Understanding Menopause, PMS, and Hormone Balancing for Today’s Women Menopause Made Easy! Understanding Menopause, PMS, and Hormone Balancing for Today’s Women HUNT NATUROPATHIC CLINIC Dr. Jeffrey J. Hunt Hon. B.P.H.E., N.D., F.C.A.H. 1618 2nd Ave., Trail, BC, (250)368-6999 E-Mail: huntandhunt@shaw.ca BACK IN BALANCE Dr. Diana Draper, BA, ND 2325 6th Ave Castlegar BC (250) 304-4401 E-Mail: drdrapernd@yahoo.ca www.backinbalance.ca www.facebook.com/drdrapernd

OverView Introduction The Physiology of Hormones Treatments for Hormone Balancing: Hormone Replacement Therapy Natural Therapies Prevention Questions

Introduction Dr. Jeffrey Hunt excels in the treatment of many complex health conditions utilizing his extensive training and diagnostic skills and tools. He is a graduate of at the top of his class from the Canadian College of Naturopathic Medicine He’s been practice at Hunt Naturopathic Clinic in Trail for over 20 years. Dr. Hunt is particularly interested in gastrointestinal disorders, hormonal concerns, cancer, Lyme disease, allergenic disorders and weight loss.

Introduction Dr. Diana Draper is a graduate of the Canadian College of Naturopathic Medicine, and a member of the College and Naturopathic Physicians of BC and the Canadian Association of Naturopathic Doctors. She recently left her practice in Calgary AB to return to her hometown of Castlegar BC. As a licensed medical practitioner, Dr. Draper use natural therapies that work with the bodies innate healing abilities to promote optimal, sustainable health by addressing all areas of the self: the physical, mental, emotional and spiritual. Her goals as a Naturopathic Doctor are to be a facilitator for anyone who wishes to reach their highest potential in life, to empowering patients and the community to take responsibility for their health, and to be a health educator and advocate. Areas of special interest include stress, anxiety, insomnia, pain management, digestive complaints, hormone regulation, and inflammatory conditions. Tools used for treatment include clinical nutrition, acupuncture, herbal medicine, homeopathy, biopuncture, IV therapy, counseling, and nutritional supplements. Aside from her practice Dr. Draper works with Hope College in Drumheller AB where she has designed 3 health diploma programs for the College and continues to provide consulting on best practices in their clinic.

Naturopathic Medicine The Naturopathic Oath First, to do no harm. To co-operate with the healing power of nature. To address the fundamental causes of disease. To heal the whole person through individualized treatment. To teach the principles of healthy living and preventive medicine

The Physiology of Hormones How Hormones Work: Lock and Key Interdependences and Interactions Hormone Key Receptor Lock Target Tissue Lock and key helps regulate function. It is important to use the right key for the right lock If slightly different, like non-identical synthetic hormones, it may fit but not open the same door or leave the door open too long or slam it shut Often takes several hormones to get specific response ie. 4 hormones are needed to stimulate the release of an egg at ovulation Hormone Key Receptor Lock

The Physiology of Hormones Steroid Hormones: Cortisol Estrogens Androgens Progesterone Made from cholesterol In Women, produced primarily by ovaries and adrenal glands There are many hormones in the body, these are the ones we are going to focus on These hormones fall into one of the following categories: estrogens, androgens, progesterone, or glucocorticoids. Slide of Hormone Synthesis

The Physiology of Hormones Adrenal Gland: Located above kidneys Release adrenaline, cortisol, and DHEA DHEA forms androstenedione which then forms Estrone and Testosterone Conversion of one hormone to another requires an enzymes Enzymes require vitamins and mineral Testosterone turns into Estradiol Estrone turns into Estradiol, Estriol or Estrong Sulphate If you are vitamin or mineral deficient then conversation cannot happen Aromatize is an enzyme used to convert Testosterone to estrogen. It is stored in fat, therefore, women who have more fat on their body experience less estrogen deficiency sx as oppose to women with little low fat percentage in their body.

The Physiology of Hormones Adrenal Gland DHEA Androstenedion Testosterone Estradiol Estron Estriol Estrone Sulphate Cortisol DHEA stands for dehydroepiandrosterone Change arrows one way from adrenal gland to DHEA to androstenedion to estrone and testosterone and estrone to estriol and testosterone to estradiol Need aromatse for androstenedione to estrone and testosterone to estradiol

The Physiology of Hormones The Adrenal Gland and Pre-Menopause Prior to menopause ovaries are the major producers of estrogen and progesterone 40% of estrogen comes from adrenal gland via conversion from androstenedione About half of womens testosterone comes from DHEA released by adrenal glands Almost all progesterone made by adrenal gland is used to make cortisol

The Physiology of Hormones Post-menopause and the Adrenal Glands After menopause the adrenal glands become the primary source for estrogens and testosterone. Ovaries produce small amounts of estradiol and testosterone Majority comes from DHEA and androstenedione Women with complete hysterectomy are similar to post-menopausal women in physiology of hormone production

The Physiology of Hormones Estrogens: Receptors found in cells throughout body Bone, brain, blood vessels, bladder, breast, thyroid gland, reproductive organs Development of breasts and menstrual cycle Conjugation in liver Estrogens are conjugated in the liver to make then more water soluble. Conjugated estrogens are considered inactive forms of the hormone, however, they can be converted back into their active form – therefore liver detox and proper filtration is very important.

The Physiology of Hormones Estrogens: 3 main forms: Estradiol – strongest, main one produced by ovaries. Primary in menstrual cycle and builds endometrium lining Estrone – main post-menopausal estrogen. Easily converted to estriol or estradiol Estriol – very high in pregnancy Estrone Sulphate – most abundant. Storage form 2 Hydroxyestrone – thought to be protective against breast cancer 2 hydroxyestrone – not considered active, estrogen breakdown product and likely balances the action of stronger estrogens. Progesterone and Indole-3-carbinol both enhance formation of 2 hydroxyestrogen (they are though to protect against breast cancer) Serum testing of ration between 2 hydroxyestrone and 16 hydroxyestrone

The Physiology of Hormones Progesterone: Receptors found throughout body: Brain, bone, breast, bladder, blood vessels, thyroid gland, reproductive organs Essential to maintain pregnancy Essential to balancing hormones Produced in ovaries, small amount in brain, and adrenal gland

The Physiology of Hormones Androgens: Testosterone Sense of wellbeing, sex drive, maintains vaginal mucosa and bone tissue Improves heart health, maintains skin elasticity and muscle mass 1/5 to 1/10 amount compared to men Converted to estradiol via aromatse – fat percentage affects this

The Physiology of Hormones Androgens: DHEA Most abundant steroid hormone in body Circulates in blood primarily as DHEAS Makes estradiol, estrone, estriol and testosterone DHEAS is conjugated sulphate form which is its storage form

The Physiology of Hormones Androgens: Androstenedione Made from DHEA in adrenal glands Building block for estrogens and testosterone Critical for production of steroid hormones after menopause

The Physiology of Hormones Cortisol: Release by adrenal glands in response to physical and emotional stresses Promotes release of sugar in the body Essential to mobilizing defense against infections and inflammation Highest in morning to combat stress of overnight fasting and provide energy Regulates effects of other hormones Competes with progesterone for same receptor – can cause functional deficiency where progesterone levels normal but cannot connect to receptor therefore deficint

The Physiology of Hormones Cortisol and Estrogen: Cortisol stimulates aromatase activity which promotes estrogen formation Promotes deposition of fat around waist Excess cortisol = excess estrogen

The Physiology of Hormones Cortisol and Progesterone: Competes with progesterone for same receptor Can cause functional deficiency progesterone levels normal but cannot connect to receptor therefore deficient

The Physiology of Hormones Cortisol and DHEA: Opposite effect on immune function and blood sugar regulation Cortisol and Thyroid: They need eachother for each to work properly Symptoms of deficiency in one family can be due to deficiency in the other family DHEA improves insulin sensitivity Higher cortisol levels = higher DHEA production leading to deficiency

The Physiology of Hormones Add in triangle of thyroid, adrenals and sex hormones

The Physiology of Hormones Insert slide on hormone def.

The Physiology of Hormones Testing: Saliva Vs Serum

Treatments Progesterone Studies: 40 premenopausal women who were scheduled for excisional biopsy of benign lesions were given topical progesterone, topical estradiol or both 10-13 days prior to surgery. Reduction in the proliferation rate of acinar cells was seen in both the progesterone and the combination groups. Influences of percutaneous administration of estradiol and progesterone on human breast epithelial cell cycle in vivo. Chang KJ, et al. Fertil Steril (1995) 63(4):785-91.

Treatments Another study involving 40 postmenopausal women who received topical placebo, estradiol, progesterone or estradiol and progesterone two weeks prior to excision showed increased number of cycling epithelial cells in estradiol cohort, but reduced in the groups using progesterone and estradiol plus progesterone. Foldart JM et al. Estradiol and Progesterone Regulate the Proliferation of Human Breast Epithelial Cells. Fertil Steril (1998) May; 69(5): 963-9.

Treatments Comparing apples to oranges: When a French study compared women using estrogen in combination with a progestin vs. women using estrogen in combination with progesterone they found a significant increase in incidence of breast cancer with the progestin group and no increase in the group using progesterone. Breast Cancer Risk in Relation to Different Types of Hormone Replacement Therapy in the E3N-EPIC Cohort. Fournier A et al. Int J Cancer (2005); 114(3):448-54.

Treatments Natural Therapies: Diet and weight management Acupuncture IV therapy Herbs and nutrients

Treatments Diet Weight management Xenoestrogens in herbicides and pesticides and plastics Promote estrogen Weight management Decrease fat for aromatase enzyme Decrease inflammation

Treatments Acupuncture: Balancing Yin and Yang Addressing anxiety Improving hot flashes Improving sleep Decreasing nighttime urination

Treatments IV Therapy: Adrenal support Include homeopathic injections for hormone balance Avoid first pass effect Avoid complications in digestive system

Treatments Herbs and Nutrients: Hot Flashes: Vitamin C Vitamin B Curcumin Gamma Oryzanol Hesperidin Fish oils Alkaline Powder Chaste Tree Berry Astragalus Valerian Black cohosh Chih Pai Pa Wei Wan Rehmannia Flax Seed

Treatments Herbs and Nutrients: Insomnia, Anxiety, Depression B complex Calcium 5-HPT St. John’s wart Siberian Ginseng Valerian Melatonin

Treatments Vaginal Dryness: Herbs and Nutrients: Black cohosh Saw palmetto Fish oils Ground flaxseeds Vitamin E Vitamin A Zinc

Treatments Combination Therapies: Estrovera – Rhapontic Rhubarb Pascofemin – complex homeopathic Menopause – black cohosh Womens support – Dong Quai, chaste tree, Black cohosh, Red clover

Treatments Valarian and Postmenopausal women: 4 week study 30% improvement in sleep quality with valiarian group vs 4% improvement with placebo group

Treatments EFA and Hot Flashes: 8 weeks 70% found positive results 50% decrease in hot flashes 45% remission rate

What to Expect from Seeing a Naturopathic Doctor Initial Consult is 1 hour Depends on severity of symptoms which route to start with Testing Informed consent Transitioning between natural products and bio-identical hormone replacement

Highlights Feedback mechanism in the brain for hormone balance Stress affects hormone balance Bioidentical hormones are plant source Hormone balance is more important than hormone levels Estrogen production in creased by obesity, Phthalates from plastic and xenoestrogens from herbicides and pesticides Low testosterone looks like depression

Questions? Thank you for coming!