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Hormone Therapy Mythology Unveiled
what are phytogenic hormones?
Let’s get the technical data covered and out of the way so we can move on to the issues that concern you the most, your hormonal balance—how to recognize an imbalance, what hormones are responsible, and how to restore your own delicate, ever-changing balance.
The term phytogenic literally means of plant origin. Hormones, chemical messengers originating in an organ or gland, disperse into the bloodstream to other parts of the body and stimulate chemical reactions to increase functional activity and secretion of the specific hormones. Hormones interact with one another and are responsible for creating and maintaining balance within each of us. The hormonal system performs the most delicate balancing act of all the systems in our bodies. To maintain our stability, we are dependent upon our hormonal balance, which affects us in many aspects of our being human—physically, mentally, emotionally, and even our spiritual sense of well-being, independent of specific belief systems. (Many women have plunged into an existential crisis resulting from hormonal imbalances.) As you will see in the next two parts of the book, when our hormones are out of balance, we do not function well, nor do we as easily retain optimal health. Imbalanced hormones can alter the normal functioning of other systems, eliciting a multitude of challenging symptoms and potentially evolving into disease.
Phytogenic hormones are created from diosgenin, a large steroid molecule that exists in plants such as the Mexican wild yam and soybeans. This molecule, extracted in a laboratory, can be compounded into each specific hormone—estrone, estradiol, estriol, progesterone, testosterone, and DHEA (dehydroepiandrosterone)—to become hormones that are biochemically identical to the hormones our bodies make.
Because these compounded phytogenic hormones are identical to our own, hence the term bioidentical, or human isomolecular, they are recognized by our endocrine system and accepted alongside our own hormones. Once our natural hormone levels have declined, these hormones maintain the essential hormonal balance we require to feel vital, to function at our optimal levels, and to support our general health and well-being.
Phytohormones are plants that in their natural form of existence have hormonal effects. Many of the available over-the-counter (OTC) natural products designed to assist with the symptoms of PMS, perimenopause, and menopause do not contain any actual hormones. You will see the word phytohormone on the label, and the ingredients list will include specific herbs. Or, for example, Promensil by Reach 4 Life states that it contains “40 milligrams of plant estrogen”—this means that plants having 40 mg of estrogenic qualities have been used in the formula. Plant estrogen or progesterone has not been extracted and then converted into actual human, bioidentical estrogen or progesterone. These are quite different from the phytogenic hormones that have been compounded into specific amounts of each hormone, which then become bioidentical to human hormones and thereby bioavailable for your endocrine system to utilize.
natural hormones demystified
The term natural is applied to all hormones derived from plant extracts, which are thus phytogenic by nature. They are considered natural not because of their natural source but because they are identical to naturally occurring human hormone functioning and because of the way they interact in the human endocrine system. Many products claim to be natural. Actual phytogenic hormones will specify the hormone by name, as in, for example, USP progesterone, rather than plant progesterone.
Extracted from either wild yam or soy, each of the three estrogens—estrone (E1), estradiol (E2), and estriol (E3)—plus progesterone, DHEA, and testosterone can be combined into a specific compound tailored to what each woman needs to feel her best and sustain her hormonal balance. In a triestrogen formula the ratio is, most commonly, 10 percent each of estrone and estradiol and 80 percent estriol, whereas a biestrogen formula is 20 percent estradiol, 80 percent estriol, and excludes estrone completely. Estrone is the primary circulating estrogen in most postmenopausal women. These ratios can be altered as needed to facilitate a more positive response.
Phytogenic progesterone, most commonly extracted from the Mexican wild yam, can be taken alone or in combination with any of the other hormones that a woman needs to restore balance. There are many types of progesterone in creams and sublingual sources now available over the counter. The disadvantage with many of these nonprescription progesterones is the lack of clarity in the exact amounts contained in each dosage. If it does not state on the label the number of milligrams in each dose, you do not know how much progesterone you are actually taking. If the label does not specify the word progesterone in the ingredients, it lacks any actual progesterone.
As a practitioner, in order to better monitor over time the adjustments a woman needs to restore balance, I want to know exactly how much progesterone she is really taking into her system. If she needs progesterone along with estrogen, testosterone, and/or DHEA, it is less expensive to have a compounding pharmacy put this all into one formula than to use a combination of different nonprescription sources. While experimenting to establish your best dosage, you might want to take each hormone separately until you have continued to take the same amount consistently for several months.
they torture horses, don’t they?
I invite you to explore the unnecessary process of extracting estrogen from a pregnant mare to produce the most widely and routinely prescribed synthetic estrogen, Premarin. Premarin stands for PREgnant MARes’ urINe. What’s unnatural about urine? is the common defense for this drug. Urine in and of itself is the result of a natural physiologic process common to every known biological creature on this planet. Urine therapy is not a new concept. In Ayurveda, a specific healing modality thousands of years old, one drinks one’s own urine as a remedy to cure disease, as well as to rejuvenate and maintain health.
The problem is that the estrogen found in horse urine is not natural to the human endocrine system. Its molecular structure is quite different from the molecular structure of human estrogens and the estrogens compounded from plant extracts. Premarin contains equine estrogens— estrone and equilin sulfate, equilenin, 17 a-dihydroequilin, 17 a-estradiol, 17 a-dihydroequilenin, and numerous other estrogens found in horses—none of which occur naturally in the human female. Premarin, like all substances, is processed by the liver; it has a greater negative impact on the liver than any bioidentical, phytogenic estrogen does.
In addition, the process used to extract this estrogen from the pregnant mare is a cruel, torturous process in which the mare is confined to a standing position devoid of movement in a narrow stall. A horse normally lies down approximately three hours for every twenty-four-hour cycle. Previously, horses were fitted with a catheter in the bladder during the eleven-month pregnancy; now, urine collection devices are used that allow urine to soak the skin of the vulva, sometimes causing severe infections and painful lesions. For more details on the mistreatment of mares resulting from the extraction of equine estrogens from their urine, go to www.premarin.org.
risks and side effects of synthetic estrogens
Taken directly from its package insert and its website, www.premarin.com, Wyeth-Ayerst, the company marketing Premarin and related HRTs such as Premphase, Prempac, and Prempro, lists the following as risk factors and side effects of its product:
1. Cancer of the uterus and endometrium (the uterine lining)
2. Cancer of the breast
3. Gallbladder disease
4. Abnormal blood clotting
5. Inflammation of the pancreas
6. Endometriosis (growth of endometrial tissue outside the uterus)
7. Cardiovascular disease including myocardial infarction, pulmonary embolism, and venous thromboembolism and thrombophlebitis—highest in the first year of therapy
8. Hypercalcemia (an excessive amount of calcium in the blood)
9. Hepatic adenoma—although benign and rare, these liver tumors can rupture and may cause death through intra-abdominal hemorrhage.
10. Hepatic carcinoma—cancer of the liver
11. Endometrial hyperplasia (excessive proliferation—rapid reproduction— of normal cells in normal tissue arrangement of the uterine lining)
12. Enlargement of uterine fibroids
13. Familiar hyperlipoproteinemia (an increase in the concentration of the three fatty substances in the blood—cholesterol, phospholipid, and triglyceride, combined with plasma proteins)
14. Glucose intolerance
15. Jaundice in women who had jaundice in their pregnancy
16. Congenital defects in the unborn with malignant potential, if taken in pregnancy
17. High blood pressure
As other side effects, Wyeth-Ayerst alerts you to the following:
In your genitourinary system:
1. Breakthrough bleeding, spotting, change in menstrual flow or amenorrhea (absence of menses)
2. Dysmenorrhea (painful periods)
4. Vaginal candidiasis
5. Change in the erosion of the cervix, effecting cervical secretions
6. Cystitis-like (bladder infection) symptoms
7. Genital itching, burning, and irritation
For your breasts, it warns of:
3. Secretions from the nipples
In your gastrointestinal tract:
1. Nausea and vomiting
2. Abdominal pain, cramps, and bloating
3. Cholestatic jaundice, caused by the arrest of bile excretion
4. Pancreatitis—inflammation of the pancreas
5. Gallbladder disease
For your skin:
1. Chloasma or melasma—discolorations of the skin, which may not go away even after HRT has been discontinued
2. Erythema multiform—a discolored flat patch of skin eruption with dark red elevated areas and erythema nodosum—red and painful nodules on legs, usually associated with rheumatism but can be caused by certain drugs and food poisoning
3. Hemorrhagic eruptions
4. Loss of scalp hair
5. Hirsutism—excessive hair growth, mostly in unwanted places, or appearance of hair in unusual places.
Your central nervous system could develop:
1. Headaches and migraines
3. Mental depression
4. Chorea—a nervous affliction marked by muscular twitching of limbs or facial muscles
For your eyes:
1. Steepening of corneal curvature
2. Intolerance to contact lenses
And a few miscellaneous ones:
1. Decrease in carbohydrate tolerance
2. Aggravation of porphyria, a metabolic disorder
4. Anaphylatic reactions—a sudden hypersensitive response to a foreign substance with symptoms severe enough to produce shock requiring immediate treatment and which may result in death
5. Weight gain or loss, though I’ve only seen weight gain
6. Loss of libido
If you have ever been prescribed Premarin, Premphase, Prempac, or Prempro, were these serious risks and side effects explained to you before you were told to take these hormones? Were you informed that you may feel and look like a pregnant mare, as well? If you had been told all of this before you filled that first prescription, would you have gone to the pharmacy or would you have asked for other options?
why take hormones at all?
Recent studies argue that taking synthetic estrogen actually increases the rate of heart attacks in the first few years before providing any potential added protection. For years, of the various reasons women were given to justify taking HRT, one of the primary incentives was to reduce the risk of heart disease. The good news is that the compounded phytogenic progesterone and estriol help protect cardiac function.
If you are menopausal or postmenopausal and still have a uterus, you may have heard that you must take progestin—a synthetic progesterone—with estrogen to protect against uterine cancer. Yet the latest study says that women who take estrogen without progestin have a lower incidence of breast cancer. If you dig deeper, you’ll find that almost all of the published research involves conjugated synthetic estrogens and synthetic progestin. The incongruity of the results of these studies raises suspicions. What is the truth?
Synthetic estrogen shuts down the functioning of a woman’s own available hormones, thus increasing her risk for both breast and uterine cancer. The synthetic progestin is not only less effective than natural progesterone, it also causes harmful side effects such as menstrual irregulari- ties, including the cessation of your cycle or an abnormal flow; nausea; depression; weight fluctuations; fluid retention; insomnia; and jaundice. Medroxyprogesterone, one of the synthetic progestins used in conjunction with synthetic estrogens, is cardiotoxic. This means it’s not good for your heart. Compounded phytogenic natural progesterone, by contrast, effectively provides cardiac protection; treats PMS, irregular cycles, insomnia, depression, fluid retention, infertility, and nausea; and helps prevent breast cancer, fibrocystic breasts, and uterine fibroids, to name a few benefits.
Over the past few years, estrogen deficiency has been linked to Alzheimer’s disease, a debilitating dementia that occurs in the forty- to sixty-year-old age group. Alzheimer’s takes a relentless and irreversible course of a few months to years, and leads to the end stage of help- lessness. Compounded phytogenic hormones provide hormonal supplementation without the serious and negative side effects of synthetic hormones.
Osteoporosis is mostly prevented and reversed with adequately absorbed and utilized progesterone and estrogen, along with weight-bearing exercise, a diet low in animal protein, and supplementation with a well-absorbed source of sufficient calcium and magnesium. Previously, women who had a total hysterectomy and oophorectomy—the removal of the cervix, uterus, fallopian tubes, and both ovaries—were told they did not need to take progesterone, that is, until the role progesterone plays in bone marrow production was understood. Here again, phytogenic hormones effectively nourish and protect without risky side effects.
When I began working with compounded phytogenic hormones many years ago, I gave women with hysterectomies progesterone with their estrogen. It made sense to me that if our bodies were accustomed to having both estrogen and progesterone, a woman needed supplementation of both because she no longer produced either on her own. I noticed how much better these women felt, within a reasonably short time, than did those women who took only conjugated synthetic estrogens or combinations of synthetic estrogens and progestins. I prescribed compounded estrogens with progesterone out of what seemed to me pure common sense, even though this was not considered standard practice at that time. Years later, research emerged suggesting the importance of progesterone in the prevention and treatment of osteoporosis. We live in a world that remains highly out of balance, as is evident by aggressive and often violent behavior worldwide. Planet Earth needs healing, rebalancing, and where else to begin this process but with ourselves. As we, the feminine aspect of humanity, choose to restore balance in ourselves in every way available, including our hormonal balance, we create opportunities to return the Earth’s energy and the masculine aspect to the heart. If we are ever to establish peace in our world, we must begin at home, within ourselves. This requires us to choose to confront our fears with love, compassion, and forgiveness, embracing the feminine paradigm of restoring balance.