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

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

Unique Targets

Where do they come from?

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

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

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

protein synthesis Lipid increase hepatic production of binding proteins increase circulating level of factors 2, 7, 9, 10, plasminogen increase platelet adhesiveness Lipid increase HDL, triglyceride decrease LDL, fat deposition

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

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

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

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

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

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

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

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

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%

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…..

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

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

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

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

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

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…

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?

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!