From out of whack to back on track
April 28, 2014
Feeling hormonal? Hormones and their most common symptoms (for women):
Low in estrogen: hot flashes, low energy and depressed mood.
Too much estrogen: weight gain, irritability and mood swings.
Low in progesterone: night sweats, anxiety, foggy thinking, and non-restorative sleep patterns (waking up in the middle of the night).
Low in testosterone: vaginal dryness, lower libido, less endurance and stamina.
VAIL — Few people really want to talk about their hormones. The topic tends to conjure images from a stereotypical commercial for tampons, menstrual pads or Midol in which at some point there's a woman who grabs her hair in frustration and groans, "Hormones, ugh."
In the case of women, we tend to think about hormones in terms of one's menstrual cycle, and for men, we tend not to think about hormones at all. In reality, hormone imbalances can affect both sexes and doesn't just occur during menopause.
Spotting the symptoms
For women, the symptoms of a hormone imbalance go beyond hot flashes. Everything from anxiety, trouble sleeping, night sweats, low energy, depressed mood and having difficulty thinking clearly can be an indication that a woman's hormones might be off balance.
Dr. Heidi Archer is a physician and owner of BodyLogicMD Vail who specializes in bioidentical hormone therapy. Archer said it's not uncommon for women to come in having previously been prescribed anti-anxiety medications or antidepressants, when in reality it's their hormones that are the real culprit. This does not mean that hormones are always the cause or that there aren't other health issues at play.
The bad comedian at open mic night is right about one thing: Compared to men, women really are more complicated. A woman can be deficient in progesterone, low in estrogen, producing too much estrogen or low in testosterone. Women experience the most significant change in their hormones during menopause, when the menstrual period stops and the ovaries cease producing estrogen and progesterone. However, women can have symptoms as early as 10 years prior to menopause, known as perimenopause. Even those outside of this range can experience hormone imbalance.
"I see (women) as early as teenagers who have bad headaches before their periods, (and) I have patients all the way up to their 80s," Archer said.
Finding the right remedy
After women discover that the reason behind those sleepless nights and uncontrollable crying while watching a video of adorable puppies on YouTube is in fact a hormone imbalance, there's more than one way to treat it. One option is biosimilar (synthetic) hormone therapy. Biosimilar hormone therapy is said to relieve hot flashes, night sweats and vaginal dryness. There has been some concern about synthetic hormones, and research has revealed that using them might increase a woman's chances of breast cancer, blood clots, heart attacks, stroke and gall bladder disease.
Since the mid-2000s bioidential hormone therapy has been on the rise, partially due to promotion from celebrities such as Suzanne Summers and Oprah Winfrey. Bioidentical hormones are identical in molecular structure to the hormones women make in their bodies. According to the U.S. Food and Drug Administration, bioidentical hormones are not "safer" or more effective than other hormone products. However, Archer doesn't see why someone would chose a biosimilar hormone therapy treatment when there are bioidentical options available.
"It's difficult because more research has been done on biosimilar (hormones) as opposed to bioidenticals," Archer said. "(I think you should) educate yourself with all the research that's out there so you can make the best informed decision."
Archer and the FDA both agree that women should be on the lowest dose of hormones possible for the least amount of time needed in order to reduce their risk of complications.
While there's debate about whether bioidentical hormones are "natural," there are ways to balance a woman's hormones without going under the needle, so to speak. Changing your diet, increasing your exercise and taking vitamin supplements can help with hormone issues. Archer said licorice root is helpful for adrenal issues, stress or hot flashes. Black cohosh is an herbal remedy that can treat hot flashes and night sweats. Chasteberry can aid women who are having symptoms right before their period and works well with estrogen dominance.
When it comes to taking supplements and using over-the-counter hormone remedies, there isn't one that works for all women and some may not work at all for some people. Archer said sometimes one remedy may be beneficial at first, but then it stops working over time.
"I can't see a downside to at least trying a herbal remedy," Archer said. "Some of them have no side affects … (and) I've seen them be effective for certain patients."
Putting the "men" in menopause
Men have hormonal changes in middle age as well. Typically 25 percent of men at age 50 have a low testosterone levels and experience the effects of this, said Dr. Timothy Kruse, board certified family physician at Premiere Medical Center, located within the Vail Vitality Center in Vail.
Kruse said this percentage could be higher, as many men don't seek treatment for their symptoms. Fatigue is the most common symptom of low testosterone, and other symptoms include a low libido and depressed mood.
When it comes to over-the-counter products to treat decreased testosterone in men, they're not very effective and contain "a lot of false advertising," Kruse said.
The only reliable way to know if a man has low testosterone is through a lab test. In women, it's more obvious when her hormones are decreasing, because of menopause, but in men hormonal changes are more subtle and gradual.
For both men and women as they age, a decline in hormone levels is normal, but this transition isn't always easy.
'A NATURAL PROCESS'
"The decrease of hormones is a natural, typical process," Kruse said. "The problem we all have now is we're living much longer than we were designed to live. (We) really demand of ourselves to live as high a quality of life as possible, and that means maintaining our hormonal integrity much later in life."
For those who specialize in hormone treatment, the goal is to make the aging process feel more like cruise control for patients, rather than a bumpy ride.
"We're trying to smooth things out to keep the hormones as balanced as possible while the body is going through a natural transition," Archer said. "The symptoms occur because (hormones) don't all decline nicely in their balanced states."
It can be hard to know if what you're feeling is due to your hormones, other health issues or just a bad hair day. But when someone is moody or feeling low in energy, it's unlikely that their first thought is, "Hmm, maybe it's my hormones." The only way to know if you have a hormone imbalance is to seek treatment, which will hopefully lead to less hot flashes and feeling more like "hot stuff" again.