Do I Need Hormones?

1. Do I Need Hormones? Dr Johnnie Ham, MD Coastal Prestige Medical Services and Clinic Pismo Beach, California

2. What are Hormones? • Hormones are BioChemical Messengers • Hormones control numerous functions in the body • One of the Two Major Controllers in your body

4. Unique Targets

5. Where do they come from?

6. Focus on the Major Sex Hormones • Progesterone • “pro” “gestational” • Testosterone • Estrogen • Estradiol – the major player • Estrone – less active, post-menopausal • Estriol – the pregnancy estrogen

7. Estradiol • Performs over 240 functions in the body • In contrast, Testosterone performs about 110; Thyroid Hormone performs about 15 • Produced by the month’s stimulated follicles in the ovary • So, no stimulated follicles, no estradiol

8. Some Functions of Estradiol • promote formation of female secondary sex characteristics • accelerate metabolism (burn fat) • increase vaginal lubrication • thicken the vaginal wall • maintenance of vessel and skin • reduce bone resorption, increase bone formation

9. protein synthesis • increase hepatic production of binding proteins • increase circulating level of factors2, 7, 9, 10, plasminogen • increase platelet adhesiveness • Lipid • increase HDL, triglyceride • decrease LDL, fat deposition

10. Fluid balance • salt (sodium) and water retention • Hormones • increase cortisol, SHBG • Gastrointestinal tract • reduce bowel motility • increase cholesterol in bile

11. Melanin • increase pheomelanin, reduce eumelanin • Lung function • promotes lung function by supporting alveoli • Brain • Stimulates endorphins, promotes seratonin and dopamine release and production

12. Symptoms of Estradiol Deficiency • Mood disturbances • Hot flashes • Night sweats • Depression • Anxiety • Dry skin • Decreased libido • Incontinence • Vaginal dryness • Insomnia • Memory Loss • Weight Gain • Skin thinning • Abnormal lipids

13. Is Estradiol Safe? • Bio-Identical Hormones – exact copies • Bio-Similar Hormones – close, generally function like the hormone • Bio-Limited Hormones – a few functions only • Bio-Antagonists – block functions

14. Is Estradiol Safe? • BioIdenticalEstradiol is the same chemical structure as what your body produces…so was it unsafe when you were making it? • Of course not…..

15. Breast Cancer and Estradiol • Does Estradiol cause Breast Cancer? • Women in China have virtually no incidence of breast cancer….yet are exposed to estradiol for 40 years of their lives • No study has ever shown a link between bio-identical estradiol and breast cancer

16. But I heard it causes Breast Cancer…. The Womens Health Initiative • Very large study in 1997 looking for benefits of HRT in post-menopausal women • Average age of inclusion – 65 • No previous HRT use • Used PremPro – then the second most common medication 2.5 million women

17. Prem-Pro • Combination of Premarin and Provera • Premarin “pregnant mare’s urine” • Contains 12 different xeno-estrogens • Only one is “similar” to estradiol • Activity of the other 11??? • Patentable • Provera – methylprogesterone – not bioidentical

18. So what happened? • Study was terminated in 2002, because a study limit was exceeded – a “reported” 26% increase in the risk of breast cancer • Actual risk of control group 2.0% • Increased risk of study group 2.5% • ….the change from 2.0% to 2.5% is 26%

19. And now for the rest of the story….. • Larger decrease in risk to colon cancer • Decrease in overall mortality • In 2009, in OBGYN News…those in the WHI who developed Breast Cancer AND were on PremPro survived their breast cancer far more than those who were in the placebo group…..

20. WHI Perspective • Abnormal study group • Abnormal hormones used – not bioidentical • Slight increase risk in breast ca, greater decrease in colon cancer • Greater survival if develops breast ca

21. Testosterone • improves oxygen uptake throughout the body • controls blood sugar • regulates cholesterol • increases lean body mass • prevents osteoporosis • maintains immune function • maintains cardiac functions • Stimulates neurological function and repair

22. Symptoms of Testosterone Deficiency in Women AND Men • Decreased or absent libido • Erectile or Sexual dysfunction • Decreased muscle mass • Decreased muscle strength • Osteoporosis • Heart disease • Sleep disorders • Memory failure • Irritability • Decreased energy level • Mood swings • Depression • Anxiety • Increased pain • Cold intolerance • Decreased self-confidence • Decreased cognition • Loss of sense of well-being

23. Is there anything I can do without taking hormones? • Lots…. • Exercise • Diet • Herbal Supplements • Stress Reduction techniques • Chiropractic care • Massage therapy

24. Managing Hormones Basic Level • Start with symptoms • Educate on risks, benefits, alternatives • Begin therapy, monitor the results • Incrementally add or subtract whatever is needed for your personal desired effect • Once everything is “perfect” then measure to get a baseline • Generally, using Estradiol, Testosterone, and sometimes progesterone

25. How much does it Cost? • If not covered by insurance: • Testosterone and estradiol cream thru the Women’s International Pharmacy is $19.50 per month each • Most insurance companies cover estradiol for women and testosterone for men, including MediCare • Most men are willing to pay $19.50 for testosterone for their wives…

26. Costs? • How much do you pay for antidepressants, blood pressure medication, cholesterol meds, or Viagra? • What is your personal cost of Osteoporosis, or Low Back Pain • What is an improved sense of well-being worth?

27. More Info? • Strongly Recommend: • “Perfect Balance” by Dr Robert Greene, featured on Oprah, bestseller • “The Life Extension Revolution” by Philip Lee Miller, MD, Los Gatos Longevity Center • “Natural Hormone Balance for Women” by Uzzi Reiss, UCLA • Caution – be careful about what you read on the Internet!