Bioidentical hormones have been shown to be effective in the treatment of symptoms of menopause and andropause.
Bioidentical hormones have the same chemical structure as hormones that are made by the human body. The key to natural (or bio-identical) versus synthetic is the molecular structure of the hormone. In order for a replacement hormone to fully replicate the function of hormones that are naturally produced and present in the human body, the chemical structure must exactly match the original.
By contrast, synthetic hormones are intentionally different. Drug companies can’t patent a bioidentical structure, so they invent synthetic hormones that are patentable and thereby profitable.
The great appeal of bioidentical hormones is that they are natural, and the human body can metabolize them as it was designed to do, minimizing side effects. Synthetic hormones are very potent and often produce intolerable side effects. Moreover, the compounded bioidentical hormones can be matched individually to each person’s needs — something that’s jus impossible with mass-produced products.
Goals of Bioidentical Hormone Replacement Therapy in Women
- Alleviate the symptoms caused by the natural decrease in production of hormones by the body
- Give the protective benefits which were originally provided by naturally occurring hormones
- Re-establish a hormonal balance
Goals of Bioidentical Testosterone Replacement Therapy in Adult Men
- Improvement in psychological well-being and mood
- Improvement in erectile dysfunction
- Improvement in libido
- Increased muscle mass, strength and stature
- Preservation of bone mass
- Decrease in cardiovascular risk
Hormone Replacement Consultations
The pharmacists at Cambrian Pharmacy will work with you and your healthcare provider to achieve optimum results. Please call us at 403-289-9181 to make an appointment and discuss consultation fees.
For more information on Menopause, click here.
For more information on Andropause, click here.
Watch Dr. Oz Talk Bioidenticals
Suzanne Somers talks about hormones
Menopause is the time when a woman’s menstrual periods stop and her ovaries stop releasing eggs. A woman is considered menopausal once she has gone a year without having a menstrual period. Therefore, the exact time of a woman’s final menstrual period can only be pinpointed by counting backwards after the fact.
Although most women go through menopause around age 50, normal menopause can happen any time between the age of 40 and 50. The last periods are usually more irregular and have less blood flow. However, some women’s periods don’t change at all.
Along with normal or natural menopause, there is also premature menopause. Premature menopause occurs before the age of 35 and can be caused by a variety of things, such as removal of the ovaries, autoimmune disorders, endocrinological reasons, or cancer therapy. Medical interventions, such as a hysterectomy (when the uterus is removed), may also prevent menstruation. If the ovaries are removed as well, production of the hormones estrogen and progesterone are stopped, causing the symptoms of menopause.
Menopause is a normal part of the aging process. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) are secreted by the pituitary gland as part of the normal menstrual cycle. They stimulate the ovary to produce estrogen and progesterone and to release an egg. As a woman ages, her ovaries don’t respond to FSH or LH as strongly as they used to. Over time, less and less estrogen and progesterone are produced and the woman stops releasing eggs
Premature menopause can be genetic or it can be caused by autoimmune diseases. These diseases produce antibodies that can damage the ovaries. Surgical removal of the ovaries causes artificial menopause, as can chemotherapy or radiation therapy to the pelvis to treat cancer.
Symptoms and Complications
Before her periods stop completely, a woman might experience a variety of unpleasant symptoms, including hot flashes, irritability, night sweats, loss of bladder control, urinary infection, vaginal dryness, and pain during intercourse. These symptoms may also continue after menopause. About 75% of women have hot flashes. During a hot flash, the woman’s head and neck will become red and warm, and she may perspire a lot. A hot flash lasts from 30 seconds to 5 minutes and may be followed by a chill. Hot flashes usually go away after a year.
Fluctuating hormone levels may cause a woman to feel irritable, tired, and nervous. She might also have trouble sleeping, have headaches, feel dizzy, or have a rapid or irregular heartbeat. Lack of estrogen makes the skin of the vagina thinner, causing vaginal dryness, itching, or burning. It can also cause pain during intercourse. Some women may experience poor bladder control and, occasionally, aching muscles and joints.
Postmenopausal women are more likely to have osteoporosis, which is a thinning of the bones. Women with osteoporosis break their wrists, hips, and backbones easily. Older women may not even have to fall in order to break a bone. A woman loses 3% to 5% of her bone mass every year during the first 5 years after menopause. After 5 years, she loses from 1% to 2% of bone mass yearly. Smoking, heavy drinking, lack of exercise, and not getting enough calcium in the diet can increase a woman’s risk of bone loss.
Making the Diagnosis
A doctor will make a diagnosis based on a woman’s symptoms, past medical history, a physical exam, and laboratory tests of hormone levels.
Treatment and Preventions
Because each woman’s experience with menopause is unique, treatment depends on the symptoms that are most bothersome.
Hot flashes can be treated with prescription medications, alternative or herbal therapies, and lifestyle changes.
Prescription medications that may help with hot flashes include hormone therapy (estrogen with or without progestin) in pill, patch, or skin gel form, clonidine (Dixarit®), and belladonna – ergotamine – phenobarbital (Bellergal® Spacetabs).
Since hormone therapy has side effects and long-term risks, it’s important for a woman and her doctor to weigh the benefits and the risks of using it.
Hormone therapy can be taken daily or in cycles. With cyclic therapy, hormones are taken on certain days of the month and women will have bleeding, similar to a light period, every month. With continuous or daily therapy, hormones are taken every day. There is no monthly bleeding, but women may have spotting (small amounts of irregular bleeding) during the first 3 to 6 months of continuous therapy. Talk to your doctor about which method would be best for you.
Women who have taken estrogen for more than 5 years may have a greater risk of developing breast cancer. An individual risk-benefit assessment and regular monitoring are required. In general, estrogen should not be taken if a woman has, or has ever had, breast cancer, advanced endometrial cancer, or abnormal vaginal bleeding.
The terms “natural” and “synthetic” are often used to describe the different types of estrogens and progestins. These terms can be misleading because they can be used to mean different things. Sometimes the term “natural” is used to describe the chemical structure of the hormone (exactly the same as the hormones normally produced by the human body), but other times it’s used to describe where the hormone comes from (e.g., from plants or animals). What’s most important is not whether the hormone is natural or synthetic, but whether you’re receiving the medication, dose, and dosage form that are most appropriate for you.
Alternative and herbal medication, such as black cohosh, may also be an option. Speak to your doctor or pharmacist before trying them, especially if you have other medical conditions or are taking other medications.
Lifestyle changes that may help reduce the discomfort of hot flashes include:
- avoiding hot drinks or foods
- consuming cold drinks or foods
- pressing in layers
- exercising regularly
- learning relaxation techniques or controlled breathing
- losing weight if you’re overweight
- sleeping in a cool, dark room
- using a fan or air conditioner
- wearing cotton or other natural fabrics
When vaginal dryness or painful intercourse is the most bothersome symptom, prescription medications, non-prescription/alternative therapies, or lifestyle changes may offer some relief.
Medications that can help with vaginal dryness include vaginal estrogen tablets (Vagifem®), vaginal estrogen rings (Estring®), or vaginal estrogen creams (Neo-Estrone® Vaginal Cream, Premarin® Vaginal Cream). These medications supply estrogen directly to the vagina rather than through the bloodstream the way pills, patches, or skin gels do.
Non-prescription or alternative therapies for vaginal dryness include polycarbophil gel (Replens®), lubricants (e.g., Astroglide®), or vitamin E cream.
Lifestyle changes that can help with vaginal dryness include:
- decreasing stress in your life
- quitting smoking
- having sex or masturbating more often
- spending more time on foreplay
To prevent the bone loss that comes with menopause, women should reduce their alcohol consumption and cigarette use, and make sure to get enough calcium and vitamin D each day (1,500 mg of calcium and 800 units of vitamin D per day – note that your doctor may recommend a higher dose of vitamin D in some cases), through your diet and, if needed, supplements. Exercise and resistance training, also called weight training or strength training, helps prevent osteoporosis and control weight.
To maintain a healthy heart, quit smoking, maintain a healthy body weight, exercise regularly, and eat a healthy, balanced diet. Depending on your risk factors for heart disease, your doctor may recommend medications to reduce your risk, including medications to control your blood pressure or cholesterol.
Menopause is a normal stage in a woman’s life. Natural menopause cannot be prevented.
Testosterone is the hormone responsible for deep voices, muscle mass, and facial and body hair patterns found in males. As men get older, the level of testosterone in the body and production of sperm gradually becomes lower, and they experience physical and psychological symptoms as a result of these low levels. This is part of the natural aging process and it is estimated that testosterone decreases about 10% every decade after men reach the age of 30.
Andropause is a condition that is associated with the decrease in the male hormone testosterone. It is unlike menopause in that the decrease in testosterone and the development of symptoms is more gradual than what occurs in women. Approximately 30% of men in their fifties will experience symptoms of andropause caused by low testosterone levels. A person experiencing andropause may have a number of symptoms related to the condition and could be at risk of other serious health conditions such as osteoporosis without proper treatment.
The decrease in testosterone is an important factor in men suspected of having andropause. However, as men age, not only does the body start making less testosterone, but also the levels of another hormone, called sex binding hormone globulin (SHBG), which pulls usable testosterone from the blood, begins to increase. SHBG binds some of the available testosterone circulating in the blood. The testosterone that is not bound to the SHBG hormone is called bioavailable testosterone, meaning it is available for use by the body.
Men who experience symptoms associated with andropause have lowered amounts of bioavailable testosterone in their blood. Therefore, tissues in the body that are stimulated by testosterone receive a lower amount of it, which may cause various physical and possibly mental changes in a person such as mood swings or fatigue.
Symptoms and Complications
Although symptoms may vary from person to person, common symptoms of men going through andropause include:
- low sex drive
- difficulties getting erections or erections that are not as strong as usual
- lack of energy
- irritability and mood swings
- loss of strength or muscle mass
- increased body fat
- hot flashes
Complications associated with andropause include an increased risk of cardiovascular problems and osteoporosis (brittle bones).
Making the Diagnosis
A doctor will ask questions about how you are feeling to see if your symptoms match those of people with low testosterone. Then, a blood test is performed to check the level of testosterone in the blood. Because there are other conditions that are associated with low testosterone levels (e.g., hypogonadism [which causes retardation of sexual growth and development], diabetes, high blood pressure), your doctor will likely do tests to rule out these possibilities before making a diagnosis of andropause.
Treatment and Prevention
Replacing testosterone in the blood is the most common treatment for men going through andropause. This treatment provides relief from the symptoms and helps improve the quality of life in many cases. Lifestyle changes such as increased exercise, stress reduction and good nutrition also help.
Testosterone is available in a variety of different preparations including skin patches, capsules, gels, and injections. Your doctor will help determine which treatment is best for you and will often consider your lifestyle when making this decision. Follow-up visits with your doctor will be important after the initial treatment begins. At follow-up visits, your doctor will check your response to the treatment and make adjustments, if necessary.
Skin patches: People who wear a patch containing testosterone receive the hormone through the skin. The patch allows a slow, steady release of testosterone into the blood stream, avoiding symptoms caused by high and low levels throughout the day. It allows a person to continue with regular day-to-day activities and is applied once a day to a dry area of skin on the back, abdomen, upper arms, or thighs.
Testosterone gel: This treatment is also applied directly to the skin, usually on the arms. Because the gel may transfer to other individuals through skin contact, a person must take care to wash the gel from the hands after each application.
Capsules: Taken twice daily after meals, this is yet another option for testosterone replacement. Men with liver disease, poor liver function, serious heart or kidney disease, or too much calcium in their blood should avoid testosterone capsules.
Testosterone injections: This treatment involves injections of testosterone (testosterone cypionate and testosterone enanthate)* in the muscle every 3 to 4 weeks. They may cause mood swings due to changes in testosterone levels. Men with severe heart disease, severe kidney disease, or too much calcium in their blood should avoid testosterone cypionate. Men with severe kidney disease should not take testosterone enanthate.
Testosterone should not be taken by any man with prostate or breast cancer. If you have heart disease, are taking some medications such as blood thinners, or have an enlarged prostate, liver or kidney disease, you will need to discuss with your doctor whether or not testosterone therapy is right for you.