An abundance of evidence from animal studies overflows in the medical literature that estrogen replacement is beneficial for menopausal symptoms, aging and overall body health. The rats do very well when we give them estrogen replacement therapy. They stay slim and fit, run on their wheel in the cage, complete the maze just as well as the young rats and their brain tissue and microbiome are significantly healthier than the non-estrogen receiving rats. However large clinical trials on humans have shown that estrogen administered to postmenopausal women increases the risk of cardiovascular disease. There is a probable and explainable cause. Timing may be everything.
Estrogen is administered immediately after removing the ovaries in animal studies, while estrogen administration in human studies is often not started until many years post-menopause. The damage is already done. Looking through a different lens may help women start the right bio-identical hormone replacement early in their life change. These actions should prevent much of the destructive inflammatory damage that accompanies the peri-menopause and menopause changes.
The first hormone identified in pure form and structure was ‘adrenalin’ in 1901. It was researcher, Ernest Starling, in the 1920’s who proposed “hormone” as a generic term for any messengers that are released by ‘endocrine’ glands into the blood to stimulate the activity of a target organ.
In the 1960s new technologies to measure hormones in blood were developed and refined.
For developing a new diagnostic method to check blood hormones, Rosalyn Yalow was awarded the Nobel Prize for Medicine in 1977. With the intro of even more technology today we are now using urine and saliva to optimize our evaluation and treatment of hormone imbalance.
What is the true history of our issues with hormones today?
In 1942, the FDA approved Premarin, an estrogen product made from pregnant mare’s urine, for treatment of hot flashes. Then in 1966, the book, Feminine Forever , became a best seller with its claim that “menopause is completely preventable.” The book’s author, Robert A. Wilson, wrote that because the estrogen level in a woman’s body dropped after menopause, postmenopausal women who didn’t receive treatment were no longer truly female. As you can imagine this created a rush to the physician’s offices and large numbers of women began HRT(hormone replacement therapy).
In the 1980s – The scientific studies on mice piled up as to how poorly mice and rats fared when challenged with different life tasks without hormones—and hormones became more widely used!
The FDA had initially approved hormone treatment for hot ﬂashes- this was Premarin and Provera(progestin) –NOT PROGESTERONE– to protect the uterine lining from malignancy.
Amidst a swirling background of confusing and conﬂicting data- some suggested beneﬁts while other studies indicated possible dangers-
Premarin still became the most prescribed drug in the country!
The Women’s Health Initiative (WHI) in 2002, a national study designed to address the most common causes of death, disability, and poor quality of life in postmenopausal women, included the first randomized clinical trials to assess hormone therapy use by healthy women.—supposedly to really provide answers!
The estrogen plus progestin arm of the study was halted in July of 2002, three years before its scheduled conclusion, because investigators found supposed increases in breast cancers, heart disease, strokes, and blood clots in the women who took the hormone pills.
To this day millions and millions of post menopausal women suffer without hormones as they are convinced hormone replacement therapy of any kind will give them cancer!!
The study actually looked at 2 very different groups of women. The placebo group were much younger and non-smokers. Over time it has been shown that you cannot use this study as a basis for decisions about hormone replacement on individual patients.
The medical literature today states:
What happens when estrogen levels drop as a woman enters menopause?
As estrogen levels decrease, the overall health of the female body significantly decreases. Insomnia, hot flashes, brain fog, and memory loss increase, motivation decreases, skin and muscle weakens, atherosclerosis risk goes up, as does the risk of Parkinson’s disease and Alzheimer’s and the development of weight gain. Yes, weight gain is a result of estrogen dominance and estrogen deficiency. The rat and mice studies show that low estrogen causes insulin resistance and weight gain is reversed by adding estrogen.
The female today lives so much in fear of the old literature and hearsay about hormones that she allows herself to develop all the above symptoms for years after her estrogen has dropped. It is at times 5-7 years or more after menopause that women seek help and by that time estrogen must be carefully replaced and only after a good cardiac and blood vessel evaluation. Unfortunately, what has been lost in health in these early non hormone replaced menopausal years cannot be completely replaced.
What is right for me? How do I test? Do I need hormones?
It is the changing connection of the central nervous system to the ovaries that creates the hormone roller coaster. Blood testing at this time is difficult as there is so much variation in the levels. Do not let anyone make major hormone recommendations based on single blood testing.
Most of your hormones are bound to proteins in your blood; therefore, you must have an evaluation at your tissue level. Many of the tissues in the menopausal woman make estrogen. Saliva testing is an optimal test to look at your baseline hormones. In conjunction with blood work an accurate decision can be made on what is the state of your hormone balance. This evaluation is only if you are not on hormone replacement.
Once hormones are added they are best added topically as a cream for estrogen and testosterone and capsule form for progesterone and DHEA. Pill form of estrogen and testosterone travels through and affects the liver and its proteins and is often associated with an elevation of inflammatory markers. Levels are best checked through a urine test, comparing levels to peri-menopausal women. Remember in our ovulating days there were times during our cycle where our hormones were elevated but during the actual menstrual flow they were very low. Keeping hormones very elevated all the time is not optimal so we look for a middle ground that is individual to each patient. This enables optimal feeling and results while keeping estrogen levels in a safe range.