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Women's Health

Be a Healthy Woman!

Being a healthy woman means recognizing your own needs and taking the steps to improve your physical and mental health. It means being active, eating healthy, getting regular checkups and preventive screenings, paying attention to your mental health, getting enough sleep and managing your stress as well as avoiding unhealthy behaviors such as smoking. 

We want to empower women to make their health - and happiness - a priority. Sadly, too often women are led to believe that they must endure problems associated with menopause. Hormonal imbalance can impact every aspect of a woman’s life, and because the onset can be insidious and begin years before menopause, the real cause of problems like irritability, mood swings, depression, weight gain, and lack of interest in sex is often overlooked. Instead of doing appropriate testing and treating women to restore hormones to normal levels, some physicians tell women that declining hormones are a normal part of aging, and prescribe antidepressants, addictive sleep medications, synthetic hormones and other drugs that produce side effects and simply add to the problems these women are having.

Schedule with our caring professionals to find out more about how to achieve hormone balance – and your health goals. We welcome your questions! CLICK HERE

Most Common Symptoms of hormonal imbalance.

Hot flashes, night sweats, trouble sleeping and weight gain are the most common symptoms of hormonal imbalance as a woman ages. Perimenopause weight gain is oftentimes misdiagnosed and is one of the first signs of hormonal imbalance.

Symptoms and conditions commonly associated with estrogen deficiency include:

  • Hot Flashes
  • Night Sweats
  • Sleep Disturbances
  • Murky Thinking
  • Vaginal Dryness
  • Incontinence
  • Thinning Skin
  • Osteoporosis

Low Androgen is usually brought about through the Natural Aging Process and can cause:

  • Osteoporosis 
  • Loss of Muscle Mass
  • Erectile Dysfunction
  • Thinning Skin 
  • Vaginal Dryness
  • Low Libido
  • Incontinence
  • Fatigue

High levels of Androgen can sometimes be found in premenopausal women due to a metabolic disorder.

Symptoms Include:

  • Loss of Scalp Hair
  • Increased Body and Facial Hair
  • Acne
  • Oily Skin

Androgens, such as testosterone and dehydroepiandrosterone (DHEA) can be added to estrogen replacement therapy to:

  • Enhance Libido
  • Provide Cardiovascular Protection (lower cholesterol)
  • Enhance Bone Building (increase calcium retention)
  • Improve Energy Levels and Mental Alertness

Common Types of Hormones

Estrogens

Estrogen is a group of related hormones each with a unique profile of activity. The three principal estrogens in humans are estriol (E3), estradiol (E2), and estrone (E1 ). They are often prescribed in combination to re-establish a normal physiologic balance. Since bioidentical hormones are identical to those that the body produces for itself, we feel it makes more sense to use these types rather than hormones from horses, or synthetic versions which are not identical in chemical structure to what your body produces. Therefore improving your total health and wellbeing as opposed to having a longer list of side effects then benefits.

Estriol (E3), Estradiol (E2), and Estrone (E1) and are most commonly prescribed as a single estrogen, Biest or Triest to re-establish normal levels in physiologic levels.

estrone (E1 ), estradiol (E2) and estriol (E3). Of these three, estradiol is the most potent.

Estrogens play an important function in protecting bones, sustaining a healthy cardiovascular system, regulating reproductive systems, and preserving brain function.

Symptoms & conditions commonly associated with excess estrogen f estrogen dominance) include:

  • Decreased Sex Drive
  • Abnormal Menstrual Cycle
  • Bloating


Estrogens have been shown to be clinically effective in:

  • relieving menopausal symptoms, including vaginal thinning and dryness
  • increasing HDL "good" cholesterol and decrease LDL
  • "bad" cholesterol
  • decreasing blood pressure and reduce plaque formation on
  • the arterial wals
  • reducing the risk of colorectal cancer
  • improving mood, energy levels, and sleep patterns
  • reducing the risk of developing or the severity of type 2 diabetes
  • improving memory or cognitive function 
  • reducing bone loss

Progesterone
Progesterone is produced in the ovaries. Women with regular cycles generally make adequate progesterone. Sustaining health during pregnancy, maintaining regular menstrual cycles, breast development, and preserving brain function are all roles that progesterone plays an important part in.

Lower levels of progesterone are typically found in postmenopausal women, women who have had their ovaries removed, or women who use synthetic progestins. Signs and symptoms include those found with estrogen dominance (listed on previous slide). Higher than normal levels of progesterone are a typical and the signs and symptoms can be quite benign.

Thyroid

The thyroid hormones levothyroxine (T 4) and liothyronine (T3) are primarily responsible for the regulation of metabolism. T3 is the active thyroid molecule, meaning that it is the form that exerts Its effects on the body's cells. However, the body also produces T4 and converts it to T3 in the blood vessels.
Hypothyroidism is by far the most common thyroid disorder in the adult population and is more common in older women. Hypothyroidism is your thyroid not working actively enough and producing less thyroid hormones than your body needs. It can make you gain weight, feel fatigued, and have difficulty dealing with cold temperatures.

Every woman is bio-chemically unique. ageVital will work together with your health care provider to individualize hormone replacement therapy. We can create hormone medications in the following delivery forms; which will increase compliance, maximize the potential for therapeutic success, and reduce the potential for unwanted side effects.

• Transdermal Creams & Gels • Capsules • Troches
• Sublingual drops • Vaginal Suppositories and others!

Goals of Honnone Replacement Therapy

  • Alleviate the symptoms caused by the natural decrease in production of hormones by the body
  • Offer the protective benefits which were originally provided by naturally occurring hormones
  • re-establish a hormone balance

Bio-identical Hormones Benefit Newly Menopausal Women

Hormone therapy with estrogen and progesterone started soon after menopause may relieve many of the symptoms experienced by menopausal women and also improve mood and markers of cardiovascular risk, according to new findings presented at the North American Menopause Society (NAMS) Annual Meeting in October, 2012. The Kronos Early Estrogen Prevention Study (KEEPS) investigated the risks and benefits of hormone therapy in women aged 42-58 who recently entered menopause. KEEPS was undertaken because the Women’s Health Initiative (WHI) found that the incidence of cardiovascular disease increased by 29% in older women (age 50-79) who were treated with oral conjugated equine estrogens (CEE) and medroxyprogesterone acetate. The WHI contradicted previous studies that suggested hormone therapy was associated with a high degree of protection against heart disease and a favorable benefit-risk ratio, so KEEPS studied a younger popular than the WHI to determine if age is a factor.
 
KEEPS was a four-year randomized, double-blinded, placebo-controlled clinical trial involving 727 women who were within three years after menopause when the study began. Women at nine major medical centers received low-dose oral conjugated equine estrogens (CEE), transdermal estradiol (E2) or placebo. All women also received cyclic micronized progesterone orally.
 
KEEPS researchers concluded:

  • 48 months of hormone treatment in this healthy, recently menopausal population neither significantly reduced nor accelerated progression of atherosclerosis.
  • Improvements in hot flashes, night sweats, mood, sexual function, and bone density were observed with hormones but not placebo. 
  • Transdermal estradiol appeared to improve insulin sensitivity (lowered insulin resistance).
  • Hormone therapy improves symptoms of depression and anxiety in recently menopausal women, without adverse effects on cognition. 
  • No significant differences in adverse events (breast cancer, endometrial cancer, heart attack, stroke, or venous blood clots) were found between different hormones or placebo. 
  • There is a need for individualized decision making about hormone therapy, given that each woman has a unique symptom profile and priorities for treatment. 
  • Additional research on hormone therapy in newly menopausal women, including differences in effects according to route of delivery, dose, and formulation of hormone therapy, is needed.

       C. Natural Progesterone Can Slow Breast Cancer

A large team of scientists have determined that natural progesterone has the potential to slow the growth of many breast cancer tumors or even shrink them, unlike synthetic progestins which increase breast cancer risks, .
 
It has long been known that tumors with estrogen receptors (ER) and progesterone receptors (PR) – termed ER/PR double positive - have the best clinical outcome. A study conducted by researchers from prestigious institutions including the Cancer Research UK Cambridge Institute; University of Adelaide, Australia; University of Texas, Southwestern Medical Center at Dallas; and University of North Carolina at Chapel Hill explain why double positive breast cancer patients have the best chance of survival. The finding could benefit up to half of all breast cancer patients.
 
Scientists know that when activated by most forms of estrogen - especially estradiol and its metabolites - estrogen receptors turn on genes within cancerous cells that program those cells to multiply rapidly and stay alive rather than die off as normal, healthy cells do. When activated by progesterone, progesterone receptors attach themselves to estrogen receptors. Once this happens, estrogen receptors stop turning on genes that promote the growth of the cancer cells. Instead, they turn on genes that promote the death of cancer cells (apoptosis) and stimulate the growth of healthy, normal cells.
 
The researchers pointed out that only natural, customized progesterone slows the growth of breast cancer. Conversely, synthetic progestins (molecularly altered forms of progesterone including medroxyprogesterone acetate and other progesterone derivatives found in birth control pills) have been shown to increase rather than decrease breast cancer risks.
 
This is exciting news for women who are diagnosed with ER/PR positive breast cancers. If such women have healthy progesterone levels, or when progesterone levels are increased through natural progesterone supplementation, treatment outcomes may improve significantly. 
 
Hormonal imbalances have reached epidemic proportions in most developed countries over the last several decades. Due to poor diets, lack of exercise, a rise in obesity levels, the widespread use of hormone-altering chemicals, and other factors, many women suffer from chronically higher than normal estrogen levels and much lower than normal progesterone levels. 
 
In their book What Your Doctor May Not Tell You About Breast Cancer, John R. Lee, M.D. and David Zava, Ph.D. noted that women with progesterone levels that are low relative to estrogen levels are more likely to get breast cancer and have poorer treatment outcomes. They concluded that estrogen dominance causes estrogen receptors to activate genes such as BCL-2 that are known to promote the rapid growth of cancer cells. They theorized that chronic states of estrogen dominance contribute to high rates of breast cancer, and their theory has been validated with this latest research.

References

 Nature 2015; 523; 313-317. 
Pharmaceutical Journal, 17 Jul 2015. 
John R. Lee, M.D.; David Zava, Ph.D.; and Virginia Hopkins. “What Your Doctor May Not Tell You About Breast Cancer.” 2002
http://www.johnleemd.com/natural-progesterone-treat-breast-cancer.html

D. Options for Treating Infertility

Infertility affects one in every 7 couples and usually multiple issues are involved. Treatments for infertility are often provided by physicians trained in subspecialties, including artificial insemination, ovulation induction, and hormonal support of the menstrual cycle. The increasing shift of treatment toward Assisted Reproductive Technologies (ART), including in vitro fertilization (IVF) and intracytoplasmic sperm injection, has further removed infertility treatment from the realm of the OB/GYN and family physician. ART is expensive, invasive, and involves some risk to women. There are also concerns about short- and long-term outcomes for the children. The most prominent concerns relate to the incidence of multiple pregnancies with ART treatment and the subsequent perinatal complications, including low birth weight and prematurity.  
 
Natural Procreative Technology (NaProTechnology, NPT) is a systematic medical approach for optimizing physiologic conditions for natural conception. When utilized by an OB/GYN or a trained general physician such as a family practitioner, NPT has produced live birth rates comparable those associated with more invasive treatments, including ART. However, NPT is less expensive than ART and has minimal risk of multiple births. The availability and use of NPT may improve access to care for couples dealing with infertility, with low risk to women and offspring. 
 
A standardized NPT investigation (involving a patient exam and lab work ) usually results in the diagnosis of one or more abnormalities associated with infertility, including decreased production of  cervical mucus,  irregular menstrual bleeding or spotting, short or variable luteal phases, and suboptimal levels of the ovarian hormones estrogen and progesterone. The physician trained in NPT then determines a course of treatment that aims to correct the underlying abnormality, with the goal of optimizing physiologic conditions for conception.

Common interventions include induction or stimulation of ovulation and medications to enhance cervical mucus production, including vitamin B6 and guaifenesin. Vitamin B6 also increases the utilization of estrogen at the level of the cervix and improves cervical fluid production. Guaifenesin is used to loosen the cervical fluid around the time of ovulation. Luteal phase support can be provided by human chorionic gonadotropin (HCG), compounded progesterone vaginal suppositories, or compounded progesterone in oil for intramuscular injection. 
 
A study evaluated outcomes in couples receiving treatment for infertility from two NPT-trained family physicians. A total of 1,239 couples had an initial consult for NPT, of which 1072 had been trying for at least a year to conceive and initiated NPT. The average female age was 35.8 years, the average duration of attempting to conceive was 5.6 years, 24% had a prior birth, and 33% had previously attempted treatment with assisted reproductive technology (ART). All couples were taught to identify the fertile days of the menstrual cycle with the Creighton Model Fertility Care System, and most received additional medical treatment, including the drug clomiphene (75%).

Younger couples and couples without previous ART attempts had higher rates of live birth. Among live births, there were 4.6% twin births. The 364 couples who ultimately conceived with NPT treatment were slightly younger (average 34.8 years); had not been attempting conception as long (mean duration, 4.8 years); were likely to have had a previous birth (30%); and less likely to have attempted ART (21%). Adjusting for withdrawals from treatment and continuing treatment at the end of study follow-up, the cumulative proportion of first live births was 27.1% for those who used NPT for up to 12 months, and 52.8% for those who used NPT for up to 24 months.

References

www.naprotechnology.com
J Am Board Fam Med. 2008;21(5):375-384.
Int’l Journal of Pharmaceutical Compounding Vol. 5 No. 2 March/April 2001:136-9

The Medical & Surgical Practice of NaProTechnology, by Thomas W. Hilgers, MD

E. Natural Estrogens: Benefits for Postmenopausal Women  

When talking about a woman’s hormones, the term “estrogen” is frequently used. Estrogens are steroid hormones present in both men and women, but at significantly higher levels in women of reproductive age. But, do you know that there are three types of estrogens found in the human body? Estriol (E3), Estradiol (E2) and Estrone (E1) each have unique biological effects, benefits and side effects. Also, the different forms of estrogen have different affinities for certain body tissues (such as the brain, breast and vagina) and therefore it is important to select the most appropriate estrogen for optimal treatment or prevention of a specific problem.  
 
Estriol, coined the “weaker” of the three estrogens naturally made by the human body, has significant therapeutic benefits, and is commonly used to treat hot flashes, insomnia, and vaginal atrophy; to reduce the frequency of urinary tract infections; and for skin enhancement. Recently, estriol has shown the potential to treat individuals with autoimmune illnesses, including multiple sclerosis and rheumatoid arthritis. 
 
After menopause, as estrogen levels fall, many women experience thinning, drying and inflammation of the vaginal walls,  clinically known as vaginal atrophy. Multiple studies have demonstrated the benefits of a vaginal tablet containing an ultra-low-dose of estriol (E3) in combination with the probiotic Lactobacillus acidophilus for the treatment of vaginal atrophy. 

The FDA “respects a healthcare provider’s decision that his or her patient should receive estriol.” E3 has a USP monograph that therefore can be compounded by prescription. E3 has been commercially available in Europe and Asia for many years and its use is well supported in the medical literature. 

References:

Journal of Restorative Medicine 2013; 2: page 45-52.
Climacteric. 2013 Jun;16(3):347-55.
Breast Cancer Res Treat. 2014 Jun;145(2):371-9.

F. Testosterone Therapy for Women: Debunking the Myths

Testosterone therapy is increasingly used to treat symptoms of hormone deficiency in pre and postmenopausal women.  Testosterone is essential for physical and mental health in women as well as men. Although frequently thought of to increase libido, testosterone’s role in sexual function is only a small part of its physiologic effect in women. Receptors for testosterone are located in almost all tissues including the breast, heart, blood vessels, gastrointestinal tract, lung, brain, spinal cord, peripheral nerves, bladder, uterus, ovaries, endocrine glands, vaginal tissue, skin, bone, bone marrow, muscle and adipose (fat) tissue. Testosterone declines gradually with age in both sexes. Pre and post-menopausal women, and aging men, may experience symptoms of androgen deficiency including anxiety, irritability, depression, lack of well being, physical fatigue, bone loss, muscle loss, changes in cognition, memory loss, insomnia, hot flashes, rheumatoid complaints, pain, breast pain, urinary complaints, incontinence as well as sexual dysfunction.

According to an article by Rebecca Glaser, MD and Constantine Dimitrakakis, MD, PhD published in Maturitus in February 2013: testosterone is not masculinizing and does not increase aggression or cause hoarseness; testosterone does increase scalp hair growth, is mood stabilizing, and is cardiac and breast protective. A source of confusion concerning the safety of testosterone therapy in both men and women is the extrapolation of adverse events from high doses of oral and injectable synthetic anabolic steroids to therapy using the natural form of testosterone in doses that simply restore normal physiologic levels (natural testosterone is the same substance that is produced by the human body). In England and Australia, testosterone is licensed and has been used in women for over 60 years.

References:

Excerpts from “Testosterone therapy in women: Myths and misconceptions” by Rebecca Glaser and Constantine Dimitrakakis. Maturitas. 2013 Feb 1.[Epub ahead of print]

 

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