July 18, 2020
Postmenopausal Hormones: Helpful or Harmful with Dr. Elizabeth Boham on The Doctor’s Farmacy with Dr. Mark Hyman
Check out the Episode Page and Show Notes
Key Takeaways
- The Women’s Health Initiative studied hormone replacement therapy with oral estrogens and ended early when dangerous side effects surfaced
- Peri-menopause represents the years just before menopause and can be symptomatic:
- Irritability
- Night sweats
- Hot flashes
- Migraines
- Heavy or missed periods
- Menopause Symptoms include:
- Vaginal dryness
- Bone density reduction
- Sleep issues
- Poor lifestyle choices can accentuate problems
- “This is not the curse of the woman, these are things that are out of balance and can be fixed “ – Mark Hyman
- Bio-identical hormones are safer because they are identical to your own
- Progesterone is best for sleep issues/anxiety because it is very calming
- Xenoestrogens such as PCBs, BPA, and phthalates can imitate estrogen with unintended estrogenic effects
Intro
Dr. Elizabeth Boham (t: @DrBoham) is s a physician and nutritionist who practices functional medicine at the UltraWellness Center in Lenox, Massachusetts
Host: Dr. Mark Hyman
The Women’s Health Initiative
- The Women’s Health Initiative studied hormone replacement therapy with oral estrogens
- Prempro and Premarin – derived from horse’s urine
- They are non-bioidentical hormones
- Oral estrogens increase inflammation in the body
- Oral estrogens go through the liver and give a higher risk of blood clots
- Women did worse on these hormone therapies – developing dementia, blood clots, and increased rate of heart attacks
- The study ended early and 50 million women stopped taking replacement hormones
Taking Replacement Hormones is More Complicated than Yes or No
- Doctors should deal with each woman separately
- Some women suffer more during menopause
What is Peri-menopause?
- Peri-menopause represents the years just before menopause
- Peri-menopause Symptoms:
- Irritability
- Night sweats
- Hot flashes
- Migraines
- Heavy or missed periods
What is Menopause?
- A woman enters menopause when she hasn’t had a period for a year
- Symptoms include:
- Vaginal dryness
- Bone density reduction
- Sleep issues
Can Lifestyle Changes Help?
- Yes, poor lifestyle choices can accentuate problems
- Take care of your adrenal glands by managing stress- practice meditation
- Cut back on alcohol- it helps with hot flashes and sleep
- Keep a balanced blood sugar level
What is Medical Menopause?
- When a woman goes into menopause because of chemotherapy
- Periods often come back afterward but actual menopause will probably happen about five years sooner than average
What is the Best Way to Treat Menopausal Patients?
- Treat everyone as an individual – ask what are they are struggling with
- “This is not the curse of the woman, these are things that are out of balance and can be fixed “ – Mark Hyman
- Doctors should understand the patient’s family history
- Doctors should check the patient’s gut flora
- The patient’s nutritional levels are important to optimize hormone levels
- If necessary, replacement hormones should be prescribed
The Case for Bio-identical Hormones
- They are safer because they are identical to your own
- Bio-identical hormones can be found at compounding pharmacies
- They are usually topicals in the form of patches or creams
- Even bio-identical hormones increase the risk of breast cancer but more studies are needed
Which is the Best Hormone Replacement Method?
- Dr. Boham doesn’t prescribe estrogen orally because of the increased risks of blood clots
- She prescribes transdermal (through the skin) applications for hot flashes or sleep issues or for bone density problems
- Vaginal estrogen treatments are best for vaginal dryness
- These have very low systemic absorption – studies with high-risk women’s still showed very low risk
The Hormones
Progesterone – Natural Progesterone is Better
- It can be taken orally or through the skin
- It’s best for sleep issues/anxiety because it is very calming
- To regulate periods, progesterone should be delivered through the skin
- Progesterone is often prescribed alongside estrogen especially if a woman still has her uterus
- Provera brand – is not natural and can cause depression
Mitigating Hormone Therapy Risks
- Watch the dosage amount
- Chose a safe delivery method – Topical treatments are best
- Be mindful of the duration taken
Before Trying Hormones, Check Your Lifestyle First
- Cut back on alcohol
- Clean up your diet
- Add magnesium
- Nutrients can mitigate risk of hormones by helping metabolize it!
- Work on nutrition and gut health
- Go for strength training and resistance training (for osteoporosis)
- Add vitamins D and K
Other Important Stuff
- Natural progesterone at night helps some women sleep better especially through the peri-menopause years
- Drops of Estrogen/Progesterone/Testosterone help with bone density
- Vaginal estrogen helps with vaginal dryness
- Xenoestrogens can be either synthetic or natural chemical compounds that imitate estrogen such as PCBs, BPA, and phthalates, which have estrogenic effects
- Increases PMS for women and infertility in men
