Hormone replacement therapy for women - what you should know?

What is Hormone Imbalance?

Hormones exist in harmony with each other – partners in a delicate balancing act. When levels of each hormone are in the right proportions, body systems are stable. When balance is lost, hormone deficiencies and excesses can become toxic to the body causing unwanted symptoms, disorders and disease.

Hormones are extremely potent substances. It takes only a minute amount to initiate an action. Hormones are secreted into the bloodstream by the glands. From there, they travel to all parts of the body. But, only the cells sensitive to that hormone—called the target tissue–will respond to the chemical signal the hormone carries. Traveling through the blood, hormones enter cells through “receptor” sites, much as a key unlocks a door. Once inside, they get to work, flipping the switches that govern growth, development, and mental and physical functions throughout life.

All that changes when your hormones become unbalanced due to physical and emotional stress or the effects of aging. Signals do not reach the right place at the right time. Sometimes cell functions shut down completely. In other cases, cells are over stimulated. All this chaos causes unpleasant symptoms, at the very least. In severe situations, these imbalances can lead to chronic disorders or disease.

Most hormones cannot be stored in the cells of the body. Therefore, they must be made and released into the blood at the precise time they are needed. To maintain the intricate systems in which hormones operate, the body must constantly fine-tune hormone release to keep levels within proper limits. This balance is accomplished through an intricate series of positive and negative feedback mechanisms. For example, an overproduction of one hormone usually prompts the release of one or more complementary hormones in an effort to restore balance.

Because of the complexity of these interactions, a hormonal issue rarely stems from only one type of hormone. More often, the problem involves a series of hormones. In addition, a disruption in the balance of hormones produced by one gland or set of glands can cause other gland systems to malfunction. 

Female Hormone Imbalance

The Ovaries produce many hormones. Chief among them are estrogen, progesterone, and testosterone. The ovarian hormones estrogen and progesterone interact to coordinate a woman’s menstrual cycle during her reproductive years. The Brain produces the hormones follicle stimulating hormones (FSH) and luteinizing hormone (LH), which trigger hormone production from the ovaries. After menopause, hormones are supposed to be made in the Adrenal Gland, among other places.  

When any of the hormones coming from the Brain, Ovaries, or Adrenals are imbalanced, symptoms may occur. Imbalances are most common in puberty and menopause, but imbalances can happen at any age. Several conditions are well known to be associated with hormonal imbalance including: polycystic ovarian syndrome (PCOS), endometriosis, Fibrocystic and other breast diseases, and menstrual irregularities.

Symptoms of female hormone imbalance (in alphabetical order)

  • Acne or oily skin
  • Bloating
  • Bone loss
  • Decreased fertility
  • Depression 
  • Excess facial and body hair
  • Hot flashes
  • Heavy or painful periods
  • Irregular periods
  • Irritability
  • Loss of muscle mass 
  • Loss of scalp hair
  • Low libido
  • Memory lapses
  • Mood swings 
  • Nervousness
  • Night sweats 
  • Poor concentration
  • Sleep disturbances
  • Tender or fibrocystic breasts
  • Urinary incontinence
  • Vaginal dryness 
  • Weight gain

Male Hormone Imbalance

The Testes produce nearly 95% of all male testosterone. The balance is supplied by the Adrenal Glands. They also produce small amounts of estrogen. The Brain produces the pituitary hormones follicle stimulating hormone (FSH) and luteinizing hormone (LH) which trigger hormone production from the Testes. As a man gets older, testosterone levels fall and estrogen levels tend to rise. Lower testosterone levels may affect bone density, muscle strength, body composition and sex drive. The imbalance that occurs when testosterone is low in relation to estrogen may also contribute to prostate problems.

Symptoms of male hormone imbalance ( in alphabetical order)

  • Bone loss
  • Decreased mental clarity
  • Decreased muscle strength
  • Decreased stamina
  • Decreased urine flow 
  • Depression
  • Erectile dysfunction 
  • Hot flashes
  • Increased abdominal fat
  • Increased urge to urinate
  • Irritability
  • Low sex drive
  • Mood swings
  • Night sweats
  • Poor concentration
  • Sleep disturbances

Adrenal Imbalance

The Adrenal Glands produce three types of steroid hormones: glucocorticoids (cortisol), mineralocorticoids (aldosterone), and sex hormones (Testosterone, DHEA, Estrogens and Progesterone). Cortisol enables the body to respond and adapt to the stresses of daily life. It also helps to maintain blood sugar levels and promote a healthy immune system. Aldosterone works to balance salt and water in the body. Androgens secreted by the adrenals provide the majority of DHEA for both men and women. For women, the Adrenal glands are the major source of Testosterone throughout life. Estrogens and Progesterone are produced for both men and women and the Adrenal becomes one of the major sources of these hormones for women after menopause.  It is the major source of Testosterone for men after andropause.  Imbalances in the Adrenal system can contribute to problems with the nervous and immune systems, body composition difficulties, blood sugar irregularities, and hormone imbalances.

Symptoms of Adrenal imbalance ( in alphabetical order)

  • Allergies / asthma
  • Arthritis
  • Bone loss
  • Chemical sensitivities 
  • Morning/evening fatigue
  • High blood sugar
  • Increased abdominal fat
  • Memory lapses
  • Sleep disturbances 
  • Sugar cravings

Thyroid Function Imbalance

Thyroid hormones control the body’s metabolism. The brain produces thyroid stimulating hormone (TSH) which triggers the Thyroid gland to produce two types of hormones – T4 and T3. At the tissue level, T4 must be made into T3 to enter the cells and produce the desired effects.  In Hypothyroidism, the body has inadequate levels of the thyroid hormone T3, either because of inadequate production of T4 or poor conversion of T4 to T3. This often leads to imbalances in relation to other hormones. Hyperthyroidism is a less common condition that exists when excess thyroid hormones are present. Because every cell of the body is affected by thyroid hormones, symptoms of imbalances are often varied and affect multiple body systems.

Symptoms of low Thyroid function ( in alphabetical order)

  • Brittle hair and nails
  • Cold temperature intolerance 
  • Cold hands and feet
  • Constipation 
  • Decreased sweating
  • Depression
  • Dry skin
  • Fatigue
  • Inability to lose weight
  • Low libido
  • Menstrual irregularities 
  • Shortness of breath
  • Sluggishness
  • Weight gain

Symptoms of high thyroid function ( in alphabetical order)

  • Anxiety
  • Diarrhea
  • Eye/vision changes
  • Fatigue
  • Hair loss
  • Insomnia
  • Palpitations
  • Rapid heart beat
  • Sweating
  • Weakness
  • Weight loss

Insulin Imbalance

Insulin is secreted by the Pancreas. Insulin “unlocks” the cells to allow glucose (sugar) from food to enter and be converted into energy. When too much glucose is present in the body, the Pancreas increases the amount of insulin being produced. High insulin as well as high glucose may contribute to multiple symptoms. A number of conditions are associated with insulin and glucose imbalances and regulation problems. These include chronic stress, polycystic ovarian syndrome (PCOS), coronary artery disease, high blood pressure, metabolic syndrome, and diabetes.

Symptoms of insulin imbalance (in alphabetical order)

  • Abnormal blood cholesterol
  • Fatigue
  • High blood triglycerides
  • Increased abdominal fat
  • Increased hunger / sugar cravings
  • Low/high blood sugar
  • Poor circulation to extremities 
  • Skin changes

Testing

At the International Center for Health and Wellness, hormone imbalance is assessed by saliva and blood testing. 

Saliva testing is a convenient, inexpensive, and above all, accurate means of testing steroid hormones. Scientific studies have shown a strong correlation between steroid hormone levels in saliva and the amount of hormone in the blood that is active or “bioavailable.” It is this fraction of total hormone that is free to enter the target tissues in the brain, uterus, skin, breasts, bone and muscle.  Remember, it is the tissue levels of hormones that is important.  Blood tests have no relationship with tissue levels.  

Saliva testing can be done anywhere anytime. Testing that relies on blood drawn in the doctor’s office makes it harder to obtain samples at specific times (such as in the early morning) or multiple times during the day. In addition, hormones in saliva are exceptionally stable and can be stored at room temperature for up to a week without affecting the accuracy of the result. This offers maximum flexibility in sample collection and shipment. 

Hormones tested in the saliva profiles include: 

  • Estradiol
  • Progesterone
  • Testosterone
  • DHEA
  • Cortisol 
Blood testing, by either a serum sample or blood spot testing, is also very accurate for hormone testing, but requires that no topical hormones are being used. Thus, it is useful for baseline testing for diagnosis and monitoring of oral therapy only. The use of topical hormone therapy requires saliva testing for accurate monitoring of free hormone levels. Blood testing is not convenient for measuring free Cortisol levels multiple times during the day and can even be inaccurate when even a tourniquet is applied to draw the blood.

Treatment

At the International Center for Health and Wellness, we believe hormone imbalance can be corrected. When this is done naturally and with the correct monitoring, symptoms either disappear or are greatly reduced. The most important step in this process is a thorough history, physical exam, and laboratory evaluation. If there are nutritional or vitamin deficiencies, sleep disorder, lack of exercise, excessive stress, or toxin exposure, then these must be corrected first. It is important to not ignore the basics of health. 

The next step is to correct underlying Adrenal and Thyroid imbalance as these affect every other gland and hormone in the body. Only after all of this is being corrected can we begin to balance the female and male hormones.

Hormones can be replaced when deficient. It is important, given cancer fears and other concerns over side effects, to become well informed about the risks and benefits of treatment. The safest approach is to use the least amount of hormone that produces the desired effects, while carefully monitoring blood and saliva levels to insure that the hormones are not over-corrected. “Bioidentical” hormones, from plant sources that mimic human hormones, appear to be safer, but still require appropriate monitoring. Hormones can be delivered topically, under the tongue, or orally, each having advantages for specific patients. The most important factor is being comfortable with the method of delivery and being consistent with the administration, being careful not to exceed the dosing.