Chapter OneThe Hormone Basics
So, you want to try natural hormones. Great! But before you take pills, rub on cream, or apply patches, it's important to know the basics of what you're doing and why. Hormones bring important messages to every cell of your body, with potent results. The hormone imbalances that led you to this book in the first place can be corrected-or made worse-depending on your treatment plan.
For many women, regaining hormone balance is a fairly straightforward matter of using some natural progesterone cream. But for others, whatever created the imbalance in the first place needs to be addressed, and still others have such complicating factors as a hysterectomy, endometriosis, or PMS. This book is designed to help you by giving simple, clear guidelines for creating hormone balance based on your symptoms, lifestyle, and health considerations.
The three basic questions you'll need answered before you can be on your way to hormone balance are:
1. Are my symptoms caused by a hormone imbalance?
2. Which hormones do I need to regain hormone balance?
3. How do I use the hormones for optimal health and balance?
Throughout this book you'll be given the guidelines you need to answer these questions.
To even talk about hormone balance, there are a few simple concepts that are important to understand. Here's a brief outline of the most important hormones you'll need to know about and how they affect your body. If you'd like more detailed information about any of these hormones, please read our previous books, What Your Doctor May Not Tell You About Menopause, or What Your Doctor May Not Tell You About Premenopause.
HRT stands for "hormone replacement therapy." In this book, we use the term "conventional HRT" to describe the hormone treatment plans prescribed by doctors for the past 30 years.
Estrogen, progesterone, and testosterone are the three hormones that are most often out of balance in women. They are made by your ovaries and, in much smaller amounts, by your adrenal glands. These three are also called steroid hormones or sex hormones.
Progesterone helps the female body regulate its menstrual cycles; it's essential for creating and maintaining a pregnancy, it balances the effects of estrogen, and most of your other hormones are made from it.
Estrogen is the hormone that makes you female, endowing you with breasts, hips, menstrual periods, soft skin, and a higher-pitched voice.
Testosterone is the male hormone, but women also make it in small amounts. In women, testosterone primarily contributes to sex drive and helps build bone.
DHEA (dehydroepiandrosterone) is a precursor to testosterone and the estrogens, meaning that those hormones are made from it. DHEA is made primarily in the adrenal glands and is essential for protein building and repair. DHEA levels decline dramatically as we age, making it a primary biomarker of aging.
Androgens are male hormones, including testosterone and androstenedione. DHEA is often considered an androgen but converts readily to estrogen in many women.
Natural or Bioidentical Hormones
Hormones are called natural or bioidentical if they are exact duplicates of what your body makes. In other words, the molecular structure of a natural hormone is identical to that of the hormones made by your body. This is an important distinction because the hormones typically handed out by your doctor are not natural; some of them are completely man-made and are found nowhere in nature, and others, notably Premarin, are made from the urine of pregnant mares. Hormones do very complex and specific jobs in the body by fitting into the part of your cells called receptors, much the same way that a key fits into a lock. Once the hormone is in the receptor, it gives the cell instructions. If the molecular structure is different, even by one atom, the instructions given to the cell are different. Hormones that aren't natural to your body give instructions that can be harmful. You'll learn more about which hormones are natural and which aren't later in the book.
Synthetic hormones are not natural to your body. Drug companies purposely make them different from natural hormones so they can be patented. Patented drugs are important to drug company profits because the company that invents them can sell them exclusively for many years, and thus they can charge more for them because there's no competition. Natural substances cannot be patented and therefore tend to be less expensive. Synthetic hormones are not necessarily made, sold, and prescribed because they work better than natural hormones, but because natural hormones can't be patented.
Progestins are synthetic progesterones, used in birth control pills and conventional HRT. Some examples are Provera (medroxyprogesterone acetate), Aygestin (norethindrone acetate), and Megace (megestrol acetate).
Provera is the most commonly used progestin in HRT.
Premarin is an estrogen extracted from pregnant-horse urine. While it is made of natural estrogens, most of them are natural to horses, not humans, which means they have different effects on your body than human estrogens.
PremPro is the most common form of conventional HRT. It is a combination of Premarin and Provera.
Hormone Cycles That Can Lead to Imbalance
Premenopause refers to the years between the ages of 30 and 50 when women's hormones begin to fluctuate and cause such symptoms as PMS, weight gain, endometriosis, fibroids, infertility, and tender breasts, to name a few.
Perimenopause refers to the few years before menopause when many women's hormones are really fluctuating, causing even greater weight gain, irregular periods, heavy bleeding, hot flashes, night sweats, insomnia, mood swings, thinning skin, vaginal dryness, loss of sex drive, fatigue, and memory loss.
Menopause is official when you haven't had a menstrual period for one year. Some 95 percent of women reach menopause between the ages of 44 and 55, but the average age of menopause is 50.
Now that you've got the hormone basics, we can move on to Dr. Lee's rules for hormone replacement therapy.