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Safe Hormone Replacement Therapy

May 1, 2018

Synthetic pharmaceuticals prescribed as “hormone replacement” therapy are among the most widely prescribed medications in this country. They are most often used for women in menopause for symptoms such as hot flashes and night sweats. Unfortunately, even when effective for symptom relief, there is concern regarding the long-term safety of taking these “hormones”. Many women fearing the consequences of being treated with hormones, refuse therapy they might otherwise benefit from.

With Bioidentical hormone replacement the benefits of hormone replacement therapy may be enjoyed while minimizing safety concerns. When hormone imbalances are present there is a long list of associated symptoms that may occur. These are important not just for women but for men as well.

Consider how many symptoms overlap between the sexes…

Women’s Symptoms

  • Low Libido
  • Depression
  • Forgetfulness
  • Sleep Disturbances
  • Aches & Pains
  • Weakness
  • Fatigue
  • Thinning skin
  • Headaches

  • Bone Loss

  • Decreased Stamina
  • Heart Palpitations
  • Thyroid insufficiency
  • Vaginal Dryness
    • Men’s Symptoms

      • Low Libido
      • Depression
      • Forgetfulness
      • Sleep Disturbances
      • Aches & Pains
      • Weakness
      • Fatigue
      • Thinning Skin
      • Headaches

      • Bone Loss
      • Decreased Stamina
      • Heart Palpitations
      • Prostate Problems
      • Decreased Erections

      Why Bioidentical Hormones?
      Bioidentical hormones are made by compounding pharmacies based on a personalized prescription from a doctor. They have a chemical structure identical to the hormone as it is produced by the human body. Therefore, when a woman or man is prescribed these hormones, what they are receiving is a replenishment of something that is naturally made in the body, but which has become deficient, thus causing symptoms. Synthetic hormones treat symptoms rather than rebalancing natural hormone levels.

      In his book, Natural Progesterone, John Lee, MD enumerates the following effects of natural progesterone (remember synthetic “progestins” like provera are not progesterone).

      • Natural diuretic
      • Natural antidepressant
      • Improved libido
      • Facilitates thyroid hormone action
      • Stimulates osteoblasts for bone building
      • Helps protect against the formation of fibrocystic breasts
      • Helps use fat for energy

      These are just some of the positive effects of hormone balancing. It is worth noting that the prescription called into a compounding pharmacy by a physician is tailor made to the exact dose the doctor is prescribing for the individual patient. This is in contrast to a pharmaceutical drug made in the millions and shipped to pharmacies which place everyone on an average dose. Bioidentical hormones are prescribed in the dose appropriate to the patient. Thus, to minimize safety concerns, the lowest effective dose can be prescribed. 


      Testing and Treating Hormone Imbalance
      What are the hormone imbalances that can be checked for?
This author routinely utilizes saliva testing as a preferred method for checking the bioactive levels of Estrogen, Progesterone, Testosterone, DHEA, and Cortisol. When these hormones are tested by blood they are testing hormones that are bound by proteins circulating in the system, and the numbers may not always accurately reflect the physiological activity of the hormone for that person. When a person’s saliva is checked, the hormones that are detected are not bound by proteins and thus may reveal more accurate reflection of the bioactive hormone, that which creates the many effects of the hormones on the body. A proper check also takes into account not just the hormone levels but the balance between them. In particular, the balance between estrogen and progesterone is important.

      A concept of great importance describing what millions of women suffer from is the condition called Estrogen Dominance. This is when the estrogen hormones are relatively too high in comparison to the progesterone levels. Estrogen dominance can occur even when a woman develops estrogen deficiency at the start of menopause causing symptoms like hot flashes. This is because even though the production of estrogen is dropping, the production of progesterone drops even more, resulting in comparatively more estrogen than progesterone circulating in the system. These women are candidates for receiving both estrogen and progesterone. It is the balance between them which needs to be addressed as well as their basic levels standing alone.

      When estrogen becomes the dominant hormone and progesterone is deficient, estrogen can have the following harmful effects on the body:

      • Water retention
      • Breast swelling
      • Fibrocystic breasts
      • PMS
      • Decreased libido
      • Uterine fibroid
      • Weight gain
      • Cravings for sweets

      The symptoms of estrogen dominance can be successfully treated with natural progesterone, with its many benefits as enumerated above.

      Testosterone for Men and Women
      There is a misconception about testosterone. Many people will identify it as “the male hormone”. While it is true that testosterone levels are normally much higher in men than in women, women also need to be tested for testosterone. If a woman is deficient (relative to the proper female levels) then the symptoms of hormone imbalance occur.

      HDL and free testosterone levels often plummet in aging men and women. This combination of low HDL and low testosterone results in the risk of cardiovascular disease development. 


      Response to Treatment and Disease Prevention
      Most people will see the benefits of bioidentical hormones quickly. Within several days a patient will begin to sleep better, and hot flashes and night sweats will start improving. Libido will begin to return and weight control will be noticeably affected over time.

      Follow up by the physician should include monitoring of the person’s response, retesting for hormone levels after a reasonable period of time, and adjustment of the treatment on an individualized basis. The compounding pharmacy can then be instructed by the doctor to change prescriptions as per the unique need of each patient. 


      As hormone levels return to more youthful levels, improved nutrition, and fitness will likewise enable an individual to feel rejuvenated, enjoying greater energy, better overall well-being, and an improved opportunity for greater longevity.

      Dr. Sobo is a Medical Doctor practicing in Stamford, CT. More information about natural hormones and about Dr. Sobo’s practice can be found on the Internet at: http://drsobo.com. Dr. Sobo’s office phone number is 203-348-8805.

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