I received the following email after my May 17 blog. The hormone “cocktail” Sue was given is exactly the issue I discussed. Every time I have seen a patient who has first been to an “anti-aging” practitioner, she comes in taking the same combination and has been told these are “natural” hormones. Patients I have evaluated have typically had the same results as Sue:
Dear Dr. Vliet,
Thank you for your blog. I have been seeing an anti-aging doctor for more than a year now. I had a hysterectomy with removal of everything including ovaries when I was 45 years old. I have been struggling since to feel normal. I was on testosterone, pregneneolone and DHEA, and I lost my hair. I was put on progesterone daily and bi-est 50/50 six days a week topically, and I have gained 20 pounds in just over one year even though my T3, T4 are within a good range. I had (vaginal) atrophy quite bad before starting and I still have zero sex drive. Is there anything else I can do to start feeling like a woman again and lose the weight?
Thank you. Sue
Why is she gaining so much weight, losing her hair, and has lost her sex drive? I see several reasons from the information she provided:
1. She was given progesterone daily, even though she had a hysterectomy and should not have been given progesterone at all. Reputable menopause specialists who know the recent medical studies do not use progesterone after hysterectomy because there is no longer a uterus to “protect” and it does not “protect” against breast cancer, as “anti-aging” doctors often claim.
Weight gain and low libido are common side effects of daily progesterone, for the reasons I explain in my book, Women, Weight and Hormones.
2. She was given “Bi-est” and pregnenolone, neither of which are medically sound hormone therapies based on the international studies. “Bi-est” is a concocted combination of estrogens from compounding pharmacies in violation of Food and Drug Administration bans on the use of estriol (one of the components).
Bi-est does not provide the correct amount of estradiol or a stable delivery system over 24 hours to have the beneficial effects of estradiol on metabolism, sexual function, mood and other critical areas. Pregenenolone is a “building block” the body uses to make estradiol and testosterone, when women have functioning ovaries. But after menopause or after a woman had her ovaries removed, she no longer has the primary organ and enzymes that carry out this process.
Precursor “building blocks” like DHEA and pregnenolone just build up and create unwanted side effects, as Sue sadly found out. I have explained the problems with estriol, pregneneolone, and low estradiol in detail in my books.
3. Sue was given both DHEA and testosterone. Excess male hormones (androgens) in women cause weight gain around the middle and upper body (trunk) and aggravate insulin resistance that comes with middle and upper body weight gain.
Insulin resistance in turn causes more weight gain. It becomes a vicious cycle. Current worldwide studies of androgens in women do not support using both DHEA and testosterone.
Women given excess amounts of DHEA and testosterone have the negative effects of hair loss and weight gain but don’t necessarily have improved sex drive, especially if estradiol is too low. I have explained this in detail in my book, The Savvy Woman’s Guide to Testosterone.
Sue has been a victim of what I call the “natural hormone scam.” The compounded hormone “cookbook” approach she was put on is no more “natural” than safer and more appropriate products made by major pharmaceutical companies. As I have explained in depth in all my books over the last 20 years: All hormones used for menopause therapy – whether compounded or manufactured by big pharmaceutical companies – come from the same raw materials derived from plants (yams, soybeans, etc.).
The plant sterols are then converted into the laboratory into molecular copies of the hormones made by the ovary so that they can be made into different products (pills, patches, gels, creams, lotions, sprays, and others).
Let me be clear: Estradiol, progesterone, DHEA and testosterone do not exist in plants in the identical form the human body makes. The human body does not have the enzymes to convert plant building blocks into the hormones natural to a woman’s body. This must be done in a laboratory – in a process we call synthesis.
The word synthetic means made in a laboratory by synthesis. Hormones made by synthesis can be either “bioidentical” – an exact copy of the hormones the body makes, or they can be chemically altered to be similar but not identical to the body’s hormones.
It is not chemically or medically correct to say that “synthetic” hormones are bad for you. Every ovarian hormone made by a compounding pharmacy or a “Big Pharma” product is “synthetic” because they are all made in a laboratory, and are not found in nature.
Women often don’t realize that FDA-approved bioidentical hormone options are often less expensive than compounded ones, since FDA-approved hormones are typically covered on most insurance plans and patients have to pay only a co-pay. Compounded hormones are not FDA-approved, and are typically not covered on insurance plans.
Please do not fall for the “natural hormone” scam. See a medical specialist who knows the good science and current medical studies, and knows how to use the variety of new FDA-approved bioidentical hormone products available to help you. I have many educational materials on my website, www.herplace.com to help you make medically sound decisions to improve your hormone health.
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