As we get older, our hormone levels decline. For women, this can be abrupt at the time of menopause, though the decline can also occur more gradually with an extended perimenopause. For some women, the transition into menopause is smooth with no symptoms and no physical or emotional distress. However, many of my patients describe a lack of energy, depression and anxiety, and the onset of all kinds of ailments such as back pain and fibromyalgia. The average weight gain during menopause is 10 to 15 pounds. Of more concern, the incidence of heart disease increases after menopause and bone density can decline dramatically during and after menopause, increasing the risk of potentially lethal hip fractures.
Just about all of these symptoms and conditions are caused by the decline and absence of estrogen and progesterone. For menopausal women, taking estradiol and progesterone help reverse the symptoms and women feel great with improved energy and vitality. These two hormones play a vital role in keeping women healthy. When these hormones are out of balance in young women, conditions such as polycystic ovarian syndrome (PCOS) may arise and they improve when the hormones are balanced.
The reason that almost all postmenopausal women should be taking bioidentical hormones is that these hormones reduce the risk of the three biggest killers of older women: heart disease, hip fractures and Alzheimer’s. Unfortunately, many women are apprehensive about taking hormone replacement because of a fear of breast cancer but this is not true. Taking estrogen does not increase the risk of breast cancer.
For women, the risk of heart disease is much higher than the risk of breast cancer. Estrogen reduces visceral fat, which reduces the inflammation in the blood vessels that leads to clot formation. Also, estrogen improves the lipid profile by decreasing LDL, the bad cholesterol, and increasing HDL, the good cholesterol. Thus, the risk of heart disease is decreased by 2.5 times when taking estrogen.
Bone density decreases during and after menopause. Often this decrease is precipitous. This decrease in bone density leads to osteoporosis, which is asymptomatic unless a fracture occurs. Hip fractures are potentially lethal because of prolonged immobility after the fracture, leading to a general decline. Eighteen percent of women with hip fractures die within the first year after the fracture. An even higher percentage are in skilled nursing facilities.
The third most common cause of death in older women is dementia, with the most common type being Alzheimer’s disease. When started soon after menopause, estrogen significantly reduces the risk of Alzheimer’s. On a more immediate basis, many of my patients report thinking more clearly after starting estrogen.
On average, women lose 10 to 15 pounds when starting bioidentical hormone replacement. A key point is that this weight loss occurs without making any other lifestyle changes such as improving diet or starting an exercise program. When implementing these lifestyle changes, the weight loss is even greater. More important, the weight that is lost is primarily visceral fat. This is the most harmful type of fat that produces inflammation and causes disease.
I have two types of patients among those who start hormone replacement. Some of my patients are overweight, with health issues related to the increased weight and increased inflammation. When they start hormone replacement they start to lose weight and they start to feel well. I have other patients who come in feeling well and are interested in starting hormones for the long-term benefits for their health and well-being. When they start hormone replacement, they go from feeling good to feeling great.
Overall, women who take hormone replacement will feel great with improved energy and better sexual health. They sleep better with improved mood. They lose weight and have great vitality. At the same time, they are reducing their risk of heart disease, reducing their risk of hip fractures, and reducing their risk of dementia.
It is perplexing that many women do not take advantage of this great opportunity to improve their health. I believe that there are many myths and misconceptions that unnecessarily create a fear of hormones. This is a shame, because taking hormones is a great way to maintain your health and energy during aging. It is part of my mission to share my knowledge of the literature that dispels all of these myths so women can take advantage of all the benefits of bioidentical hormones. It is a joy for me to see women who have not allowed the myths to deter them from taking hormones. As they get older, they continue to feel great, and one of their challenges is to find people their age who can keep up with them. I strongly urge all women to take advantage of this great opportunity to improve their health with bioidentical hormones.
By Warren Slaten, M.D.
Dr. Slaten is a wellness physician specializing in regenerative pain treatments and lifestyle counseling. He is certified in advanced bioidentical hormone replacement. You can learn more by checking his website, njhormones.com.