How to use natural medicine to address imbalances in stress and sex hormones.
In the first part of our coverage of endocrine health, we discussed how to take an integrative approach to restore balance with regard to insulin resistance and thyroid health. This article will look at restoring balance to sex and stress hormones.
As we age, levels of sex hormones naturally decrease in both men and women. For women, this transitional period is referred to as menopause, when menstrual periods stop. Many women (about 20 percent) experience no health effects other than menstrual irregularity as they approach menopause. But the change in hormone levels associated with menopause, particularly the drop in estrogen levels, can cause a range of health effects: diminished sex drive, hot flashes, night sweats, vaginal dryness, sleep problems, weight gain, mood changes, memory loss, fatigue, and more.
To address these health concerns, many women turn to hormone replacement therapy. The conventional approach uses synthetic hormones like Premarin, an estrogen made from conjugated equine estrogen (CEE)—pregnant horse mares’ urine—or Prempro, which contains CEE and synthetic progesterone. Major studies have found that prolonged use of these synthetic products is associated with higher rates of coronary heart disease, breast cancer, stroke, and more.
Millions of women opt for bioidentical hormones, hormone medicines that are biologically identical to those produced by the body. These medicines are often made specially for individual patients at compounding pharmacies, although there are some FDA-approved bioidentical hormone products. A review of the clinical literature concluded that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more effective than synthetic or animal-derived hormones.
Yet, as we’ve been reporting for some time, the FDA is threatening to ban estriol and other bioidentical hormones from being compounded; as there are no FDA-approved estriol drugs, a ban on compounded estriol would mean complete loss of access. This is important, because estriol has a number of important benefits. For one, it doesn’t come with the dangers of alternatives, like an increased risk of endometrial cancer. Estriol also improves bone health, helps with multiple sclerosis, and protects urinary health. ANH has been leading the charge to protect estriol, as well as other bioidentical hormones that are compounded, from an FDA ban.
Hormonal imbalances can be an issue outside of menopause. Women with menstrual problems, or sometimes just acne, are often prescribed birth control pills, for example, without an assessment of what the underlying issue of hormonal imbalances producing these effects might be. These are medications that contain a combination of hormones, usually estrogen and progesterone, to prevent ovulation. We are not commenting on the merits of birth control—which is every woman’s choice—merely the conventional medical practice of treating symptoms rather than root causes when it comes to prescribing birth control pills for medical issues like irregular periods, PMS, or painful cramping. Many women may not be aware of the potential dangers of taking birth control pills. For example, they can cause micronutrient deficiencies (in vitamins B6, B12, folate, vitamin C, magnesium, and zinc). They can also disrupt the hypothalamic-pituitary-adrenal axis, which is the control system for hormone regulation.
Integrative doctors take a different approach. They will spend more time with patients to learn more about their history and overall health. To address menstrual concerns, as with most other health problems, they start with lifestyle and diet modifications, looking at nutrition, gut function, blood sugar regulation, exercise, figuring out if there are mold or heavy metal exposures, and micronutrient deficiencies that could be contributing to hormonal imbalances. Of course, if symptoms are making life very difficult, short term hormone replacement may be part of the equation to help the patient on the road to recovery.
Testosterone levels for men also drop with age. For older men, low testosterone can be addressed with bioidentical hormone replacement therapy, including testosterone, DHEA, and sometimes thyroid hormones, melatonin, and oxytocin as well. An even bigger issue is declining testosterone in younger men. There are a variety of lifestyle factors that explain this drop in testosterone (obesity, physical inactivity, poor sleep, etc.) but a major contributor is the environmental toxins we are exposed to in the modern world. Glyphosate, for example, is toxic to testicular cells at small concentrations. The ubiquity of endocrine disrupting chemicals in consumer products of all sorts is also tied to drops in testosterone. These exposures are also contributing to a fertility crisis: research has shown that sperm counts for men have fallen 59% from 1973 to 2011. One researcher bluntly stated, “Not everyone who wants to reproduce will be able to.”
A variety of nutrients can help support testosterone production, including vitamin A, vitamin D, manganese, magnesium, and vitamin K. Getting rid of heavy metals that suppress testosterone, like lead and cadmium is also critical. This can be achieved with chelation with EDTA—another modality that the FDA is threatening to ban.
For men, most of the focus is on balancing testosterone, but proper estrogen levels in men need to be maintained for optimal health, too. In older men, low estrogen levels were linked with increased mortality risk, heart problems, prostate cancer, bone fractures, and Alzheimer’s disease.
We’ll close off our discussion of hormone balance with adrenal health. The adrenal glands produce hormones that regulate metabolism, the immune system, blood pressure, and the stress response. They produce cortisol, epinephrine (or adrenaline), and norepinephrine, among others. The most common imbalance of these hormones is referred to as “adrenal fatigue.” When we’re exposed to chronic stress over a long period of time, our adrenal gland pumps out more and more cortisol, but we become more and more resistant to its effects until the adrenal glands cannot keep up with our demand for cortisol, resulting in low cortisol levels. Symptoms of “adrenal fatigue” are brain fog, low sex drive, low blood pressure, low blood sugar, waking up unrested, and increased severity of allergic responses. The ways to restore balance with adrenal hormones like cortisol, naturally, are similar to other protocols we’ve discussed in restoring hormone balance, including getting enough sleep (8 hours per night), eating a proper diet of lots of vegetables, fruits, and quality protein and fats, and managing stress with mind-body activities like yoga or mindfulness exercises.
As always, please consult an integrative health practitioner to develop the best treatment program to meet your individual problems and needs.
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