Hormone replacement therapy allows for life enjoyment after menopause. Why Bio-Identical hormones? Dr. Ianculovici in Wall Township NJ Explains

Hormone replacement therapy allows for life enjoyment after menopause. Why Bio-Identical hormone? Dr. Ianculovivi in Wall Township NJ Explains

Aging presents to both men and women with many undesirable symptoms, such as skin, hair, and nails changes, loss of muscle mass, diminished bone density, joint pain, memory impairment, vision problems, sexual dysfunction, cardiovascular disease, insulin resistance, inflammation, decrease in thyroid and adrenal function, just to name a few. Although hormonal changes are delayed and don't present with such severe symptoms in men, they are certainly not precluded from these changes.

In women, however, the hormonal decline starts during perimenopause and the symptoms could be debilitating. Statistics show a significantly increased rate of divorce around the age of menopause. In interviewing divorced men, I learned from the majority that the couple drifted apart around the time she experienced menopause. Armed with this information and my knowledge of hormone replacement therapy, I am striving to help anyone who wants to be helped. The hormone stigma started with the misinterpretation of The Women's Health Initiative (WHI) HRT Study by biased sources.

The study found that women who took Prempro (not Premarin alone) had a 26% increase in the risk of developing breast cancer; 29% increased risk of heart attack; 41% increased risk of stroke, and double the risk of developing blood clots. These were considered “statistically significant” increases in risk, but in spite of how frightening it sounds when written as percentages, it’s actually really only a slightly increased risk in “absolute” terms. Only 2.5% of women in the estrogen plus progestin study had these health events.

It is however worth mentioning that the study was conducted using equine estrogen and synthetic progesterone.

What is the difference?

It is estimated that one-half of women quit taking their synthetic hormone replacement therapy after one year because they are unable to tolerate the side effects. Synthetic estrogen is not the same chemical structure of estrogen that the patient’s body was born with. Synthetic hormones waste energy by giving incomplete messages to cells which then fail to produce a balanced hormonal response.

What the heck is synthetic/equine estrogen?

Most common synthetic estrogens available woldwide are: Estrone, Sodium equilin sulfate, and Concomitant components: 17 alpha-dihydroequilin, 17 alpha-estradiol, and 17 beta-dihydroequili

Equine estrogen like Premarin is derived from pregnant mare urine. The horse and the woman are significantly different in many ways. Female horse urine contains more than 10 different forms of estrogens, including estrone sulfate (E1) as the primary form of estrogen, and only a minimal level of estradiol (E2). Remember that the female human body naturally produces just 3 types of estrogen: E1 (estrone), E2 (estradiol), and E3 (estriol), and in different ratios than female horses.

It is not surprising that these 10 different forms of estrogen (along with different ratios and strengths) might impact the human body in an unhealthy manner.

Sure enough, the Premarin used in the WHI study was shown to increase the risk of endometrial hyperplasia and endometrial cancer in women with a uterus.

If that wasn’t enough, conjugated equine estrogen (CEE) was also shown to increase the risk of blood clots, cardiovascular disease, and breast cancer (when combined with progestin in older women), however bioidentical progesterone does not seem to have this effect and is even thought to be protective. CEE also seems to lower nitric oxide, leading to potential vascular events.

Since the publication of the WHI study, CEEs have begun to fall out of favor relative to bioidentical estradiol (E2), which is the most widely used form of estrogen for menopausal hormone therapy.

Natural estrogen means that it has the same chemical structure that the patient produced naturally. Bio-identical hormones like natural estrogen help protect against endothelial dysfunction by increasing endothelial nitric oxide. Endothelial nitric oxide synthase is a crucial enzyme involved in the production of nitric oxide in endothelial cells. Nitric oxide is the key to longevity and health. The study by Novensa, L., et al., “Equine estrogens impair nitric oxide production and endothelial nitric oxide synthase transcription in human endothelial cells compared with the natural 17(beta)-estradiol,” Hypertension 2010; 56(3):405-11), showed that compared to natural estrogen, gene transcription of endothelial nitric oxide synthase was 30 to 50% lower inresponse to equine estrogens.

What does that tell us?

ESTROGEN: THE GOOD

Appropriate levels of estrogen provide more than 400 functions in the body!

Breast development

Fat storage
Growth of the uterine lining
Maintenance of collagen in the skin and connective tissues (who doesn’t love this part?)
Support of neurotransmitters (aka serotonin and dopamine, our happy brain chemicals)
Relief of symptoms (mostly forgetfulness, hot flashes, night sweats, dryness of the skin in he post-menopausal years)
Prevention of memory loss
Protection of heart health
Protection of bone health
Anti-aging effects
Prevention of cancer

Estrogens are life altering hormones.

Once you regain your balance after 3 months of use, you will never look back.

While on hormones, your health status will be closely monitored.

Small horomonal adjustments can save your relationships, due to the positive effect they exert on your mental and physical health.

ESTROGEN: THE BAD

The WHI study showed estrogen replacement may come with health risks.

The bio-identical estrogen must be compounded and is not covered by insurance.

Compounding pharmacies vary in the quality of product they compound. The base in which the hormones are placed and the quality of the hormones are game changers. You might hear of cheaper options, but buyer beware.

Compounded estrogen needs to be applied transdermally and massaged into the skin for 2 full minutes, because it does take that long for the medication to absorb.

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