1. HORMONE THERAPY AND THE AGING ADULT Jackie Springer, M.D., F.A.C.E. Co-founder International Hormone Society and David Johnson, President International Hormone Society Kansas City, Missouri; U.S.A. www.intlhormonesociety.org

2. The question Can hormones help to alleviate or improve the symptoms of aging (menopause, heart disease, osteoporosis, dementia)? Just use a little common sense.

3. COMMON SENSE We only need to use common sense to realize that what we are doing when we treat the adult with hormone therapy is: MERELY REPLACING THE HORMONES THE BODY CAN NO LONGER MAKE!

4. When does the risk of osteoporosis increase? AS WE AGE! There is NO question that the risk of fractures increases as the level of estrogen decreases and thus bone density declines. Most women should not have to suffer from osteoporosis if they take bioidentical hormone therapy.

5. Hormones that affect bone density Calcitonin Growth hormone/IGF-1 (enhances resorption of bone) Estrogens (enhances resorption of bone) Progesterone Parathyroid hormone (PTH) Androgens (in form of estrogen) Thyroid Cortisol

6. When does the risk of dementia increase? Again, AS WE AGE! There is no question that estrogen and progesterone (natural only) help prevent some forms of dementia. Estrogen increases blood perfusion to the brain. Estrogen and progesterone are important for the integrity of the brain.

7. When does the risk of heart disease increase? AS WE AGE! Postmenopausal women are at a much higher risk of heart disease. Research shows that estrogens are beneficial to the heart, if administered properly.

8. Hormones and heart disease Many hormones affect the heart The heart is dependent on multiple hormones to remain healthy Testosterone, estrogen, thyroid, cortisol and most importantly growth hormone affect the heart

9. Synthetic hormones vs Bioidentical hormones Bioidentical estrogen must be administered through the skin NOT the mouth Estrogen administered orally passes immediately through the liver and causes multiple problems with many other hormones

10. Studies of estrogen therapy These studies looked ONLY at oral estrogen Bioidentical hormone therapy has been proven safe in many studies outside of the United States The Woman’s Health Initiative study looked ONLY at conjugated estrogen

11. Science content: The process of conjugation Hormones administered topically enter the blood stream and are carried directly to the cells of the body. After performing their function those hormones re-enter the blood stream and are carried to the liver where they are marked (conjugated) as used (waste.) Then they travel to the kidneys are excreted in the urine.

12. Science content: The process of conjugation Anything, such as food or medication, that enters the body orally, enters the blood stream from the gut and is immediately processed by the liver. Nutrients are sent back into the blood stream to be used by the cells. Those used nutrients return to the liver and are marked (conjugated) as “used” so the kidneys will remove it as waste. Estrogen made from horse urine is already conjugated BY THE HORSE LIVER. When it enters the human liver it causes chaos. The liver recognizes it as estrogen but it is already marked as waste. The already conjugated estrogen interferes with IGF/1 (growth hormone) and other hormones. The horse conjugated estrogen then travels to the cells where it causes even more chaos!

13. Conjugated estrogen Conjugated estrogen is the waste product the body produces after the hormone has performed its function in the cells This is the form that comes from horse urine It is present in the horse’s urine because it is WASTE Humans also conjugate estrogen to turn it into WASTE so it can be excreted in human urine Taking conjugated estrogen (oral) is merely eating estrogen WASTE from horses

14. Male hormone therapy Do we see oral forms of testosterone being pushed onto men? No, because oral testosterone, like oral estrogen, is not good for the human body Oral testosterone, like oral estrogen, goes to the liver and causes more problems with other hormones

15. Women and men BOTH need hormones Hormone replacement therapy helps to prevent Heart disease Dementia Osteoporosis Fatigue Depression Weight gain Loss of sexual drive

16. You decide Do you want to give up hormone therapy and give up all the benefits? Just read the list in the previous slide again. No sensible adult would give up these benefits. Hormone therapy is the ONLY way to preserve these functions into the later years of life.

17. COMMON SENSE Bioidentical hormone therapy is the only way to live healthy and postpone or even prevent the diseases of aging. Big pharmaceutical companies want to take away bioidentical hormones because they are losing money on their synthetic versions. Don’t be fooled, the research is there but many doctors are not aware of it.

18. Take your care into your own hands You have to live in your body You decide whether to have a healthy or unhealthy body. Ultimately you are the one that makes the decision to take hormones. Just use COMMON SENSE and you will realize hormones are a must for a healthy aging woman OR man. And, the very last bit of common sense, as always ask your doctor!