Read an Excerpt
Revitalize Your Hormones
By Theresa Dale
John Wiley & SonsISBN: 0-471-65555-4
Chapter OneStep 1
Understanding the Dangers of Hormone Replacement Therapy
After finishing a lecture recently, I was approached by Sarah, an office manager with a hectic schedule who said that she was desperately seeking relief from hot flashes and perimenopausal symptoms. Sarah was prepared to try anything to get relief. As she listed the various hormone combinations her doctor had prescribed, I empathized how Sarah's story typified so many women's perimenopausal predicaments.
Sarah had tried conventional hormone replacement therapy (HRT) (drugs made from a combination of synthetic estrogen and synthetic progesterone, also known as progestin). She had also taken so-called natural or bio-identical HRT (pills, liquids, patches, or skin creams containing hormones that are synthesized in the laboratory and derived from either wild yam or soy). Even the so-called natural, bioidentical HRT caused her symptoms to intensify.
Doubts about the safety of taking so many chemicals over the years compounded Sarah's uneasiness. Like many other women whom I speak to, Sarah had become increasingly concerned that taking HRT chemicals might negatively affect her health.
Sarah's story is fairly typical. From my private practice, I know that women feel frustrated and often desperate about their hormone health options, and they worry about the dangers involved in taking conventional ornatural HRT. I know how depressed you can get when you believe that you lack a safe alternative to HRT and you feel stuck in an unhealthful lifestyle. Nonetheless, you can relax now, because I am going to tell you about natural, effective choices that will help you feel healthier, sexier, and stronger.
Contrary to what the media and your doctor may lead you to believe, your body has the ability to produce the hormones it needs for as long as you are alive. For example, when the ovaries shut down after menopause, the adrenal glands continue producing progesterone and other hormones. Studies show that a healthy endocrine system is essential to making hormones in appropriate amounts throughout life. While chapters 3 through 7 detail numerous effective endocrine-support strategies, part 3 provides recipes and pantry and food guidelines that you can use to nourish your body and mind for the rest of your life.
Another key point: hormone health depends not on age or where you are on the perimenopausal or postmenopausal spectrum. It depends on a complex of factors, such as the air that you breathe; the water you drink; the quality of your diet, sleep, and exercise; the relative health of your relationships and emotional life-and that's just for starters. Many women are surprised to learn that hormone health depends not on how old they are but on how healthy they are.
To give you the tools you need to master your hormones, I will revisit some lessons that you first learned in high school biology class.
Hormonal Facts and Figures
A hormone is a chemical messenger formed by an orchestra of highly talented players, such as the adrenal glands, the hypothalamus, the pituitary, the liver, the pancreas, the ovaries, and the thyroid. Hormones commute through your bloodstream via an information superhighway that connects the executive suites of your brain to the DNA managers working in your body's cells.
Hormones communicate with chemicals, called neurotransmitters, such as serotonin, dopamine, and norepinephrine, that are produced by our brains. These neurotransmitters greatly influence our energy levels, moods, and other bodily functions. Women's bodies contain female hormones such as estrogen, as well as male hormones such as testosterone and androstenodione, which are made by various endocrine glands and are responsible for libido, energy, and well-being.
Imagine your body as a city consisting of different commercial and residential neighborhoods, where several hundred trillion cells are busy living and working. Inside and outside the membranes of every cell, receptor sites function like elite clubs that can be entered only with special passwords. For any substance to enter the club and provide information to the DNA, the cells require the proper password. In this case, it is a hormone, which makes contact with a specific target cell and gains entry to the receptor site.
Once inside, the hormone delivers its biochemical messages for processing. For example, hormones have the power to switch various cellular functions on or off, such as telling the liver to make more blood glucose. They can orchestrate menstrual cycles and measure cellular activity throughout the body.
Depending on a woman's age, health, diet, fitness levels, and circumstances, her body will produce different hormones at different times of the day and the month. In most women, hormone levels peak in the early twenties and start descending after age twenty-five or so. Around age forty, hormone levels typically start to fluctuate, as the body moves beyond childbearing age and starts to prepare for life after menstruation, or postmenopause.
Because hormones affect the body in staggeringly complex ways, there are dozens of hormones that scientists have yet to fully understand. One of the most heavily researched female hormones, however, is estrogen, which is made in the ovaries and which circulates throughout the bloodstream. Besides activating a girl's metamorphosis into womanhood, estrogen creates the perfect conditions in the womb for the implantation and the nourishment of the early embryo. While estrogen acts as a growth hormone for breast, uterine, and ovarian tissue, it also fortifies the collagen layer of the skin, which improves elasticity and helps to prevent wrinkles. In addition, estrogen regulates mood and works many more health-enhancing wonders, which are detailed in chapter 2.
Women are often amazed when I tell them that the body produces more than two hundred different hormones every day. Just as certain nutrients from our food support specific aspects of mind/body health, each of your hundreds of hormones decisively influences specific body functions. In addition, hormone levels vary at different times of the day and night-they rise and fall throughout the twenty-four-hour cycle.
Your most famous hormones are undoubtedly the sex-related ones: estrogen, progesterone, and testosterone. Yes, even women produce the male hormone testosterone, and it's a lucky thing, too. Essential to healthy female sexual response and libido, testosterone also stokes energy and enhances general well-being. In most women, testosterone levels are doing fine until women reach a certain point in perimenopause, the six- to thirteen-year-long span that culminates in the last menstrual period.
Perimenopause may take place anywhere between the ages of forty and the late fifties, and symptoms vary from woman to woman. Irregular menstrual periods, missed periods, heavy or scanty bleeding, anxiety, and insomnia are some of the most common signs of perimenopause. Because these symptoms overlap with common PMS symptoms, the two conditions are often confused and thus misdiagnosed by health-care professionals. This book will help you pinpoint whether your mind/body conditions are caused by perimenopause or PMS. You will also find effective, safe, and evidence-based strategies for alleviating your symptoms.
You can develop a better sense of your exact condition(s) by completing the following questionnaires. Self-knowledge is empowering. Recording your symptoms is a great way to start balancing your hormones.
This first test increases your awareness about your current state of health. Please note that if you have had a hysterectomy, chances are high that you have a hormone imbalance.
If you check off three or more symptoms on the following Hormone Self-Assessment Test, you probably have unbalanced hormones. Please do not worry, as I will present solutions in the coming chapters that will help you take control of your health and eliminate any fears you may have now.
The following Premenstrual Syndrome Self-Assessment Test will help you further define your physical and emotional health specifics so that you can better balance your hormones. Some of the following symptoms occur three days to two weeks prior to menstruation.
Many women suffer from painful, tender swelling in the breasts and other disturbing symptoms that may be associated with fibrocystic breast disease. In my experience, this condition is widely underdiagnosed, yet easily treatable, so please take the following assessment to help you learn more about your body.
Did you know that some women enter menopause in their late thirties, while others may keep menstruating regularly into their mid to late fifties? The following test will help you understand whether you have reached menopause.
Because critical hormones like testosterone are made in the ovaries, it's vital to check out your ovarian function. Here's an ovarian dysfunction self-assessment test to guide and educate you about your body. Just check off your symptoms and any diagnosis you have had.
As you read this book and follow its detoxification and hormone-balancing strategies, your symptoms should improve. Refer back to these quizzes to check your original answers, which will help clarify any improvement in endocrine functioning and hormone health.
If you find that you're experiencing a hormone imbalance, then you're not alone. Today, about 40 million women in the United States are either in perimenopause or are postmenopausal. In the United States, the average age of menopause is currently about fifty-two, with a range from forty-five to the late fifties. I have seen women who experienced menopause in their late thirties, either naturally or as a result of surgical hysterectomy. Over the last four decades or so, the medical profession and the pharmaceutical industry have treated perimenopausal and postmenopausal symptoms (caused by hormone imbalances) as diseases that require synthetic hormone replacement therapy (HRT) drugs.
I have been a health provider for almost twenty-five years and have never recommended a drug. Nor do I find them able to cure any degenerative disease. I believe that a combination of homeopathic remedies, careful diet, exercise, meditation, and naturally derived nutritional substances are the best choice for PMS, perimenopausal, or postmenopausal symptoms.
I see perimenopause and the stages beyond as highlights of the female journey and growth process. I say growth process, rather than aging process, because not only are women living longer than ever before, they are living smarter. Recent medical advances and more healthful lifestyles mean that women enjoy a better quality of life-as well as greater longevity-than their mothers or grandmothers did.
The Scientific Evidence against Conventional HRT
In the United States most women with a uterus who report symptoms such as Sarah's are put on conventional HRT, which combines synthetic estrogen with progestin, also known as synthetic progesterone. An estimated 13.5 to 16 million women in the United States use HRT, synthetic estrogen either alone or combined with synthetic progesterone.
The most commonly prescribed synthetic estrogen is called Premarin, a collection of over twenty different conjugated equine estrogens made from the urine of pregnant horses. Premarin, the oldest synthetic estrogen, has been on the market since 1944. The name Premarin is an acronym derived from a weirdly unforgettable product, pregnant mare's urine. Whoa! Logic dictates that it is wholly unnatural for women to consume hormones sourced from the urine of pregnant mares. If you drop a little water on a Premarin tablet, the pungent aroma of horse pee will help you smell my point.
Nevertheless, women have willingly swallowed this stuff for decades under the direction of their physicians. Premarin is one of the world's most widely prescribed drugs and is sold alone or combined with another hormone in the drugs Prempro and Premphase.
Progestin, usually Provera (medroxyprogesterone acetate), is combined with estrogen because it prevents Premarin from causing excessive tissue growth inside the uterus, which over time can lead to cancer of the endometrium, or uterine lining. Produced in the laboratory, Provera is markedly different from naturally occurring progesterone. The combination of Premarin and Provera is called Prempro. Synthetic hormones like Prempro place a tremendous stress on your liver and the other players in your body's detoxification system.
Conventional HRT's health risks made front-page news back in July 2002, when the largest and longest U.S. study of HRT ever conducted came to a dramatically premature end. The study was halted three years ahead of schedule because participants (16,608 healthy women, ages fifty to seventy-nine years) taking synthetic estrogen and progestin were found to be at significantly higher risk for breast cancer, heart attack, stroke, and blood clots than were women in the placebo group.
This historic study was sponsored by the Women's Health Initiative (WHI), funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH). Results published in the Journal of the American Medical Association specified that women who take estrogen and progestin for more than five years expose themselves to the risk of a
26 percent increase in breast cancer 22 percent increase in cardiovascular disease 41 percent increase in strokes 100 percent increase in blood clots
In its press release on the cancellation of the trial, the NIH sounded an exceptionally clear warning regarding the dangers of taking estrogen plus progestin. The study results offered irrefutable proof that "on balance the harm was greater than the benefits." Contradicting popular medical belief, the study also reported that HRT's effects on osteoporosis and dementia prevention appeared negligible. WHI researchers, who rarely recommend any actions except more studies, secured their place in the annals of medical history by advising doctors to be very cautious about prescribing HRT to their patients. This unprecedented action confirmed that the American public should avoid taking HRT because of its many dangerous side effects.
Physicians and health researchers also have compelling reasons to wonder whether the widespread practice of prescribing Prempro over the last three decades is linked to the rise in U.S. breast cancer rates. According to the National Alliance of Breast Cancer Organizations (NABCO), "based on the current life expectancy for women in the United States, one out of nine women will develop breast cancer in her lifetime-a risk that was one out of 14 in 1960." That clearly adds up to a dangerous increase.
The WHI results came as a shocking wake-up call to the approximately 6 million U.S. women who were taking estrogen plus progestin in 2002. Understandably, the results also alarmed women who had used it in the past. It is only natural that they felt (or continue to feel) angered and frightened by the findings. When the study's disease risk numbers were evaluated with respect to the 6 million women in the United States who were currently taking HRT, it meant that tens of thousands of women were at increased risk of serious illness or disease. The truth contained in these figures is unassailable: taking HRT may seriously endanger your health.
Following the publication of the WHI results in July 2002, hormone therapy prescriptions declined in successive months. Relative to January-June 2002, prescriptions from January to June 2003 declined by 66 percent for Prempro and 33 percent for Premarin.
Along with alerting women to the potential dangers of conventional HRT, the WHI scandal woke up millions to the fact that even though a drug is FDA-approved, it may never have been thoroughly researched in large-scale, double-blind, placebo-controlled trials. In other words, a drug's relative safety may be in question long after it is FDA-approved, and like HRT, the drug may even negatively affect your health.
That HRT was FDA-approved before being adequately researched is undeniable and a major reason why women were encouraged to take HRT for so long. So is the fact that over the years, numerous small studies have shown that long-term, constant HRT helps to preserve bone mass, an important concern among women over fifty. You can't blame physicians or patients for wanting to prevent osteoporosis with a drug that has been found to help prevent it. But then again, more recent research about HRT's effects may not have reached all of the doctors who treat postmenopausal women, or the women themselves.
Excerpted from Revitalize Your Hormones by Theresa Dale Excerpted by permission.
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