Bio-Identical Hormone Therapy in Women and Men

Bio-Identical Hormone Therapy in Women and Men

Jake Ames, MD, HMD

Menopause

The average woman enters menopause between ages 48-52. It is defined medically when there has been an absence of menstruation for 12 months. There is a perimenopause period that can start a few years before menopause, which can produce menopausal symptoms.

Symptoms

Symptoms can include night and day hot flashes and sweats, brain fog, dry skin, hair loss, loss of libido, vaginal atrophy and dryness, weight gain, depression and anxiety.

Bio-Identical Hormones

Bio-identical hormones are identical molecularly with the hormones that your ovaries and adrenal glands make.  Most of them are made from plants, and without getting into chemistry they do contain different isotopes (molecular weight), so they are not absolutely identical, but work the same in your body as the hormones your body originally made before menopause.

Application of Hormones

Bio-identical hormones can be taken orally, topically, sublingually or implanted as a pellet.  The problem with taking estradiol orally and sublingually is that your liver will convert the estradiol to estrone easier, which is more carcinogenic.  The ideal ratio of estradiol (E2) to estrone (E1) is 2:1.  This can only be achieved with hormone pellet implants (testosterone and estradiol).

Estrone metabolites

There are two metabolites of estrone, which can potentially promote breast cancer growth. 

Estrone has 4 main metabolites:

4-hydroxy estrone BAD

16-alpha hydroxy estrone BAD

2-hydroxy estrone GOOD

Estriol (E3) GOOD

DIM

DIM is a phytonutrient (plant nutrient) found in cruciferous vegetables.  These include cabbage, kale, broccoli, bok choy, Brussels sprouts, cauliflower, kohlrabi, mustard, rutabaga, and turnip.  DIM is used as a supplement by some physicians to protect women from breast and ovarian cancers.

Ways To Take Hormones

Some women do not want to come into the physician’s office and get pellet insertion every four months, so they elect to have topical estradiol, progesterone and testosterone creams.  These hormone creams can be applied to the skin or vagina.  Usually, the hormones are separated into three different jars at first, to find the correct dosage of all three hormones.  Later all three hormones can be put into one jar for convenience and to save on costs.

Get Your Hormones To Age 25

Within a week to a few weeks, your hormone levels should be at a 25-year-old level, and you should have an elimination of your menopausal symptoms.  Estradiol protects you from osteoporosis, heart disease, hypertension, depression, anxiety, and Alzheimer’s disease.  We are using these hormones as part of our anti-aging program.

Bio-Identical Hormone Replacement Therapy in Men

As men age, they slowly get low on testosterone and other adrenal gland androgenic hormones. Testosterone in men usually declines 1% a year after age 30.  Since the decline in testosterone is so slow, men usually don’t recognize it.

Signs of Low Testosterone

Signs of low testosterone in men are fatigue, abdominal obesity, increase in LDL cholesterol, decrease muscle strength and mass, brain fog, erectile dysfunction, moodiness and grumpiness, and loss of vitality.

Increased Estrogen

The decline in testosterone usually is associated with an increase in estrogen in men, which can cause abdominal obesity, erectile dysfunction, loss of libido prostate enlargement and prostate cancer.

Types of testosterone and estrogen blockers

Men have the option of taking synthetic testosterone injections with different half-lives, testosterone pellet implantation done usually every 6 months or using bio-identical topical testosterone cream.  Bio-identical progesterone cream is usually given to help keep the prostate gland healthy, and counteract excess estrogen.  Men do need a small amount of estrogen for brain and bone health, and to achieve and maintain erections.  Every man responds differently to various types of testosterone and delivery systems.  We are experts in finding the correct type of testosterone supplementation.   We usually put most men on an estrogen blocker called Arimidex (anastrozole).   Most 50-year-old men will have estrogen levels greater than their wives.

Prostate Cancer

Forty-Nine percent of men between the ages of 40-50 have some evidence of prostate cancer.  Eighty-Five percent of these men will have a slow-growing prostate cancer and may die of natural causes never knowing that they had prostate cancer.  It is controversial, but it is now thought that estradiol contributes to prostate enlargement and prostate cancer, and testosterone protects men from getting prostate cancer.

I have been safely prescribing bio-identical hormones for 23 years.  I understand that each patient is unique.  I treat the patient, not necessarily the lab results.  I am an expert in interpreting laboratory analysis, having treated thousands of patients over the years.

© 2017 Jake Ames, MD, HMD  All Rights Reserved