The Latest on Hormone Research

By Jeanne Drisko, M.D.

Dr. Drisko is a Clinical Assistant Professor at the University of Kansas School of Medicine and a Research consultant at The Center

Women over 40 should be taking hormone replacement therapy, not only to prevent osteoporosis, but to enhance healthy lifestyles.

Natural hormone replacement therapy uses molecules that naturally occur in your body…

Just because you are not having a hot flash doesn’t mean you don’t need hormone replacement therapy (HRT). HRT helps prevent night sweats and mood swings as well. And recent research done at the University of Kansas School of Medicine shows that you should be taking Natural HRT instead of artificial hormones that are foreign to your body found in non-natural HRT.

First, a little background on HRT. Despite the benefits of HRT, the overall compliance rate is only about 30% of the women needing HRT actually taking it. About 113 of the women never fill the prescription for HRT. They just drop it in the wastebasket. About 40% of those who do fill the prescription stop taking HRT within 12 months.

There are various reasons why women stop taking HRT. One reason is they may have had a bad reaction with the artificial HRT prescriptions they received and stopped it because of this. Another reason is the conflicting information they receive from the various research studies that are out there today. Some research says that HRT is good for heart disease while others say that it will actually in crease heart disease and may contribute to cancer in certain women.

The women figure that if the experts can’t agree on the subject, they will not take HRT until the experts can agree with each other. This brings us to Natural Hormone Replacement Therapy (NHRT). NHRT uses molecules that naturally occur in your body, but you don’t make them in adequate levels for your body to function normally as you get older. These are natural estrogens, progesterones, and testosterones that women need.

In NHRT, we like to use Estriol, Estradiol, and Estrone to make up the estrogen women take. Again, these are the natural estrogens that the body makes, but the body has fallen short of what it needs.

When formulating the three, estriol is 90% of the mix with 7% estradiol, and 3% estrone to complete the mix. Estriol is considered a weak estrogen or metabolite. But if the effective concentration is kept at an equivalent to estradiol, estriol can produce a similar biologic response. Estriol, most likely, has a heart protective effect and it does not contribute to high blood pressure nor to high cholesterol.

Estradiol, the second of the three, is the ovarian hormone. It is protective against osteoporosis or bone thinning. Estradiol may need to be opposed by estriol which acts as an estrogen receptor binder and modulator.

The third estrogen in the mix is estrone. Estrone should never be taken alone because it is very strong and may contribute to breast cancer. But in the combination with the other two, it is very effective and relatively safe.

There is often one more component that needs to be used in conjunction with the three estrogens and that is progesterone. If you have an intact uterus, you will most likely need progesterone as well. Progesterone has demonstrated that it protects the uterus from the stimulatory effects of estrogen.

Progesterone has none of the “bad” effects of synthetic progestins. Progesterone helps prevent mood swings, headaches, and fluid retention. It most likely stimulates osteoblast and helps build your bones. According to the PostMenopausal Estrogen Progesterone Intervention trial completed in 1995, natural progesterone is superior to synthetic progestins for controlling cholesterol and protecting against cardiovascular disease.

The last hormones you need are DHEA and testosterone. You should take not more than 10 mg of DHEA a day and even this is not advised for women with apple shaped bodies. Check with your doctor to find out if you need DHEA or testosterone.

Now, for the results of the Natural Hormone Replacement Therapy study recently completed at the University of Kansas School of Medicine. This was a double-blind study done with 20 women divided into two groups. Ten women were given a placebo NHRT and active Prempro, a synthetic estrogen replacement. The other ten were given an active NHRT and a placebo Prempro. Five of the women in the active Prempro group completed the study as did nine of the women in the active NHRT group.

We wanted to look at several end points in this study. First, we wanted to look at bone density to find out if it had changed. We also wanted to see if there was any change in the LDL (bad) cholesterol, the HDL (good) cholesterol and the triglyceride levels during the study. Finally, we wanted to see if there was any change in the endometrial thickness of the uterus, the estradiol and progesterone levels, and any weight change in the women.

The results are very interesting. For instance, the bone density levels in the NHRT group were preserved and even showed a modest increase. This is good. There was no stimulation of the endometrium, also good. The HDL cholesterol was maintained which is what we hoped. The triglycerides showed a modest decrease-good. Progesterone and estradiol levels both increased-also good. These were all the results from the women in the group who took the natural hormone replacement therapy.

These results clearly showed natural hormone replacement therapy is an effective therapy when compared to the gold standard of Premarin and Provera.

There were two limitations of the study. It was small; only 20 women were entered into the study, but it was a preliminary study. The next study will be expanded to take care of this limitation.

The second limitation was that only troches or lozenges were used in this preliminary study. The women did not like putting the troche between their cheek and gum and letting it dissolve for 30 to 45 minutes when they could just take a capsule and be done with it.

This is an important concern and those women in the expanded study will receive capsules to take for NHRT instead of the troublesome troches.

The positive effects seen in this study can be even further increased by what we eat and the nutrients we take. One thing to keep in mind is to eat whole foods. These are foods that are a  close to the way they grew as possible and are relatively fresh. Also eat plenty of fresh fruits and vegetables.

Essential fatty acids influence every cell function and the hormone responsiveness. Saturated fats and trans fatty acids we eat decrease membrane fluidity and hormone receptor binding. Eating whole foods greatly reduces saturated fats and trans-fatty acids we eat and increases the individual cell membrane fluidity and hormone receptor binding capability.

Soy is high in natural phytoestrogens (one of the food based estrogens). Studies have shown that these phytoestrogens overlap with the natural hormone replacement. but they do not replace natural hormone replacement. Don’t use these as a substitute for NHRT.

It is good to add soy to your diet for many reasons such as it occupies the estrogen receptor sites in the cell making them not available to estradiol. This increases the anti-cancer activity of the cell. Soy phytoestrogens tend to increase the HDL cholesterol (the good one) and decrease the symptoms of menopause.

Micronutrients are also valuable for NHRT. Vitamins E, C, B5 (pantothenic acid),B6. and B 12 are valuable, along with the trace minerals calcium, boron, and selenium. You can also take bioflavonoids, probiotics, and essential fatty acids to further assist NHRT.

In the herbal area, chaste berry, black cohosh, dong quai, panax ginseng, and licorice root can help support NHRT.

To sum up, hormones act to alleviate symptoms of menopause and increase your quality of life. Natural hormone replacement therapy has proved to be as effective as the synthetic hormones, if not more so. The food you eat and the nutrients you take act in synergy with your body and the hormones and can help to increase natural function. Be sure you eat as many whole foods as possible. And finally, eating whole foods and taking nutrients may not replace the hormones you need but will assist NHRT in doing a better job of what they do now.

All this adds up to taking your Natural Hormone Replacement Therapy when prescribed. You will feel better, help your bones stay strong, work to keep heart attacks away and, most of all, you will keep the symptoms of menopause away from you.