the balance

By Dr. Amy Whittington, NMD

It’s likely just reading the title of this article triggered your feelings about the subject of hormone therapy for menopausal women and andropausal men. Many of you are likely to be happy, confident users of HRT (hormone replacement therapy). While, others may have deep-rooted, and sometimes justifiable, fears about such treatments.

Sadly, hormone therapy has become a divisive issue with practitioners and patients tending to fall on one side or the other without exception. But this doesn’t need to be so. While a small minority are not good candidates for some types of HRT based upon personal or family history, the vast majority of patients could benefit from hormone balance treatments. with ver y low risk. Such treatments can provide relief from nagging symptoms, and provide long-term benefits, helping to combat diseases such as dementia, osteoporosis, cardiovascular disease, and more.

Hormones begin to change for most as early as age 40, reaching their lowest levels during menopause for women and andropause for men. Women, often mistakenly equate menopause with simply hot flashes and mood swings. Although these symptoms can certainly be a part of the picture, menopause also commonly leads to insomnia, fatigue, low libido, weight gain, skin and hair changes, brain-fog, and flat affect (low mood). Unfortunately women often believe if they aren’t having hot flashes, they are not showing menopausal symptoms, and they do not pursue treatment, even if they are suffering in other ways. As a result, women are more commonly prescribed anti-depressants, lipidlowering medications, and sleeping pills to control symptoms related to the age-related decline of their hormones. Men, too, are typically only tested for testosterone levels if they have functional issues, leaving men who have had significant changes in sleep, energy, brain-clarity, and mood without effective treatment.

Making matters worse, HRT research history has been tumultuous during the past 20 years. We’ve seen vast changes in researchgathered risks versus benefits associated with hormone therapy. Unfortunately, way too many physicians still quote old, flawed research with regards to risks when discussing HRT options with patients.

In reality, hormone balance should be considered for increased quality of life, longevity, and increased healthy years as we age. Strong evidence shows hormone balance for men and women, especially if it is pursued close to the onset of menopause or andropause, results in lower rates of dementia, and cardiovascular disease, improved bone strength, and protection from colon cancer, to name a few. Conversely, studies associate lower testosterone levels in men with increased rates of diabetes, hypertension, and elevated cholesterol levels (these findings likely cross over to women as well).

In terms of risks, while cancer is serious and scary, cardiovascular disease remains the leading cause of death in the United States. We should consider it first before all others. The breast cancer risk for women treated with hormone therapy is believed to be increase by about 1 in 1,000 or less, meaning one more case of breast cancer for every 1,000 women treated versus untreated. This increased risk is equivalent to being overweight or consuming more than one glass of alcohol daily. These rates might be even lower with the addition of testosterone to the therapy which seems to have protective effects. Similarly for men, the connection between prostate cancer and testosterone therapy is no longer thought to be significant for most men. None of this is meant to make light of those who do carry increased risks for certain cancers. Family or personal history of hormone-sensitive cancers should be considered when evaluating each individual’s risks versus benefits. However, the risks are relatively low for most patients. This is, especially true when compared to the much more common risks for cardiovascular disease, dementia, osteoporosis, and quality of life decline.

There are many ways to receive BRHT (bio-identical hormone therapy) or HRT. Traditional standards of care still focus on oral use or patches for women, and injections or gels for men. There is strong evidence creams, gels, patches, and pellet versions of therapies lower risks more than oral or injection treatments. The most adequate and beneficial hormone treatment plans should also take into consideration the intricate balance of our most-common hormones, including estrogen (for men and women), testosterone, progesterone, Vitamin D, thyroid hormones, and adrenal hormones including cortisol. These hormones show protective benefits against risks when given together. Treatment considerations should also include the length of time since menopause and age. Risks and benefits, especially for estrogen, change over time. In nearly all cases, even if risks for an individual seem greater than benefits for a particular hormone, there are other options to help control symptoms and improve risk factors.

Whether hormone therapy should be considered is an individual decision between you and your providers. But, if you or your provider, have only negative connotations for even the consideration for HRT, it’s time to delve back into the research before decisions are hastily made. Too often, this option for treatment is not given, or is still perceived to carry risks that just aren’t significant for many of us. Too many menopausal and andropausal men don’t feel well; a treatment option is available that improves mood, sleep, energy, motivation, and lean tissue building, all while decreasing what are actually our most prominent age-related risks. n

Finding

DR. AMY

Dr. Amy publishes a monthly Wellness Journal on MyTrilogyLife.com, does presentations via Club Connect™, and provides individual consultations in Arizona.