Want to stay young and beautiful forever? Who isn’t searching for that elusive Fountain Youth? Unfortunately the fountain of eternal youth only exists in fairy tales, however, hormone optimization therapy may be our closest bet yet. Due to the ingeniousness of modern medicine, we are now living into our 100s, but at what cost? With age comes fragility, incontinence, memory impairment, loss of sexuality and, thereby loss of identity, not to mention the slew of various medical diagnoses that you will acquire as you age. Well, what if simply by properly regulating your hormones, to keep them in the upper 25% of the normal range, you could dramatically lessen, if not entirely prevent many of the expected medical conditions that come with aging.

What is Hormone Replacement Therapy?

Hormones are our body’s chemical messengers. They send messages to and from the brain regarding the functioning of every single aspect of our body. It is absolutely astounding how crucial hormones are, with Testosterone, Estrogen and Thyroid hormones being huge players, if not the most important chemical messengers we have. Our body naturally does a fantastic job regulating our hormones without us even realizing it. Then we hit age forty.

The natural lifespan of a human being, pre-industrial revolution, pre-modern medicine, was 35-40. Let me repeat that, 35 to 40 was the expected human life expectancy. So our body does what it needs to do until around 35 to 40. After that, we need more maintenance. Just like our aging cars and homes, we have to maintain our bodies to keep them healthy and stay functional. Can you imagine what your home would look like if you never painted it in 40 years? What about your car? What would happen if you never went in for maintenance? Our bodies are no different and should be treated accordingly. When our hormones are not optimized, we simply cannot be our healthiest selves.

The research is in and it shows that by replacing testosterone and thyroid to the upper 25%, your quality of life and overall health will be improved. Optimization of hormones will have a positive benefit in every single body system you have. Do you want to decrease your risk of Alzheimer’s Disease? Do you want to decrease your risk of breast cancer? Do you want to improve your bone density by 8% a year? Do you want to reduce your risk of heart attack and stroke? Hormone replacement therapy could very well be your answer. Not to mention improved strength, endurance and libido. I can go on and on about the benefits of hormone optimization. Everyone over the age of 40 should have their hormone levels checked and in women with a family history of Alzheimer’s, they should start screening for hormonal imbalance even sooner. According to neuroscientist, Dr. Lisa Masconi, it seems, for women, Alzheimer’s starts in midlife with negative changes in the brain years,if not decades prior to the onset of symptoms.

What are the risks?

Good question. Here’s the issue with this simple seeming question.There is a lot of misleading information in both the science and history around hormone therapy and it can be difficult to tease apart fact and fiction.

There has been quite a substantial amount of scientific support for the use of hormone therapy with little risk to the patient dating back to the 1880s. However once hormones are made synthetically the risks of adverse outcomes increase. When a hormone is bioidentical to your naturally occurring hormones the risk has been found to be very low.

Legitimate bioidentical testosterone side effects include:

  • Acne, about 2-10% of patients treated
  • Facial hair, typically mild and reported in about 2-10% of patients
  • Scalp hair loss, <1% risk
  • Fluid retention
  • Sperm suppression
  • Erythrocytosis, or increased number of red blood cells (not to be confused with polycythemia vera)

What about Heart Attacks and Blood clots?

No. Evidence suggests not with bioidentical hormones (BHRT). Let me explain why. An interesting thing about hormones is pharmaceutical companies cannot patent them. This has to do with FDA laws around natural occurring substances within our bodies. So in order to be profitable, pharmaceutical put little additions to testosterone and estrogen molecules to be able to patent drugs like Prempro ***little R or Premarin***little R, and Depo-Testosterone ***little R. They add a little something, something and it is this little something, something that gets us into trouble.

Let’s use Depo-Testosterone, who’s real name is Testosterone-cypionate as an example: It is the cypionate component of this medication that increases risk of unstable angina and acute MI. Aveed aka Testosterone Undecanoate, has been shown to increase risk of pulmonary microembolism but this is due to the effects of the undecanoate component, not the testosterone. Testosterone alone does not show to increase this risk. (1, 2)

Testosterone therapy is not currently recommended in women who are pregnant or trying to conceive, however, I feel the research is building to show support for the use of testosterone in women with infertility issues.

Will testosterone make me look like a man?

NO! Ladies, trust me, if you are properly dosed by a licensed medical provider who specializes in hormone replacement therapy, you will in no way shape or form turn into a man. It takes substantially higher doses to cause any type of masculinizing features. For example, a typical 50 year old male patient of mine will be on 2000 mg of Testosterone when being pelleted every 5-7 months, while my typical 50 year old female patient is on 112.5mg. Women get a fraction of the dose. You get just what you need to return to your youthful hormone levels you had when you were in your 20s.

Will estrogen therapy give me cancer?

Estrogen replacement in women is a controversial topic and continues to be debated amongst the greatest minds in medicine. So to pretend that I have the end-all, be-all answer to this question would be a lie. What I do know, is that when conjugated, meaning given along with progesterone, there has not been shown to be an increased risk of developing gynecological cancers such as uterine and endometrial cancers. In the past, women were given estrogen alone, there was absolutely an increased risk of inducing cancer. As with the discussion of testosterone, when you are properly managed, the risk profile is low. Women with a history of breast cancer are not given estrogen at this time. However, one of the cool things about testosterone is that it will convert to estrogen. So, ladies, just being on testosterone therapy alone will increase your estrogen and it has even been shown to reduce risk of breast cancer! If you have had a history of breast cancer, you can still be a candidate for hormone replacement therapy and save yourself from the misery of the multitude of symptoms that is menopause. Per the FDA, hormone therapy,”is the most effective relief of hot flashes, night sweats and vaginal dryness”.

Why are hormone pellets not FDA approved?

Another difficult question to answer, and honestly, from a person who has practiced medicine for the past 15 years, has read the research and first hand seen the life changing differences it has made of my patients and millions of other people, I don’t know why. Despite the risks associated with pharmaceutically engineered, which are FDA approved, pellet therapy continues to not. Pellet therapy is superior with lower risk to the patient. I do not pretend to understand the inner workings of the FDA, their association with pharmaceutical companies or the politics that surround getting FDA approval, but when you take an educated look at the data, pellets are the most superior hormone replacement therapy option currently available on the market.

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