The difference between natural hormones and synthetic hormones at the molecular level is minimal. However, this small change in structure accounts for the multiple side effects and risks associated with synthetic hormones including stroke, heart attack, blood clots, heart disease, breast cancer and Alzheimer’s disease. The reason pharmaceutical companies make synthetic hormones is so that they can be patented. A patented product makes more money.
According to Dr. Peter Koshland, Associate Professor of Clinical Pharmacy at UCSF School of Pharmacy, research supports natural hormones as a safe and effective treatment approach for menopause (see newsletters), andropause (see newsletters) and premenstrual syndrome. There is strong evidence they improve bone mass and prevent osteoporosis, and moderate evidence for prevention of breast cancer, heart disease, stroke, depression, dementia and Alzheimer’s disease.
Natural hormones are derived from plants using specialized laboratory techniques. They are custom compounded to match each person’s unique needs and body chemistry, unlike the "one size fits all" approach used with synthetic hormones. Estrogen, progesterone and testosterone affect every system in the body including breast tissue, brain, heart, bone, skin, cardiovascular system and intestinal tract. That is why an imbalance or deficiency can lead to a host of symptoms.
Estrogen Deficiency Symptoms
Hot flashes, night sweets, vaginal dryness, vaginal irritation and infection, bladder infections and irritation, incontinence, heart palpitations and decreased libido
Progesterone Deficiency Symptoms
Edema, weight gain, infertility, anxiety, depression, mood swings, cramping, PMS and joint pain
Testosterone Deficiency Symptoms
Skin wrinkles, hot flashes, decreased libido, weakness, fatigue, loss of muscle tone, lethargy, foggy thinking, fibromyalgia, slow recovery time after exercise, and slowed healing
Curiously, symptoms of hormonal excess can mirror symptoms of deficiency. This can happen if a person is receiving too strong of a therapeutic dose.
The actions of estrogen, progesterone and testosterone overlap and inter-relate with other hormones and bodily systems. For example, a hot flash can result from low estrogen, high estrogen, high progesterone, high cortisol (adrenal stress hormone), low thyroid, insulin resistance (see Diabetic Syndrome newsletter), and exposure to synthetic hormones from plastic (see Plastic newsletter) and non-organic food. That is why it is important to have a good methodology to evaluate for hormonal imbalance.
Initially I only prescribed oral natural hormones, but switched to topical hormones several years ago because they provide better results. The efficacy of oral hormones is compromised by stomach acids and liver metabolism, while topical hormones go straight to where we need them; tissues and organs outside of the blood system. Since topical hormones reside mainly outside of the circulatory system, blood tests are not a useful or reliable indicator of how well hormonal therapy is working. Saliva tests are meant to provide a clearer picture of hormonal status however I have found this not to be true.
My perspective on the limitations of salvia tests is corroborated by the internationally renowned authority on women’s health care, Dr. Tori Hudson. In a recent article she highlighted multiple concerns regarding the efficacy of saliva tests especially in regard to menopause and andropause. Here are just a few of the concerns she raised.
- Saliva contains a relatively small amount of hormone
- Sublingual hormones and sometimes topical hormones give falsely elevated readings
- Collection tubes are easily contaminated if the person is already taking topical hormones
- Identical test samples sent to multiple labs yielded inconsistent results
- Lab accuracy is not sufficiently monitored
- There is a lack of scientifically proven accuracy of these tests
- Food, beverages, medications and chewing gum can alter test results
- Reference ranges for people who are taking hormones are unreliable for evaluating therapeutic dosage due to individual variation in how hormones are metabolized.
- Hormone levels change by the hour, so any sample that is collected may or may not be a true reflection of the overall hormonal picture.
Dr. Hudson states that there is no scientific evidence to support any claims that there is increased efficacy, enhanced safety, or need for testing (saliva or blood) in order to determine appropriate dose. That’s why I have developed a patient symptom questionnaire that groups symptoms in a manner that helps me to identify which hormones need attention. I find this symptom questionnaire along with an office visit to discuss one’s concerns the most reliable means for testing and monitoring treatment. For women without contraindications to hormone treatment, such as certain cancers, natural hormones offer a safe and effective means to address hormone related ailments.
I hope that you have enjoyed this month’s newsletter. As always, comments are welcome.
Jon Dunn, ND