The goal of anti-aging is to slow, stop, or even reverse many of the changes associated with aging. This means staying healthy, active, and vibrant of body and mind, while avoiding the common diseases and infirmities of aging. One cornerstone of anti-aging strategy is to replace the hormones that naturally decline with aging.
Bioidentical Hormone Replacement Therapy (BHRT)
Hormones are chemical messengers that help the entire body function normally. They work in concert with the nervous system by responding to neuronal commands that regulate everything from growth and development, to reproduction, to the aging process itself. Hormones control metabolism, mood, energy, sleep, and sex drive. Put simply, humans are designed to be healthy with optimal levels of hormones.
Bioidentical means identical to our biology. A bioidentical hormone has 100% exactly the same chemical and molecular structure as the hormone that is normally found in the body. By contrast, many drugs are similar to natural hormones, and will activate hormone receptors in the body, but are not identical. Birth control pills, for example, are much stronger than our natural hormones yet not identical.
For women, the natural ovarian hormones include estrogen, progesterone, and testosterone, and these hormones plummet after menopause. In the world of hormone replacement, there are synthetic “look-alike” drugs that will stimulate the natural hormone receptors, such as brand name Premarin for estrogen, and Provera for progesterone. Both of these drugs have effects beyond that of their natural hormone equivalent, and as one would expect, numerous side effects not observed with bioidentical hormones.
Unlike drugs such as Premarin, which contains ten estrogens derived from pregnant horse urine, none of which are the same as the three naturally occurring estrogens in the human body, bioidentical hormones are derived from plant sources and synthesized into the exact same chemical found in the human body.
The Typical Patient
My new patient relayed to me, teary eyed, that she “was tired and depressed, not sleeping well, frustrated with her weight, and had no sex drive”. Despite previously being in great health, and continuing good diet and exercise habits, her body was in her words “out of control”. There were also new aches and pains as well as noting her skin looked dry and lifeless.
Added to this was a host of new medications started in recent years for symptom control, including Prozac for mood, Xanax for anxiety, Ambien for sleep, and Lipitor for her newly diagnosed high cholesterol. To make matters worse and behind the scenes, at the young age of 55, silent aging processes such as thinning bones and artery plaque were beginning.
The stress of not feeling well, poor sleep, and medication side effects were pushing her toward adrenal fatigue. The high stress hormone called cortisol had been on overdrive for many years, causing the secondary effects of high blood sugar and high insulin, which conspire along with cortisol to put weight on especially around the midsection. In times of additional stressors her “reserves” of cortisol were depleted leaving her emotionally labile and energy drained.
This patient represents thousands of patients that I’ve had the pleasure of successfully helping with all of these issues. While the sad truth is that most of them had stories that included the majority of the issues in this one example, the good news is that a real solution exists. That solution involves replacing missing hormones.
Evidence of Safety
In 2002 the Women’s Health Initiative (WHI) study shocked doctors and patients alike with the revelation and proclamation that “hormones cause cancer”. More specifically, the non-bioidentical look-alike to progesterone, called Provera, caused a 26% increase in the rate of invasive breast cancer. Provera also caused a 200% increase in blood clots, a 41% increase in stroke, and a 29% increase in heart attack or death from heart disease.
It is worth noting in a case of “missing the forest for the trees” that for the treatment group in the WHI, the decreased mortality from hip fractures and colon cancer offset the increase in breast cancer and 97.5% of women on treatment had no adverse events.
Bioidentical progesterone has been studied extensively, in dozens of studies head to head with Provera, and simply stated it does not have the same risks. For everything bad with Provera, progesterone does the opposite. As an example, in the largest study involving progesterone, the European EPIC study involving over 50,000 women taking hormones, it was found that progesterone actually lowered the risk of breast cancer by 10%.
Evidence of Efficacy
Bioidentical hormone replacement therapy is not all about treating menopausal withdrawal symptoms such as hot flashes, night sweats or mood swings. Although it does treat those symptoms quite effectively, it is really about preventing disease and maintaining quality of life. It’s about keeping the body operating well. Not having optimal hormone levels is like letting a fine automobile just run out of oil, then declaring it is “growing old” as the red light comes on and it overheats.
Bioidentical hormones were being used long before drug companies even came into existence. They are available in a few commercial forms, but mostly we employ the compounding pharmacist to make BHRT formulations that are specific to each patient and uniquely available in either a tablet that dissolves under the tongue or a topical cream that contains just the right mixture of the ovarian hormones. It is a well researched and proven branch of medicine that is growing rapidly as more and more people discover its health promoting and quality of life benefits.
If you wish to take a proactive approach to health and aging, and maximize the quality as well as the quantity of life, then you should research and consider BHRT.
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.