It is interesting that this question has come up lately for several patients, and I thought we could look at it together since you may have thought about it too.
First, it’s good to think back to the reasons why we consider using them in the first place.
I think that they can be boiled down to three:
1. To relieve distressing symptoms of hormonal decline that negatively impact our quality of life – like insomnia, depression, low libido and a litany of others;
2. To slow down the aging process. We all age. However, we can slow down the progression so that it becomes more graceful and we can maintain our vitality and strength as much as possible for as long as possible; and
3. To prevent the major diseases that we tend to die from in this society. This is a huge potential benefit from bio-identical hormone replacement therapy (BHRT). When it is started early around the beginnings of hormonal decline at mid-life, we can see these common illnesses held at bay for years and even for one’s whole lifetime. Heart disease, diabetes, osteoporosis, Alzheimer’s and dementia, and cancer risk rates can all be reduced with the proper use of balanced bio-identical hormones. No matter when you start BHRT, some benefits for slowing disease processes can be achieved.
There is no study on Bio-identical Hormones that shows that patients should come off them by any certain age.
This is unlike the synthetic hormones, which are associated with definite health risks that increase with the length of use. When on BHRT, we always recommend that you get appropriate yearly health screenings, and based on those findings and your general health we can then determine that the treatment remains appropriate. As we get older, the required doses do decline. However, if you stop them, you may within approximately 2 years develop the beginnings of the major diseases that your body is prone to and that you have been preventing by using BHRT.
One thing that I promise to do for you is to keep myself up to date on the most recent information available on hormones and health at mid-life, and that means attending professional conferences. For four days just last week, I attended the annual conference of the American Association for Restorative Medicine, of which I am a member. It was attended by over 600 professionals, and offered cutting edge information in Integrative Medicine to help us better support your good health. I want to share with you some highlights of that conference to help you further answer the above question for yourself.
An hour lecture by Neal Rouzier, MD, an emergency room doctor who also has a successful bio-identical hormone practice, reviewed a large number of research articles on sex hormones and included the following:
• Estrogen therapy safely and effectively reduces total mortality and coronary heart disease in women recently entering menopause- something aspirin and lipid lowering therapy have not been able to do;
• Estrogen has effects on calcium metabolism at the arterial wall level, which could account for its unique ability to reduce the calcium content of atherosclerotic plaques, thus reducing plaque buildup. This is not seen with any other intervention;
• The evidence of disease prevention of estrogen therapy in postmenopausal women is stronger than ever;
• Ovarian conservation until at least age 65 seems to benefit long-term survival and lower risk of multiple diseases;
• BHRT decreases the risk of Alzheimer’s disease in women by 65-75%;
• Estrogen therapy, recent and long term, is associated with a substantial decrease in the risk of colon cancer;
• Bio-identical progesterone is reported to be associated with a lower risk of breast cancer than the use of progestins (synthetic progesterone) which have double the risk;
• Low free testosterone in men is associated with increased risk of Alzheimer’s disease;
• Meta- analysis showed low testosterone was associated with increased risk of all-cause as well as cardio-vascular disease death
• Testosterone replacement shifts the cytokine balance in the body to a state of reduced inflammation and lowers total cholesterol;
• DHEA levels are a predictor of longevity;
• Decreasing levels of Free T3 (including relative low but clinically “normal” levels) are associated with elevated risk factors for coronary artery disease, elevated risk of fatal heart attacks, depressive symptoms, poor performance, and increased mortality.
Each of us has to weigh in on what we want to contribute to our health and well-being.
For some it will be to use bio-identical hormones. They, and others who choose not to use hormones, may focus on nutrition, exercise, herbs, vitamins/minerals, stress reduction, mind/body health – all of which need support for us to continue to function at our optimal level as we move through life.
Whatever you decide, I hope you will join with me in aiming to live life as fully and vitally as I can right up to my last day on this planet!
Here’s to an alive and vital life for all of us!
Jane Kennedy, CFNP, MN, MPH