Estrogen has become a tricky problem for many women in the present day. There are many conflicting studies -- depression studies, dementia studies, menopause studies, and more. There are a number of different kinds of estrogen; pharmaceutical estradiol comes from plant molecules modified in a lab.
There’s also Premarin and Prempro, which are manufactured from the urine of pregnant mares. Writing in the New York Times, Cynthia Gorney, who teaches at the Graduate School of Journalism at the University of California, Berkeley, discusses her personal experiences and attempts to learn more about the hormone.
SourcesNew York Times April 12, 2010
Dr. Mercola's Comments:
Hormone replacement is a hot topic in medicine right now, largely because it holds the promise to relieve symptoms and slow down some of the signs of aging for menopausal women.
But this is a complex topic, one that threatens the health of many women who choose to take synthetic hormones to relieve hot flashes, mood swings and other menopausal symptoms.
First, it’s important to realize that natural menopause is not a disease that requires treatment, as many would have you believe. It’s a natural and normal event in every woman’s life that occurs when you stop having your period.
Menopause is typically related to aging, and generally occurs around the age of 50. But it can also be due to a number of other circumstances. Surgically induced menopause, for example, occurs if you have your ovaries removed and typically requires bioidentical hormone replacement to resolve the acute loss of hormone support..
There are a number of symptoms associated with menopause, which makes it such an important topic for many women – probably the most debilitating of which are hot flashes and, for some women, depression. So it’s important to have an effective strategy to deal with those symptoms.
But is hormone replacement the answer?
What Women Need to Know About Estrogen Replacement Therapy
You may not realize this, but after finishing my medical residency training in the mid-80s, I was a paid speaker for the drug companies. I was actually paid to lecture physicians about estrogen replacement therapy because, at the time, I was convinced it was a great strategy for menopausal women, since it was replacing their hormones.
I still believe replacing your hormones can be a good strategy. But in my journey of learning about and truly coming to understand health, I’ve realized that using synthetic hormones, and even natural hormones from animals, is not a wise choice -- as have most of the conventional medical establishment, this is now common knowledge.
The following prescriptions now have black box warnings and need to be avoided 1.Premarin. Premarin is an estrogen extracted from Pregnant Mare’s Urine. We now know it is associated with an increased risk of heart disease.
2.Estrogen Therapy. Estrogen, which is extracted from Premarin, was effective in combating some menopausal symptoms but proved to have serious, negative side effects, such as the increased risk of breast cancer and an increase in insulin levels.
3.Provera. This drug is a progestin or a synthetic form of progesterone, which probably makes it even more toxic than Premarin. Its well-documented, negative side effects include blood clotting
In addition, long-term usage studies revealed many other negative side effects of HRT, including high blood pressure and vaginal bleeding.
And a year after millions of women quit taking hormone replacement therapy, incidents of breast cancer fell dramatically -- by 7 percent!
So clearly, you do not want to be on any one of these synthetic options to treat your menopausal symptoms -- but there is an alternative option out there.
Natural, Bioidentical Hormones
Bioidentical hormones are natural hormones that are “bioidentical” to your own. The bioidentical that is prescribed 80 percent of the time is estriol. It’s natural, not a drug, and you get it at compounding pharmacies.
Estriol has been used safely for decades, and I believe it’s particularly useful when your ovaries have been removed or you’ve had a hysterectomy. Dr. Johathan Wright, who I’ve interviewed many times, is a pioneer in bioidenticals, and you can see what he has to say about their value in this short video.
Keep in mind that when it comes to administering bioidentical hormones, some delivery methods are clearly superior to others.
Oral supplementation is perhaps your worst option, as your liver processes everything in your digestive tract first, before it enters your bloodstream. Any method that bypasses your liver will therefore be more effective.
Hormone creams are one common alternative that achieves this. However, since hormones are fat-soluble, they can build up in your fatty tissues and lead to having too much in your body. This in turn can disrupt other hormones. It’s also near impossible to accurately determine the dose when using a cream.
Sublingual drops seem to offer the best of both worlds, as it enters your blood stream directly and will not build up in your tissues like the cream can. It’s also much easier to determine the dose you’re taking, as each drop is about one milligram.
Beware of FDA-Approved “Knockoffs”
You should know, too, that although not an FDA-approved drug, the FDA has proposed to allow estriol-containing prescriptions to be filled if they’re accompanied by an Investigational New Drug (IND) application, if and when a physician believes it’s in the patient’s best interest.
However, the IND places a significant financial burden on physicians, most notably by requiring them to submit applications to an Institutional Review Boards (IRB).
This process effectively bans most prescriptions for estriol.
Meanwhile, the FDA is in the process of considering the approval of Trimesta, a knock-off of natural estriol. Clearly, the FDA has never been concerned with estriol being used in an unsafe manner -- they were concerned that their drug-company buddies were not getting their fair share of the profits.
Aside from the obvious bias, this is even more troubling because Trimesta may not be a safe version of natural estriol.
What to do BEFORE Taking Hormones of Any Kind
Natural bioidentical hormones can offer relief from menopausal symptoms, but they should not be your first go-to option.
Treating hormone imbalances requires a whole-body approach; the best approaches are often preventive and involve diet, exercise and other lifestyle-based strategies.
For instance, both estrogen and progesterone are necessary in the female cycle, and their balance is key for optimal health. Many women have an imbalance of these hormones, regardless of their age. And if you have insufficient levels of progesterone to counter excessive estrogen, this imbalance can be further exacerbated by chronic stress.
So your answer might not necessarily lie in using hormones, but rather addressing your stress levels so that your body can normalize your hormone levels naturally.
Likewise, eating right for your nutritional type and exercising regularly can go a long way to keeping your hormones balanced as you age.
Refined carbohydrates, processed and heated fats, empty foods -- and too much of it -- all serve to raise your estrogen to abnormal levels, as much as twice the normal, which are maintained for the better part of the adult lives of most American women. This is a MAJOR contributing cause of menopausal symptoms in the first place.
Consuming plenty of phytoestrogens (plant-estrogens) such as licorice and alfalfa before menopause can also help moderate your day-to-day estrogen levels so that when menopause comes, the drop won’t be so dramatic. (Beware, however, that soy is not a good option here.)
You’ll also want to make sure your vitamin D levels are optimized, as this is a must for gene regulation and optimal health. For more information, I recommend you watch my one-hour video lecture on this essential nutrient.
Certain polyphenols have also been shown to have some HRT-like benefits without the drawbacks, and are associated with a lowered risk of heart disease. Royal Macha seems to be an amazing adaptogenic herbal solution for menopause that has helped many women. Be sure to avoid the inexpensive varieties, as they typically don’t work. If you chose this option make sure to obtain the authentic version from Peru.
You’ll also want to get plenty high quality animal-based omega-3 fats, such as krill oil, and Black Cohosh may help regulate body temperature and hot flashes.
In many cases, these lifestyle strategies will be very effective in relieving menopausal symptoms, but in cases where it is not enough, bioidentical hormones may be able to help.
However, you’ll want to make sure you get your hormonal levels checked properly before embarking on any kind of hormone supplementation program, and work with a knowledgeable health care practitioner who can guide you.