Hormone Replacement Therapy – Study Comments

Researchers writing in the Journal of the British Menopause Society say “Many women have been denied or have discontinued HRT because of the fear of risks, which may not have been put in perspective or fully understood.”

Davey DA. Hormone replacement therapy: time to move on? J Br Menopause Soc. 2006 Jun;12(2):75-80.

Hormone replacement therapy: time to move on?
The risks and benefits of hormone replacement therapy (HRT) need to be put in perspective. In the analysis of clinical trials, emphasis is often placed on relative risks, statistical significance and 95% confidence intervals, whereas, from a clinical perspective, more may be gained from a consideration of the absolute and attributable risks of therapy.

The Council for International Organizations of Medical Sciences recommended that the frequency of adverse events be categorized as ‘rare’ if less than 1/1000 but more than 1/10,000, and as ‘very rare’ if less than 1/10,000. In the analyses of the Women’s Health Initiative (WHI), the attributable risks were ‘appreciable’ (i.e. more than 1/1000) only in women aged over 70 years, with the exception of the risks of venous thromboembolism and stroke. The women in the WHI trial do not represent the relatively younger, healthy, postmenopausal women most commonly prescribed HRT, who are probably at much lower risk.

Moreover, the WHI trial did not take into account the benefit of relief of menopausal symptoms, which is, for many women, paramount and outweighs the ‘rare’ long-term risks. Age may be a useful guide to risks and some simple guidelines for management, based on age, are suggested. Many women have been denied or have discontinued HRT because of the fear of risks, which may not have been put in perspective or fully understood. The care of postmenopausal women is not static, and sufficient has now been learned to enable each menopausal woman, with the help of her medical adviser, to come to a balanced and reasonable decision.

Hormones, Oxidative Stress, Menopause

In the News…
Researchers writing in Clinica Chimica Acta, the International Journal of Clinical Chemistry and Applied Molecular Biology suggest that Hormone Replacement therapy may play a beneficial role in the protection against oxidative stress.

Clin Chim Acta. 2006 Jul;369(1):73-7. Epub 2006 Feb 10.
Unfer TC, Conterato GM, da Silva JC, Duarte MM, Emanuelli T. Influence of hormone replacement therapy on blood antioxidant enzymes in menopausal women. Clin Chim Acta. 2006 Jul;369(1):73-7. Epub 2006 Feb 10.

From the abstract:
BACKGROUND: Natural loss of estrogen occurring in menopausal process may contribute to various health problems many of them possibly related to oxidative stress. Hormone replacement therapy (HRT) is the most common treatment to attenuate menopausal disturbances. This study was aimed at evaluating the influence of HRT on the activity of antioxidant enzymes (superoxide dismutase, SOD; catalase, CAT; and glutathione peroxidase, GPx) and lipid peroxidation (thiobarbituric acid reactive substances, TBARS) in menopausal women.

CONCLUSIONS: HRT antagonizes the decrease of SOD activity that occurs after menopause, suggesting that HRT may play a beneficial role in the protection against oxidative stress.

Related links
Estrogen Selected Research

More Estrogen Links
Breast Cancer and Estrogen Replacement Therapy
What Effects Does Estrogen Have On The Skin?
Estrogen and Sun Damaged Skin
Women With Higher Levels of Estrogen Have Prettier Faces

Estrogen Selected Research

Estrogen and Women’s Heart Disease
Grodstein F, Stampfer MJ. Estrogen for women at varying risk of coronary disease. Maturitas 1998;30:19-26.

Study: Researchers cited that estrogen was beneficial for heart disease risk. “However, few studies have assessed the impact of estrogen use among women with a distinctly higher cardiovascular risk.”

The researchers stated: “Analysis of the effect of estrogen within different risk factor categories in the 16-year follow up of the Nurses’ Health Study confirms that although relevant risk estimates are highly similar, the magnitude of the protective effect of estrogen is more pronounced among women with high baseline risk of disease.”

Estrogen, Depression, and Blood Pressure

Canada SA, Hofkamp M, Gall EP, et al. Estrogen replacement therapy, subsyndromal depression, and orthostatic blood pressure regulation. Behav Med. 2003;29:101-106.

Study: From the abstract: “Although estrogen replacement therapy (ERT) alleviates depressed moods in postmenopausal women, it is not known whether ERT is equally effective in reducing affective and somatic depressive complaints. One of the authors’ goals in this study was to examine possible differences between women receiving and not receiving ERT.”

The researchers stated: “The authors studied a group of postmenopausal women. Somatic symptoms in the ERT group were significantly lower than in the Non-ERT group. Affective scores were only marginally lower in the ERT group…In response to orthostatic challenge, the change in systolic blood pressure was significantly smaller in the ERT group. Apparently ERT is associated with more effective blood pressure regulation.”

Breast Cancer and Estrogen Replacement Therapy
Researchers writing in the August 6, 2005 edition of the British Medical Journal say maybe the risk of developing breast cancer from estrogen replacement therapy is not as great as everyone thought.

The researchers noted that estrogen therapy accounted for eight additional cases out of 10,000 women.

In 2002, headlines cited that researchers discovered that estrogen therapy could double the risk for getting breast cancer.Read abstract

Estrogen and Physical Appearance
Women With Higher Levels of Estrogen Have Prettier Faces
Researchers at the University of St. Andrews in Scotland announced that women who had higher amounts of estrogen in their urine were found to be more attractive than women who had lesser amounts.

What Effects Does Estrogen Have On The Skin?
Researchers have found that “Estrogen loss at menopause has a profound influence on skin.” Writing in the medical journal Climacteric, study authors noted, “Estrogen treatment in postmenopausal women has been repeatedly shown to increase collagen content, dermal thickness and elasticity, and data on the effect of estrogen on skin water content are also promising.”

Hormone Replacement Therapy and Possible Cardiovascular Benefits in Women
Researchers writing in the medical journal Climacteric say that “Women who receive 2-3 years of HRT after menopause do not have increased all-cause mortality, and results of the present study suggest relative cardiovascular benefits compared to those who had not used hormones.” Read more

Estrogen and Sun Damaged Skin
Researchers at the University of Michigan Department of Dermatology are currently recruiting subjects to participate in a study to test Estrogen’s effect on the skin.

Risk of stroke and hormone replacement therapy
Researchers writing in the medical journal Maturitas say that there is no significant association between hormone therapy and risk of total stroke in women during 10.5 years follow-up.

Postmenopause and periodontal disease
A recent study in the Journal of Periodontology says that in an 11.7 year follow up, 57.5 percent of women lost at least one tooth after menopause.

Testosterone in Post Menopausal Women

An article in the medical journal Current Opinion in Obstetrics & Gynecology says that testosterone therapy is a promising option for treating women with HSDD (very low libido or desire)

Somboonporn W.Androgen and menopause.Curr Opin Obstet Gynecol. 2006 Aug;18(4):427-32.

From the article abstract:

PURPOSE OF REVIEW: Androgen therapy is being increasingly used in the management of postmenopausal women. The most common indication is to improve sexual function. The aim of this review is to evaluate current knowledge pertaining to testosterone and sexual function in postmenopausal women.

RECENT FINDINGS: The change of testosterone levels during the menopause transition remains controversial. A correlation of endogenous testosterone levels and sexual function is still inconclusive. A Cochrane Review and recent randomized control trials have, however, consistently demonstrated that short-term testosterone therapy in combination with traditional hormone therapy regimens improves sexual function in postmenopausal women, particularly surgically menopausal women with hypoactive sexual desire disorder.

An adverse effect on the lipid profile has been identified which appears to be mostly associated with oral methyltestosterone. Data for other effects of testosterone and long-terms risks are lacking. Testosterone may act in a variety of ways in different tissues. This is, however, an area that requires further investigation.

SUMMARY: Testosterone therapy is a promising option for treating women with hypoactive sexual desire disorder after surgical menopause. Two remaining questions need to be answer: who is most likely to benefit from testosterone therapy and what are the long-term health risks?

You, Aging, and Hormone Supplementation Therapy

Studies show that when we restore endocrine balance by augmenting hormone levels to their optimal ranges, quality of life improves and degenerative diseases decline.

Is hormone supplementation and age management medicine right for you?
Hormone supplementation has been practiced for decades. Commonly we hear of people who have been on “Thyroid” for over 30 years, and millions of women have been prescribed estrogen.

The typical patient who wants their hormones optimized are healthy middle-aged people that have started to notice some declines in their level of energy, who maybe for the first time in their lives “just didn’t feel like having sex,” who had lost some of the ambition and drive that they enjoyed only a few years ago.

They also notice that their waist line was getting a little wider and that things were sagging lower than before.

Is hormone replacement therapy right for you?
This is a decision you need to make with your physician. Before entering into hormone supplementation, please discuss the benefits, realistic goals, risks, dangers, and side-effects with your physician.

Hormone Supplementation Parts 1 2 3

Hormone Replacement

Hormone Supplementation

What are hormones?
What is hormone supplementation?
How does it enhance vitality even as we age?

Hormones are chemicals within our bodies responsible for many things including the regulation of our metabolism, immune function, blood pressure, sugar levels, body temperature as well as a host of other things including regrowth and repair of damaged tissue. They are produced by our glands, namely the Thyroid (Thyroid), Adrenals (DHEA, Pregnenolone), Pituitary (Human Growth Hormone (HGH)), Ovaries (Estrogen, Progesterone, Testosterone) or Testes (Testosterone), and Pineal (Melatonin). After about the age of 30, our body’s hormone levels start to decline. Many cite this decline with the “normal” aspect of aging and its familiar characteristics of fatigue and loss of energy, problems of memory and mood, lack of ambition, loss of libido, weight gain and muscle loss and much more that add up to a sense of poor health. This hormonal decline continues as we age, and usually becomes problematic in our 40’s and 50’s, although, it can create issues at an even younger age. An example are the statin drugs that can cause a dramatic decrease in testosterone even at a young age. With testosterone decline, we find incidence of erectile dysfunction.

Giving “pause” to thought We have all heard of and embraced the term menopause to describe a decline in the female sex hormones, but there are other “pauses” that are becoming more recognizable as house-hold names. Doctors have coined the terms “andro-pause” to describe the decline of male sex hormones in men, “somatopause” to describe the decrease in human growth hormone, “adrenalpause” to describe a decline in DHEA, and “pinealpause” to describe a decline in melatonin.

In the opinion of many doctors, maintaining optimal hormonal balance is our best opportunity to enhance vitality into “old age” and overcome these “pauses” in life. Some doctors however believe that aging is inevitable and that nothing can be done about it except to accept it gracefully. This is a stigma of modern medicine. On one hand, medicine is proud, and rightfully so, of enormous jumps in life expectancy ages, but on the other hand, they are skeptical about enhancements in quality of life. Therefore some doctors may be reluctant to treat hormonally deficient patients because they see this as a normal result of aging, and something they can’t do anything about.

In other words a 70 year-old man presents himself to the doctor’s office with complaints of loss of sex drive, fatigue, and inability to lose weight. It is likely that his doctor will say, “You are 70 years old, and this is normal for your age!”, rather than take blood tests of hormone levels. If the patient was insistent about getting his hormones checked the doctor may see “normal” results, that are the normal ranges for a man 70 years old and tell the patient that he is normal. But the patient isn’t “normal,” that is why he went to his doctor! He doesn’t want the hormones of a 70 year-old man, he wants the hormones necessary to have sex drive, muscle tone, strength, ambition, joy, and his vitality back. He also wants a good chance to be free of heart disease, diabetes mellitis, and other diseases of aging. Why not check his c-reactive protein, fasting insulin, and homocysteine levels, along with many other markers of hidden disease?

Hormone Supplementation Parts 1 2 3

Hormone Supplementation

HORMONE  SUPPLEMENTATION
An indisputable fact in medicine is that we do age. Another fact that is indisputable, at least for the very foreseeable future, is that you will not live forever. However, there is a great likelihood that you can enjoy a quality of life of vitality well into your senior years because of research into the medical science of hormone replacement and supplementation.

Aging: Fight it or embrace it?
The average life span of an American continues to increase. The current life expectancy of 72 (male) and 79 (female) increases into the mid-eighties IF you can make it to age 65 and now, British researchers think that if you make it to 65 you can get a few more years and should make it to 90! It is also estimated by many gerontologists that by 2050, life expectancy will be well over 100 years old and that there will be millions of Americans at those ages. So if you are 50 now, in the year 2006, the odds will be pretty good that with a healthy lifestyle and regular physical examinations you will make it to vote in the 2056 Presidential Elections.

 

Is living longer any good if you are not “living?”
With any discussion about increased life expectancy comes the question posed by many: “Do I want to live longer if my mental and physical abilities are impaired?”

There are many who say that we should not seek to live longer if living longer means institutional care, living with chronic pain from disease, or living with impaired mental faculties. But is this the only lifestyle option there is with advanced age? Disability?

There are a growing number of doctors who say that old age does not inevitably bring disability. That the key to enjoying our later years, that is remaining active, mentally alert and independent may rest with hormone replacement therapy.

Can we really control the aging process?

Is it possible to roll back the hands of time and give ourselves a more youthful vigor even when we reach ages that doctors tell us we should consider vitality a thing of the past?

Hormone supplementation is a choice, one that needs to be made by a patient who understands the realistic goals of its benefits and a practitioner who understands the need of moderation—doing just enough and not more to enhance the delicate hormonal balance of our bodies.

What are hormones?
What is hormone supplementation?
How does it enhance vitality even as we age?

Hormones are chemicals within our bodies responsible for many things including the regulation of our metabolism, immune function, blood pressure, sugar levels, body temperature as well as a host of other

Hormone Supplementation Parts 1 2 3