Your Hormones: Why You Need Them, Why You Can't Live Without Them
by Mike Bauerschmidt, M.D., C.C.T.
We human beings are a curious bunch. By “curious” I mean, not only that we want to know why things happen, how things happen or why they happen when they do; I also mean that we can be strange and peculiar. Nowhere is this demonstrated more truly than in the field of aging.
Isn’t it curious that we begin life, and travel through life very similar to Shakespeare’s seven ages of man? We begin as helpless infants with little knowledge. We travel through life gaining experience and wisdom only to encounter our end-of-life as remembering little, and being equally helpless. Are we destined to end life this way? I think not! I would like to take the time now to explain our best ideas as to why we age, and address at least one of the ways that we can age more gracefully, ending our lives as fully and vibrantly as we can.
Why We Age
We know from the study of our somatic cells (the cells that are used to make up our different organs) that we should be capable of living between 120 and 150 years. This is why I maintain that middle age begins at 60. I recently moved that number to 75. We are constantly in a state of growth and/or repair. So when and why does our growth and repair become breakdown and despair?
When, depends on how well we have treated our bodies. Why, is a function of things called telomeres. Telomeres are like the caps on the end of your shoelace. Each time our cells need to grow and repair, these telomeres unravel and allow our DNA to open so that the new instructions for growth and or repair can be executed. So, the good news is that we theoretically have the capacity to live forever. However, the bad news is that these telomeres do not last forever. Each time they’re asked to unravel they lose a little piece of themselves. So, in essence, they are the rate limiting factor for how long we live. Therefore, the best way for us to live a long and healthy life is to treat our bodies as best we can and reduce the rate at which we require repair work. Here at Riordan Clinic our goal is to provide the best environment that we can for your body to continue to grow, develop, and age with grace and ease. Bioidentical hormones help us age with that grace and ease.
What Are Hormones?
Unlike vitamins, minerals, and enzymes that are the cofactors, we need to turn our food into energy and building blocks; hormones are the chemical messengers that our body needs to tell our cells what to do. Think of the difference like your state Department of Transportation road workers. Your vitamins are the actual guys out there slinging the shovels and filling the potholes. Your hormones are the guys telling the workers which holes to fill. Without your hormones you just have a bunch of guys standing around leaning on their shovels.
Hormones also come in a variety of shapes and sizes! Your thyroid hormones, which Dr. Ron has talked about, manage your metabolic rate. Your appetite command and control hormones, which Dr. K has talked about, manage when you feel hungry and when you feel full. There are still other hormones that let you know when it is OK to sleep and when to wake up, when to be fearful and when to be happy, when to build bone and when to release calcium from bone, you get the idea. The one thing all these hormones have in common is that they all pretty much work until you die. Not so for the hormones most involved in the aging process: estrogen, progesterone and testosterone. Unfortunately they take a permanent vacation when women enter menopause and men begin andropause. But just because they leave doesn’t mean you don’t need them anymore!
Why You Need Them
There is not a single cell in your body that does not have a receptor site for your hormones. Granted, some have more receptor sites than others; however, they all have them. Remember the analogy of the road workers. Without your hormones telling your cells what to do, your cells, like the road workers, sit and do nothing, or worse, they just quit and walk off the job—forever! Why do you think women get a thing called post menopausal osteoporosis? And why is it that the risk for heart disease, stroke and cancer go up in women after menopause? It isn’t because they got it when they were 20 years old. So, if they are so important why haven’t we heard of them before? Mostly for two reasons:
- Not so long ago (three generations at most) many, if not most, women did not live much past menopause
- There wasn’t a whole lot we could do about it anyway. That is until Jonathan Wright, MD, and Daved Rosensweet, MD, and others like them, came up with a way to deliver hormones safely and effectively.
Hormones, Safety and the Women’s Health Initiative
Say what you will about drug companies, they are good at one thing: coming up with ways to sell products that we don’t need or that are patently dangerous,requiring us to use more stuff we don’t need. Pregnant Mares Urine, commonly known as Premarin, and its equally evil counterpart, the synthetic progestin Provera, are two such products. Premarin, being equine derived, has 5 – 20 times the potency of our normal bioidentical estrogens. Consider once again our road workers, out in the hot summer sun with boiling asphalt being quite literally flogged into their jobs. How long are they going to last? So, while Premarin was very good at soothing the symptoms of menopause, it exacted a pretty heavy price on a cellular level. The companies then developed Provera to balance the effects of the Premarin on the lining of uterus. Actually, that was a pretty good idea, in theory. However, like the Premarin, the Provera was a synthetic imitator of our real progesterone.
The short answer to all this resulted in a study entitled The Women’s Health Initiative that looked at the potential down side to using Premarin alone, and Premarin and Progesterone together, in the drug known as PremPro. The results were that while the symptoms of menopause were alleviated, and women felt and looked better and retained much of their youth; certain “side effects” like stroke, heart disease, and cancer went up in the women on the PremPro therapy. This effect seemed to be due primarily to the Provera component of therapy. The result was that Hormone Replacement Therapy was relegated to short term use to manage the acute symptoms of menopause. Unfortunately, the use of Bioidentical Hormone Replacement (BHRT) was not looked at in the study and the baby got thrown out with the bath water.
Bioidentical Hormone Replacement Therapy
So does BHRT work and how do we use it? If you look at the thousands of patients who have been using BHRT since Jonathan Wright, MD, and Daved Rosensweet, MD, and others started more than 30 years ago, it quickly becomes evident that, yes, BHRT does indeed work. Patients, both male and female, who use BHRT report improved health, well-being and demonstrate reduced incidence of things like osteoporosis, aging skin, loss of libido, loss of muscle mass, brain fog, sleep disorders, as well as reduced incidence of heart attacks and strokes.
Initially, it was felt that we needed to restore women’s hormones to levels that were present when they were menstruating and cycle in a similar fashion to that period of time. However, with time we found that the use of the same daily dose that does not cause vaginal bleeding, achieves the same affects without the complexity of a regimen that varies throughout the month. In women, we’re basically targeting that sweet spot between good vaginal health and breast tenderness. We find that when we are in that sweet spot that all the other problems associated with lack of hormones also disappear. Further, from studies looking at 24- hour urine tests, we have found that we are indeed restoring hormone levels to those equal to when women were menstruating, without causing recurrence of their periods.
This is not to say that there is no debate about the best way to use or apply them. My personal belief is that we want to mimic nature whenever possible. Hormones are generally secreted by the organs that create them, directly into the bloodstream and circulated throughout the body before they are processed by the liver. To mimic this, it is best to use hormones as either creams, for application to the skin or vagina, or as organic oils applied directly to the skin. There are practitioners that use subcutaneous implants. However, I find these to be not only invasive, but also impossible to control in the event that small adjustments in dosage are necessary. Other practitioners use troches or capsules. I find these to be better than the implants; however, anything that is placed in the mouth and therefore to a degree swallowed, has to pass through the liver first. In this case, they do not mimic nature and they have the potential to become more toxic metabolites before they are excreted. For these reasons, I favor creams or oils as the best delivery system that offers me the ability to fine tune dosage, as well as avoid unnecessary side effects.
As with any therapy, monitoring is essential to protect and optimize your health. And, just like the delivery system, there are several ways to see how your body is metabolizing your hormones. My preferred method is a 24-hour urine test. This looks not only at your three most important estrogens, as well as testosterone and progesterone. It also looks at the myriad metabolites that can be biologically active in your system. The bonus is that we also get a look at your stress hormone levels, cortisol and cortisone, with their metabolites. For those who don’t like sitting around the house collecting their urine all day, we can do blood tests to look at many of the hormone levels, but not so many of their metabolites. While useful, it does not give me the same depth of information that the urine does. Finally, there are salivary hormone levels that can be measured; however, no one has ever been able to tell me how hormones are excreted in the saliva, or assure me that these are a direct reflection of what is actually happening in the body. Therefore, I generally do not use these measures.
Hormones are absolutely essential if we are to live a long healthy life with grace and ease. BHRT is a safe and effective way to deliver those needed cellular messengers and can be used in both men and women. Appropriate monitoring is essential to ensure safety. Regular follow-up care is essential to ensure effectiveness. With a little bit of effort, the results can be absolutely amazing. And they can be used even years after menopause or andropause. In fact, Dr. Rosensweet is currently conducting a study using bioidentical hormone replacement in a much lower dose for women over the age of 75, who are suffering with issues of memory, loss of muscle strength, or general physical debility. The initial results have been very gratifying.
The bottom line is that:
- We need our hormones
- We don’t lose our hormones because we get old; we get old because we lose our hormones.
- We don’t have to suffer because of our age.
There is a simple solution. That solution is BHRT. Schedule an appointment so that we can show you how to live your life with grace and ease.