Have you been experiencing weight gain, mood swings, sleep disorders, low or absent sex drive, memory disorder, the feeling of being tired or sluggish?

Have you been told that you have chronic fatigue, depression, thyroid disorder or fibromyalgia?

Hormone imbalances can occur in men and women of almost any age.1 A variety of factors can be related to these imbalances, including high insulin levels from diets high in refined foods and sugar, exposure to environmental toxins (xenoestrogens), high consumption of hydrogenated fats, and lack of physical activity leading to weight gain.2-5

Age is also a factor in reduced levels of hormones, creating feelings of imbalance in everyday pursuits. For example, testosterone levels in women begin going down after age 20. By age 40 a woman’s testosterone level will be half of what it was when she was 20 years old. This is why getting hormone levels checked even while in your 20′s may be necessary if you aren’t feeling yourself. For women between the ages of 40–60, testosterone levels can remain pretty constant. After menopause testosterone declines once again.1

How can you help hormones maintain balance?

Diet

The food you choose to eat can have a major impact on your health. If your diet is high in sugar, processed carbohydrates, hydrogenated fats, genetically modified foods, and conventional beef, dairy, and poultry, then you are more susceptible to obesity and all the associated diseases, plus an increase in hormone imbalances.6-11 It’s important to maintain a healthy weight, as storing excess fat can lead to hormone imbalances and an increase in stored environmental toxins. Toxins have a negative impact on overall health and should be avoided at all ages of life, especially during pregnancy where the developing baby can carry the negative impact the rest of its life.12-15

Exercise

Physical activity is important to hormone balance, not to mention overall health and a good mental state. Exercise helps to keep cortisol levels low and also helps maintain hormone balance by reducing the level of cortisol in the body and sustaining serum insulin levels. Cortisol levels can become significantly high when the body is experiencing stress, either real or imagined.17 Exercise helps counter the effects of stress and regular moderate exercise can lower cortisol levels.18-20 Moderate exercise for 30 to 60 minutes each day can have a profound effect on hormone balance.21-23

Bioidentical Hormones

Bioidentical hormone replacement therapy (BHRT) can balance hormone levels that become upset or deficient through lifestyle habits and aging. Unlike conventional HRT, BHRT is derived from plant sources and structured similarly to hormones circulating in the body.24-26 Since the Bioidentical hormones are recognized in the body, they are effectively assimilated and used. BHRT replenishes the body with the healthy hormone levels your body needs to function optimally. Forms of BHRT include progesterone, estrogen, and testosterone.

Blood tests are taken to determine hormone levels. If there is a deficiency or imbalance, BHRT is recommended to safely balance hormone levels. Restoring hormone balance can provide greater protection from chronic diseases and alleviate menopausal symptoms. Saliva testing of hormonal levels is used by some practitioners, but peer-reviewed studies from saliva testing are not nearly as prevalent. Serum hormone studies show the ideal levels to reduce the risk of heart disease and some cancers.

Compounding pharmacies specialize in producing BHRT. Doses are determined on an individual basis and available in different administrations (topical, oral, sublingual, etc.). A few studies show that topical BHRT has a better safety profile than the orthodox oral HRT.27-29 It is important to note that most physicians are not trained in prescribing BHRT and they may be unfamiliar with the medical literature that supports this treatment. Fortunately, there are physicians specializing in age-management medicine who can help you determine which BHRT treatments are best for you.

References

1. Rohr U. The impact of testosterone imbalance on depression and women’s health.Maturitas. 41 Suppl. 1 (2002) S25–S46.
2. Ruano M, et al. Morbid obesity, hypertensive disease and the
   renin-angiotensin-aldosterone axis. Obes Surg. 2005 May;15(5):670-6.
3. Masi AT, et al. Neuroendocrine, immunologic, and microvascular systems interactions in rheumatoid arthritis: physiopathogenetic and therapeutic perspectives. Semin Arthritis Rheum. 1999 Oct;29(2):65-81.
4. Nadal A, et al. The pancreatic beta-cell as a target of estrogens and xenoestrogens: Implications for blood glucose homeostasis and diabetes. Mol Cell Endocrinol. 2009 May 25;304(1-2):63-8.
5. Park SH, et al.  Cell growth of ovarian cancer cells is stimulated by xenoestrogens through an estrogen-dependent pathway, but their stimulation of cell growth appears not to be involved in the activation of the mitogen-activated protein kinases ERK-1 and p38. J Reprod Dev. 2009 Feb;55(1):23-9.
6. Kochan Z, et al. [Dietary trans-fatty acids and metabolic syndrome]. Postepy Hig Med Dosw (Online). 2010 Dec 27;64:650-8.
7. Biswas M, et al. Reduced total testosterone concentrations in young healthy South Asian men are partly explained by increased insulin resistance but not by altered adiposity. Clin Endocrinol (Oxf). 2010 Oct;73(4):457-62.
8. Kelly DM, et al. Testosterone: a metabolic hormone in health and disease. J Endocrinol. 2013 Apr 29;217(3):R25-45.
9. Pimentel GD, et al. Intake of trans fatty acids during gestation and lactation leads to hypothalamic inflammation via TLR4/NFκBp65 signaling in adult offspring. J Nutr Biochem. 2012 Mar;23(3):265-71.
10. Collison KS, et al. Effect of trans-fat, fructose and monosodium glutamate feeding on feline weight gain, adiposity, insulin sensitivity, adipokine and lipid profile. Br J Nutr. 2011 Jul;106(2):218-26.
11. Duque-Guimarães DE, et al. Early and prolonged intake of partially hydrogenated fat alters the expression of genes in rat adipose tissue. Nutrition. 2009 Jul-Aug;25(7-8):782-9.
12. Lang IA, et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008 Sep 17;300(11):1303-10.
13. Markowski VP, et al. Tissue-specific and dose-related accumulation of arsenic in mouse offspring following maternal consumption of arsenic-contaminated water. Basic Clin Pharmacol Toxicol. 2011 May;108(5):326-32.
14. Blüher M. Adipose tissue dysfunction contributes to obesity related metabolic diseases.Best Pract Res Clin Endocrinol Metab. 2013 Apr;27(2):163-77.
15. Silva AP, et al. Dietary fatty acids early in life affect lipid metabolism and adiposity in young rats. Lipids. 2006 Jun;41(6):535-41.
16. Eliakim A, Nemet D. Exercise training, physical fitness and the growth hormone-insulin-like growth factor-1 axis and cytokine balance. Med Sport Sci. 2010;55:128-140.
17. Turakitwanakan W, et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai. 2013 Jan;96 Suppl 1:S90-5.
18. Broocks A, et al. Effect of aerobic exercise on behavioral and neuroendocrine responses to meta-chlorophenylpiperazine and to ipsapirone in untrained healthy subjects.Psychopharmacology (Berl). 2001 May;155(3):234-41.
19. Marc M, et al. Plasma cortisol and ACTH concentrations in the warmblood horse in response to a standardized treadmill exercise test as physiological markers for evaluation of training status. J Anim Sci. 2000 Jul;78(7):1936-46.
20. Scerbo F, et al. S. Effects of exercise on cravings to smoke: the role of exercise intensity and cortisol. J Sports Sci. 2010 Jan;28(1):11-9.
21. Hill EE, et al. Exercise and circulating cortisol levels: the intensity threshold effect. J Endocrinol Invest. 2008 Jul;31(7):587-91.
22. Cust AE. Physical activity and gynecologic cancer prevention. Recent Results Cancer Res.2011;186:159-85. doi: 10.1007/978-3-642-04231-7_7.
23. Haff GG, et al. Force-time curve characteristics and hormonal alterations during an eleven-week training period in elite women weightlifters. J Strength Cond Res. 2008 Mar;22(2):433-46.
24. Watt PJ, et al. A holistic programmatic approach to natural hormone replacement. Fam Community Health. 2003 Jan-Mar;26(1):53-63.
25. Mahmud K. Natural hormone therapy for menopause. Gynecol Endocrinol. 2010 Feb;26(2):81-5.
26. Francisco L. Is bio-identical hormone therapy fact or fairy tale? Nurse Pract. 2003 Jul;28(7 Pt 1):39-44, table of contents.
27. Eilertsen AL, et al. The effects of oral and transdermal hormone replacement therapy on C-reactive protein levels and other inflammatory markers in women with high risk of thrombosis. Maturitas. 2005 Oct 16;52(2):111-8.
28. Kurtay G, et al. A comparison of effects of sequential transdermal administration versus oral administration of estradiol plus norethisterone acetate on serum NO levels in postmenopausal women. Maturitas. 2006 Jan 10;53(1):32-8.
29. Lazzeroni M, et al. The effect of transdermal estradiol or oral conjugated oestrogen and fenretinide versus placebo on haemostasis and cardiovascular risk biomarkers in a randomized breast cancer chemoprevention trial. Ecancermedicalscience. 2008;2:67.

Hormone replacement therapy (BHRT) has been around for many years as a way to help women relieve menopausal symptoms. Yet, HRT has been a confusing topic for medical professionals and patients. The debate over the safety of HRT has been questioned since the Women’s Health Initiative study in 2002, which showed the therapy could have greater health risks than benefits.1,2

To clarify this study, researchers found that women taking Prempro (a combination of Premarin and Progestin) significantly increased breast cancer, heart attack, and stroke risks. Due to the chemical makeup of these synthetic treatments, they can have negative effects on the body. Fortunately, there are alternatives to conventional BHRT. Bioidentical hormones are another method for treating menopause and hormonal imbalances. This form of HRT comes from natural compounds and contains a molecular structure that is identical to hormones found in the body. The body uses BHRT the same way it uses hormones naturally produced in the body.

Hormones in the body are vital messengers that communicate between body tissues. When hormone levels become unbalanced or decrease, they can leave you feeling exhausted, irritable, depressed, and wear on your physical and mental abilities. If they stay unbalanced for too long, they can lead to greater health risks, including cardiovascular disease, osteoporosis, cognitive ailments, and certain forms of cancer.3,4

When should you consider taking BHRT?

There are different reasons to consider BHRT, but it is most commonly used for menopause or significant hormone imbalances. The need for HRT can be clearly defined through simple blood tests to determine your hormone levels.

Menopause – Symptoms of menopause are a common frustration among middle-aged American women. Menopause can be recognized with the development of hot flashes, night sweats, sleep disturbances, depression, mood swings, low libido, fatigue, vaginal dryness, poor concentration, and unexplained weight gain.5

PMS – The main cause of PMS is too much estrogen and not enough progesterone. PMS symptoms can be characterized with mood swings, bloating, heavy bleeding, breast tenderness, acne, migraine headaches, severe menstrual cramps, and fatigue. Women who have PMS are more susceptible to postpartum depression. Progesterone levels that are significantly high during pregnancy decrease rapidly after women deliver a baby, which can lead to postpartum depression.6

Andropause – Andropause is similar to menopause, but it affects men. It is mostly recognized through low libido, but other symptoms may include fatigue, increased irritability, loss of motivation, abdominal weight gain, decreased strength, and even occasional hot flashes. This can all be associated with a decrease in testosterone levels. Low testosterone levels can leave men more prone to cardiovascular disease and prostate cancer.7

Supplementing with bioidentical hormone replacement therapy can restore and balance hormone levels to increase quality of life and offer greater protection against various chronic diseases.

References

1. Rossouw E. Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial, JAMA. 2002;288:321–333.

2. Gambrell RD. The Women’s Health Initiative reports: Critical review of the findings. The Female Patient. 2004; 29:25-41.

3. Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgrad Med. 2009 Jan;121(1):73-85.

4. Formby B, Wiley TS. Progesterone inhibits growth and induces apoptosis in breast cancer cells: inverse effects on Bcl-2 and p53. Ann Clin Lab Sci. 1998; 28(6): 360–369.

5. Newton KM, Buist DS, Keenan, NL, Anderson LA, LaCroix AZ. Use of alternative therapies for menopause symptoms: results of a population-based survey. Obstet Gynecol. 2002 Jul;100(1):18-25.

6. Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression. Am J Obstet Gynecol. 2009 Apr;200(4):357-364.

7. Hoffman MA, DeWolf WC, Morgentaler A. Is low serum free testosterone a marker for high grade prostate cancer? J Urol. 2000 Mar; 163(3):824-827.

Description

Testosterone, important to both men and women,1 is a hormone secreted by the ovaries, adrenal glands, and testes.2 Women require less testosterone than men, but the hormone is needed to sustain a woman’s libido and enhance the functions of estrogen.3 In both males and females, it strengthens bones to help prevent bone loss.2

Testosterone is the primary male sex hormone, responsible for male sexual development and critical in maintaining erectile function, libido, energy levels, mood, and a wide range of other physical functions throughout the body.2 As with other hormones, testosterone declines with age. Testosterone levels begin declining when a man is in his thirties. Although the total testosterone does not drop dramatically, the free testosterone, which is the biologically active testosterone, declines dramatically with age.4 Because the drop in testosterone is gradual, andropause symptoms appear over a longer period of time as compared to female menopause.5 Symptoms appear as a gradual decrease in energy, thinning bones and muscles, increased visceral fat, depression, and impaired sexual function.1,5,6 Testosterone deficiency has also been linked to hypertension, obesity, and increased heart disease risks. Stress levels may also play a role in declining testosterone levels. Testosterone replacement therapy is available @ Preventative Medicine Clinic in Bend.

Benefits of Testosterone Therapy or Testosterone Optimization

The focus of testosterone therapy and reaching optimal levels result in:

• Increase in bone density, bone formation, and bone minerals2,7-10
• Increase in energy5,11-13
• Improvement in sexual function3,5,6,11,13-19
• Increase in sexual satisfaction16,18-20
• Decrease in body fat or improved body composition5,7-9,12,16,18,21
• Balance healthy cholesterol and/or improve lipid profiles21,22
• Decrease in cardiovascular ailments5,7,16,21,23-25
• Improved brain function, learning, concentration, and memory5,12,16,26
• Improved blood glucose levels5,7,21
• Balance healthy blood pressure5,21,22
• Increase in sexual desire16,20,22,27-29
• Increase in both muscle strength and in the diameter of muscle fibers8,30
• Enhancement of skin and hair texture5
• Improved mood6,10,11,13,14,18,22,29,31,32

Side Effects

Too much testosterone can increase aggressive behavior. Testosterone should not be prescribed if prostate cancer is present. Testosterone has not been shown to cause prostate cancer; however, it may accelerate the growth of a tumor. PSA levels should be monitored yearly or every 6 months.

Administration

Testosterone therapy includes administration of bio-identical or synthetic testosterone orally, by injection (hormone pellets), patches, pellet implants or application of a cream/gel form. The most common way to take testosterone is in the cream or gel form. It is quickly absorbed, short-acting, and less toxic for the liver. Dosing is usually done in the morning and evening, and the strength varies from 50–100 mg. Other testosterone therapy includes implantation of pellets and regular injections. Many patients find these delivery systems convenient and cost effective.

Frequently Asked Questions

Q. Will women taking testosterone have an increase in hair growth?
A. No. They would have to take a man’s dose to experience any hair growth. While men take 100–200 mg daily, women take only 4–8 mg.

Q. How often can I get my prescription refilled?
A. Testosterone is a controlled substance and cannot under any circumstances be refilled before your dose is due to run out. Take your medication exactly as prescribed by your doctor.

Q. Will taking testosterone cause my body’s own production to decrease?
A. Yes, it can in some cases and some men may experience a small decrease in testicle size, which may be unsettling but does not impact sexuality or well-being.

References

1. Horstman AM, et al. The role of androgens and estrogens on healthy aging and longevity. J Gerontol A Biol Sci Med Sci. 2012 Nov;67(11):1140-52.

2. De Oliveira DH, et al. Androgens and bone. Minerva Endocrinol. 2012 Dec;37(4):305-14.

3. van Anders SM, et al. Preliminary clinical experience with androgen administration for pre- and postmenopausal women with hypoactive sexual desire. J Sex Marital Ther. 2005
May-Jun;31(3):173-85.

4. Krasnoff JB, et al. Free testosterone levels are associated with mobility limitation and physical performance in community-dwelling men: the Framingham Offspring Study. J Clin Endocrinol Metab. 2010 Jun;95(6):2790-9.

5. Tsujimura A. The Relationship between Testosterone Deficiency and Men’s Health. World J Mens Health. 2013 Aug;31(2):126-135.

6. Hori Y, et al. Clinical study of 62 patients with symptoms of male climacterium. Hinyokika Kiyo. 2013 Aug;59(8):491-5.

7. Corona G, et al. Risks and Benefits of Late Onset Hypogonadism Treatment: An Expert Opinion. World J Mens Health. 2013 Aug;31(2):103-125.

8. Cunningham GR. Andropause or Male Menopause? Rationale for Testosterone Replacement Therapy in Older Men with Low Testosterone Levels. Endocr Pract. 2013 Sep 6:1-18. PubMed PMID: 24014001.

9. Miller KK, et al. Effects of risedronate and low-dose transdermal testosterone on bone mineral density in women with anorexia nervosa: a randomized, placebo-controlled study. J Clin Endocrinol Metab. 2011 Jul;96(7):2081-8.

10. Dolan Looby SE, et al. Effects of long-term testosterone administration in HIV-infected women: a randomized, placebo-controlled trial. AIDS. 2009 May 15;23(8):951-9.

11. Amano T. Role of Androgen in the Elderly. Clinical androgen replacement therapy for late-onset hypogonadism. Clin Calcium. 2013 Aug;23(8):1179-84.

12. Blick G. Optimal diagnostic measures and thresholds for hypogonadism in men with HIV/AIDS: comparison between 2 transdermal testosterone replacement therapy gels. Postgrad Med. 2013 Mar;125(2):30-9.

13. Studd J. Ten reasons to be happy about hormone replacement therapy: a guide for patients. Menopause Int. 2010 Mar;16(1):44-6.

14. Miner MM, et al. Twelve-month observation of testosterone replacement effectiveness in a general population of men. Postgrad Med. 2013 Mar;125(2):8-18.

15. Panay N, et al. Testosterone treatment of HSDD in naturally menopausal women: the ADORE study. Climacteric. 2010 Apr;13(2):121-31.

16. Davis SR. Androgen therapy in women, beyond libido. Climacteric. 2013 Aug;16 Suppl 1:18-24.

17. Abdallah RT, Simon JA. Testosterone therapy in women: its role in the management of hypoactive sexual desire disorder. Int J Impot Res. 2007 Sep-Oct;19(5):458-63.

18. Blick G, et al. Testosterone replacement therapy in men with hypogonadism and HIV/AIDS: results from the TRiUS registry. Postgrad Med. 2013 Mar;125(2):19-29.

19. Kingsberg S, et al. Evaluation of the clinical relevance of benefits associated with transdermal testosterone treatment in postmenopausal women with hypoactive sexual desire disorder. J Sex Med. 2007 Jul;4(4 Pt 1):1001-8.

20. Davis S, et al. Safety and efficacy of a testosterone metered-dose transdermal spray for treating decreased sexual satisfaction in premenopausal women: a randomized trial. Ann Intern Med. 2008 Apr 15;148(8):569-77.

21. Saad F. Androgen therapy in men with testosterone deficiency: Can testosterone reduce the risk of cardiovascular disease? Diabetes Metab Res Rev. 2012 Dec;28 Suppl 2:52-9.

22. Stephenson K, Neuenschwander PF, Kurdowska AK. The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women. Int J Pharm Compd. 2013 Jan-Feb;17(1):74-85.

23. Poliwczak AR, Tylińska M, Broncel M. Effect of short-term testosterone replacement therapy on heart rate variability in men with hypoandrogen-metabolic syndrome. Pol Arch Med Wewn. 2013 Aug 19. doi:pii: AOP_13_047. PubMed PMID: 23974276.

24. He H, et al. Sex hormone ratio changes in men and postmenopausal women with coronary artery disease. Menopause. 2007 May-Jun;14(3 Pt 1):385-90.

25. Worboys S, et al. Evidence that parenteral testosterone therapy may improve endothelium-dependent and -independent vasodilation in postmenopausal women already receiving estrogen. J Clin Endocrinol Metab. 2001 Jan;86(1):158-61.

26. Möller MC, et al. Effect of estrogen and testosterone replacement therapy on cognitive fatigue. Gynecol Endocrinol. 2013 Feb;29(2):173-6.

27. Gettler LT, et al. Do testosterone declines during the transition to marriage and fatherhood relate to men’s sexual behavior? Evidence from the Philippines. Horm Behav. 2013 Sep 7.PubMed PMID: 24018138.

28. Lejeune H, Huyghe É, Droupy S. Hypoactive sexual desire and testosterone deficiency in men. Prog Urol. 2013 Jul;23(9):621-8.

29. Vigesaa KA Pharmd, et al. Efficacy and Tolerability of Compounded Bioidentical Hormone Replacement Therapy. Int J Pharm Compd. 2004 July-Aug;8(4):313-319.

30. Sinha-Hikim I, et al. Testosterone-induced muscle hypertrophy is associated with an increase in satellite cell number in healthy, young men. Am J Physiol Endocrinol Metab. 2003 Jul;285(1):E197-205.

31. Miller KK, et al. Low-dose transdermal testosterone augmentation therapy improves depression severity in women. CNS Spectr. 2009 Dec;14(12):688-94.

32. Goldstat R, et al. Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women. Menopause. 2003 Sep-Oct;10(5):390-8.

Are you tired, irritable, having trouble sleeping? Depressed Anxious? Skin drying, suddenly gaining weight when diet and exercise haven’t changed, and libido lagging? These questions aren’t for women. They are for men. Bioidentical hormone therapy and testosterone therapy is available in Bend for men.

Men have as many issues with hormones as women, they have the same symptoms, but  it isn’t talked about as much. It’s truly unfortunate because men can benefit as much from education and bio-identical hormone therapy too.

First, men need to understand that they have more hormones than testosterone. Secondly, they need to understand that testosterone is important for overall heath, not just sexual function.

As I evaluate men’s health, i pay attention to five hormone functions: thyroid, insulin, testosterone, cortisol, human growth hormone and DHEA. All combined they regulate a man’s health and body function. Unfortunately, men don’t have a monthly ‘report card’ like women do, so it’s less clear when something or a combination of things is off track.

While women often initially cite emotional and psychological concerns like feeling anxious and depressed, men zero in on physical issues like middle-aged bulge, lack of energy or increases healing time after a minor injury. Men notice that their physical performance has changed, often they think they need to tough it out, but it’s more than enough reason to seek out some medical advise.

This is something that women can be very sensitive to, perhaps suggesting men in their lives to see a doctor. If a woman is changing metabolically, she can assume her male partner is too. It is not uncommon for a man in his 40’s and 50’s to see a significant drop in his production of testosterone, or see the thyroid function falter. Both result in symptoms like fatigue, being short-tempered, drying of skin and a vague sense of depression. But many men don’t seek help until sexual function is involved. That’s a man’s ‘report card’.

Once trouble with the prostate is ruled out, that’s when I as a specialist in bio-identical hormone replacement therapy can have a candid and comprehensive conversation about hormone balance and overall health. It’s all about goals with men once the labs are in and the numbers are on the table, most men are very willing to talk about diet exercise and treatments. Most often, they zero in on testosterone, and while improving intimacy is an important goal, hormonal balance is critical in protecting against heart disease and bone loss too. The first goal is to get the thyroid functioning at optimum levels, this gland is the traffic cop for any body, it has to be functioning well for other systems to work as they should. With that done, testosterone in the form of creams and injections can be considered. Bringing those levels up can significantly change how a man is feeling, both physically and emotionally. They will also see an increase in energy, brighter looking skin and better moods, The same feeling women experience when they are correctly balanced.

Many men are feeling the benefits of bio-identical hormone replacement therapy. Dr. Brust @ Preventative Medicine Clinic in Bend is a specialist in this area. However, don’t assume that testosterone is an easy fix. It requires consultations with the prescribing physician frequently, and having labs drawn at least twice a year, as testosterone is a controlled substance. Also don’t confuse hormonal balance with anabolic steroids, each have different goals, different dosages and different results. It’s best to focus on feeling your best regardless of your age. Men shouldn’t avoid the conversation, they should feel comfortable in seeking out options.  Testosterone is supplemented in a variety of forms: hormone pellets, creams, gels, and intramuscular injections.  To find out if this therapy is right for you, please contact Preventative Medicine Clinic in Bend @ 541-383-3424.

What is the controversy surrounding Hormone Replacement Therapy (HRT)?

For years, women going through menopause have been prescribed hormones to reduce hot flashes, vaginal dryness and other perimenopausal and menopausal symptoms. In many cases women continued to take the hormone supplements for the rest of their lives in the belief they also reduced the risk of heart disease. A recent large scale study (11,000 plus women) showed dangerous side effects for a significant percentage of the women in the study. These side effects included risks for stroke, heart disease and breast cancer.

What are the new recommendations arising from the study?

1. Women should be more careful in embarking on the prolonged use of HRT
2. Short term use of HRT for symptomatic relief of hot flashes, insomnia, mood swings, and vaginal dryness may be more appropriate
3. Individual approach with different hormones doses, and types depending on a woman’s age, weight, sensitivity, personal and family medical history should be considered
4. Preventative measures of non-pharmaceutical approaches such as dietary changes, exercise, meditation, natural medicine, herbs and use of supplements may also be indicated.

Are there other treatments for hot flashes and menopausal symptoms other than hormone replacement therapy?

The evaluation and treatment of perimenopause and menopausal symptoms are at the heart of naturopathic medicine. We are the only physicians trained in the art and science of medicine involving prescription medications and hormones as well as natural medicine, herbs, supplements, lifestyle and nutritional counseling. If, as a woman you desire and integrated or natural approach to your health concerns please call our office today. We look forward to serving you.

As an expert in natural medicine, and because so many women are confused about this issue, we have decided to provide a brief summary of the Women’s Health Initiative (WIH) research study for women who are interested in more of the study details. Keep in mind, the clinical implications are complex, and therefore should be evaluated on an individual basis with each woman and her physician.

Specific study findings using both oral conjugated equine estrogens (.625 mg/day CEE) known as Premarin and oral medroxyprogesterone acetate (2.5mg/day MPA) known as Provera compared to a placebo group over an average period of 5.2 years are:

• A 41% increase in strokes
• A 29% increase in heart attacks
• Over 100% increase in venous thromboembolism (blood clots)
• A 22% increase in total cardiovascular disease
• A 26% increase in breast cancer
• A 37% reduction in colorectal cancer
• A 30% reductions in hip fractures
• A 24% reduction in total fractures
• No difference in total mortality

If you would like a more detailed report of the study, please contact our office at (541) 383-3424.