Top 5 Hormones Affecting the Health of Your Skin

There are many important factors to healthy skin:  a diet rich in fruits and vegetables of many colors, good hydration, regular exercise.  There are some important factors to avoid as well including sun damage, smoking, sugar and processed foods.  

But did you know that there are also many hormonal issues that can affect skin health?

Estrogen has many important actions on the skin:  It retains moisture, to prevent dry skin (and dry hair and dry eyes and vaginal dryness…).   It maintains collagen and elasticity to prevent wrinkling.  It also helps to maintain the thickness of the skin.  There are more estrogen receptors in the skin of the face than on other parts of the body, so declining estrogen levels cause more obvious changes on facial skin.  

Estrogen replacement has been shown to increase skin thickness and elasticity, improve collagen content in the skin, and reduce fine lines and wrinkles.  Some women actually choose to apply their topical estrogen cream on their face to maximize skin benefits.  Even if estrogen is not applied to the skin, women often notice improvements in their skin, including that healthy glow, when their estrogen levels are restored.  

Testosterone can cause skin problems when it is too low OR too high! 

When testosterone levels are low in older men and women,  skin tends to become thinner, and wound healing is impaired.  Testosterone adds some oil to the skin, and this can be helpful in aging skin which tends to be dry.

On the other hand, excess testosterone or DHEA can cause excessively oily skin and acne breakouts, as well as excess hair growth.  

Progesterone has been found to help maintain skin thickness and elasticity, and helps to maintain scalp hair growth.  It also helps to reduce the negative effects of testosterone on the skin, so a lack of progesterone can exacerbate the effects of excess testosterone.

Hypothyroidism (low thyroid function) is often associated with skin dryness as a result of decreased sweating and reduced sebum production.  Many other factors may be seen with low thyroid:  pale skin color, dry bumps on the upper arms, puffiness around the eyes, scalp hair loss, loss of the outer third of the eyebrow,  dry and brittle hair.   

Cortisol is your main stress hormone.  Stress has been associated with skin problems such as acne breakouts.  Since cortisol regulates your immune system, stress can exacerbate rashes such as psoriasis and eczema, which are due to immune system problems.  There is actually a new area of study called psychodermatology looking at the links between skin health and emotional stressors. 

As you can see, there are many ways in which hormones affect your complexion.  If you want healthy, glowing skin then proper hormonal balance is important!

If you are having skin issues and feel that hormones may be part of the problem, please give us a call!  704-752-9346 or email us at questions@signaturewellness.org.  You can find more information at www.signaturewellness.org

10 Causes of Hair Loss in Women (and what to do about it!)

Thinning hair worrying you?  Lets do something about it. 

Are you dismayed by how much hair you see in the hairbrush and shower each day?  Hair loss can be extremely devastating for women, and it is not uncommon for women to be in tears in the office because of emotional distress from their hair loss.  While women do not typically lose all their hair, once the hair shedding is underway baldness feels like a very real possibility!  

Here are 8 reasons you may be losing your hair.

 1.  Thyroid problems 

Thyroid problems are a common cause of hair loss, and since thyroid problems are very common in women, we see this often.  Other symptoms associated with low thyroid function include:  fatigue, weight gain, constipation, feeling cold, depressed mood, anxiety, poor memory, low libido, dry skin, and dry/dull hair.  Standard thyroid blood tests often overlook subtle thyroid dysfunction, but even mild problems can be associated with distressing hair loss.  Many women who are being treated with standard thyroid hormone replacement continue to have symptoms despite treatment.  Fortunately, with a more comprehensive lab assessment and natural thyroid replacement, we can optimize thyroid function and achieve healthier, thicker hair.   An over-functioning thyroid gland can also cause hair loss, so good thyroid balance is important. 

2.  Stress

 Cortisol is your main stress hormone.  It is produced in your adrenal glands  to help you cope with emotional stressors, as well as physiologic stressors  (such as pain, allergies, insomnia, toxin exposures, etc). If cortisol levels  are abnormal, hair loss can result.  If you can reduce your stress, your hair  loss may diminish, but you made need some help.  It is possible to measure  your cortisol levels and while there are no prescription medicines to correct  this problem, there are lifestyle changes and nutritional supplements that  can help resolve the issue.

3.  Menopause

Hormone changes associated with menopause (or peri-menopause) can also cause thinning hair (and thinning skin, and thinning bones….).  Restoring hormone levels with bio-identical hormone replacement can help improve the health of your hair (and skin, and bones!) . In a study of women receiving testosterone pellet therapy, 63% noted hair regrowth, and none of the women in the study reported an increase in hair loss after treatment with testosterone.  (Glaser et al, British Journal of Dermatology, 2012).

4.  Prescription medications

Many drugs can contribute to hair loss in women, including the use of birth control pills.  The American Hair Loss Assocation (AHLA) recommends that women consider using a low-androgen index birth control pills to avoid possible hairlsos, especially if they are genetically predisposed to hair loss.  Changing pills or choosing a non-hormonal birth control option may help to correct the problem.  .

5.  Pre-diabetes

Diabetes, or even pre-diabetes may be associated with hair loss.   A holistic approach to balancing blood sugar metabolism including lifestyle changes, nutritional supplements, and weight loss may have a positive impact on hair loss, as well as reducing the risks for some very serious longterm health issues.

6.  Nutritional deficiencies

While americans do not typically suffer with malnutrition, we tend to be nutritionally deficient due to poor quality food choices.  Even if you are trying hard to eat right, the food available at the grocery store may not have optimal vitamin and mineral content due to our modern farming practices.  If you have symptoms such as gas, bloating, indigestion, heartburn, constipation or diarrhea your ability to digest and absorb the nutrients in your food may be impaired.  Certain medications, such as ant-acids, can also impair your ability to digest nutrients.  Nutritional testing is available to determine whether this may be a problem for you.

One of the common nutrient deficiencies we see associated with hair loss is an iron deficiency.  The lab test that is most helpful is a ferritin level -  this is a marker of your iron stores, and if your level is below 80 it is possible that insufficient iron levels may be contributing to the problem

7.  Chronic disease

If you have any chronic disease, hair growth may be slowed to help redirect your body’s resources to other areas to help promote healing.  So hair loss may be a symptom of another problem going on in your body, such as an auto-immune disorder or chronic inflammatory condition.

8.   Androgenic Alopecia

This is the medical name for genetic hair loss (female pattern baldness)  This is hereditary and happens slowly over time (over a period of many years). Typically there is family history of baldness in male relatives and thinning hair in female relatives.  Women do not typically become completely bald.  Hair loss is first noticeable at areas of parts, and hair thinning progresses until the scalp becomes visible.  The hair loss occurs even with normal levels of hormones so treatment for hair loss, such as a PRP (platelet rich plasma) treatment,  is frequently required to restore hair growth.

9.  Alopecia Areata

This is a medical condition where the immune system attacks the hair follicles, causing patches of hair loss.   This is much less common, but more difficult to manage.  The hair may not grow back on its own and may require treatment to restore hair growth.  PRP has been effective in helping with this type of hair loss. 

10.  Physical stress  

If you have any kind of physical trauma, such as a severe illness, a serious injury or surgery, this can trigger increased hair shedding which is not usually seen until 3-6 months later.  The stressful event "shocks" the hair cycle temporarily, so less hair is shed around the time of the incident (you don't notice this!).  When the hair cycle starts up again, more hair is lost all at once (so you notice the shedding!).  The good news is that this is a self limited problem called "telogen effluvium", and the hair growing cycles will reset and go back to normal without treatment.

Healthy Hair Recommendations

Reduce stress.  Simplify your life if possible, and know that it is not always the AMOUNT of stress you are under that is the biggest factor, but how you ALLOW the stress to affect you that matters. 

Ensure hormonal balance – Take steps to restore hormone levels to optimal ranges.  Measuring your hormone levels and restoring normal hormone balance with natural, bio-identical hormone therapy can be life changing for women and affects far more benefits than simply improving the health of your hair. 

Improve nutrition and optimize digestive health to allow better absorption of nutrients.  Eat whole foods including fruits and vegetables, avoid processed food and especially sugar.  Ensure that you are not iron deficient, and consider being tested for a full panel of nutrients. 

Get regular moderate exercise – exercise increases blood flow to the scalp and improves your overall health.  Since your hair is a reflection of your overall health, your nutrition and fitness level are important to hair health.

Take biotin, a nutrient that can be helpful for hair and nails.  Our patients have found excellent results with RegeneMax Plus, which is a form of biotin with added silica (another nutrient important for hair).  This has worked better than standard biotin, and has quickly become one of our top selling supplements (people come back for more because they can see a difference!)

Consider PRP (platelet rich plasma) treatments.  PRP is appropriate for most woman concerned about hair thinning.  By the time the hair thinning is visible, approximately 50% of the hairs have been lost.  Most women are well aware far sooner – their pony tail is thinner, their part becomes wider and they can see the hair shedding.  PRP treatments will have the best effects on hair follicles that still have some function.  This innovative procedure has been featured on  ABC news (Oct 2015).  http://abcnews.go.com/GMA/video/treatment-millions-people-suffering-hair-loss-34336528

For best results, it is important to address your hair loss BEFORE it is in the advanced stages  So starting sooner rather than later (as a preventive measure) is perfectly reasonable.

If you would like more information or need help to correct your hair loss issues, please contact the office at 704-752-9346 or email us at questions@signaturewellness.org.  More information is available at www.signaturewellness.org.  

Deborah Matthew MD

Could you be in perimenopause?

Before you go through menopause, there is a period of time (up to 10 years!) where things start to change. The changes can be subtle or not so subtle. We call this phase of life "perimenopause", and it can be one of the most difficult transitions in a women’s life. Sadly, some women are told to tough it out and that it will pass. And often women are told that they are too young to be in perimenopause.

Addressing the hormonal symptoms of perimenopause can dramatically improve quality of life for many women. Lets talk about what is going on.

While estrogen levels start to decline around the time of menopause (average age of menopause is 52), progesterone levels start to decline much earlier.  In fact a your progesterone production may decline by as much as 80% between age 30 and 40.  This is one of the reasons that women in their forties have a harder time getting pregnant.

Progesterone is produced in two main places in your body. It is produced in the ovaries and in the adrenal glands. The majority of progesterone is produced in the ovaries after ovulation.  It helps to prepare the uterine lining in case of a pregnancy and is very important throughout pregnancy (it is “pro-gestational”).  

When a woman is in the second half of her monthly cycle, she is producing between 20 and 25 mg of progesterone a day. During pregnancy, production of progesterone spikes to between 300 and 400 mg per day.

When progesterone levels start to decline because of age, and symptoms of hormone imbalance become noticeable, we call this “perimenopause”.  

Progesterone deficiency is the most common hormonal problem we see in peri-menopausal women, but younger women can have this problem as well.  Because progesterone levels naturally vary over the menstrual cycle, the symptoms vary as well.  

Typically the week after a period is a “good” week; you are eating your broccoli, exercising regularly, and cleaning out your closets.  Then as you get closer to your period,  symptoms get worse and worse including irritability, anxiousness, and interrupted sleep.   You may feel more negative, critical, impatient, and easily frustrated - and this can affect how you behave towards your family and co-workers!

In fact, this variation in symptoms is a big clue that hormones are the problem.  If your mood symptoms or insomnia are exactly the same on every day in your cycle, it is less likely that hormones are the cause.

Progesterone has mainly been studied for its effects on the uterus but it turns out that progesterone has far more roles to play.  Women have progesterone receptors on cells in all parts of our bodies, and surprisingly the cells with the most progesterone receptors are our brain cells.  Anyone who has experienced PMS symptoms with mood swings and irritability may not be surprised after all!  

Research is showing that progesterone has important neurological effects.   It acts as a natural anti-anxiety compound, helps with sleep and is calming - sort of like nature’s version of valium or a glass of red wine.

Here is a checklist of symptoms that you may experience if you progesterone levels are declining:

Insomnia (especially wakening in the night)

Night sweats

Anxiety

Irritability

Mood swings

Weight gain

Increased PMS

Pre-menstrual headaches

Heavier periods

Shorter cycles (periods coming less than 28 days apart)

If this sounds like you, please know that there is help! You can feel like YOU again.

You can find more information at our website www.signaturewellness.org or contact the office at 704-752-9346

Yours in health

DrM

How to have younger looking skin

You know the basics for promoting healthy skin.  A “whole foods” diet (as opposed to processed foods), rich in a variety of colorful fresh fruits and vegetables is the basis of overall health, and skin health is no exception.   Staying hydrated is important.   Exercise improves blood flow to the skin, and helps maintain skin health.  

Avoiding sun damage is critical.  Some sun exposure is important to make sure you are getting vitamin D (which is also good for skin health!), but sun damage can be prevented by wearing a hat and a non-toxic sunscreen.

Did you know that hormonal balance is also important to skin health?  A medical study found that women with the lowest estrogen levels looked 8 years older than their actual age, and women with higher estrogen levels looked 8 years younger than their age (that is a 16 year differential!).  Estrogen helps maintain collagen production in your skin, which helps minimize fine lines and wrinkles, and it helps your skin remain hydrated.  You may notice that your skin “glows” when you are hormonally balanced.

Significant changes occur in your skin during menopause, including thinner skin, increased wrinkling, skin dryness, and loss of elasticity and firmness of your skin.    Skin thickness has been found to decrease by 1.5% per year after menopause, and collagen content can be reduced by as much as 30% within 5 years of menopause.  These skin changes appear to be more closely related to length of time that you have been estrogen deficiency than to your actual chronological age.  (In other words, the longer you have been without estrogen, the older you look!)

Hormone replacement has been shown in a number of studies to help improve hydration of the skin, maintain skin thickness and elasticity, improve blood flow to the skin and increase collagen production. 

In one study, estrogen replacement resulted in a measurable increase in skin thickness after only 2 weeks of applying topical estrogen.  Another study found that skin thickness was increased by 30% after 12 months of estrogen therapy.

A large study showed reduced wrinkling in postmenopausal women on estrogen replacement.    Another study of women on hormone replacement found less wrinkles in the estrogen treated group compared with women on no hormones.  

Estrogen has also been shown to speed up wound healing and offer some protection against photoaging (sun damage).  

Estrogen is good for your heart, your bones, your brain and also your skin!

Apart from maintaining your hormone balance, there are a number of aesthetic treatments that can help you to look as young as you feel!  

SkinPen treatments are ideal if you want to treat fine wrinkles, acne scars,   or sun damage.  A small device contains tiny surgical-grade needles that produces microscopic punctures in your skin.  This stimulates the production of collagen and elastin which give your skin a more youthful appearance. It mimics what a laser treatment does, but without the discomfort or downtime. 

And have you heard about PRP (platelet rich plasma) to rejuvenate the skin?  PRP is obtained from your own blood - it is the fraction of your blood which contains growth factors.  It is injected into your skin, where it activates your own stem cells to stimulate growth of collagen, blood vessels and nerve fibers.  We are harnessing your own innate healing potential to create younger looking skin! 

If you are interested in learning more about how to have younger looking skin,  please visit our website at www.signaturewellness.org.  Or you may contact us at questions@signaturewellness.org, or call at 704-752-9346.   

Yours in health, 

DrM

The most important nutritional factor in healthy aging

Fat used to be the bad guy, but recently carbs have become the dietary villain.  Low carb diets have convincingly shown more benefit than low fat diets for weight loss . But WHAT KIND of carbs we are talking about matters a lot.  A doughnut is a carb, but so is broccoli! 

In an effort to reduce the starchy carbs in our diet (which is a a good thing to do!) we need to be careful that we don't end up eating less fiber.  

A recent Australian study looked at 1,600 adults aged 50 years and older and evaluated their dietary risks for long-term sensory loss and systemic diseases, related to their carbohydrate consumption. Out of all the factors they evaluated,  including total carbohydrate intake, total fiber intake, glycemic index, glycemic load, and sugar intake - fiber intake resulted in the biggest difference in "successful aging.  

"Essentially, we found that those who had the highest intake of fiber or total fiber actually had an almost 80 percent greater likelihood of living a long and healthy life over a 10-year follow-up. That is, they were less likely to suffer from hypertension, diabetes, dementia, depression, and functional disability."

Here are a few possible reasons behind these important findings.   

1. Bowel regularity.    Insoluble fiber helps to keep you regular by "sweeping out" your colon.  Having regular bowel movements is an important part of detoxification.  We are all exposed to environmental chemicals and natural waste compounds from our own bodies that we need to eliminate.  Many of these compounds are excreted into the digestive tract.  If you aren't moving your bowels regularly, there is a greater opportunity for these compounds to be reabsorbed and result in increase health risks.

2.  Stable blood sugar levels.  Fiber in your meal also helps to slow the rate that your blood sugar rises as you digest your meal.  A slower rise in blood sugar is healthier - it allows the body to make an appropriate amount of insulin to handle the sugar load.  A meal high in sugar or refined carbohydrates (like white bread) and low in fiber results in a rapid spike in blood sugar and the body has to scramble to gain control over the metabolic situation.  Over time, this can lead to insulin resistance and diabetes.

3.  Prebiotics.  You have probably heard that the healthy bacteria in your digestive tract is very important to your health and disease prevention.  Probiotics are the healthy bacteria (for example found in yogurt) that you need to stay well.  Have you heard of Prebiotics?  This is the food source for the probiotics!  It is not enough to simply take a probiotic supplement - you need to nourish your gut bacteria by feeding them plenty of prebiotics.  And can you guess what your probiotic bacteria eat?  Fiber, of course!  So a diet rich in fiber is a diet rich in prebiotics, which help to nourish your healthy gut bacteria.

4.  Healthy cholesterol levels.  Soluble fiber does not dissolve in water (think about how oatmeal becomes gelatinous when you mix it with water).  Soluble fiber binds to cholesterol and helps you to clear it from your system.  We know that the actual AMOUNT of cholesterol is not really what is important - it matters much more whether or not the cholesterol is inflamed or oxidized.  But eating enough soluble fiber helps to maintain cholesterol levels in the normal range.  

5.  Estrogen metabolism.  Another factor to consider is the very important role that fiber plays in hormonal balance, and this is important in women AND men.  Each day you excrete estrogen into your digestive tract to clear it from your system (whether you made the estrogen in your own body or whether you are on estrogen replacement or birth control pills).  The insoluble fiber in your diet helps to keep you regular so you can excrete estrogen.  Soluble fiber helps carry estrogen out in your stool, and helps prevent it from being reabsorbed into the blood stream.  This makes sense when you remember that many of your hormones (including estrogen) are made from cholesterol!  So just as fiber is important for lowering your cholesterol, it is also important for clearing estrogen.  

This is especially important in women who have "estrogen dominance" with symptoms like heavy periods, PMS symptoms, breast tenderness, weight gain, insomnia, anxiety, fibroids, fibrocystic breast disease, or ovarian cysts.  Estrogen dominance is a risk factor for breast cancer, and a high fiber diet can help reduce the risks (we have lots of research to support this).  Too much estrogen is also a risk factor for prostate cancer.  As men age, they often convert more of their testosterone into estrogen, and an increase in fiber can help minimize the amount of estrogen that accumulates.

How much fiber do you need?  Many studies have looked at a goal of 30gram of fiber per day.  One challenge in trying to achieve this goal is that I typically recommend eating "whole" foods that do not come in a package (and therefore don't have a label to tell you how many grams of fiber per serving).   But here are some foods that are good sources of fiber, especially soluble fiber which is the best for balancing hormones.  

Fruits including citrus fruit, berries, apples, apricots, dates, prunes, and pears.  
Vegetables including asparagus, brussels sprouts, squash, zucchini, broccoli and root veggies like carrots, turnips and sweet potatoes.  
Legumes including lentils, chickpeas and pinto beans
Nuts such as almonds and walnuts
Seeds like ground flax seeds, chia seeds, hemp seeds, raw pumpkin seeds

While you are eating these terrific foods to make sure you get enough fiber, you will also be benefitting from the antioxidant vitamins, trace minerals and abundant "phytonutrients" (plant compounds) that will help keep you heathy.  Perhaps higher fiber intake was not the only reason the people in the study had reduced rates of disease - it may have been because fiber tends to come packaged by nature along with the other important nutrients you need to stay well!  So eat more fiber today to help maximize your chances for a healthy tomorrow.  

For more information on healthy hormone balance and healthy aging, please see our website www.signaturewellness.org or contact the office at 704-752-9346 or questions@signaturewellness.org

Yours in health,

DrM


1.  Association Between Carbohydrate Nutrition and Successful Aging Over 10 Years. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2016

2.  High fiber diet reduces serum estrogen concentrations in premenopausal women.  American Society of Clinical Nutrition.  1991

P.S.:  New testing allows us to measure your estrogen metabolites.  Would you like to know whether you are metabolizing estrogen in a way that increases your breast cancer risk (and then do something to correct the problem?)  Please contact the office for more information.  The test is $200 and is not covered by health insurance.  

How to reduce your risk for breast (or prostate) cancer

Are you worried about breast cancer?  (Or prostate cancer?) You certainly, aren’t alone!  This is the number one concern I hear about when I am talking to patients about hormone balance.  Many men are not aware that their estrogen level can affect their risk for prostate cancer (high estrogen levels may increase the risk).   

Estrogens are essential for health and well being in both women and men. Estrogen plays a role in mood, energy, memory, sleep and sexual function.   Estrogen is important for bone health, brain health, heart health, breast health and prostate health.  

Every day, the body has to clear today’s estrogen to make way for tomorrow’s estrogen.  This is true whether you are making your own estrogen or whether you are taking estrogen replacement (synthetic or bio-identical).  If you are not clearing the estrogen properly, levels can climb and lead to symptoms.  Another factor to consider is HOW your body is clearing the estrogen.

Some estrogen metabolites (or “breakdown” products) have been shown to be harmful and increase risk for breast cancer in women, and prostate cancer in men.  On the other hand, some estrogen metabolites are protective, and associated with a REDUCED risk of breast cancer.  Wouldn’t you like to know which ones you are making?

The levels of the various metabolites can be measured, and we can use this information to help assess breast cancer (and prostate cancer) risks.  The good news is that armed with this information, there are many steps we can take to CHANGE the risks.  

How does it work?

There are 2 main estrogens we need to consider here.  Estrone,  also called E1, is the predominant postmenopausal estrogen.  Estradiol, also called E2, is the predominant pre-menopausal estrogen and the one that we replace in estrogen replacement therapy.   Men also have these estrogens, and estrogen levels tend to increase in men with age.

In “Phase One” of detoxication of estrogen, the liver metabolizes these estrogens into 3 different possible metabolites:

2-hydroxyestrogen (2-OH) is breast protective, so we want the most of your estrogen to go down this pathway.

16-hydroxyestrogen (16-OH) is bone protective (reduces the risk of osteoporosis) but is not breast protective.  We used to think that the ratio of 2 to 16 hydroxyestrogen (or the “2 to 16 ratio”) was a good predictor of breast cancer risk, but the current research does not support this.

4-hydroxyestrogen (4-OH) is the metabolite that you really don’t want.  This one has been associated with an increase in the risk for breast cancer.   This is also the one that breast cancer cells release into the bloodstream, so an increased level of 4-OH is concerning.  This is a newer test, and was not available in the past.   If the level of 4-OH is too high, we can help correct this with cruciferous vegetables (like broccoli, cauliflower,  kale, brussels sprouts), ground flax seed and fish oil.  We can also use a nutritional supplement called DIM.

In “Phase Two” of estrogen detoxification, the metabolites are altered further:

2-methoxyestrogen (2-Me) and 4-methoxyestrogen (4-Me) are made when 2-OH and 4-OH estrogens are “methylated” into methoxyestrogens.  This is a biochemical event where a “methyl” molecule is attached to the estrogen.  Even if estrogen has been converted into the “bad”  4-OH, once it is “methylated”  into 4-Me,  it becomes harmless.  Some people have a genetic variation resulting in reduced ability to methylate, and this leaves more 4-OH.  If the level of 4-OH is too high, we can help reduce it with supplements such as folate, B12 and SAMe which help methylation.

If the 4-OH is not methylated, it can be “oxidized” to a quinone-estrogen which can damage DNA and cause cancer.  But here too, we can intervene to prevent this!  Anti-oxidants, including glutathione (an important anti-oxidant produced in your liver), protect the 4-OH from being oxidized into a quinone-estrogen.  We can help clear the 4-OH safely by increasing your levels of glutathione.  This can be done by eating foods such as garlic, onions and beets, and with a supplement called N-acetylcysteine (NAC).  

Where should you start?

Previously we could only test for 2 and 16 estrogen metabolites, which didn’t give us the whole picture.  Now we can also measure for the 4 estrogen metabolites, which allows us to map out your personal estrogen metabolism  pattern.  We can also test for genetic variations that may be pushing your estrogen metabolism in the undesirable direction, as well as test for levels of anti-oxidants such as glutathione which help to clear the “bad” estrogen metabolites.   With this information we are able to make recommendations to alter your pattern so you make more of the protective estrogen 

metabolites and less of the harmful ones.  Then we can repeat the test to make sure we got it right! 

There are many other factors that are important for reducing cancer risk, including maintaining a healthy weight, eating a whole foods diet rich in fruits and vegetables of many colors, getting regular exercise, coping with stress in a healthy way, avoiding environmental toxins and making sure your estrogen is balanced with progesterone.  

Knowing your estrogen metabolism pattern, and optimizing it, is an example of how emerging medical science can help guide our nutritional recommendations to help you reduce your risk for hormone sensitive cancers.  The test is not covered by health insurance, and the cost is $200 or less, depending on the lab.  I recommend this test be done at least once in all patients.  If it is abnormal, we can talk about further testing for the gene variants, so we can compensate for any genetic weaknesses.  

If you are interested in being evaluated for your estrogen metabolism pattern, please contact the office for more information, 704-752-9346 or email us at questions@signaturewellness.org.   You can find more information at www.signaturewellness.org

Yours in health,

DrM

Is Estrogen Replacement Safe?

In July 2002, the well publicized Women's Health Initiative (WHI) study suggested increased rates of heart disease, strokes and breast cancer in women on hormone replacement therapy.  Naturally women and their doctors were fearful of the risks, and in the next 10 years hormone replacement use dropped by 79 percent.  Newer studies are showing that warning women off hormones was a mistake.  We know that estrogen and other sex hormones are vital for many functions in a woman's body.  

A study done by doctors at Yale and published in the American Journal of Public Heath, Sept 2013, evaluated the result of this widespread reduction in hormone use.  According to their calculations, estrogen AVOIDANCE may have led to as many as 90,000 preventable deaths.  The study found that estrogen therapy (ET) was actually associated with a REDUCTION in deaths from heart attacks and breast cancer.   According to the authors:  “Estrogen therapy in younger postmenopausal women is associated with a decisive reduction in all-cause mortality” 

A new study supports this.  Almost half a million women in Finland were followed over 15 years, and the results show that the longer the women were on estrogen replacement, the lower their risks for heart disease and strokes.  In fact, all cause mortality (meaning death from ANY cause, including breast cancer) was reduced by up to 30%.

There is no need to suffer with symptoms of menopause due to fear of side effects of hormone replacement. Your individual risks are related to many factors including your age, whether you are using bio-identical or synthetic hormones and the delivery method of the hormones (for examples pills vs topical estrogen).  Please ask us about your personal risks and the potential benefits, including improved memory, energy, mood, sleep and even younger looking skin.   Click here for more information.

Why is estrogen important for women?

Lets talk about the benefits of estrogen.  It has literally hundreds of roles in a woman's body!

Estrogen helps to protect your heart.  When you are premenopausal, your risk of a heart attack is significantly less than a man’s risk.  But after menopause, when estrogen levels drop, the risks become equal.   

It also helps to keep your tissues hydrated.  Without estrogen you can become dry:  dry eyes, dry mouth, dry skin, dry hair, dry vagina……

Bone health also depends on hormones, and estrogen in particular helps to prevent bone loss.  While this may not be something you are particularly worried about right now, it should be!  If you have a broken hip because of osteoporosis, there is a good chance that you will end up in assisted living. Preventing bone loss now is very important for your future mobility and independence.  

Something you may be very concerned about right now is how old you look!  Estrogen affects skin health - it helps to provide hydration and blood flow to keep that youthful glow to your skin,  and it maintains collagen to provide elasticity, which helps to minimize fine lines and wrinkles.  You may notice your skin aging rapidly as you go through the menopause.  One research study found that women with higher estrogen levels looked on average 8 years YOUNGER than women with low estrogen levels! 

Arguably the most important role of estrogen is on brain health.  Estrogen is energizing to the brain, so if estrogen levels are low you may feel more tired.  It is also important for quality of sleep, and obviously you have to be able to sleep to have good energy!

Estrogen is a natural anti-depressant in women.  It is needed to activate serotonin receptors in your brain, and serotonin is the natural brain chemical responsible for peace and joy, so obviously you want that!  If your estrogen levels are low, you may feel more flat, anxious or unmotivated.   You may be prescribed an anti-depressant medication to try to boost serotonin levels (like Prozac, Celexa, or Zoloft for example), but if you can normalize your estrogen levels,  your mood may improve without the need for medication.

There is a very important relationship between estrogen and memory.   If your estrogen level drops you may find yourself forgetting names, why you walked into the room or where you left the car keys.  It can be alarming and you may even worry that you are experiencing the early stages of Alzheimers!  Fortunately in many cases your memory can improve significantly with restoration of normal estrogen levels.  

Did you know that the average woman gains 20 pounds as she goes through menopause?  Estrogen deficiency can cause you to pack on the pounds, even if you haven't changed your diet or exercise. Of course, if you are tired, unmotivated and not sleeping well you may be finding it more difficulty to maintain healthy lifestyle habits!

As you can see, estrogen is very important for how you feel, how you look and how you will age. 

If you are interested in learning more about estrogen and whether estrogen replacement may be a good idea for you, click here.  If you are interested in scheduling an appointment to talk with us about your personal situation, please call 704-752-9346.  

Bioidentical progesterone restores sleep

This study looked at insomnia in menopausal women and found that different types of progesterone replacement had different effects.

Twenty-one postmenopausal women were studied. They were randomized to receive estrogen plus synthetic medroxyprogesterone acetate or estrogen plus bioidentical progesterone.

Sleep efficiency was found to be significantly improved in the progesterone group with no such increase observed in the medroxyprogesterone acetate group. Time spent awake after sleep onset was also significantly improved in the progesterone group but not in the medroxyprogesterone acetate group.

CONCLUSION: This study suggests that bioidentical progesterone might better improve the quality of sleep in postmenopausal women taking estrogen.

OUR COMMENT: We regularly see women complaining of poor sleep during perimenopause and menopause. Chronic sleep deprivation may contribute to weight gain, insulin resistance, mood problems, cognitive function and daytime fatigue. Restoring healthy sleep can make a profound difference in a woman's quality of life.

Menopause. 2001 Jan-Feb;8(1):10-6.
Sleep in menopause: differential effects of two forms of hormone replacement therapy.
Montplaisir J, Lorrain J, Denesle R, Petit D.

Bio-identical hormones improve bone density

A 2003 study published in the Journal of the American Medical Association (JAMA 290:1042-1048) studied whether hormone replacement at low doses would be effective at maintaining bone mineral density. Lower doses are desirable as higher doses are associated with more adverse events. Bio-identical hormones were used in this study (hormones that are an exact chemical match to human hormones).

This was a “gold standard” double-blind, placebo controlled trial done at an American university research center from 1998-2002, following 167 healthy women 65 years and older.

The bone mineral density of the hip, spine, wrist, and total body was measured annually for 3 years. Mean bone mineral density increased at all sites for participants taking low-dose bio-identical hormone replacement (BHRT) compared with placebo . There were no statistically significant differences in breast tenderness, changes in uterine thickness, or annual mammographic results between women on BHRT and the placebo group. There were no reports of breast cancer during the study.

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