A Guide to Natural Hormone Balancing for Women
  by James Occhiogrosso, N.D. 


Health Naturally - Home Page

The human body is an amazingly complex mechanism.  The more one studies it, the more one realizes how complex it is.  Yet, all this complexity is—for the most part—controlled seamlessly with little conscious effort.  Much of this control is due to the actions of minute amounts of substances called hormones.

Hormones are the chemical messengers of the body. They circulate through the body in the bloodstream producing powerful effects on virtually every organ they encounter.  Their effects are profound and range from regulating body temperature and blood chemistry to generating sexual desire. Thus, hormones control virtually every aspect of your existence.  This article focuses on a group of hormones called the “sex steroid hormones” and their effects on a woman’s body.  The main pathways for synthesizing these hormones are shown in the diagram. While most are created from their parents, some are synthesized by the body bi-directionally. For example, estradiol can be converted to estrone and visa-versa. This is indicated in the diagram by double-arrows.

Menopause, Premenopause, Perimenopause and Premenstrual Syndrome (PMS)

As we all know, hormone levels change as a woman ages.  Most women think of this as menopause and expect it around the age of fifty.  But hormone levels also vary due to influences aside from aging.  What many women do not know is that nutrition and overall health play an important role—and poor nutrition can accelerate hormonal imbalances and the onset of menopause.  Aside from normal aging, which is beyond our control, lifestyle issues also cause hormone imbalances.  For example, since fat tissue produces and stores estrogens, a sedentary or overweight woman can have excessive estrogen and low testosterone, resulting in PMS symptoms and low sexual drive. Alcohol  consumption, smoking, and other environmental factors can also exacerbate age-related hormone imbalances.

Contrary to the message conveyed by the mass media, menopause really begins somewhere in a woman’s thirties as her hormone levels begin to decline.  When her levels are low enough, symptoms appear, and she is said to be pre-menopausal or peri-menopausal.  Typically, around the age of fifty, her menstrual period ceases, and she is said to be in menopause.  The important thing to understand here is that menopause is not something that comes on like an attack of the flu, but a process that begins in a woman’s thirties, continues throughout life, and is marked by a visible physical change—the cessation of the menstrual flow—at around fifty years old.  Many women, from their late twenties on, should monitor their hormone levels and correct imbalances long before they reach their fifties and menopause.  This allows them to benefit from long-term hormone balance, which can help reduce the physical effects of aging.  

Many women start to feel hormonal problems in their thirties, — and sometimes even in their late twenties. These problems usually occur around a woman’s menstrual period.  They can cause irritability, nervousness, excessive anxiety, or headaches just before or after the menstrual flow, and sometimes are associated with severe menstrual cramps or bleeding.  Such symptoms are typically known as PMS. As a woman’s age nears fifty, symptoms typically become more pronounced, and may include any of those mentioned above, as well as hot flashes, night sweats, and sleep disturbances.  The latter ones mentioned are usually associated with the onset of menopause.

Female Hormone Basics and Prescription Hormone Replacement Therapy (HRT)

Hormones are created as they are needed in the body. As shown in the diagram, cholesterol is the primary biochemical substrate used to build all the sex steroid hormones.  Cholesterol is transformed into pregnenolone, which in turn is used to produce the two “mother hormones” of progesterone and dehydroepiandrosterone (DHEA).  From these all the other sex steroid hormones are synthesized.  Insufficient levels of the primary building blocks, cholesterol, progesterone or DHEA, can cause deficiencies in the others.  For most women, a cholesterol deficiency is not likely, but poor health and aging can result in low progesterone or DHEA which can affect other hormones in the tree.

All hormones occur in two forms in the body—free and bound. The bound form travels through the bloodstream bound to a protein and is not usually active.  The free form is the one that has the active role.  Most laboratory tests are done using blood samples and measure the total hormone value—which is a combination of both free and bound forms.  Saliva testing is inexpensive and easily done in the convenience of your home using a test kit that is mentioned later in this article. Measuring free hormones in saliva is more accurate and convenient than blood testing. 

It is important to remember that only free hormones do the work.  Thus, measurements of total hormone levels do not tell the full story.  It is quite common for the total level of a hormone to be in the normal range but the free value to be below normal.  This can result in various symptoms including those associated with PMS and reduced sexual ability or libido. 

In 2002, a study of about 16,000 women called the “Woman’s Health Initiative” released preliminary results which shocked the medical community.  The unexpected result was that HRT with synthetic hormones—which had been used for decades in the mistaken belief that it would be protective against cardiovascular disease, breast cancer and stroke—was causing more problems than it was solving.  The study was terminated early because of the widely published negative results, and many women stopped their HRT.  The situation is unfortunate because the negative publicity cast doubt on all hormone use— including natural hormone balancing—which I discuss later in this article and can yield many positive effects with little risk. 

Prescription hormone replacement therapy typically consists of various forms of synthetic estrogens sometimes combined with synthetic progesterone.  They may resolve symptoms, but the body does not recognize them completely and thus they can introduce new problems, potentially triggering chronic illnesses. The overall evaluation of prescription HRT in the hazardous substances databank of the National Library of Medicine (TOXNET) is: “Post-menopausal estrogen therapy is carcinogenic to humans.” 

As shown in the diagram, there are three main forms of estrogen—estradiol, estrone and estriol. Of the three main estrogens, estradiol is the most active. It is also the form linked to a higher risk of several chronic conditions and the dominant chemical in most prescription HRT.  Estrone is less active, and estriol is the most abundant—and least active.

Younger women with severe PMS symptoms, particularly those under forty, typically have high estrogen levels, mostly in the form of estradiol and estrone—a condition called estrogen dominance.  Unlike estriol, both estradiol and estrone can be converted to more damaging metabolites in the body, and studies indicate that excess levels can cause serious problems. [1] [2] [3]  The estrogens in many prescription HRT products contain little estriol.  They are composed mainly of synthetic estradiol and estrone from equine sources.

The synthetic hormones in HRT have been shown to increase the risk of cancer, stroke and cardiovascular problems. On her web site, Dr. Christine Northrup states: “the FDA and Wyeth are using this as an excuse to scare women into thinking that they will put their health in jeopardy by using any kind of hormone replacement. But research and years of clinical use have already found that estriol is safe and effective!” Our “Real Estrogen” cream is composed of only natural, bio-identical, USP estriol

Another problem with prescription HRT is the use of synthetic progesterone (known as progestin). Synthetic progestins have been associated with increased risk of cancer, stroke and cardiovascular problems.  Natural progesterone, has not been associated with negative effects, in fact, studies show progesterone is actually protective and inhibits a gene that tends to induce cancer. [4] [5] [6] [7]

Bio-identical or Natural Hormone Supplementation

Supplementing with hormones should only be done using bio-identical hormone creams or herbal creams designed to help the body increase hormone production. The term bio-identical indicates the molecular structure of the hormone is identical to that produced by the body.  Prescription hormone replacement therapy is synthetic and is not bio-identical.  This is an important concept. The body does not recognize synthetic hormones the same way as bio-identical hormones.  Many manufacturers label their products as natural or plant-based.  Such products may be composed of natural substances, but they are not necessarily bio-identical, and thus are of little use in the body.  Only natural bio-identical hormones should be used for supplementation.    

Also, you should avoid hormone supplementation using pills or capsules.  They put an unnecessary load on your liver since it must first process the hormone before it gets into the blood stream.  Trans-dermal (through the skin) creams avoid this problem by delivering the hormone directly to the bloodstream.  According to Dr. John Lee, M.D.—a physician who devoted much of his life to studying the effects of natural hormones on women and wrote several books on the subject—it  takes about seventy times as much oral hormone to reach the same concentration in the blood as absorption through the skin.[8]  Thus, lower doses can be used, and they are absorbed quickly into the bloodstream.

Testing Your Hormone Levels

Determining which hormones you need is a two-step process that consists of testing your hormone levels and evaluating your symptoms.  It is especially important to measure your hormone levels prior to implementing a program to rebalance them.  You should test hormone levels before starting supplementation and repeat testing regularly at one or two month intervals. The best way to do this is to start with a complete hormone panel that measures the critical free hormones using the test kit mentioned at the end of this section.  This kit provides all materials needed for collecting and shipping your saliva sample to the laboratory.  Its price is dependant on the hormones selected. You can select one or two hormones to test, or choose from three comprehensive female panels that test a group of hormones. Comprehensive panels include a personal phone or email phone consultation.  For most women, it is best to perform a comprehensive test first to determine which hormones are in need of balancing. After that, subsequent testing can be limited to only hormones that are out of range, lowering your costs. 

Establishing a record over a period of time also allows you to monitor and adjust your progress to best enhance your overall health.  Excessive supplementation can cause serious problems, and insufficient supplementation is not effective. It is best to pick a specific laboratory for your testing and stick with it.  Laboratories may have different equipment or testing protocols that may make results slightly different. 

Since the levels of many hormones fluctuate during the day, it is also best to make your measurements at the same time of the day. Mid afternoon is usually best. The saliva home test kit is available on this website. Click on "Hormone Test Kits on the left menu.

Evaluating Your Symptoms

Progesterone and dehydroepiandrosterone (DHEA) are the precursor or “mother” hormones for all of the sex steroid hormones.  Many menopausal and premenopausal symptoms, like hot flashes, night sweats, sleep disturbances, headaches, and irritability can be alleviated by the application of natural progesterone cream.  Similarly, supplementing with DHEA may also help—especially if you have skin problems. There is also growing evidence that DHEA deficiency plays a role in the development of atherosclerosis and DHEA appears to reduce insulin resistance, thus it may help reduce abdominal obesity.  [9] [10] [11] [12] [13] [14]

Many symptoms can also be caused by low estrogen—but unless your estrogen level is extremely low, or you have extreme vaginal dryness—it is usually best to try progesterone and DHEA first.  If your symptoms continue after a few weeks and subsequent saliva tests still show low estrogen, then it is appropriate to add an estriol cream.  Our “Real Estrogen” cream contains micronized USP natural estriol and may help with many of the symptoms. Estriol—as shown in the diagram—is an end-point hormone.  It is not converted to more damaging forms by the body, making it the least risky estrogen to use. [15]  Unfortunately, it is rather expensive to produce; hence, it is not usually used in prescription HRT formulas.  Natural estrogen cream is produced from plant extracts, contains no animal products, and is composed of estriol only.         

In the past, testosterone was considered to be of little importance to woman, but recent research indicates that it is much more important than previously thought.  While Progesterone and DHEA supplementation can have a major impact on PMS symptoms, they usually do not have a significant effect on women with low sex drive (low libido), or low sexual ability.  If this is a problem, supplementing with testosterone can help—but it is best not to use a pure hormone for this purpose. [16]

Currently, pure bio-identical testosterone cream is available only by prescription and then only from a compounding pharmacy licensed to mix such creams.  The FDA has approved it only for use by men deficient in testosterone and most physicians will not write a prescription for a woman.

Pharmaceutical manufacturers have been lobbying the FDA to approve synthetic testosterone for use by women. The FDA has turned down these requests on the grounds of safety, a good decision.  However, simply replacing testosterone via a patch, pill or cream is not the answer. Prescription testosterone can upset the delicate hormonal balance of the body.  It is far better to use herbs and nutrients designed to support the body’s production and help it to produce more testosterone.

Our “Homeopathic Testosterone Cream for Women” consists of several herbs along with other natural ingredients as well as homeopathic testosterone and homeopathic human growth hormone.  It is formulated to support increased testosterone production in women, and my experience is that it works quite well.  This cream works in conjunction with precursor hormones like progesterone and DHEA to increase your testosterone levels, and it can have a major impact on your sex drive and ability. It is an all-natural product with no artificial or animal ingredients and is well worth a try. A normal testosterone level is particularly critical for maintaining an active and satisfying sex life. [17]

Also, while my book is aimed specifically at men, it discusses hormone paths and the use of natural hormones in far greater detail.  It also discusses many other natural ways to enhance testosterone production that apply to both sexes. You can purchase a copy by clicking here or from Amazon.com.

How to use Hormone Creams

Trans-dermal hormone creams are designed to be readily absorbed into the bloodstream through the skin.  They typically use a liposome base that aids their absorption.  When spread on thin-skinned areas of the body, the cream is quickly absorbed into the fatty parts of the skin and transported into the blood stream.  It is important to rotate areas where the cream is used so that no particular skin area gets overused.  Hormones are stored in the fatty tissue layer just below the skin and if you use the same skin area day-after-day, the tissue becomes saturated and will absorb less. 

Continuous supplementation with any hormone can cause the body to shut down internal production. To prevent this, you should cycle hormone use.  This is particularly true for women who are still menstruating. Use the hormone for the three weeks before your menstrual flow begins and then take a one-week break.  The resulting deficit during the break triggers the body to turn up production of that hormone.  Sometimes a few months of cycling may nudge the body to permanently increase production, thus eliminating the need for external supplementation. 

Summary

Progesterone, DHEA, estrogen, and testosterone are extremely important hormones for a woman’s overall health.  A healthy body will always try to maintain a constant balance of its hormone levels at normal levels.  Unfortunately, nutritional deficiencies, lifestyle, certain medications, and the process of aging all contribute to hormone deficiencies.  

Restoring your hormone levels to their biological norm can be very rewarding in terms of how you feel and for your overall health.  Progesterone, estrogen, DHEA and testosterone levels all drop slowly as a woman ages.  The effects of low progesterone or estrogen can cause a woman to have hot flashes, night sweats, irritability, vaginal dryness, headaches, as well as all the other symptoms known as PMS.  Low testosterone can cause a woman to lose her desire for sex, and low DHEA can cause skin problems or deficiency in any or all of the above hormones, resulting in symptoms similar to any of those mentioned above.  

Low hormone levels also increase your risk for contracting many chronic diseases, as well as reducing your overall health and vitality.  Just remember that it is critical to test your hormone levels before starting a supplementing program and at regular intervals thereafter.  Also, remember that hormones are very powerful, and a little goes a long way.  More is definitely not better and excessive supplementation can damage your health.

Click here to order our Home Saliva Test Kit.
Click here to order Testosterone or other Hormone Creams.

 


Copyright 2008-2011, James Occhiogrosso, N.D., http://www.HealthNaturallyToday.com, All Rights Reserved

Parts of this article including the hormone diagram are excerpted from the book, “Your Prostate, Your Libido, Your Life: A Guide to Natural solutions for Common Prostate Problems”, by James Occhiogrosso.

 

References:


[1] Bhavnani, B.R., Pharmacokinetics and pharmacodynamics of conjugated equine estrogens: chemistry and metabolism, Proceedings of the Society for Experimental Biology and Medicine, Vol. 217, 6-16, Jan. 1998

[2] Smith, Nicholas L., et al. Conjugated Equine Estrogen, Esterified Estrogen, Prothrombotic Variants, and the Risk of Venous Thrombosis in Postmenopausal Women, Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 26:2807, Sept. 2006

[3] www.news-medical.net, Conjugated equine estrogen increases benign breast disease risk, Published: Wednesday, 9-Apr-2008

[4] Formby, B., et al. Progesterone inhibits growth and induces apoptosis in breast cancer cells: inverse effects on Bcl-2 and p53. Annals of Clinical & Laboratory Science, Vol.28, No. 6:360-9, Nov-Dec 1998

[5] Formby, B., et al. Bcl-2, surviving and variant CD44 v7-v10 are downregulated and p53 is upregulated in breast cancer cells by progesterone: inhibition of cell growth and induction of apoptosis. Molecular and cellular biochemistry, Vol. 202, No. 1-2:53-61, Dec. 1999.

[6] Hetts, S., To Die or Not to Die: an overview of apoptosis and its role in disease. Journal of the American Medical Association, Vol. 279, No. 4:300-307, Jan 1998.

[7] Campagnoli, C., et al.  Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. Journal of Steroid Biochememistry and Molecular Biology, Vol. 96, No. 2: 95-108, July 2005

[8] Lee, John, Natural Progesterone, Multiple Roles of a Remarkable Hormone, 2nd Ed, 1999, Jon Carpenter Publishing, Market Street, Charlbury, UK

[9] Simoncini, T., et al. Dehydroepiandrosterone Modulates Endothelial Nitric Oxide Synthesis Via Direct Genomic and Nongenomic Mechanisms. Endocrinology, Vol. 144, No. 8:3449-3455, May 2003.

[10] Williams, M., et al. Dehydroepiandrosterone Inhibits Human Vascular Smooth Muscle Cell Proliferation Independent of ARs and ERs. The Journal of Clinical Endocrinology & Metabolism, Vol. 87, No. 1:176-181, 2002.

[11] Kawano, H., et al. Dehydroepiandrosterone Supplementation Improves Endothelial Function and Insulin Sensitivity in Men. The Journal of Clinical Endocrinology & Metabolism, Vol. 88, No. 7:3190-3195, April 2003.

[12] Villareal, D., et al. Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men. Journal of the American Medical Association, Vol. 292, No. 18:2243-2248, Nov. 2004.

[13] Stomati M, et al. Six-month oral dehydroepiandrosterone supplementation in early and late postmenopause. Gynecol Endocrinology, Vol. 14, No. 5:342-63, Oct. 2000

[14] Genazzani, A., et al. Long-term low-dose dehydroepiandrosterone oral supplementation in early and late postmenopausal women modulates endocrine parameters and synthesis of neuroactive steroids.  Fertility and Sterility, Vol. 80, No. 6:1495 – 1501, June 2003.

[15] Takahashi K, et al. Efficacy and safety of oral estriol for managing postmenopausal symptoms. Maturitas, Vol. 15, No.34(2):169-77, Feb. 2000

[16] Somboonporn W., et al. Testosterone for peri- and postmenopausal women. Cochrane Database of Systematic Reviews, Issue 4. Art. No. CD004509, Oct. 2005

[17] Tuiten, A., et al. Time Course of Effects of Testosterone Administration on Sexual Arousal in Women, Archives of General Psychiatry, Vol. 57, No. 2, Feb. 2000.