Hormone Replacement Therapy
Hormone depletion is a major cause of aging. Despite the medical establishment’s recent stance against hormone replacement therapy, there are major benefits derived from the careful prescribing of bioidentical hormones. The highly publicized adverse effects of hormone replacement relate to the use of synthetic or non-bioidentical formulations given by suboptimal routes of administration.
Dr. Perry utilizes the following hormones:
Estradiol
Estriol
Progesterone
Testosterone
DHEA
Thyroid hormone
Estrogen and Menopause in Women
Menopause is defined as beginning with the last menstrual period. Blood tests will reveal low estradiol levels and high FSH (another hormone secreted form your brain to stimulate those ovaries to produce estrogen).
Menopause is characterized by hot flashes, night sweats, depression, insomnia, weight gain, reduced libido, vaginal dryness and atrophy, and skin changes. Many women are spared severe symptoms, others unfortunately not. Other medical conditions are initiated with menopause, including osteoporosis, cardiovascular disease manifested by heart disease and stroke, and memory and cognitive loss.
Estrogen replacement resolves most menopausal symptoms, reduces osteoporosis, and in numerous studies has prevented cardiovascular disease and cognitive decline. Dr. Perry avoids the use of oral estrogens because of evidence that it may increase blood clotting factors thereby increasing the possibility of stroke and heart attacks. In addition there are studies showing that oral administration may also increase your risk of urterine and breast cancer. Instead, Dr. Perry orders sublingual drops, and transdermal creams or gels. These are usually obtained through a compounding pharmacy, which can prepare formulations in specific dosage.
Estrogen increases bone density, maintains vascular elasticity, produces collagen in the skin to prevent wrinkles, and likely supports cognitive function. There is always a risk of increased breast or uterine cancer with estrogen therapy, but this is reduced by using bioidentical formulations only and keeping with a lower dose – and it is important to discuss both your family history and past medical history before starting any hormnone therapy. A study at Fred Hutch showed that the intake of certain nutrients, Indole 3 carbinol or DIM along with calcium D glucarate, can effect estrogen metabolism away from carcinogenic metabolites. Adding estriol to estradiol and progesterone may also provide protection against breast and uterine malignancy.
Testosterone in Men and Women
Testosterone declines in some women at the time of menopause, while in others the level is maintained by adrenal production. In men, testosterone declines gradually with age. Testosterone replacement maintains bone density, increases libido in both men and women, raises the blood count, and increases muscle strength and athletic performance. It is usually taken as a transdermal preparation, sublingual drops or an oral troche. Men often administer testosterone as an injection into the buttocks, given every 1-2 weeks – but I really prefer the gels or drops.
DHEA
DHEA is a testosterone related hormone that declines with age in both men and women. Levels decline further in people on steroids and in sicker patients. DHEA increases libido, supports bone density, controls blood sugar, supports immune function and prevents depression. It is often taken as an oral supplement – dosage is determined on an individual basis for sex and for the purpose of treatment.
Thyroid Hormone
Thyroid hormone levels are often low in both men and women, though more often in women. The thyroid gland is frequently involved in autoimmune processes, and is also very sensitive to environmental toxins and to radiation. Dr. Perry prescribes thyroid in oral formulations combining T3 and T4, usually using the TSH level to guide the dosage. Frequently iodine deficiency is present. This can be diagnosed through a urine test to measure excretion of a known iodine dose. Low urine excretion indicates deficiency.
