Hormone Replacement Therapy (HRT) began over six decades ago in the 1950’s. Doctors seeking to provide menopause treatment options for their patients were encouraged to supplement the depleted hormones with synthetic substances created from pregnant mare urine. For many women, this provided a welcome relief from hot flashes, night sweats and the emotional swings associated with this period of life.
In time, however, serious concerns were raised about the apparent increased incidence of certain cancers, blood clots and strokes among women who received HRT. Then in 2002 the Women’s Health Initiative halted a study it was conducting using synthetic estrogen and progesterone because of a verifiable increased risk in these significant health issues.
The Introduction of Natural Hormones
In the early 1980’s, as safety concerns began to grow, there were no natural hormone supplements available in North America. However a physician in the US, at the request of a patient, worked with a compounding pharmacy in Canada to produce the first bioidentical hormone supplements. Extracting information from hormone tests taken in labs across the country, the supplements mimicked the balance of estrogen, progesterone and testosterone found in younger women.
Dr. Edward Jacobson, a Board certified gynecologist who administers natural hormone replacement in Greenwich CT insists on using only bioidentical hormones, substances that are chemically and structurally identical to those produce by the human body. He takes the balancing act one step further; rather than using pre-determined hormone levels he believes in testing each woman first, and then works with a compounding pharmacy to create the exact proportions of depleted hormones for that particular patient.
Impact on Menopause
What many people don’t realize is that there are three primary kinds of estrogen produced by the human body, and good health depends upon having these three in proper proportion. These are estrone, estriol and estradiol. Estrone, which is the predominant form of estrogen in premenopausal women, and estradiol, the predominant form of estrogen after menopause, are both weaker forms of estrogen. Estriol replacement is very effective for treating vaginal dryness and hot flashes during menopause. A decrease of the most active form of estrogen, estradiol is associated with decreased bone density leading to osteoporosis as well as the more typical menopausal symptoms.
Progesterone, the second most dominate female hormone, disappears completely after menopause. The primary function of progesterone is reproduction, something not required later in life, but maintaining a minimal level of progesterone has other significant advantages. Tests indicate that progesterone prevents estrogen from stimulating abnormal tissue growth in the uterus and breast, thereby protecting those areas from cancer.
Women also produce very small amounts of testosterone, another hormone that is depleted with age. While these levels should be minimal, testosterone is tied to muscle mass, bone density, sexual desire, decreased abdominal fat and healthy connective tissues.
As many women age, they begin to exhibit the symptoms of hypothyroidism even when medical tests indicate the thyroid levels are normal. The reason for this is that thyroid production usually remains constant throughout life, but the ability of the cells to convert thyroid into Free T3, the usable form, diminishes. Simply taking more synthetic thyroid does not resolve the issue if the cells are not able to make the conversion. When Dr. Jacobson examines a patient for potential natural hormone replacement at his Greenwich CT office, thyroid function is one of the areas tested.
DHEA, or Dehydroepiandrosterone, is the most common human hormone and is also affected by age and stress. Maintaining high levels of DHEA has been associated with numerous positive health benefits including increase sex drive, energy and longevity. Low levels of DHEA, on the other hand, result in a suppressed immune system and increased incidents of cancer, diabetes and heart disease.