Читать книгу Hormone Replacement: How to Balance Your Hormones Naturally - Dr. Cabot Sandra - Страница 10
ОглавлениеHow Hormones Work
Oestrogen Dominance
You may have heard of the term ‘oestrogen dominance’ and wondered what it is. Some doctors use this term, which describes the effect of a relative excess of oestrogen in the body compared to progesterone.
This can be caused by over-production of oestrogen in the body, or a deficiency of progesterone. During the pre-menopausal years, due to ageing of the ovaries and infrequent ovulation, it is common for women to produce adequate oestrogen but not enough progesterone. Oestrogen dominance can also be caused by the oestrogenic effects in the body of xenoestrogens, which are chemicals derived from petro-chemicals and oestrogens used in the mass production of some meats.
SYMPTOMS OF OESTROGEN DOMINANCE
weight gain around the buttocks, hips and thighs
fluid retention
abdominal bloating
lumpy, tender breasts
heavy and/or painful periods
irregular or infrequent periods
endometriosis
fibroids
endometrial hyperplasia and an increased risk of uterine cancer
The condition of oestrogen dominance can be confirmed by finding pre-menopausal levels of FSH (less than 20) combined with low levels of progesterone and normal-to-high levels of oestrogen in a blood test. This can also be confirmed with saliva tests.
WHAT CAN YOU DO ABOUT OESTROGEN DOMINANCE?
Use natural progesterone in doses of 25 to 100 mg daily for two weeks of every month, or for the last two weeks of the menstrual cycle.
Increase fibre in the diet, as this lowers oestrogen levels.
Improve the liver function, as the liver breaks down the excess oestrogen into the weak water-soluble oestrogen called oestriol, so that it can be excreted in the body via the urine.
Reduce your exposure to xenoestrogens – see page.
Eat only organic eggs and organic chicken.
Increase your consumption of foods containing phytoestrogens, such as beans, whole flaxseeds, alfalfa, peas, lentils and vegetables.
Summary of What You Can Do about Hormonal Imbalances
Balance your diet – Eat more plant-based foods, especially beans of all varieties, alfalfa sprouts, raw nuts and ground whole flaxseed.
Use herbal formulas containing phytoestrogens from mixtures of Black Cohosh, Hops, Liquorice root, Red Clover, Wild Yam, Kelp and Horsetail. These can be found available combined with vitamins and minerals in one capsule.
Maintain a healthy weight through a balanced diet and regular exercise programme.
Use more feminine oral contraceptives such as Marvelon, Femoden, Minulet and Trioden.
Use natural hormones instead of synthetic hormones – such as progesterone cream or progesterone lozenges for premenstrual syndrome or peri-menopausal hormonal imbalances. Use Hormone Replacement Therapy (HRT) that is more natural and does not overwork the liver. Creams containing mixtures of natural hormones, and hormone patches, do not overwork the liver.
Consider adrenal gland exhaustion, a common cause of chronic fatigue, which can be helped with antioxidants such as vitamins C and E, flaxseed oil and the minerals selenium and magnesium. In stubborn cases of adrenal gland exhaustion, the natural adrenal gland hormones such as DHEA and pregnenolone, can produce excellent results.
Reduce your exposure to alcohol, as women who drink more than two glasses of alcohol a day may be increasing their risk of breast cancer. Avoid smoking, as this reduces the production of hormones from the ovaries and adrenal glands.
Avoid over-exposure to toxic chemicals, which are foreign substances called xenobiotics. Xenobiotics are petrochemical compounds found in plastics, solvents, pesticides, herbicides, emollients and adhesives. Over the last 100 years they have become prevalent in household items, garden chemicals, insecticide sprays, plastic pipes and containers, various creams and shampoos, food and water supplies. These xenobiotics are toxic to humans and animals, and result in disruption of the hormonal system and an increased risk of cancer. In the excellent book titled Our Stolen Future by Theo Colborn, documentation is given about the effects of xenobiotic exposure in the early life of wildlife populations; it explains how these chemicals produce a large variety of congenital abnormalities. Petrochemicals are fat-soluble and accumulate in the fatty parts of the body, such as the endocrine glands, where they cause hormonal imbalances and dysfunction. The liver is the only organ in the body that can break down these petrochemical xenobiotics, so it is imperative to support your liver function in this toxic day and age. See www.liverdoctor.com.
How Are Hormones Made in Our Glands?
All of our steroid hormones, including the sex hormones, are made in the body from cholesterol. Cholesterol is a sterol that is found in foods of animal origin and is vital for health. If you did not have any cholesterol in your body, you would not make any steroid hormones, including the sexy ones! Thus it does not surprise me when patients on cholesterol-lowering medication, which stops the liver from making cholesterol, complain of a big reduction in their sex drive.
The liver and some parts of the intestine manufacture cholesterol, and if you do not eat any cholesterol-containing foods, your liver will make extra cholesterol to compensate for this.
As seen in the diagram above, cholesterol is first converted into the hormone called pregnenolone. Pregnenolone can be considered a ‘mother hormone’, as it can be converted into many other types of steroid hormones. For example, pregnenolone can be converted directly into the female hormone progesterone, or it can follow another biochemical pathway and be converted into cortisol. Pregnenolone can also take another pathway and be converted into DHEA, which can then be converted into all the different types of male and female sex hormones. Pregnenolone is a vitally important hormone, as it is the hormone from which ALL the other steroid hormones, including the sex hormones, are made. It could be asked, then, ‘Why don’t we give pregnenolone alone, so that the body can convert it into all the other steroid sex hormones as we need them?’ Unfortunately, as we age the enzymes that are required to convert pregnenolone into the other hormones like DHEA and progesterone also decrease, and become less efficient. Thus it is necessary to replace the specific hormones that are found to be deficient.
The production of steroid hormones from cholesterol occurs in the ovaries, testicles, adrenal glands and, to a much lesser extent, in the fat tissue of the body. Lower-level body fat produces predominantly oestrogen in the form of oestrone, whereas upper-level body fat produces predominantly male hormones. This is why women with excess weight in the upper part of their body, around the trunk and abdomen, often have quite high levels of male hormones, even years after the menopause.
After the menopause occurs, the ovaries no longer produce adequate amounts of the sex hormones. If the adrenal glands are healthy, they will continue to produce some of these steroid hormones, especially pregnenolone and DHEA. This is why women who have healthy adrenal glands will have less severe hormonal symptoms during the menopause. In patients with adrenal gland exhaustion, the hormones DHEA and pregnenolone can be administered, often with excellent results.
The following table gives you, at a glance, the symptoms of imbalances in the hormones oestrogen, testosterone and progesterone.
| HORMONE | SYMPTOMS OF EXCESS | SYMPTOMS OF DEFICIENCY |
| OESTROGEN | Fluid retention Breast pain and swelling Heavy menstrual bleeding Painful menstrual bleeding Weight gain in the hips and thighs Headaches and migraines Aching legs and aggravation of varicose veins Growth of fibroids and endometrial hyperplasia Growth of endometriosis Increased risk of cancer of the breast and uterus | Hot flushes Night sweats and insomnia Vaginal dryness and discomfort Vaginal shrinkage Vaginal infections Painful sexual intercourse Loss of libido Inability to orgasm Urinary frequency and/or incontinence Dry and wrinkled skin Depression and anxiety Memory loss Lack of menstruation Bone loss and loss of teeth Muscular aches and pains (fibromyalgia) |
| TESTOSTERONE | Hair loss from the scalp Excess facial and body hair Pimples or acne Greasy skin and hair Excess sex drive Weight gain, especially in the trunk and abdomen Elevation of cholesterol Aggressive moods | Shrinkage of muscles Weakness of muscles Loss of sex drive Inability to orgasm Depression and anxiety Loss of confidence and panic attacks Muscular aches and pains (fibromyalgia) Bone loss Fatigue |
| PROGESTERONE | Depression Sleepiness and feeling too relaxed Fluid retention Abdominal bloating Constipation | Breast pain and lumpiness Hair loss Heavy menstrual bleeding Growth of fibroids Growth of endometriosis Endometrial hyperplasia Increased risk of cancer of the uterus and breast Premenstrual mood disorder, depression and anxiety Premenstrual fatigue Menstrual irregularity Absent menstruation Exacerbation of premenstrual asthma and epilepsy Exacerbation of multiple sclerosis |
What Can You Do If You Have Too Many Male Hormones?
If you have excessive amounts of male hormones (androgens) in your body, you may notice several things:
excess facial and body hair (hirsutism)
loss of scalp hair, especially in the male pattern of balding
greasy skin and/or pimples
difficulty losing weight, especially from the trunk and abdomen
The hormonal profile of a woman going through the menopause, and after the menopause, can vary greatly, and this is why blood and/or saliva tests are so useful, to pinpoint your individual hormonal profile. Some women will have elevated levels of androgens even many years after they go through the menopause. These androgens are produced from the fat in the upper body and abdomen, and also from the adrenal glands. Obviously women with elevated levels of their own natural androgens do not need to receive any testosterone therapy, and usually find that synthetic progestogens make their hormonal imbalance worse. This is because synthetic progestogens may exert a mild androgenic effect. Natural progesterone does not have any androgenic effects, and should be used in women with excess androgens who need HRT.
The blood test that is most accurate to detect raised levels of the androgens is called the Free Androgen Index (FAI). This measures the amount of active androgens, which are unbound to proteins and are thus free to exert their effect in the body. If your FAI level is elevated, it is definite that you have excessive male hormone activity in your body. If you do not have any troubling symptoms and are not overweight, then this is not really a problem and you do not need to worry about it; however very high levels of male hormones should always be investigated by a specialist endocrinologist.
I have found that many women with an elevated FAI have normal blood levels of total testosterone, and thus just by measuring total testosterone levels alone you cannot get an accurate diagnosis of androgen excess. You must ask your doctor to order a Free Androgen Index (FAI) test if you want an accurate diagnosis.
Strategies for Women with Symptoms of Excess Androgens
Weight loss from the upper body and abdomen will reduce the production of androgens from the fat tissue.
Creams or troches containing natural oestrogens and progesterone can reduce the dominance of the androgens, thus making the hormonal profile more feminine.
If the androgen excess is severe and is producing marked symptoms, the anti-male hormone called Cyproterone acetate can be prescribed. Cyproterone acetate comes in the form of 50-mg tablets. The dose of cyproterone can vary from 1/4 of a tablet (12.5 mg) to one tablet (50 mg) daily. Cyproterone also acts as a progestogen, and as such can be given along with oestrogen to balance the effect of oestrogen on the uterus. If cyproterone is given every day, then there will not be any bleeding; if you desire to have a regular period, then the cyproterone can be given cyclically, for 18 days of every calendar month, along with your oestrogen. You must avoid pregnancy while taking cyproterone acetate. Generally speaking cyproterone is well tolerated, especially if the dose is tailor-made to match the patient’s blood tests and the severity of her symptoms. If the correct dose is used, then cyproterone will reduce the action of the male hormones so that we achieve a big improvement in all the symptoms of excessive androgens. Interestingly, we find that in women whose obesity is associated with excess androgen levels, the use of cyproterone will aid weight loss. This is because high levels of androgens will aggravate the high insulin levels found in Syndrome X. Syndrome X is a chemical imbalance that makes your body store fat and prevents your body from burning fat. If too much cyproterone is given, the level of the body’s androgens will be reduced too much and the patient may complain of fatigue, depression and loss of libido. As with all forms of hormone therapy, it is vital to tailor-make the correct dose for each patient, and over time the dose may need further adjustment.
