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Myth: Every woman in menopause is deficient in estrogen.

Truth: Not every menopausal woman is estrogen deficient.

Possibly one of the biggest medical confusions is that estrogen levels in all women drop strongly after menopause, and these low levels are responsible for all the many symptoms modern women suffer. This includes everything from depression to hot flashes. In truth, Western women in America and Europe often have excessive estrogen levels (even after menopause). Consider that 80% of breast cancer cases are hormonally driven by estrogen. Breast cancer incidence rates are most common in women of menopausal ages, during a time when estrogen is supposedly low. How could that be? Menopause merely means that ovarian production of estrogen declines to levels that do not induce a menstrual cycle. It is a natural phenomenon indicating only that one’s period of fertility is over. It does not mean estrogen has gone to zero. Since a woman’s fat cells and skin cells still produce estrogen, estrogen levels can remain high. Estrogen continues to be produced, although in lesser amounts, by conversion of a sterol, androstenedione, which is found in fat, including the fat in muscle cells. Furthermore, studies of blood and tissue levels – especially of estrone show estrone rising with age and is more relevant for estrogen-driven diseases such as breast cancer(Contraception 1981 Apr;23(4):447-55).

Myth: Bioidentical hormones are dangerous.

Truth: Bioidentical hormones are safe and likely protective.

Bioidentical HRT (BHRT) is “a bioidentical steroid hormone that is not human in origin but is identical in organic structure and function to human hormones” (My Hormone Therapy.) Bioidentical hormones are usually derived from a type of plant oil called diosgenin, which is very similar in chemical structure to our endogenous precursor steroid hormone, cholesterol. There are thousands of studies along with millions of women that have shown BHRT to be incredibly safe and even protective. For example, natural pregnenolone is linked to the prevention of bone loss. In studies, pregnenolone managed to prevent and reverse osteoporosis (Frontiers in Pharmacology, 2020). Progesterone also seems to be beneficial in preventing mitochondrial dysfunction that results in the loss of hippocampal cells after a controlled cortical contusion (Robertson et al., 2006). Furthermore, a study on obesity showed “…decreases in abdominal visceral fat occurred during the 6 months of DHEA replacement. (JAMA 2004)

Myth: Estrogen is the female hormone.

Truth: Estrogen is the shock hormone, not the female hormone.

Many believe estrogen is the female hormone due to a long history of hormone confusion. In 1964, a gynecologist named Robert Wilson and his wife published a book called Feminine Forever. He told women that menopause was a disease, and that horse estrogen was the solution for their symptoms. One year later, Ann Walsh followed up with her book Now! The Pills to Keep Women Young! Unfortunately, both of these books were huge successes. In reality, there was no scientific evidence that all menopausal women needed estrogen or that estorgen made a woman more “feminine.” Estrogen is the shock hormone, not the female hormone. “Estrogen, at least when it is not opposed by a very large concentration of progesterone, creates all of the conditions known to be involved in the aging process. These effects of estrogen include interference with oxidative metabolism, formation of lipofuscin (the age-pigment), retention of iron, production of free radicals and lipid peroxides, promotion of excitotoxicity and death of nerve cells, impaired learning ability, increased tendency to form blood clots and to have vascular spasms, increased autoimmunity and atrophy of the thymus, elevated prolactin, atrophy of skin, increased susceptibility to a great variety of cancers, lowered body temperature, lower serum albumin, increased tendency toward edema, and many of the features of shock.”- Dr. Ray Peat PhD

Myth: Food choices do not impact hormone levels.

Truth: Food choices do impact hormone levels.

What we eat affects everything – our hair, skin, nails, bones, internal organs, brain, and emotions. Food can also impact our hormone production and secretion, which goes hand in hand with menopause. There is evidence that menopause is much easier for Asian women than for western women. While hot flashes have been reported in 10% of China, 22.1% of Japan, and 17.6% of Singapore, it is estimated that 75% of women in America experience hot flashes due to menopause. The difference? Their diets. When women consume the Standard American Diet, they tend to carry more fat on their bodies. Diets high in refined sugars and carbs, hallmarks of the standard American diet are to blame. With more fat cells, comes more estrogen produced. This result is sustained monthly estrogen dominance leading to a wide variety of medical problems stemming from unopposed estrogen side effects. Therefore, food choices have a major impact on our bodies and hormones.

Myth: Hot flashes can’t be solved.

Truth: Hot flashes can be solved (and solved naturally).

Hot flashes are the main reason women seek hormone therapy and remain compliant with it. When progesterone fails to be produced, hot flashes may be induced. Progesterone and pregnenolone are synthesized in large amounts in youth and both hormones decline with age. Therefore, these hormones are often referred to as “youth” hormones. Bioidentical progesterone was found to be effective for decreasing hot flashes, and a month after discontinuing it, the hot flashes were still less frequent than before using it (Menopause, 2012). What else can you do to solve hot flashes?
-Support the thyroid. The thyroid controls metabolism, growth, and many other bodily functions. Some patients take a thyroid replacement to support their thyroid.
-Remove stress. . Often called the “stress hormone,” cortisol causes an increase in your heart rate and blood pressure. As noted, high cortisol is involved in hot flashes.
-Minimize exposure to estrogens. Plastics, chemically-laden cookware, and personal care products eating PUFAs, drinking alcohol, drinking tap water, etc. all increase our estrogen.
-Natural sugars may help. Sugar reduces levels of cortisol, the stress hormone. As stated, cortisol is implicated in hot flashes. Make sure it’s naturally occurring sugar like fruit and honey.
Myth: Progesterone levels don’t have anything to do with menopause symptoms.
Truth: Progesterone deficiency is one of the main causes of menopausal symptoms.
Our providers often see patients whose estrogen levels are high enough for all the necessary and needed bodily functions. Of greater importance is the fact that it is common that women’s production of progesterone falls to near zero at least 6-8 years before menopause. John Lee MD explains, “Though estrogen falls only 40 to 60 percent from baseline on average, the decline in progesterone levels is 12 times greater.” Progesterone belongs to the body’s youth-associating hormones, which all have anti-stress and anti-aging effects. Progesterone is the body’s most protective hormone. It neutralizes inflammatory substances including excess estrogen. Progesterone is critical for the function of a healthy’s body’s energy production. Unfortunately, menopause usually means less progesterone, and more symptoms like hot flashes fatigue, and brain fog. The good news is with the help of bioidentical progesterone, we can solve many of these issues.
 

Myth: Progesterone levels don’t have anything to do with menopause symptoms.

Truth: Progesterone deficiency is one of the main causes of menopausal symptoms.

Moment providers often see patients whose estrogen levels are high enough for all the necessary and needed bodily functions. Of greater importance is the fact that it is common that a women’s production of progesterone to fall to near zero at least six to eight years before menopause. John Lee, MD explains, “Though estrogen falls only 40 to 60 percent from baseline on average, the decline in progesterone levels is 12 times greater.” Progesterone belongs to the body’s youth-associating hormones, which all have anti-stress and anti-aging effects. Progesterone is the body’s most protective hormone. It neutralizes inflammatory substances including excess estrogen. Progesterone is critical for the function of a healthy body’s energy production. Unfortunately, menopause usually means less progesterone, and more symptoms like hot flashes, fatigue, and brain fog. The good news is with the help of bioidentical progesterone, we can solve many of these issues.

Myth: Synthetic hormone therapy is safe.

Truth: Synthetic hormone therapy is dangerous.

By 1975, women on estrogen replacement therapy (ERT) were getting high levels of uterine cancer among many other problems. To attempt to overcome the cancer connection, progestin was added to the formula. Since natural progesterone cannot be patented, pharmaceutical companies used synthetic progestin. The side effects were just as severe as before, only different in nature. Many doctors still confuse “progesterone” and “progestin,” but they are very different. Progestin still carries many negative side effects. A study in the British Journal of Cancer has confirmed that HRT triples the risk of breast cancer following a 6-year follow-up in nearly 40,000 women.

Half of the population experiences menopause, yet misconceptions like these are still extremely common. To start treating menopause accurately start with our at-home blood test kit here: https://momenthealth.co/at-home-blood-kit/

References:

Contraception 1981 Apr;23(4):447-55. Comparison of plasma and myometrial tissue concentrations of estradiol-17 beta and progesterone in nonpregnant women. Akerlund M, Batra S, Helm G Plasma and myometrial tissue concentrations of estradiol (E2) and progesterone (P) were measured by radioimmunoassay techniques in samples obtained from women with regular menstrual cycles and from women in pre- or postmenopausal age. In women with regular cycles, the tissue concentration of E2 ranged from 0.13 to 1.06 ng/g wet weight, with significantly higher levels around ovulation than in follicular or luteal phases of the cycle. The tissue concentration of P ranged from 2.06 to 14.85 ng/g wet weight with significantly higher level in luteal phase than in follicular phase. The tissue/plasma ratio of E2 ranged from 1.45 to 20.36 with very high values in early follicular phase and the lowest in mid-luteal phase. The ratio for P ranged from 0.54 to 23.7 and was significantly lower in the luteal phase than in other phases of the cycle. One woman in premenopausal age with an ovarian cyst was the only case with a tissue/plasma ratio of E2 Less Than 1, since her plasma E2 levels were exceptionally high. In postmenopausal women, the tissue concentration of E2 was not significantly lower than in menstruating women in follicular phase, and the tissue concentration of P was not significantly lower than in fertile women in any of the phases. Neither in these women nor in menstruating women was there a close correlation between tissue and plasma levels. The present data indicate that the myometrial uptake capacity for ovarian steroids may be saturated, and also that a certain amount of these steroids is bound to tissue even if plasma levels are low.

Frontiers in Pharmacology. 2020 Mar. Pregnenolone Inhibits Osteoclast Differentiation and Protects Against Lipopolysaccharide-Induced Inflammatory Bone Destruction and Ovariectomy-Induced Bone Loss. Xiaochen Sun, Chenxi Zhang, Huan Guo, Jiao Chen, Yali Tao, Fuxiao Wang, Xixi Lin, Qian Liu1, Li Su, An Qin.

Retrieved from https://www.frontiersin.org/articles/10.3389/fphar.2020.00360/full

Peat, R. (2012). Not the “female hormone,” but the shock hormone.

Retrieved from: https://raypeat.com/articles/hormones/h1.shtml.

Menopause. 2012. Oral micronized progesterone for vasomotor symptoms–a placebo-controlled randomized trial in healthy postmenopausal women. Prior J, Hitchcock C.

Retrieved from https://pubmed.ncbi.nlm.nih.gov/22453200/

What Your Doctor May Not Tell You About Menopause. 2004. Lee J.

Contraception 1981 Apr;23(4):447-55. Comparison of plasma and myometrial tissue concentrations of estradiol-17 beta and progesterone in nonpregnant women. Akerlund M, Batra S, Helm G.

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