risk of dementia, heart disease, osteoporosis, colon and breast cancer. (See specific references below)

Bone Health

  • Hormone Replenishment Therapy helps protect your bones from bone loss and improves bone resilience. 1 2
  • Estrogen is a superior treatment for osteoporosis. 3 4 5
  • Unfortunately, the protective benefit to bone loss disappears when estrogen is discontinued. 6 7

Heart Health

  • Although most women fear breast cancer, heart disease kills seven times more than breast cancer. 8
  • Estrogen causes blood vessels to dilate and increase blood supply to the heart. 9
  • Estrogen keeps blood vessels healthy, but it cannot reverse damage, so the sooner estrogen is started the better. 10

Brain Health and Dementia

  • Estrogen may decrease your risk of Alzheimer’s dementia by 30-60%. 11
  • Estrogen enhances neuroplasticity, also known as the brains ability to adapt, compensate, and form new connections after injury or disease. 12 13 14 15
  • The best window of opportunity for brain preservation and health is before neurologic decline begins. 16

Cancer

  • Study after study shows no association between hormone replenishment therapy and breast cancer. 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
  • Women diagnosed with breast cancer while taking hormone replenishment therapy have a better prognosis for remission than women diagnosed with breast cancer who are not taking hormones. 33
  • Women with BRCA 1 & 2 mutations have a decreased risk of breast cancer on hormone replenishment therapy. 34
  • Women who take HRT have a lower risk of getting colon cancer. 35
  • HRT can assist women with postmenopausal symptoms. In addition, research shows that HRT can help some postmenopausal women with selected comorbid conditions such as osteoporosis, type II diabetes, certain cardiovascular pathologies, and colorectal cancer. 36
  • Progesterone is a natural hormone commonly known as micronized progesterone, or prometrium. In contrast progestins are synthetic compounds that mimic the activity of progesteron
  • Studies have shown no increased risk of breast cancer recurrence or death in hormone replacement therapy users. 37
  • Among hormone replacement users with breast cancer the recurrence rate and mortality is lower than non-users. 38
  • Unfortunately, mass media sensationalism, not good science, has driven the decision of post-menopausal women in relation to their healthcare. 39

Footnotes

  1. Seeman E. Bone quality: the material and structural basis of bone strength. J Bone Miner Metab. 2008;26(1):1-8. doi: 10.1007/s00774-007-0793-5. Epub 2008 Jan 10. PMID: 18095057. https://pubmed.ncbi.nlm.nih.gov/18095057/ ↩︎
  2. HENNEMAN PH, WALLACH S. A review of the prolonged use of estrogens and androgens in postmenopausal and senile osteoporosis. AMA Arch Intern Med. 1957 Nov;100(5):715-23. doi: 10.1001/archinte.1957.00260110031005. PMID: 13468816. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/561780 ↩︎
  3. Weiss NS, Ure CL, Ballard JH, Williams AR, Daling JR. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen. N Engl J Med. 1980 Nov 20;303(21):1195-8. doi: 10.1056/NEJM198011203032102. PMID: 7421945.
    https://pubmed.ncbi.nlm.nih.gov/7421945/ ↩︎
  4. Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy I: a 10-year prospective study in the relationship to osteoporosis. Obstet Gynecol. 1979 Mar;53(3):277-81. PMID: 218151. https://pubmed.ncbi.nlm.nih.gov/218151/ ↩︎
  5. Weiss NS, Ure CL, Ballard JH, Williams AR, Daling JR. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen. N Engl J Med. 1980 Nov 20;303(21):1195-8. doi: 10.1056/NEJM198011203032102. PMID: 7421945.
    https://pubmed.ncbi.nlm.nih.gov/7421945/ ↩︎
  6. Lindsay R, Hart DM, MacLean A, Clark AC, Kraszewski A, Garwood J. Bone response to termination of oestrogen treatment. Lancet. 1978 Jun 24;1(8078):1325-7. doi: 10.1016/s0140-6736(78)92402-9. PMID: 78095.
    https://pubmed.ncbi.nlm.nih.gov/78095/ ↩︎
  7. Ettinger B, Grady D. The waning effect of postmenopausal estrogen therapy on osteoporosis. N Engl J Med. 1993 Oct 14;329(16):1192-3. doi: 10.1056/NEJM199310143291610. PMID: 8377785.
    https://www.nejm.org/doi/full/10.1056/NEJM199310143291610 ↩︎
  8. M.Legato and C. Colman. The Female Heart: The Truth about Women and Heart Disease. (New York: Perennial Currents, 2000). ↩︎
  9. Barrett-Connor E, Bush T.L.  Estrogen and Coronary Heart Disease in Women. jama. 1991; 265: 1861-67. ↩︎
  10. Mikkola T.S., Tuomikoski P., Lyytinen H, et al.  Increased Cardiovascular Mortality in Women Discontinuing Postmenopausal Hormone Therapy. J Clin Endocrinol Metab.2015; 100: 4588-99. ↩︎
  11. Tang MX, Jacobs D, Stern Y, et al. Effect of oestrogen during menopause on risk and age at onset of Alzheimer’s disease. Lancet 1996;348:429-32. ↩︎
  12. MA, Azcoitia I, Garcia-Segura LM. The neuroprotection actions of estradiol and oestrogen receptors. Nat Rev Neurosci.  2015;16:17-29. ↩︎
  13. Jones KJ. Steroid hormones and neurotrophism:  Relationship to nerve injury. Metabolic Brain Dis. 1988;3:1-16. ↩︎
  14. Gould E, Woolley CS, Frankfurt M, et a.l Gonadal steroids regulate dendritic spine density in hippocampal pyramidal cells in adulthood. J Neurosci. 1990;10:1286-91. ↩︎
  15. Sherwin B. Hormones and the brain. J Obstet Gynaecol Car 2001;23:1102-4. ↩︎
  16. Brinton RD. Investigative models for determining hormone therapy-induced outcomes in brain: Evidence in support of a healthy cell bias of estrogen action.  Ann NY Acadamy of Sci. 2005 1052:57. ↩︎
  17. Brinton LA, Hoover R, and Fraumeni JF.  Menopausal oestrogens and breast cancer risk: An expanded case control study. Br J Cancer. 1986;54:825-32. ↩︎
  18. Armstrong BK. Estrogen therapy after menopause: Boon or bane?  Med J Aust. 1988;148:213-14. ↩︎
  19. Palmer JR, Rosenberg L, Clark EA, et al. Breast cancer risk after estrogen replacement therapy: Results from the Toronto breast cancer study. Am ] Epidemiol. 1991;134:1386-95. ↩︎
  20. Dupont WD, Page DL. Menopausal estrogen replacement therapy
    and breast cancer. Arch Intern Med. 1991;151:67-72. ↩︎
  21. Nachtigall MJ, Smilen SW, Nachtigall RD, et al. Incidence of breast cancer in a 22-year study of women receiving estrogen-progestin replacement therapy. Obstet Gynecol. 1992;80:827-30. ↩︎
  22. Dupont WD, Page DL, Rogers LW, et al. Influence of exogenous estrogens, proliterative breast disease, and other variables on breast cancer risk. Cancer. 1989;63:948-57. ↩︎
  23. Dupont WD, Page DL, Parl FF, et al. Estrogen replacement therapy in women with a history of proliferative breast disease.  Cancer. 1999;85:1277-83. ↩︎
  24. Consensus Development Conference: Prophylaxis and treatment of osteoporosis. BMJ. 1987;295:914-15.
    Martin KA, Freeman MW. Postmenopausal hormone replacement therapy. N Engl J Med. 1993;328:1115-17. ↩︎
  25. Stanford JL, Weiss NS, Voight LF, et al. Combined estrogen and progestin hormone replacement therapy in relation to risk of breast cancer in middle-aged women. JAMA. 1995;274:137-42. ↩︎
  26. Colditz GA, Hankinson SE, Hunter DJ, et al. The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. N Engi J Med. 1995;332:1589-93 ↩︎
  27. Willis DB, Calle EE, Miracle-McMahill HL, et al. Estrogen replacement therapy and risk of fatal breast cancer in a prospective cohort of postmenopausal women in the United States. Cancer Causes Control. 1996;7:449-57. ↩︎
  28. Sol NF, Eckman MH, KarasR H , et al. Patient-specific decisions about hormone replacement therapy in postmenopausal women.  JAMA. 1997;277:1140-47. ↩︎
  29. Sellers TA, Mink PJ, Ceerhan ]R, et al. The role of hormone replacement therapy and the risk for breast cancer and total mortality in women with a family history of breast cancer. Ann Intern Med 1997;127:973-80. ↩︎
  30. Takeuchi M, Saeki 1, Sano M, et al. Case-control study of hormone replacement therapy (HRI) and breast cancer in Japanese women. Proc ASCO. 2006;24:10012. ↩︎
  31. Stefanick ML, Anderson GL, Margolis KL, et al. Effects of conjugated equine estrogens on breast cancer and mammograph screening in postmenopausal women with hysterectomy. JAMA 2006;295:1647-57. ↩︎
  32. T Parker-Pope, The Hormone Decision (Emmaus, PA: Rodal 2007), 14 ↩︎
  33. Bergkvist L, Adami HO, Persson I, et al.  Prognosis after breast diagnosis in women exposed to estrogens and estrogen-progesterone replacement therapy. Am J Epidemiol.  1989;130: 221-28. ↩︎
  34. Rebbeck TR, Levin AM, Eisen A, et al. Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers: J Natl Cancer Inst. 1999;91:1475-79.
    Rebbeck TR, Friebel I, Wagner I, et al. Effect of short-term hormone replacement therapy on breast cancer risk reduction after bilateral prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers: The PROSE Study Group. J Clin Onc 2005;23:7 ↩︎
  35. Tsilidis KK, Allen NE, Key TJ, Sanjoaquin MA, Bakken K, Berrino F, Fournier A, Lund E, Overvad K, Olsen A, Tjønneland A, Byrnes G, Chajes V, Rinaldi S, Boutron-Ruault MC, Clavel-Chapelon F, Chang-Claude J, Kaaks R, Bergmann M, Boeing H, Koumantaki Y, Palli D, Pala V, Panico S, Tumino R, Vineis P, Bas Bueno-de-Mesquita H, van Duijnhoven FJ, van Gils CH, Peeters PH, Rodríguez L, González CA, Sánchez MJ, Chirlaque MD, Barricarte A, Dorronsoro M, Khaw KT, Rodwell SA, Norat T, Romaguera D, Riboli E. Menopausal hormone therapy and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2011 Apr 15;128(8):1881-9. doi: 10.1002/ijc.25504. PMID: 20533550. ↩︎
  36. Canderelli R, Leccesse LA, Miller NL, Unruh Davidson J. Benefits of hormone replacement therapy in postmenopausal women. J Am Acad Nurse Pract. 2007 Dec;19(12):635-41. doi: 10.1111/j.1745-7599.2007.00269.x. PMID: 18042129. ↩︎
  37. Natural P, Blixen CE, Moore HCF, et al. Menopausal hormone therapy (HT)in patients with breast cancer.  Maturity’s. 2006; 53:123-32. ↩︎
  38. Mueck AO, Rabe T, Kissel L, Strowitzki T. Hormone Replacement therapy after breast cancer.  J Reprod Med Endocrinologist.2008; 5:83. ↩︎
  39. Letter from Dr. Philip DiSaia to Avrum Blumming, January 3, 2007. ↩︎