Hormones and Aging
Estrogen and Progesterone
Let us take a look at these various hormones, and contrast some of them with their synthetic counterparts.
When we talk of hormones and women, most of us think of estrogen and a few more will also include progesterone. Estrogen and progesterone are closely interrelated in many ways. In a normal functioning premenopausal woman, estrogen is made from progesterone and/or androgens within the cells of the body. After menopause, estrogens are converted from adrenal produced androgens (DHEA), primarily in body fat. Estrogen and progesterone are, in many ways, antagonistic; yet each sensitizes receptors for the other. A key to hormone balance is the knowledge that when estrogen becomes the dominant hormone and progesterone is deficient, the estrogen becomes toxic to the body; thus progesterone has a balancing or mitigating effect on estrogen.
Estrogen is responsible for the maturation of young women at puberty. Estrogen causes the accumulation of fat that gives the female body its contours, but in excess or when it is not in balance with progesterone, can contribute to excess fat accumulation. When women consume considerably more calories than what is needed, estrogen production increases to supernormal levels and may set the stage for estrogen dominance syndrome and exaggerated estrogen decline at menopause.
In the United States and most industrially advanced countries, diets are rich in animal fats, refined starches and processed foods. This provides calories in excess to the bodies needs and leads to estrogen levels in women twice as high as those do in women of the more agrarian third-world countries.
Estrogen Dominance Syndrome
In this context, it is worthwhile to compare the physiological effects of estrogen versus progesterone:
|Estrogen’s effectsStimulates breast tissues
Increases body fat
Causes salt and water retention
Depression and headaches
Interferes with thyroid hormone
Increases blood clotting
Decreases sex drive
Impairs blood sugar control
Causes loss of zinc and retention of copper
Reduces oxygen levels in all cells
Reduces vascular tone
Slightly restrains osteoblast function
Reduces vascular tone
Increases the risk of autoimmune disorders
Increases the risk of endometrial & breast cancer
|Progesterone’s effectsProtects against fibrocystic breasts
Helps use fat for energy
Facilitates thyroid hormone action
Normalizes blood clotting
Restores sex drive
Normalizes blood sugar levels
Normalizes zinc and copper levels
Restores proper cell oxygen levels
Restores normal vascular tone
Stimulates osteoblast bone building
Restores normal vascular tone
Precursor of corticosteroid disorders
Prevents endometrial and breast cancer
It is clear that excess estrogen, when unopposed or unbalanced by progesterone, is not something wholly to be desired. It becomes clear that many of estrogen’s undesirable side effects are effectively prevented by progesterone. I would propose that a new syndrome be recognized: That of estrogen dominance. This syndrome, with symptoms familiar to most women in industrialized countries, commonly occurs in the following situations:
- Estrogen replacement therapy.
- Premenopause (early follicle depletion resulting in a lack of ovulation and thus a lack of progesterone well before the onset on menopause).
- Exposure to xenoestrogens (foreign chemicals that have an estrogen effect in the body that cause early follicle depletion).
- Birth control pills (with excessive estrogen component).
- Hysterectomy (can induce subsequent ovary dysfunction or atrophy).
- Postmenopause (especially in overweight women).
- Estrogen use in the meat industry.
Thanks to a nearly universal misconception in Western medicine that estrogen deficiency brings about all menopausal symptoms, it is the custom to prescribe unopposed estrogen for women who do not have a uterus (i.e. have had a hysterectomy). Equally unfortunate is the fact that premenopausal estrogen dominance is simply ignored.
A peculiarity of Western industrialized societies is the prevalence of uterine fibroids, breast and/or uterine cancer, fibrocystic breasts, PMS, ovarian cancer, premenopausal bone loss, and a high incidence of osteoporosis in menopausal women. I believe that most of these are the symptoms of estrogen dominance.
The following is a list of symptoms that can be caused or made worse by estrogen dominance:
|Acceleration of aging process
Decreased sex drive
Fat gain, especially around the abdomen, thighs, and hips
Thyroid dysfunction mimicking
Water retention, bloating
Autoimmune disorders, such as Lupus,
Erythematosus, thyroiditis, and possibly Sjogren’s disease
Natural Progesterone vs. Synthetic Progestins
A progestin is often defined as “any compound able to sustain the human secretory endometrium”. This refers to the ability to keep the lining of the uterus healthy and blood-rich in preparation for pregnancy and to support the developing embryo. When a woman comes to the end of her monthly cycle and no pregnancy has occurred, the levels of her reproductive hormones drop dramatically and in response, the lining of the uterus is shed in menstruation.
Throughout much of the medical literature, natural progesterone is either equated with progestins, as if they were the same, or classified as one of the progestins, which strictly speaking is also incorrect. There is only one progesterone, the specific molecule made by the adrenal glands or by the ovary as a consequence of ovulation. We define progestins as “any compound other than the natural progesterone, able to sustain the human secretory endometrium”.
Why do we insist on this separation? First and foremost, natural progesterone is essential for the survival and development of the embryo and throughout pregnancy. On the other hand, Provera, the mostly commonly prescribed progestin, carries the warning that its use in early pregnancy may increase the risk of early abortion or congenital deformities of the fetus.
Because progesterone is a natural hormone, the body is normally able to produce it, use it, and eliminate it. The synthetic progestins, on the other hand, are not well processed by the body. Its activity is prolonged, creating reactions in the body that are not consistent with natural progesterone.
Progestins bind to the same receptor sites in the cell as progesterone, but from that point on they carry a different message to the cell. This undoubtedly explains the alarming array of listed warnings, contraindications, precautions and adverse reactions to progestins, uncharacteristic of natural progesterone.
Some may ask, “What difference could a few atoms make that differentiate a natural hormone from a synthetic?” To answer that question, one needs only to look at the chemical difference between testosterone and estrogen. The only difference is one hydrogen atom and a few double bonds. Yet, that is the profound difference hormonally between men and women.
Natural Estrogens vs. Synthetic Estrogens
In certain instances, estrogen therapy may be necessary and desirable. However, there appears to be a more rational way to prescribe “Estrogen Replacement Therapy” than the conventional Premarin or related drugs. As its name implies, Pre-mar-in is derived from the urine of pregnant mares. Although it exerts estrogenic effects in humans, horse estrogen is not the same as human estrogen, and is not necessarily as safe or effective.
In addition, the cruel torture that pregnant horses are put through in “Premarin factories” has led many women to seek another source of estrogen.
Estrace is a synthetic version of 17-beta-estradiol, which occur naturally in the human body. However, Estrace is not a balanced form of estrogen, because the human body also manufactures two other important compounds: estrone and estriol. There is evidence that estriol, although a relatively weak estrogen, does not promote cancer, and may actually prevent it.
For that reason, some physicians who prescribe estrogen prefer to use estriol alone or in a combination formula called triple or Tri-Estrogen. Tri-Estrogen is composed of 80% estriol and 10% each of estradiol and estrone. The same ratios as produced naturally by the body. Tri-Estrogen is available through compounding pharmacies.
Testosterone is a naturally occurring hormone, which in addition to being responsible for developing adult male physical characteristics during and after puberty is also critical for erectile function, libido, muscle mass and normal energy level, mood and bone formation. The last five functions are not only critical in men, but also in women.
“Unfortunately, most men aren’t comfortable discussing the symptoms of testosterone deficiency – such as a decrease in sexual interest, erectile function, or depressed mood and fatigue – with family members, friends, or even their own doctors,” said Adrian S. Dobs, M.D., M.H.S., Associate Professor of Medicine, John Hopkins University School of Medicine. “Because of that, many men may go undiagnosed and untreated (for testosterone deficiency). Physicians and their male patients need to establish a dialogue where topics of this nature can be freely discussed.”
Obesity, insulin resistance, hypertension, dyslipidemia, and increased risk of myocardial infarction (heart attack) have been associated with what has been called the “neuroendocrine syndrome.” This syndrome is associated not only with signs of low sex-steroid secretion in both men and women, but also with a decrease in growth-hormone activity and an increase in cortisol activity.
In two double blind placebo-controlled studies, it was found that by increasing testosterone levels to physiologic levels, that there was a decrease in visceral adipose-tissue mass (spare tires around the waist). It was demonstrated in separate studies that testosterone exerted this effect by decreasing triglyceride assimilation and enhancing lipid mobilization. Testosterone supplementation also improved fasting blood glucose, blood lipid levels, diastolic blood pressure decreased, and insulin sensitivity increased. A general improvement in psychological parameters was also observed. The men felt better.
Testosterone is available, with a prescription in its natural form, either in a transdermal cream or in an oral capsule. The transdermal cream is better absorbed.
DHEA is a natural hormone that is made by the adrenal glands. Being it is a natural substance made by the body it cannot be patented and made into a drug. As such, it is not FDA approved, since the FDA does not approve a natural substance, only synthetic substances, which are not made in the body and have inherent side effects. DHEA is short for dehydroepiandrosterone (Di-hi-dro-ep-E-an-dro-stehr-own) a hormone made by the adrenal glands.
More than 150 hormones are synthesized by the adrenal glands. However, the most abundant hormone made by the adrenal glands is DHEA. After DHEA is made by these glands, it goes into the bloodstream, and from then on it travels all over the body and goes into our cells, where it is converted into male hormones known as androgens, or female hormones, known as estrogens. Whether DHEA gets converted predominately to androgens or estrogens, depends on the person’s medical conditions, age and sex. Every person has a unique biochemistry. The only hormone class that DHEA cannot make is progesterone and its sister hormone, cortisol and aldosterone.
From the studies that have been done so far, it seems that DHEA helps fight disease by boosting your immune function, improves mood and energy (many people say they have an increased sense of well- being), boosts your sex drive and influences longevity. It has been shown in some studies to reduce your risk of cardiovascular disease in men, help symptoms of Lupus, Rheumatoid Arthritis and Multiple Sclerosis as well as Diabetes and some forms of cancer.
Whenever doctors discuss the safety of a medicine, they separate it into short-term safety over a few days or weeks, and a long term safety over months and years of use. Dr. Nestler, a researcher at the Medical College of Virginia/Virginia Commonwealth University in Richmond, gave 1600mg of DHEA a day for 4 weeks to healthy young men without any serious side effects. At this dosage, there was a lowering of cholesterol and a decrease of body fat, with a greater response in obese individuals. Most DHEA supplements on the market are less than 50 mg.
As to the safety of using DHEA for 5, 10, 20 years or longer, no formal human studies have been published, then again, few long-term human studies have been done for any medicines, hormones or nutrients.
Pregnenolone is a natural hormone, which cannot be patented and made into a drug. Back in the 1940’s when researchers started experimenting with pregnenolone, they realized that it could be helpful to people under stress and it could increase the energy of those who were fatigued. However, about the same time, cortisol, another closely related hormone was discovered. Cortisol stole the limelight. Scientists basically put pregnenolone aside and focused on cortisol. Pregnenolone has stayed in relative obscurity since the 1940’s with only rare mentions in the medical literature. Over the last year or two, public attention has slowly refocused on pregnenolone.
Pregnenolone is made in many organs and tissues of the body. The most common of these organs are the adrenal glands, liver, skin, and gonads (testicles and ovaries). The amount of pregnenolone made depends on how much cholesterol is brought into the mitochondria. The mitochondria are the chemical factories of a cell that also produce the energy molecules of the body.
The chemical name for pregnenolone is 3-alpha-hydroxy-5-beta-pregnen-20-one. You can see why it is called Pregnenolone. Pregnenolone can be easily converted into DHEA, another hormone that has been in the news a lot lately. DHEA can then be converted into androgens, estrogens and other steroids within the body. There is one other pathway that Pregnenolone can take which distinguishes it from DHEA and that is pregnenolone can be metabolized into progesterone which DHEA cannot. Thus, DHEA has often been called the “Mother hormone”. I guess that would make pregnenolone the “Grandmother hormone”.
Because of the wide number of hormones that can be made by the body from pregnenolone, it has a long list of conditions that can be effected by supplementing. A few of the conditions for which pregnenolone can be helpful are: brain function including mood and memory and thinking, Alzheimer’s, sleep, Chronic Fatigue, Immune System, Lupus, Multiple Sclerosis, Premenstrual Syndrome, Psoriasis, Rheumatoid Arthritis, Scleroderma and stress.
In a long-term study, mice were given 1 gram of pregnenolone per kilogram (2.2 Ib.) of body weight three times a week for 50 doses with no toxic reaction. There were no changes noted in the red blood cells, white blood cells, hemoglobin, or the weight of the body organs. Also, no changes were found in food intake, growth rate, fertility, or size and condition of their offspring. In fact, researchers, Dr. Gregory Pincus and Dr. Hudson Hoagland were confident of Pregnenolone’s safety back in 1944 when they wrote: “We would like to point out that we have encountered no deleterious results in connection with the ingestion of Pregnenolone in our studies involving several hundred men and women who have taken the medication, in some instances in doses of 100 mg per day for as long as four months”. Pregnenolone is nontoxic.
Melatonin is a natural hormone made by the pineal gland, which is located in the brain. Melatonin helps set and control the internal clock that governs the natural rhythms of the body. Each night the pineal gland produces melatonin, which helps us fall asleep. Research about this hormone has been ongoing since its discovery in 1958. But it is only in the last few years that much attention has been paid to melatonin. Close to one thousand articles a year about melatonin are now published worldwide. One reason for this growing interest is that we are realizing that deep sleep is not the only byproduct of melatonin. We are learning that it has a significant influence on our hormonal, immune and nervous systems. Research is showing melatonin’s role as a powerful antioxidant, its anti-aging benefits, and its immune enhancing properties. It is an effective tool to prevent or cure jet lag, an ideal supplement to reset the biological clock in shift workers and a great medicine for those who have insomnia.
Melatonin also may have a role to play in the treatment of prostate enlargement, as an addition to cancer treatment, in lowering cholesterol levels, in influencing reproduction, and more. A delightful bonus is that melatonin can promote vivid dreams.
For estrogen replacement, we recommend Tri-Estrogen. Tri-Estrogen is composed of 80% estriol, 10% estrone and 10% estradiol. These levels closely mimic the body’s own natural production. The precursors for making Tri-Estrogen are derived from soybeans. Each woman’s dosage will be different and will be customized to each individual patient.
The natural progesterone is made from wild Mexican yams or soybeans. It can be given either transdermally or orally. We recommend that if the progesterone is taken orally, it be placed in a sustained release base, which will give sustained release of progesterone in the blood by protecting it from stomach acid degradation. Each woman will again get a customized formulation.
DHEA and the other natural hormones are derived from plant saponins that are found in soybeans. The most comm
on dosages of DHEA are 10mg, 25mg, and 50mg capsules. The most common dosages of Pregnenolone are 10mg, 30mg and 50mg capsules.
Testosterone replacement for women and men is individually customized to meet each patient’s needs. The level of testosterone as well as other hormones should be checked periodically to keep them within the physiological range. If men experience any urinary difficulties, we suggest that they take a natural prostate health formula containing Saw Palmetto and/or Pygeum Africanim extract.
Melatonin for insomnia, the suggested dose is quite variable. We suggest starting dose of 1mg, two hours before bedtime and titrate up to 3mg is needed. For jet lag, we suggest trying 1mg for every hour time difference up to 6mg. If you use 6mg, split it into two divided doses, take 3mg two hours before bedtime and the remaining 3mg one hour prior to bedtime.
When you are taking hormones, we recommend that you have periodic lab evaluations and checkup to properly assess their benefit.