It's Not Just About the Ovaries

Women are driving the ship of Bio-identical hormone therapy more than ever before.  Honk Honk!!  Let me just pause there for a HIGH FIVE!!  The momentum is gaining to the point that pharmaceutical companies are beginning to strong arm insurance companies in efforts to combat the abandonment of the synthetic regimens of years gone by.  Their wallets are getting thinner because of individualized and customized medicine, that WORKS!! I had a call yesterday from a long standing patient who received a letter in the mail that her custom therapy would no longer be covered by her private insurance plan.  Boo-Hiss!!  Those are fighting words I tell you and there's nothing like telling a peri-menopausal woman that she can't have something anymore that she loves and that makes her feel better.  She simply wanted answers and I don't blame her.  I had my hand up saying the "Amens" right there with her. Remember, I'm a bio-identical hormone user MYSELF.  Truth!  I immediately directed her to call her insurance company and ask them to explain why.  I absolutely love that the new force to be reckoned with in this hormonal balancing field of medicine are a brigade of believers with ranks including stay-at-home moms, executives, laborers, physicians and practitioners (believe me, I have many), stage performers, menopausers, peri-menopausers, and young women who just want some good options in treating their symptoms and needs.  Years ago, I had to do a lot of the fighting myself for people.  Uh, not so much anymore and I love that.   Turn the women loose!!

Hormones are where it's at, my blog friends.  I have never seen so many clear cut studies coming out supporting the role of hormonal balance in overall health, improved mortality, cognitive function, bone health, reduction of other disease risks, and in longevity.  A staff member recently brought in a popular magazine article with the title,  "I knew I shouldn't feel this tired."  The article focused on adrenal fatigue, low DHEA and cortisol, and the impact that it had on this woman's life.  I excitedly read it for myself and proclaimed, "That's what I'm talkin' 'bout!"  (My team is used to me and they know I love that kind of stuff)  I'm especially excited because this is hitting the media and press in every form.  I still have Oprah's magazine in my office from 2009 where she shares her personal story about hormonal imbalance.  From about that time forward, I have seen a tremendous amount of growth and attention to this area of health and wellness.  And, I didn't go back to school because I didn't think this would happen.  I'm now buckling my seat beat and enjoying the new drivers at the wheel of their (and their families) healthcare.  Drive on, ladies!

Today, as an example of the importance of this, I want to highlight one key hormone that can't be ignored for the aging woman.  Progesterone is a BIG player in the female scheme of things, and typically the first hormone to go down, down, down with aging.  Although the ovaries are the powerhouse of production for sex hormones, that decline of progesterone and other hormones can have a significant impact on HEART health.  We can live without ovaries ladies, but we cannot live without our heart.....and we can't deny what the studies are showing us.  It's time to talk hormones and heart disease like never before.

At menopause (avg age of 51), the levels of estrogens, progesterone, and testosterone, secreted by the ovaries, decrease considerably.  In a woman's third decade of life and up to about 50 years old, progesterone can drop by up to 75%.  Whoa!  That should get your attention.  And, if you have had a hysterectomy with ovaries removed, just consider yourself right there on the quick hill of decline with those who are going through menopause naturally.  Here's something you need to know.  Progesterone is not the same as the 'synthetic and pharmaceutical company version' called medroxyprogesterone.  There's an added prefix to that name for a reason and it's because it's not a true replica of what the body produces on it's own.  Add a methyl, get a patent!! Although they sound similar, their similarity ends there.  The methyl group addition at C-6 in the structure (pardon me for the organic chemistry lesson but I think it's important) is ABSENT with progesterone.  Studies show us that this little switcheroo does not provide the benefit that progesterone does to our body. 

Remember that progesterone is a pro-gestational hormone.  It is KEY in sustaining a pregnancy, impacting fertility, regulating menstrual cycles and the list goes on and on.  Conversely, medroxy-progesterone is teratogenic and contraindicated in pregnancy.  Say what??? Are you seeing this picture???  I hope so!  One cannot reasonably be substituted for the other in pregnancy, but also as a general rule in providing hormone replacement therapy (in my professional opinion).  I'll take progesterone, hold the methyl please!!   You must also know that Progesterone is essential in the production of other hormones.  (ie. cortisol, aldosterone, estrogens, testosterone, etc. etc.)  We need ALL of these hormones working on our behalf and progesterone is the necessary start of the steroid production pathway.  Take a look at a hormone synthesis chart and you'll see progesterone near the top.  You will quickly realize (hopefully) that you don't want to use a synthetic substitute!! 

Remember the title of this blog.  It's not just about the ovaries.  It's not!  Heart Disease is the number ONE cause of death in women.  Not cancer!  And, I repeat, not cancer!  In many studies to date, we are seeing evidence that progesterone (NOT medroxy-PG) added to estrogen can have a complimentary role in protecting the heart and other health improving markers.  Cholesterol profiles improve, treadmill exercise times improve, a natural diuretic effect occurs, and blood pressure profiles improve.  Conversely, medroxyprogesterone consistently shows negative effects when tracked in studies.  Now that's getting down to the "heart" of the hormone matter if you ask me. In other matters, progesterone can help re-establish menstrual cycles, provide sedation for those suffering from insomnia, and acts as a anti-anxiety agent to most everyone I talk to in my care.  I can verify that during my days on cycle progesterone therapy, I feel more at ease, less bloated, and sleep without those crummy sweats that tend to creep up in those golden peri-menopausal years.   I don't mind sharing my own experiences because I know that it will help others feel comfortable in getting the help that they need.  But, I'm sure you don't have any aging symptoms going on for yourself, right?  (wink wink)

Hormonal balance is one of the areas of my expertise that I love working in the most.  If you could sit in this office and hear the benefits that women share back, you would easily understand why it's so rewarding.  I'm convinced that it's the right thing to do.  From the young woman struggling with PMS, PCOS, or irregular cycles, to the post-menopausal woman noticing that she's foggy in mind, gaining tremendous weight, and has no energy to perform daily tasks, our team can help give insight to all ages and all stages of aging and guide you through testing.  It's easy and affordable to see how well you are doing on the hormone measuring scales.  I'm not sure why you would wait to be checked if you are suspicious that your problems are a direct result of hormonal imbalance.  Perhaps it's time for YOU to get back to normal. 

To your good hormone health,
Dr. Sonja