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 PCBsBPA, 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 PCBsBPA, and phthalates, which have estrogenic effects
    • Increases PMS for women and infertility in men
Doctor's Farmacy with Mark Hyman, MD : , ,
Notes By EWerbitsky

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