Bio-identical Hormone Replacementsam
by Dr. Thomas Alexander
Once one understands that the sex hormones function like a part of a complex hormonal orchestra, the art of replacing hormones becomes straightforward. In the past mistakes have been made in equating all estrogens as the same. Now these subtle nuances are understood, and there are numerous tests available to measure the levels of all these different hormones in the human body. As always for me and my staff, safety is my number one priority in using this modality of treatment. By getting a sound understanding of the facts, we aim to provide replacement in the safest possible way while getting maximum benefit.
Suzanne Somers popularized bio-identical hormone replacement in her book Breakthrough, and introduced true hormone replacement therapy to millions more in her book Ageless.Interestingly bio-identical hormone replacement was pioneered by Dr. Jonathan Wright in 1982, but no one really paid attention til Ms. Somers became a patient, and then sang his praises repeatedly in her books.
I was privileged to work with Dr. Wright for three years. And with his mentoring, incorporated his 28 years of experience into my understanding of this field of Endocrinology.
The major hormones in a woman’s body are estrogens and progesterone. Estrogens get the attention because by nature they tend to be thought of as the women’s hormones, but the role of progesterone is invaluable and vital in the human body.
Progesterone keeps the body and mind calm and is vital to offset the many problems that unopposed estrogens could cause. Progesterone is an upstream hormone which means estrogen’s, testosterone and many other hormones are made from progesterone. Progesterone maintains the lining of the uterus supports survival of the embryo and the fetus in pregnancy, helps utilize fat for energy, supports thyroid function, helps eliminate sodium and water (diuretic) , preserves and calms nerve and even helps you sleep.
Many women are well familiar with the symptoms of progesterone deficiency that include PMS, heavy bleeding, cramps, all the symptoms of excessive estrogens (discussed later) including tender and fibrocystic breasts, irritability and sleep disturbances. Most women who are approaching menopause lose progesterone before they lose estrogen.
Estrogens are more complicated because they are a group of hormones rather than a single hormone. There are more than twenty different estrogenic compounds made in the human body and hundreds more found in the environment – both natural and man-made. The three most common estrogens found in the human body are estriol, estradiol and estrone. So it is important to not just have good levels of estrogen in the human body but also the relative proportions of the different estrogens.
Estradiol is the most publicized of the estrogens and is often referred to as the dominant estrogen in the human body. It is the estrogen that most impacts reproductive and sexual functioning and has effects on strengthening bone and preventing osteoporosis, supports brain function and mood, maintains elasticity of the skin, improves the function of the lining of your blood vessels (endothelium) and hence prevents heart disease, increases your good cholesterol and keeps your body young to name just a few! On the flip side estradiol has a stimulating effect on certain cells in the body, most famously on breast tissue and hence too much or unbalanced estradiol can have harmful effects. Symptoms of hot flashes are most specifically due to low estradiol levels. The reason many women experience changes in their mental functioning at menopause is because the positive effect of estradiol on brain function is lost. Too much estradiol on the other hand will lead to conversion to estrone and the symptoms of estrogen dominance discussed below.
Estriol is the calming protective estrogen and is believed to even have a protective effect on breast tissue and possibly prevent breast cancer. The only part of the body that estriol has a stimulating effect on is the uterus. That is why vaginal dryness usually signifies a lack of estriol and too much of it can cause thickening of the lining of the uterus.
Estrone is probably the strongest of the estrogens and can cause a significant effect on stimulation of breast tissue. Too much estradiol in the body will lead to its conversion to estrone. This will cause a collection of symptoms termed Estrogen Dominance. Symptoms of estrogen dominance are heavy and irregular periods, breast tenderness, painful lumps in the breast, fibrocystic breasts, weight gain around the hips and the thighs, water retention and bloating, PMS and fibroids in the uterus.
Finally there is testosterone, considered the male hormone, but the reality is that both men and women have and need testosterone. It is only the relative proportions of each that varies. Men have much more testosterone, but even the smaller amount of testosterone that is in women is important in maintaining libido and sex drive. A decrease in sex drive in women is most often a lack of testosterone.
Bio-identical Hormone Replacement:Once one understands that the sex hormones function like a part of a complex hormonal orchestra, the art of replacing hormones becomes straightforward. In the past mistakes have been made in equating all estrogens as the same. Now these subtle nuances are understood, and there are numerous tests available to measure the levels of all these different hormones in the human body. As always for me and my staff, safety is my number one priority in using this modality of treatment. By getting a sound understanding of the facts, we aim to provide replacement in the safest possible way while getting maximum benefit.
About the author:
Dr. Thomas Alexander is part of a new breed of doctors who specialize in wellness and prevention as a means of keeping people healthy rather than palliative treatment of symptoms. He believes in looking at the whole individual, their means of interacting with their environment, and the consequences of poor daily choices on health. His treatment is backed by studies that have documented the powerful effect of changing our health by making simple lifestyle choices. Not only is this approach potent for maintaining health but also for combating chronic diseases that were once thought to be purely due to age-related degeneration. Dr. Alexander chooses to view things holistically, but his interests lay in diabetes, autoimmune conditions, weight loss, adrenal problems, male & female hormonal issues, cardiovascular disease and gastrointestinal problems.
After practicing in a mainstream medical clinic for five years, he was better able to appreciate the drawbacks and the strengths of the current approach to medicine. It was his three year stint working under Dr. Jonathan Wright (pioneer in Integrative Medicine and founder of using Bio-identical Hormones in North America) that aided him in his quest for a more holistic and preemptive approach to treating patients.
Thomas Alexander received his MD and served as a resident in Internal Medicine at the University of Missouri, Kansas City in 1998. He then did ten months of an Endocrinology Fellowship before joining a medical practice in Butler, Missouri. He previously practiced both inpatient and outpatient medicine in addition to working at the Emergency Department. He is a board certified doctor of Internal Medicine. Thomas currently resides in Scottsdale, AZ, where he founded his practice. http://drthomasalexander.com/