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Hormones

Alternative Solutions

The Other Hormones

 

Synthetic Hormones

Synthetic hormones are chemical concoctions created in a laboratory. They are similar enough to natural hormones to have some of the same effects but are altered so they can be patented.

Just a few years ago, the prescription written for the vast majority of perimenopausal women consisted of synthetic hormones. To a large degree, this is because physicians are constantly barraged with expensive, glossy advertising and prodded with sales "perks" by enthusiastic drug salesmen whose jobs depend on selling buckets of synthetic hormones before the patents run out. For many women, the synthetic products are fine. For many, they are too harsh.

The vast majority of synthetic hormones contains conjugated estrogens--a collection of several different estrogen-like chemicals "harvested" from the urine of pregnant mares. Not technically synthetic, the effect is similar to that of synthetic hormones; components of the product, tailor made for horses, are foreign to the woman?s physiology. For some women the chemical by-products that result when the numerous foreign hormones are broken down in your body can be stronger than the original product, producing equivalent of an overdose. This can worsen the frequency and severity of side effectsThankfully, many doctors are now prescribing bio-identical hormones.

 

Natural or Bio-identical hormones

The principal human female hormones produced by the ovaries during the child-bearing years are 17-B estradiol (the main estrogen) and progesterone, and it is primarily these two hormones that are deficient after menopause.Deficient levels of the natural hormone testosterone are also possible after menopause.

Clinical studies have shown that HRT using these and other natural substances, rather than cross-species or synthetics are gentler and associated with fewer side effects. The dose is easier to precisely adjust to the proper dose for each individual. They can be administered in a variety of ways to suit each persons needs, including oral, sublingual (under the tongue) and topical (gel, cream or skin patch)

Following are some of the treatments available today with their ingredient. It is by no means a complete list of all that is obtainable from your physician.

Provera, Cycrin, Amen synthetic progesterone Progesterone Natural progesterone (soybeans or wild Mexican yams) Premarin cross-species estrogen Estra-Test Premarin plus synthetic testosterone Ogen & Ortho-est quasi-natural estrogens Estratab synthetic estrogen Prempro Premarin & Provara packaged together Estraderm (Climara or Vivelle) natural estrogen (estradiol) Estrone, Estrace natural estrogens Estriol weak natural estrogen Remifemin Black cohosh extract

Information taken from Dr. Christiane Northrup?s book; Women?s Bodies, Women?s Wisdom. Bantam Books, 1994

 

Natural or Alternative Solutions

 

What are some of the non-HRT methods of dealing with menopause?

Taking vitamin E is said to help, but it must be natural vitamin E, not synthetic. The ingredients list on the label should say D-Alpha Tocophenryl. If it says DL-Alpha Tocopheryl or has the word 'acetate' it's not what you want - it's synthetic.

Vitamins B5 and B6 are both good for hot flashes and other symptoms. A B-complex vitamin should also be taken to prevent the other B vitamins from becoming inbalanced.

Borage Oil, Evening Primrose Oil, and Flaxseed Oil are sources of essential fatty acids that help with many of the symptoms of menopause.

Others prefer the benefits of ginsing, dong quai and other herbs. But the overwhelming choice of many is Mexican yam cream. All of these things can be found at your local health food store. There are several good books that can help you make good decisions about which herbs to use for which symptoms.

 

What is 'Mexican yam cream', also know as Natural Progesterone?

Wild Mexican Yams contain diosgenin which can be converted into a progesterone that very closely matches the molecular structure of the progesterone produced by our own bodies.

Some women do experience side effectsfrom Mexican Yam cream or Progesterone cream such as: diarrhea, irritability, night sweats, PMS-type mood changes, muscle and joint aches. For many these symptoms are gone by the 3rd or 4th month of use. Others just need to decrease the amount of cream used.

 

The other hormones...... DHEA, Pregnenolone, Testosterone

According to Dr. Alan Gaby, in his book 'Preventing and Reversing Osteoporosis', "DHEA can be converted by the body into other hormones including estrogen and testosterone....In a study of postmenopausal women [Mortola and Yen, 1990, in J Clin Endocrin Metab], administering DHEA increased serum levels of both testosterone and estrogens (estradiol and estrone). Finally, DHEA may be capable of raising the levels of progesterone.....Both DHEA and progesterone are produced from the same precursor hormone, pregnenolone. If enough DHEA is present, then pregnenolone will be converted primarily to progesterone, rather than to DHEA." (page 164)

Gaby believes that more needs to be known about the interaction of DHEA and the other ovarian hormones (estrogens, progesterone, testosterone) and that combining DHEA supplementation with estrogen and progesterone would be a good thing to do, because lower doses of all of them could be used.

 

Testosterone in Women

Physiological Functions ascribed to Testosterone, in women:

  • Increased adrenal cortical androgen production at adrenarche triggers pubertal events including growth of pubic and axillary hair as well as emerging sexual libido.

  • Anabolic action including on bone density and muscle tone.

  • Heightened sensitivity of nipples and genitals and sexual libido.

  • Overall vitality and sense of psychological well-being.

Physiological Testosterone levels in premenopausal women:

Total testosterone: 25-70 ng/dl - Free testosterone: 0.7-2.0 pg/dl Circulating testerone in the premenopausal woman originates 25% from the ovaries, 25% from the adrenal and 50% from peripheral conversion of adrenal precursor androgens. Most of it (97 - 99%) is bound to sex hormone binding globulin (SHBG0 and therefore not biologically active. Only free, unbound testosterone can bind to cellular receptors.

Postmenopausal Testosterone deficiency:

Adrenal androgen production begins to decrease by the time a woman reaches her late 30s or early 40s by more than 50% as well. The reduction of adrenal testosterone production is especially significant for the approximately 35% of US women who have had a hysterectomy, which frequently results in ovarian failure due to impaired blood supply even in women who's ovaries were spared at the time of surgery. Symptoms of postmenopausal Testosterone deficiency include diminished sexual pleasure due to decreased sensitivity of breast and genital tissues, decreased orgastic response and decreassed libido. Women will also frequently present with symptoms of low energy and depression.

Adrenal androgen production begins to decrease by the time a woman reaches her late 30s or early 40s by more than 50% as well. The reduction of adrenal testosterone production is especially significant for the approximately 35% of US women who have had a hysterectomy, which frequently results in ovarian failure due to impaired blood supply even in women who's ovaries were spared at the time of surgery. Symptoms of postmenopausal Testosterone deficiency include diminished sexual pleasure due to decreased sensitivity of breast and genital tissues, decreased orgastic response and decreassed libido. Women will also frequently present with symptoms of low energy and depression.

Until the results of this and further studies become available, postmenopausal Testosterone replacement remains, although widely practiced, more an art than a science depending more on the woman's subjective response than any clearly measurable parameters.

Current routes of (?) include oral methyltestosterone, alone or in combination with estrogens, and compounded testosterone creams. Advocates of methyltestosterone point to the fact that it, unlike testosterone, is not converted into estrogen.

Concerns with Testosterone administration to women:

1. Hepatotoxicity Only huge doses of methyltestosterone far in excess of the commercially available estrogen-androgen combination products have been associated with hepatotoxicity. The hepatic safety of the doses used in women has been well established.

2. Lipids The addition of oral methyltestosterone has been shown to lower triglycerides, which is a beneficial effect that can be used to advantage in women suffering from hypertriglyceridemia. While totalk cholesterol and LDL are lowered just like with ERT alone. The lipid changtes in response to both oral and transdermal testosterone are quite varied among different women and while the ratio remains in the majority within the normal range, there are outlieres (?) that end up with a highly undesirable lipid profile. Lipid levels before starting testosterone supplementation and after the first few weeks are therefore a must.

3. Virilization Supplementation within the physiological range does not result in virilizing effects. Even at physiological doses some women will report and increase in acne and oil skin that will respond in most cases to further lowering of the dose.

The abstracts were taken from Medline and are as follows:

Estrogen-androgen for hormone refplacement. A review. Rosenbert MJ, King TD, Timmons MC JReprod Med 1997 Jul;42(7):394-404

Estrogen receptors: bioactivities and interactions with cell signaling pathways Katzenellenbogen BS Biol Reprod 1996 Feb;54(2):287-93

Antiestrogens: mechanisms of action and resistance in breast cancer Katzenellenbogen BS, Montano MM, Ekena, K, Herman ME Breast Cancer Res Treat 1997 May;44(1)23-38

Human estrogen receptor ligand activity inversion mutants: receptors that interpret antiestrogens as estrogens and estrogens as antiestrogens and discriminate among different antie- Montano MM, Ekens K, Krueger KD, Keller AL, Katzenellenboagen BS Mol Endocrinol 1996 Mar;10(3):230-42

A controlled trial of raloxifene (LY 139481) HCL: impact on bone turnover and serum lipid profile in healthy postmenopausal women. Draper MW, et al - J Bone Miner Res 1996 Jun;11(6):835-42

Clinical uses of antiestrogens Baker VLl, et al Obstet Gynecol Surv 1996 Jan;51(1):45-49

Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population based prospective stu Hokanson JE et al J Cardiovasc Risk 1996 Apr;3(2):213-9

Hypocholesterolemic activity of raloxifene (LY 139481): pharmqacological characterization as a selecticve estrogen receptor modulator. Kaauffman RF et al J. Pharmacol Exp Ther 1997 Jan;280(1):146-53

Antiestrogens: future prospects Howell A Oncology (Huntingt) 1997 Feb;11(2 Suppl1):59-64

Human estrogen receptor ligand activity inversion mutants: receptors that interpret antiestrogens as estrogens and estrogens as antiestrogens and discriminate among different antie Montano MM et al Mol Endocrinol 1996 Mar;10(3):230-42

Clinical potential of new antiestrogens Gradishar WJ J Clin Oncol 1997 Feb;15(2):840-52

Antiestrogens: mechanisms of action and resistance in breast cancer Katzenellenbogen BS Breast Can Res Treat 1997 May;44(1):23-38

Estrogen-androgen for hormone replacement. A review. Rosenbert MJ et al J Reprod Med 1997 Jul;42(7):394-404

Androgen and estrogen-androgen hormone replacement therapy: a review of the safety literature, 1941 to 1996 Gelfand MM et al Clin Ther 1997 May-Jun;19(3):383-404;discussion 367-8

The role of androgens in menopausal hormonal replacement Kaunitz AM Endocrinol Metab Clin North Am 1997 Jun;26(2):391-7

Androgen replacement therapy in women:myths and realities Casson PR Int J Fertil Menopausal Stud 1996 Jul-Aug;41(4):412-22

The article by Susan Rako: "Testosterone Deficience and Supplementation for Women: What Do We Need to Know?"

 

The articles found on these pages are for informational purposes only and not intended to take the place of professional medical care. Always check with your doctor before starting any new treatment.

 

 
 

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Some symptoms may also be associated with thyroid, heart disease and other medical conditions and your primary caregiver should be consulted.

The information found on these pages is for informational purposes only and not intended to take the place of professional medical care.

This site was created by Judy Bayliss, originator and owner of the Menopaus Email Support Group

Any questions or comments can be directed to :

menopaus-request@listserv.icors.org