Is Bioidentical Hormone Replacement Therapy Safe?
Of course there are conflicting ideas on this, as with anything. I'll spell it all out for you and share what I've learned, and then I'll explain what my 2-part plan is moving forward…
Not at this stage in your life?
I'm assuming that not all of you are real curious about the state of my menopausal journey, as gripping a story as it may be (riiiight…), but just remember, it will be you eventually if not already! Or I'll bet you know someone at this stage in their lives — please share this post with them. Also, there are other facts toward the bottom about birth control pill dangers and breast cancer risks that you need to share with your nieces and daughters.
In my last post, Are Extreme Menopause Symptoms Normal? Should We Embrace Our Muffin Top?, I shared my own experience and symptoms, the information I’ve found, and what my plan was — that plan included researching natural solutions and trying to figure out the answer to the question, IS bioidentical hormone replacement therapy safe? So go read that post first for the back-story, and if you're having pre-menopause symptoms, we can compare them!
I left you with more questions than answers in that post, though, but today I'm coming around to some conclusions…
First, you guessed it, a disclaimer!
I say this all of the time: Don't blindly follow what you read here or anywhere. I'm not a doctor, a naturopath, or an expert on any of this, not even close. I'm going to share my own journey, what I'm doing and why, and you take it from there. Research, ask your doctor and/or naturopath, READ, study your own body, figure out what's best for you.
Now let me piece together what I've found…
Hormone replacement therapy (HRT) seems to be the recommended course for many in my pre-menopausal /menopausal situation, so I knew I needed to give this a good look. Mostly it's presented in the context of alleviating symptoms, but I've learned that there are much more serious implications than that.
As a starting point, note that across all fields, conventional and natural-minded experts alike, almost everyone agrees that conventional HRT is dangerous, it causes breast cancer, and raises the risk for other health problems as well. (Some docs are still prescribing it though?!)
The recent Lancet publication of the Million Women Study (MWS) removes any lingering doubt that there is something wrong with conventional HRT (see Million Woman Study in the UK, Published in The Lancet, Gives New Insight into HRT and Breast Cancer for details). Why would supplemental estrogen and a progestin (e.g. not real progesterone) increase a woman's risk of breast cancer by 30 percent or more? Other studies found that these same synthetic HRT hormones increase one's risk of heart disease and blood clots (strokes), and do nothing to prevent Alzheimer's disease. When you pass through puberty and your sex hormones surge, they don't make you sick—they cause your body to mature into adulthood and be healthy. But, the hormones used in conventional HRT are somehow not right—they are killing women by the tens of thousands. (Source)
As I shared in the “update” section at the end of my last post on this, however, even plant-based hormonal supplements or bioidentical estrogen hormone replacement therapy cause considerable concern due to the vascular changes that all of these cause in the breast, as shown in thermagram images — all of this is explained in a book I just read called, Breast Cancer Bootcamp.
Enter Elizabeth.
Elizabeth is a longtime Kitchen Kop reader friend, who is also a psychiatrist practicing in Davis, California (with a primary professional interest in adult psychiatry and in particular the relationship between nutrition and brain health), and is certified in Advanced Bioidentical Hormone Replacement Therapy.
You need to replace your hormones (just like Suzanne Somers teaches) to prevent your adipose (fat) tissue from increasing, resulting in increased visceral fat (fat around the middle), which is correlated to an increased risk of heart attacks, stroke and cancer.
In other words, getting our hormones on track is not just to alleviate symptoms, but also to decrease the risk of chronic disease. So she says we should NOT embrace our muffin top! It may be “normal”, but it doesn't mean it's good for us.
Elizabeth suggested I read another book, so I just finished that one too (I read them both on the treadmill, multi-tasking, ha!):
How to Achieve Healthy Aging by Dr. Rouzier.
This led to a lot of back and forth Q & A's between Elizabeth and I, and I'm going to share all of that here so you can learn, too, but first I asked her to give us an overview of her thinking:
Hormone Misinformation:
When I read Kelly's blog post “Are Extreme Menopausal Symptoms Normal? Should We Embrace Our Muffin Top?“, her confusion about the seemingly conflicting advice on the subject of hormone replacement was obvious. I therefore suggested that she read a book that I consider to be the best on the subject “How To Achieve Healthy Aging (2nd Edition)” by Neal Rouzier, MD. I should note I have studied under Dr. Rouzier in recent years in the course of my studies in hormone replacement therapy. The following are some important pieces of information to consider as you are attempting to understand this complex subject.
Most of the medical literature does not distinguish between synthetic and bioidentical hormones.
For example, the landmark Women's Health Initiative study (WHI) published in 2002 found an increase in breast cancer, stroke and heart attacks in women treated with the synthetic hormone combination of Premarin and Provera (PremPro). Unfortunately PremPro is the main synthetic hormone that has been correlated with breast cancer – it is a combination of Premarin (synthetic horse estrogen) and Provera (a synthetic progesterone-like drug called progestin not found in any species on the planet) and it is the Provera that has been correlated with breast cancer in the studies. The bioidentical progesterone that we use in bioidentical hormone replacement therapy (BHRT) actually has a protective effect on the breasts and other organs, meaning there is decreased breast and other cancers with progesterone in all of the studies.
Based upon this finding, women were subsequently advised to discontinue all hormones, instead of being advised to discontinue the dangerous synthetic hormones and switch to the safe, bioidentical hormones.
Bioidentical means that the hormone molecule is identical to the hormone molecule that is produced by the human body, it does not refer to soy or plants. There are very clear differences between the synthetic and bioidentical hormones. Unfortunately, even many doctors do not understand these differences and will scare their patients into stopping bioidentical hormones based on the results of the WHI – which had absolutely nothing to do with bioidentical hormones.
Such advice has done a great disservice to women, since we know that women who have very low, postmenopausal hormone levels die earlier, have greater disability and disease as they age, and a poorer quality of life than women who maintain adequate hormone levels following menopause.
Think about it, if our own natural hormones were so dangerous, doctors would recommend that all women have their ovaries removed once they were finished having children. In fact, previously we routinely removed ovaries when doing hysterectomies, with devastating results for women. Now, the ovaries are preserved if at all possible, because, even if they are only making tiny amounts of hormones, it is far better than having no hormones at all.
It really makes perfect sense.
If these natural hormones caused cancer, young women, and especially pregnant women (who have the highest hormone levels), would have very high rates of cancer as that is when hormone levels are highest, but that is just not the case. Young women and pregnant women have very low levels of breast and other cancers. It is older women, with declining or menopausal levels of hormones, either on no hormone replacement or improper/inadequate hormone replacement, who are getting breast and other cancers.
It is important to find a practitioner who is familiar with the medical literature and who prescribes bioidentical hormones according to the current state of the science. You do not want to be one of those women I sometimes see who are taking bioidentical hormones that are providing no protection against the degenerative diseases of aging. It is necessary to do your homework, do the necessary recommended reading, and ask questions of potential practitioners about their training and practice before deciding on a particular practitioner and a course of treatment.
In summary, bioidentical hormones for postmenopausal women (and also for aging men, they lose hormones too!) can be life-changing. I am convinced that if women truly understood the benefits of taking properly prescribed bioidentical hormones, and the degenerative diseases of aging that can be avoided and reversed by doing so, no woman would want to be without them.
As Dr. Rouzier says in his book, “Women need to fear losing estrogen and progesterone and not fear replacing them. I encourage everyone to seize the opportunity to live a healthy and productive life.”
So if I thought there was a risk of getting breast cancer by taking bioidenticals, then sticking with the natural route is okay with me, since I can handle the hot flashes and belly fat and weird cycles if I must (but again, I feel bad for those with extreme menopause symptoms), HOWEVER, if there is NOT a risk by taking them AND they are actually protective against chronic diseases, AND it will decrease my menopausal symptoms, then I want to take them!
This led to more questions after I read the above books, and Elizabeth was kind enough to answer them all for me, and it made a lot of sense, too!
Some of the following is a repeat of the what she shared above, but I'm just going to let you in on our whole conversation over the course of several weeks of emailing…
Q: I wish I knew though, even if we're using bioidentical hormones to get our levels corrected, it still doesn't seem very *natural*, that's not what women have done through the centuries, so is it more a matter of our diets? So part of me wonders if we should just ride it out, assuming that's possible, depending on each person's symptoms, and try to eat the best we can.
A: We are living longer and going into menopause earlier, so you can absolutely do nothing and come down with the degenerative diseases of aging even while eating a perfect diet – many women will choose to do this because it is more “natural” but it is also more natural for women to die earlier than we do currently. Suzanne Somers has written a lot about this.
Q: It says in Breast Cancer Bootcamp, “Estrogen does not cause cancer but rather “feeds” the receptors of the cancer.”
A: This is correct, some cancers have estrogen receptors which is why we don't prescribe hormones to women who have active breast cancer or who are not yet 5 years cancer-free. However, advising women to keep their estrogen levels as low as possible is contrary to medical literature. If this were correct, then every woman should have her ovaries removed as soon as she is finished having children, but we know from experience that doing that has devastating results for women, they die earlier and have more disease and disability and poorer quality of life. It is too bad that women may fear estrogen — Rouzier's book has excellent scientifically-based information and every woman would do well to read it.
Bioidentical estrogen does indeed stimulate the breast and uterine tissue to some extent, it's supposed to, even when we make it naturally – but the progesterone prevents the formation of cancer- that's why we make both naturally and why we prescribe both when we do BHRT. Progesterone is a powerful anti-cancer hormone, so as long as you are taking it in the proper amount and proper form (that is the key, so not a progestin) and getting adequate blood levels (not saliva levels), you don't have to worry, you are protected.
Q: How long will it take to get my hormones regulated so that my visceral fat decreases?
A: If you are on adequate BHRT with proper levels of all the necessary hormones, you will start noticing improvements almost immediately, but it will take several months up to a year for things like “central” weight gain (muffin top) to reverse.
Q: Rouzier said that many go on bioidenticals willy-nilly, and this may help alleviate symptoms, but they're not at the right dosages to actually prevent chronic disease. But one of the books, I can't remember which now, suggested that there ISN'T really a reliable way to TEST proper levels, not saliva and not blood. “Hormones captured through blood and saliva samplings do not accurately represent the actual circulation of these hormones throughout the body. These should be considered rough estimates, at best. Blood and saliva tests can only attempt to check for circulating hormones. (Because it's also stored in fat cells.)” Then this guy says saliva IS an accurate test and blood is not. Which is it?? What are your thoughts on how to accurately gauge where our hormones are at any given time?
A: Blood tests are very reliable – it is blood tests, not saliva, that are used in the scientific studies on the subject – the blood levels of sex hormones are not “rough estimates” any more than thyroid hormone or any other hormone levels that are measured via blood tests. Some hormones seem to correlate saliva compared to blood fairly well, others do not, so we don't generally recommend using saliva for that reason, it's rather hit and miss. What we try to do, is follow the science and replicate what is found in the medical literature, which is blood testing. What really matters is how much hormone is in the blood as that determines what actually gets to the organs that need it.
Q: As you know, the Breast Cancer Bootcamp book is against ALL estrogen replacement (synthetic, plant-based in supplements, AND bio-identical), because they say it is RARE for anyone to actually be low in estrogen (especially if they're still menstruating at all, which I am, off and on) AND they say that any and all estrogen causes vascular changes in breast tissue as seen on thermograms (I assume ALL vascular changes = cancer or pre-cancer?), however they DO strongly suggest using testosterone and progesterone bioidenticals. They say that with proper testing, you can tweak the progesterone and get things where they need to be, because it's all about the BALANCE of the progesterone with the estrogen already there. (I think I have that right.) However, I understand and it makes sense what you said, that if all estrogen was bad, why aren't women in their 20's getting breast cancer? But would it HURT to just try testosterone and progesterone only? Or do you feel that is irresponsible, depending on what our body tests that it's deficient in?
A: As a general rule, women who are having periods have enough estrogen and do not need additional – progesterone falls off first, starting to decline about 8 years before menopause so it usually needs to be replaced first. Testosterone also drops off before estrogen and often needs to be replaced as well. You first have to see what the levels of the different hormones are and replace accordingly. Anyone who recommends that women never replace estrogen is doing a great disservice to women. As for it being rare for a woman to be low in estrogen, a postmenopausal woman who is not taking estrogen will have a very low, postmenopausal estrogen level. If hormones really caused cancer, women in their 20s would have high rates of cancer, pregnant women even higher, but that is not what we see. It is peri- and postmenopausal women who have the highest rates of breast and other cancers, which is consistent with what is found in the medical studies.
We never use estrogen without progesterone so the risk of breast cancer is even lower than with no treatment. In fact, even in the Premarin-only arm of the Women's Health Initiative study, the number of deaths from breast cancer was less than it was with no hormones at all.
Q: Could it be that the issue with the vascular changes in the breast while on bioidentical hormones may be due to incorrect amounts or ratios?
A: Not all bioidentical hormones are created equal. I routinely see women who are taking “bioidentical hormones” of one sort or another, yet when I check their hormone blood levels, they are at very low, postmenopausal levels i.e. near zero. These women believe that that they are doing the right thing by taking hormones, and they might, in fact, be experiencing some relief from uncomfortable symptoms like hot flashes and night sweats, but with such low levels, they are not being protected from things such as heart attacks, strokes, Alzheimer's, osteoporosis, cancer, loss of teeth, vaginal atrophy, urinary tract infections, macular degeneration, cataracts, etc., etc.. It is important to take the correct bioidentical hormones, at the proper dose, and via the correct delivery system (oral capsules, transdermal creams, sublingual tablets etc.) in order to achieve adequate hormone levels.
Q: Would it be safer taking bioidenticals while being monitored by thermagrams along the way??
A: Thermography is an excellent evaluation tool. But it is not necessary to increase breast cancer screening above normal while on proper BHRT, since your risk of breast cancer is lower than it would be otherwise. Standard screening is quite adequate.
Q: How long should we take bioidentical hormones then, forever? That doesn't seem very natural either!
A: My patients ask me the same thing, how long do I have to take hormones? I tell them they can stop their hormones any time they want to start aging (biologically) and getting heart disease, strokes, osteoporosis, cancer, dementia and other diseases. So yes, we recommend taking them indefinitely. Yes, it is “normal” for hormone levels of men and women to decline with age – it is also “normal” to get the degenerative diseases of aging and die after we lose our fertility. Since we are living well past our age of fertility (or our usefulness from a biological perspective), then presumably we want to remain as healthy as possible for our remaining years, which is the whole point of maintaining youthful levels of hormones. The notion that we should age “naturally” is a different subject entirely and is a philosophical discussion rather than a medical one.
I don't think anyone is trying to live forever, but we are certainly trying to have good health for as long as possible.
It's about adding life to our years rather than years to our life. For example, I have a very strong family history of severe osteoporosis. By the time my mother was my age (62) she had already lost 2 inches of height and had a compression fracture of one of the vertebrae in her back. She is now 86 and can no longer stand up straight and has lost 5 inches of height due to osteoporosis, it is a very debilitating disease. I have been doing BHRT for over 10 years and have no signs of osteoporosis at this point, my quality of life has been improved tremendously and for that I am very thankful. I will never be without hormones!
My 2-part plan moving forward:
1. My appointment with a local natural doctor is next week. (Originally it was last month, but a major snowstorm screwed that up.) I'm definitely leaning toward bioidenticals, but if tests show I need estrogen, even though Elizabeth says it's not necessary, I'm going to ask about more frequent breast thermograms just to monitor any vascular changes. (These are surprisingly affordable!) It's just that I'm extra paranoid since breast cancer most likely due to PremPro is what killed my Mom. Yes, the Women's Health Initiative study showed that the problem in PremPro was most likely the Provera (the fake progesterone, progestin), not the Premarin (the estrogen part), but I still figure that being extra cautious can't hurt.
And by the way, you know what REALLY ticks me off?
When Mom's cancer came back, not ONE person mentioned ANYTHING about Mom being on PremPro, which is what I'm convinced caused her breast cancer originally. (And the treatment for that cancer is what led to the metastatic breast cancer almost 5 years later — which means it had spread throughout her body. This is what caused the blood clot that took her suddenly less than 2 months after her stage IV diagnosis — here's my post about saying good-bye to my Mom. I still can't believe she's gone and I'm a mess many days.) NO CONNECTION was made with any of the docs who saw her. No one gets it, no one is looking at this or talking about this, and some docs are still using conventional hormone replacement therapy and even still prescribing PremPro!!!
Side note: Did you know that women who use birth control pills before their first child have a four times greater risk for breast cancer?! And that women who have had abortions have an increased breast cancer risk?
Here's what I want to know:
WHY don't we hear any of this from all the “pink” campaigns?
Or the information about Provera being so dangerous?!!!!!!! (More of my PINK rants are here if you're interested: Are the Pink Ribbons a Big Scam? One more: Politically Incorrect Thoughts on Breast Cancer.) I wish I could ask Mom more about it now, like when she started and stopped taking it, but my hunch is that the study showing the increased risk of breast cancer from taking PremPro was already out by the time it was prescribed for her…
2. Thankfully Kent is showing zero signs of his hormones dropping, but I want him to get a baseline reading because according to Dr. Rouzier, men also have long-term chronic health risks when testosterone levels start to drop. Getting a baseline will be good for down the road when he may need to go on bioidenticals as well. Read my post on this: Testosterone Replacement Therapy for Andropause — Should Men Have Their Testosterone Levels Checked?
UPDATE SEVERAL YEARS LATER:
I'm just popping back in now, in late 2022, to share a little update. As convincing as Elizabeth is in this post, my menopausal symptoms were never bad enough to consider any bio-identicals. (Also see this: Are Bioidentical Hormones Natural? Thoughts from the Other Side of the Issue from Joette.) I also have a very natural-minded friend who did go on them, but has since decided to go off. I reached out to her for more info and will add it here later. I also reached out to Elizabeth to see if her thoughts have changed on things, and will also add that here later if I hear back.
More reading and information:
- PLEASE DON'T MISS THE COMMENTS below — some interesting insights are coming in, and as usual, all of you are SO smart, I don't want you to miss more great information there.
- Elizabeth suggests you find practitioners who have been trained by Rouzier at worldlinkmedical.com. (Hover over “resources”, then click on “directory”, or just go here.)
- Three rules for bioidentical hormone replacement therapy (BHRT): “Over the years I have adopted a simple set of three rules covering hormone supplementation. When these rules are followed, women have a decreased risk of breast cancer, heart attacks, or strokes. They are much less likely to get fat, or have poor sleep, or short term memory loss, fibrocystic breasts, mood disorders or libido problems. And the rules are not complicated.” (Rule 1. Give hormones only to those who are truly deficient in them. Rule 2. Use bioidentical hormones rather than synthetic hormones. Rule 3. Use only in dosages that provide normal physiologic tissue levels. Read here for more details.)
- So you can hear another side, and from someone I trust: Click here to read what Joette thinks of bio-identical hormones. Elizabeth's comments on Joette's article: “My response to homeopathy is the same as my response to any other therapy – check the hormone levels! If they are optimal, then the therapy is fine, if they are not, then you are not receiving proper protection even though there might be some symptomatic relief.“
- The above note on birth control pills doesn't bode well for me. Maybe I should get another mammogram, in addition to thermograms… Read about my original decisions regarding a baseline mammogram.
- And this one: Are Mammograms and Colon Cancer Screenings Safe? (Trusting the “Government’s Most Dysfunctional Agency”) Do you get mammograms or colon cancer screenings? As more concerns come to light, my doctor shouldn't be surprised that I don't go skipping right in for another mammogram when he says it's ‘time'…
- What to do if you are on or were on PremPro? Elizabeth has these suggestions: “If someone is taking one of the synthetic hormone-like drugs, the first thing to do is to get to someone who can get them off the drugs and onto natural bioidentical hormones. There are a number of strategies to decrease your breast cancer risk, including a proper diet: low sugar, lots of healthy fats, fermented foods, eat organic and non-GMO, avoid toxic chemicals like antiperspirants and flame retardants, maintain good Vitamin D levels with sensible sun exposure, CLO and a vitamin D supplement if necessary, using curcumin, getting sufficient amounts of iodine, maintaining healthy body weight, and getting regular exercise and proper sleep.“
- Check out my FAVORITE gadget to help my HOT FLASHES!!!
- And here's one more: a wireless remote control that I use for flipping on my fan at night so I don't have to get up when I'm having another flash!
- Update that I'm adding later: I've heard that many women get relief from hot flashes by drinking 2 Tablespoons of ACV in 6-8 ounces of water am & pm — let me know if it works for you!
More about Elizabeth:
Elizabeth Bowler, MD is a board certified psychiatrist practicing in Davis, California. She is certified in Advanced Bioidentical Hormone Replacement Therapy through WorldLink Medical, the premier physician training organization in this field. In addition to hormone replacement, her primary professional interest is adult psychiatry and in particular the relationship between nutrition and brain health, having done her undergraduate studies in dietetics and human nutrition. She is a Certified GAPS Practitioner. (More about the GAPS Diet for healing: GAPS Diet for Rookies.)
“Like many practitioners, I initially got really into hormones while looking for answers to my own health problems – I knew I had low thyroid based upon my symptoms but was repeatedly told by multiple doctors that my thyroid was “normal”. Thyroid and psychiatry are very closely related because a lot of depression and anxiety that we see is caused by thyroid problems. After successfully treating my own thyroid condition, I went from studying thyroid to studying all of the hormones, again in part based upon my own experience going through menopause. Now hormone replacement is a significant part of my practice and even when I see someone for purely psychiatric reasons, I always check all their hormone levels (along with doing nutrition and lifestyle counseling) and correct any imbalances before even considering psychiatric medications. I consider hormone balance to be foundational to good health along with proper nutrition and avoiding toxins.” (Why can't all docs think like her?!)
Amy Winters says
Thank you for pointing out that hormone replacement therapy is usually what is recommended for women who are menopausal or pre-menopausal. My mother has been thinking about seeking professional help to balance her hormones. It’s good to know that hormone replacement therapy is what may be recommended.
KitchenKop says
Amy, instead of hormones have her look into homeopathy! I’ve heard this course is very good for these issues: https://kellythekitchenkop.com/feminopathy and also Joette’s site has a ton of info too.
Kelly
KitchenKop says
Also Amy, be sure to read this post too: https://kellythekitchenkop.com/are-bioidentical-hormones-natural-other-side-of-the-issue/
Rosemarie says
Both my sister and I have been on BHRT (Estrogel and Prometrium) for close to 25 years. I am 70 and my sister is 68, I feel younger and look younger. I can either continue indefinitely and not get cancer, or get cancer any day now because of how long I’ve taken it. However, cancer does not run in my family although heart disease and stroke do. Why is no one collecting longitudinal information about women who have been on BHRT?
Lorraine Rudd says
Is it a done deal or can she take a month to radically change diet and lifestyle? Is she perimenopausal and had all her kids?
An herbalist’s tools is herbs, a holistic nutritionist’s tools are foods and supplements, and a surgeon’s tool is a knife. I’d look in the toolboxes first.
Brooke Shambley says
I would definitely find an herbalist. They are very skilled at educating about herbs that have been used for centuries by women who are going through menopause.
Lisa says
JP, I know your comment is over a year old now and maybe you won’t get this reply. I am in a very similar situation. Just found I out I will need ovaries removed due to large cysts and will be in instant menopause. I’m sorry to hear of your trouble and am dreading going through that. Did you ever find any good information to help you through? I sure hope things have evened out for you. Thanks for sharing your experience. It is so helpful to hear about others who are in the same boat, good or bad. I want all the info I can find.
kitchenkop says
Carol, I actually have that book, I’ll have to dig it out and take a look, thanks for the tip!
Kelly
Carol S. says
Maybe I missed it in your articles, but have you read “Fertility, Cycles and Nutrition” by Marilyn M. Shannon. Her advice has helped me through numerous female issues. Presently taking Optivite, magnesium and following her dietary advice. Surprisingly, cutting out a lot of dairy and meat has helped a lot – even though I was eating meat and dairy straight from the farmer, grass fed, no hormones added!! I’m not advocating vegetarianism, but my mood improved immensely during the first cycle. Cutting back isn’t a bad thing. Also, because extra estrogen is a problem, adding a fiber to absorb estrogen in the lower intestines may help – like chitosan?? Her flax seed bread recipe is pretty good. She does recommend progesterone creams as a last resort after attempting every nutritional alternative. I am only now beginning to use these slightly. Most of my improvements have been through nutritional changes.
seekingsolutionsue says
The problem comes when at age 49, relatively fit and quite healthy on the surface, your world falls apart almost overnight and no matter what you do, you can’t recover.
I’ve had 3 years of despair, of misery and of fear. My hormone levels are a mess. Sex hormones almost non-existent. Thyroid suppressed. Adrenals in abnormal pattern. My brain function is sometimes badly fogged and I have no energy or stamina. My ability to run my business is highly compromised, frankly I have no idea how I’m still going. I can’t exercise, even going for a shirt walk hurts and can consign me to the sofa for the rest of the day.
Before this I was sociable, active, engaged and I had lots of physical hobbies. My diet was 90% home cooked, organic and best quality. I don’t use chemicals that are harmful. I use organic beauty products. In short I was doing everything right. My Mum had no trouble with menopause.
But the final nail in the coffin for me was the dreadful anxiety and depression that can take me to the depths of despair in the time it takes to switch the light off. I never suffered depression before. I’ve considered ending my life I’ve felt so bad. All my GP can offer is HRT, which I didn’t want. So I have found a clinic specialising in bioidentical hormones and I am now 2.5 months into treatment.
It’s been tough going, but there have been times of joy, laughter and energy that give me hope for the future. 10 days straight of the old me back in action. Walking with ease, speed and pain free. I walked 5 miles round London one day whereas the week before I was cowering in dread, crying, at work one day. I’ve been warned it will take a while for me because I was so low. But if I need to take this for the rest of my life and it works, then it’s a no-brainier. It’s a shame my body can’t do that for me on its own, but I don’t want to die young so I will do whatever it takes to get well again. Now my brain, mood and hope are recovering. My physicality has a long way to go.
These are the reasons I don’t think you should think it’s easy to avoid hormone replacement. My clinic doctor feels my GPs response to worsening periods with onset of peri menopause in my early 40’s is what has affected me so badly. I was naive then and thought doctors knew what they were doing! So I had a progestin emitting coil fitted for 7 years and when it was removed I was screwed.
So it’s wrong to assume we can be compared to our grandparents. They didn’t have hormone messing birth control to cope with, or the high levels of growth hormones and antibiotics/pesticides in foods. They didn’t have the high levels of xanoeastrogens from plastics in the products we are sold as safe and the water we drink. We have badly messed with our environment and some people are sensitive to that.
Do I want to pass my 50’s feeling old beyond my years and physically crumbling? No. I am literally praying that bioidentical hormones can restore my hormonal balance so that I can live my life again rather than just watching it trickle down the drain.
KitchenKop says
Wow, what a road you’ve been down! Thank you for sharing so much with us because I think it really could help others!!
I’ll pray you find exactly what you need to feel better for good,
Kelly
lorenesauro says
When you are stressed, your body is in a state of fight or flight and this means the adrenals have the power to convert other hormones to cortisol to give your the extra power you need in fight or flight. The adrenals do not know the different between you running away form a bear or getting yelled at by your boss or running around doing errands on a short timeline so this is why we are constantly activating our fight or flight response which is really only for physical danger but we have messed all that up. The favourite hormone that the adrenals love to convert is progesterone, causing a bad ratio between estrogen and progesterone. During menopause, the first stage is a natural drop in progesterone. If we are stressed and the progesterone is already being converted to cortisol, then the drop is too big and this causes symptoms. When we are stressed, we sweat and a hot flash is an extreme version of that caused by the adrenal glands. Adrenal issues are also connected to mood swings, depression and other symptoms of menopause. Adrenals also cause you to burn sugar, not fat (because you need quick carb energy to run away from the bear) and this leads to weight gain especially around the middle. The adrenals also convert testosterone to estrogen. This is worse for men but can also affected women, too, Supporting the liver to detox out excess estrogen and supporting the gut to ensure the estrogen leaves is helpful. There is also a relationship between the gut and the adrenals and the gut can affect hormones but this is relatively new information and not everything is known at this time. Supporting the adrenals with supplements such as adrenal adaptagens ( a health food store person can show you a good formula) and/or glandulars can help. I am a holistic nutritionist and teach future holistic nutritionists this info every year. I also use to work in a health food store and when women came in with menopausal symptoms, I always recommend adrenal support for them – I had so many come back and tell me their hot flashes had gone away. It is not easy to work on adrenals – they really do rule to roost in the body and if they want you to have excess cortisol, you are going to have it so you need to work on ways to reduce stress – easier said than done. Walking is good, massage, relaxation techniques, being nice to yourself as well as eating small meals more often can all help. Watch the caffeine as they stimulate the adrenals. I hope this helps explain it further. The important thing to remember is that the adrenals are responsible for making the progesterone, estrogen and testosterone we need past menopause and keep us healthy. The gut thing is a whole other matter – there are no quick fixes but if we at least know what we are supposed to fix , it can help us find the answers..
lorenesauro says
Menopausal symptoms are an adrenal problem and adrenals have a huge connection to the gut as well. We are not suppose to have menopausal symptoms. However, due to our stressed lives and lack of support for our adrenals, they malfunction during menopause. They are supposed to produce and regulate our own hormones during and after menopause to protect us from heart disease and other conditions of biological aging. In many more indigenous cultures, the women have no symptoms and I, too had no symptoms during menopause. I should have had a terrible menopause as I had endometriosis and fibroids for years until I fixed my gut and supported my liver and adrenals – this was not easy but I did it and fortunately, I managed to do it before I hit menopause. I did use natural progesterone cream when I was at my very worst with my endometriosis but I believed that I should function naturally. To suggest that nature did not have a proper plan for us and that we need to take these hormones forever does not make sense. What we need is knowledge to support the systems that can helps us – we need gut health info, stress management and a good diet that supplies us with liver support, gut support, adrenal support, thyroid support and helps protect us from cancer, heart disease etc. There a lot of women past menopause age who are thin and healthy and not taking bioidentical hormones and they look amazing. There also women in many cultures who eat better than we do and are far less stressed and are also thin and healthy. I j have no problems with someone taking bioidentical hormones if their symptoms are severe – not everyone has the opportunity to get their hormones and adrenals into proper functioning order before they hit menopause but the goal should be to function well without them eventually.
KitchenKop says
This makes a LOT of sense, thanks for sharing your thoughts,
Kelly
Chandra says
Could you expound on this, I would love to hear more? I have been having almost every menopausal symptom in the book. I tried the bio-identical route for several months, but after the first month, it didn’t seem to be helping anymore. I still had symptoms, but it did help with some. I am getting ready to get my thermal imaging done this week, along with seeing my gynecologist. I missed my yearly exam, and thought I should get back to it. I would love more information on how the adrenals work in affecting menopausal symptoms. I completely understand about the benefits of good gut health. I am really struggling with going back on the bio-identical hormones or not. Please share. Thank you.
Meredith Thomas says
Hi Kelly! What a thorough article. So much information and very well presented. Women need this help. Thank you!
I want to respond to your thoughts on the article by Joette Calabrese:
“My thoughts on Joette’s article: The solutions at the end of her article are geared at alleviating symptoms, but I’m learning that it goes much deeper than that, because it’s more about preventing the very serious long-term health consequences of naturally decreasing hormone levels.”
These homeopathic protocols are created and proven by the Drs. Banerji in Kolkuta, India. They have decades and decades of success and not for alleviating but for CURE. Real Cure that goes to the root of the problem and ends it.
In Joette’s words:
“Hormones are supposed to be produced inside the body, in complex combinations, and in quantities that vary every minute of the day and night. No artificial replacement can successfully match our body’s natural abilities. Doesn’t it make much more sense to help our bodies heal themselves?”
We can use homeopathy to HEAL ourselves, so that the complex hormonal system unique to each of us is stimulated to produce exactly what we need when we need it. Beauty.
Joette also advises that the individual may have other aspects of their condition that bears on the correct homeopathic remedy. And that is the wonder of homeopathy, it treats us uniquely because we are unique. Not one size fits all.
I hope you will try the ammonium carb recommended before you begin the BHRT.
Blessings!
Meredith
KitchenKop says
Hi Meredith, thank you for that information!!
Do you have a link or know where I could read more about this? According to Elizabeth, we should still have our hormones *tested* to see if the homeopathics (ammonium carb and what else?) are working, but I have no idea how much I would take, how long until it should help regulate things, etc.
I like the idea of healing ourselves and eventually not needing to take anything at all!
Thanks!
Kelly
Margaret says
I’m not convinced that bio-identical hormones are safe. Women do get cancer from their own hormones. Women who have early puberty or late menopause or no children, have an increased amount of time they are exposed to their own estrogen, and they are more at risk for breast cancer. This is even true in dogs–if you spay them at a young age, ideally before their first heat, they are at much less risk for mammary cancer. A friend of mine who is a holistic health expert, PhD in nutrition and follows the WAPF diet, was doing bio-identical hormones. She now has advanced primary peritoneal cancer (which is similar to ovarian cancer). I wonder about the connection between the hormone treatment and her cancer.
KitchenKop says
Hey everyone, I just wanted you to know that Elizabeth is willing to answer all your questions and then I’m going to post them in a follow-up post soon, so those of you who asked questions in the comments so far, I just wanted you to know I’m working on it.
Thanks!
Kel
Kristy A. says
Hi Kelly,
Wow our lives are really running in similar directions. I started in with body changing symptoms about 5years ago when I turned 40. Extreme bloating, gas, brain fog and chronic fatigue. I began researching, changed my eating, found your blog and others and also went to an integrative med. Dr. They really helped jump start my diet and gut healing. But the supplements were too much for me. I did all the blood tests and most came back normal. I would like to put a different spin on this for everyone. I had a lot of stress in my life. I was the primary care giver for my Mom in the last year of her life, then the primary caregiver of all of her stuff. I would have days where it was all I could do to get off of the couch and I have 4 kids. So not good. I started reading about minimalism and decided to start reducing things in my life. I let the emotional attachment of my Moms stuff go. I see my mom everyday when I look at my hands they look like hers. I don’t need her stuff to remind me of her. I stopped taking all the supplements. I will probably continue on a few but I feel less is more. My house is clean almost all the time because I don’t have stuff all over. This has lightened my load and mood so much. I have energy. Still have occasional hot flashes and my period is hit or miss. But I’m embracing it and will be even more thankful when I get rid of it too! Good luck on your journey Kelly, you are helping many. God Bless.
Kristy A. says
Ha! Ok maybe disregard my house is always clean! But I’m able to keep up better. Point being, consider stressors in your life, they can hinder your healing.
KitchenKop says
I think that’s great advice, Kristy. 🙂
Kel
JP says
I wish there was MORE info in surgical menopause. I had to have a radical hysterectomy (they took EVERYTHING, I MEAN EVERYTHING…(even cervix). Went into surgery for a growth removal on ovary and ended up in surgery for 6 hours. ?I was NOT happy when I woke up but my hunny had to make the call and was afraid it was cancer. It was many things as well as severe endometriosis whihc most likelt would have turned into cancer in a few years b/c it was so bad. And it was a mess all arounf my interenal area with scar tissues and adhesions, with unexplained & unidentifed growths, cells, etc… and they had to take it all. Although, I’m grateful all was benign….NO ONE prepared me for this terrible extreme menopause symptoms. There are days it is so unbearable, I cant even begin to explain unless you are going through it. The extreme and constant hot flashes, the sweating all day, the weight gain, the sleepless night b/c of it all, the extreme fatique, the emotional rollercoaster ride, the changes in my body. I swear it’s really bad. There are so many books on meopause and hyterectomy’s but I can’t find one on surgical meopause where they take everything and throws your body into shock! If ANYONE knows of anything, please advise. I went on plant HRT from a compound pharmacy b/c I can’t take these symptoms. But so far, not working very well. I also believe I’m reactive to the testosterone, needs to be lowered. My doctor ok, but questionsing some of his decisions about my HRT. Anyway, one thing I DO KNOW, everyone is sooooooo incredibly different with menopause and HRT. I mean, it’s really like snowflakes, no two are alike in symptoms, reactions to treatments, etc. But I still wish it was easier somehow, or I had better answers.
Susan says
Thank you for posting this Kelly. This is an issue that I am very interested in and am always looking for new information. I had problems with my uterus and ovaries and ended up having a hysterectomy at age 40. I regret this. In all my visits to the doctors in the years leading up to it never once was it mentioned to look at my hormone levels and get them balanced. (Maybe it wouldn’t have helped, but at least I could have tried.) (I did not have cancer.) Currently, one doctor has told me I should be on HRT and the other said no. I have tried BHRT for 2 months and needed to stop because of cost. I think I may try to go on them again until I hit a “normal menopausal” age. There is a compounding pharmacist that makes BHRT in my area and his cost is 100.00 per month.
Lucy says
Have you heard of the Femring? It delivers hormones closer to the ovary area. My doctor says that limits the undesirable side effects of HRT. It’s also expensive, but not as much as the BHRT.
Susan says
Lucy- Femring is not bioidentical. And it is an estrogen only source of hormones. You would also need to get some progesterone in your therapy, as well. Please read one of Suzanne’s book on hormones and you’ll get a much deeper understanding on why women need both hormones during treatment. She also explains why we should avoid big pharma’s form of hormones at all cost.
Janknitz says
Has anyone run across any information for post menopausal women with PCOS? I am reluctant to do any HRT because I’m actually loving menopause. The absence of unexpected bleeding, severe and constant (for more than FORTY YEARS!!!) PMS, breast pain and all is gone. I feel great, finally! PCOS is characterized by too much estrogen and testosterone, and severe insulin resistance. I’ve got the insulin resistance under control with a low carb Paleo diet, and have no clue what my estrogen and testosterone levels are doing these days.
With Kaiser’s one size fits nobody approach, I’m not going to get much help from my health care provider and since all my money goes to premiums there’s none left for alternative care. I’m looking for any information on PCOS and menopause.
Kay Conway says
Interesting post Kelly. It is an individual journey! After my mom was on Prempro for 20 years, she had breast cancer. She survived and is now 80 years old and well. This greatly influenced my decision to go through menopause naturally. Yes, certainly some uncomfortable times. Yes, a weight gain. But not enough to change my active life style or put me above a healthy body mass. I am 57 and have been on a WAPF diet for 8 years. I don’t see my friends on bio replacement doing any better or different than my natural route. My family is blessed with longevity and I have learned to look to that history for so much advice. Thanks for the well researched post!
Tonya Scarborough via Facebook says
Coincidentally, I happened to be reading Dr. Natasha’s response to a similar question on her website just last night. Her opinion is that if the gut is in healthy shape, then you won’t get the severe symptoms of menopause, just like you won’t get the severe symptoms of pms. Her concerns with HRT are that it tips the fine balance of hormone interplay in the body and it’s not a long term solution.
Susan says
Both my husband and I have been on BHRT and have had good experiences. We are no longer on them now because it is just sooo much money to be on the protocol. $500 for the initial visit, $195 in blood work before the visit, and then $200 for follow up visits with, of course, more blood work each time. The hormones themselves are pretty cheap, but we just couldn’t keep up with the office visits any more. When I told my doctor why we couldn’t continue on, she told me that staying healthy is expensive and perhaps we could make cut backs in other areas of our life in order to afford it. Well yes, perhaps we could quit eating.
I just don’t understand why it has to cost so much. I’ve called around to other doctors and it turns out my doc was one of the cheaper ones. The prices to see the docs in Suzanne’s books are CRAZY expensive. I’ve watched videos of BHRT docs where they show luxurious, spa-like medical offices, and while they are beautiful, you know what? It does me no good. The whole experience -dollar wise, not BHRT wise- left a really bad taste in my mouth. Why does BHRT have to cost so much? Why should only wealthy women be allowed to have access to these life-giving hormones? I realize these docs went to medical school and blah, blah, blah, but wouldn’t it be nice if they lowered their prices to a level where we could all get access to BHRT, and instead of them making their money by charging exorbitant prices, they made their money by volume instead?
Do I hope to go back on BHRT someday? Yes. Just as soon as I win the lottery.
KitchenKop says
Oh noooooo, I was afraid of that!!!!
I guess I’ll find out next week…
Kel
Mary says
Kelly, what a wonderful, thorough post. Coming from a family with a background in women’s health, I can appreciate it very much.
I’m so glad you mentioned the connection between breast cancer and the birth control pill and also abortion. Many women don’t realize that the pill doesn’t keep you from getting pregnant; it keeps the embryo from embedding in the uterine lining. That’s an abortion and in fact carries risks with it. I may have missed it if it was mentioned here, but mammograms also bring an increased risk of breast cancer. I was glad to see your mention of thermography!
I’ve used the Creighton Model Fertility Care System since college for reproductive dysfunction and later for conceiving and avoiding pregnancy. In case anyone is looking for an alternative, it’s highly effective used either way.
I do have to say that after careful research, Kelly, I believe Suzanne Sommers’ recommendations and the Wiley protocol are absolutely NUTS. It’s just not healthy for a woman past child-bearing years to produce those levels of hormones we make during pregnancy!
As always, thank you for sharing a wonderful article!
Sarah says
Thank you so much for your open attitude on all of this. I am 38 and know it is not too far in the future (10years?) for me. I have a very dear friend that I will be sharing this with. Thank you for walking before us for some of us!
jenny says
this is my opinion only, but the statement that we r living longer is where i stopped listening. evolutionary basis, yes we r living longer than the caveman time but since the formation of our country, not really. take out childbirth and infant mortality and go to cemetaries and u can c that people lived just as long as we do now and sometimes longer. i enjoy, prolly kinda morbid but, walking cemetaries and finding the oldest tombstone and the oldest person i can. i have a small, extremely old cemetary down the road from me that is a fascinating place. the people as a whole did not die any younger than now nor has any cemetary i have visited reinforced the statement that we r living longer. read the obits and let it sink in how many people r dying intheir 40s and 50s. scary! women did not have the breast cancer rates we do nor anyone the cancer rates we do now. they also did not take bioidentical hormones. my family is blessed with long life on my moms side. mom, still living, grandmother, great grandmother, great great grandmother all lived very long healthy lives and i mean healthy. not one took any pharma based bio identical. they did eat a varied diet including ” weeds” and such that possible r they evil plant based bios i now am seeing being vilified. funny but that seems to be happening kinda frequently now, the villification of plant based bios that is. makes me wonder whats afoot. the natural health industry, i would like to think, is more honest than the pharma one, but i also know i am wrong. i am having a problem with the vascular change issue also. i firmly believe, especially in 2015, that we prolly all experience vascular changes but, and this is a very big but, our immune systems should b taking care of it and in some cases is. the immune system is driven by the…..microbiome of our digestive tract. the digestive tract that our ancestors had. i am getting close, in my life, to a 100% diet that is clean no matter what others think. could our 80/20 rule be hurting us. r our hormones falling because of this and our gut health. before i personally would ever get on a substance that requires me to purchase it for life i would make darn sure i was doing eveything else first. when anyone tells me that i need to fear a natural process that has been going on forever, that i will cut my life short if i do not take a man made product, bio identical or not, and will more than likely cost me a lot of money, that i am doomed to look frumpy ( look at some on the beaches inthis country that r 50 plus. many 20 years olds would envy them) i sit back and wonder what the new angle is. kelly, this is my view only, made from my gut instincts, research, schooling in master herbalism, and just watching and listening. i am very interested in what you find out next week. good luck and i hope i didn’t offend you. that wasn’t my intention at all. i have been seeing this pop up alot lately and something about all of this isn’t sitting well. and, to b honest, i’m not sure exactly what is causing the disquiet in me about the issue. i have just learned, many times the hard way, to heed that inner disquiet, for myself especially. thank you for your blog posts. they are real, honest and oh so normal which is the draw. you r like the rest of us in this world that doesn’t have it all figured out but is trying. thanks for that. oh, the vascular changes always makes me think of the study from europe, didn’t go back and find it for you, that showed the spontaneous healing of approx 50%, i believe, of the very small cancers and vascular changes in women. the study was in support of backing off some of the hysteria in the “prevention” we have since in their opinion we r treating “cancers” that will never fully develop into anything and will heal on their own. that is what always leads me back to the immune system and gut health. we all have dna mutations,ie cancer, in us sometimes happening frequently. the difference is some have the immune health to take care of those mutations and some don’t. so, is the vascular changes really abnormal or have they been going on forever? is some of this the same as the cholesterol issue? cholesterol there, plaque there, must b cholesterol. vascular changes, plant based bio foods and herbs in diet, must b plant based herbs and foods. does women as a whole have vascular changes? do people on bio hormone replacement have more? Does the vascular changes = more cancer in both groups? have we studied a large group of women together with all these variables accounted for and r the rates statistically higher? have we studied large groups of women on bio identical for several years to verify that the exact same thing is not going to appear in them and we have another uh oh? i keep hearing increased vascular changes but the article the healthy home economist did had some people in comments ask some of these same questions but i did not read any answers to them. sorry, i seem, lol, strike that, i’m known for my rants. this is one. this whole thing just screams to me as exactly the same as big pharma. take a pill, for the rest of your life and all will b well. difference, this is for a natural condition that all humans, both male and female, go through and have been going through since adam and eve. god made our bodies to have the ability to regulate and heal themselves,yes sometimes with help. but, that should b help, as in eventually the body does it for itself not help as in it overtakes the bodies natural ability to regulate itself. that is exactly what our pharmaceutical companies are doing, and they are doing a very good job of it also. i really would like ur opinion on some of what i wrote especially if u have found some of the answers to any questions i wrote. thanks again. you made me revisit this. i am 49 and as of right now going thru this like my mom, with very little upheaval. knock on wood. but, i am paying attention and adjusting as necessary. i am also not saying i would never take bios. just not for the rest of my life. i have no intention of taking any medical intervention for the rest of my life. a long time goal of mine
KitchenKop says
Jenny,
You make some REALLY good points & made a lot of sense, too — you have given me more to think about and look into!!
Kelly
jmr says
Despite your disclaimer that we may not be interested, I think your story is “gripping” because I’m about your age and not particularly informed about menopause and hormones.
I suffered terribly with symptoms (and now know I probably should have seen a doctor at about age 14 to get some help with my messed up hormones-I was having hot flashes in jr. high). I started taking bioidentical progesterone and testosterone a couple years ago. It took about 1 day for me to go from misery to complete alleviation of every symptom. After about a year, I started having issues, we unsuccessfully adjusted my doses repeatedly and I finally stopped taking them. I still feel good, my cycles are normal. Maybe that’ll change and I’ll want to start again, but for now, I think they were a miracle when I began taking them and something in my body seems to be “reset” for now.
Chris says
This brief talk may help on the path to obtaining more knowledge on this topic (the question/answer session is approximately 1 hour, the talk 45 minutes).
https://www.youtube.com/watch?v=3dR6zBtY-V4
KitchenKop says
Is that you in the video, Chris?
Kelly
KitchenKop says
I’m just wondering because it might be easier for many (myself included!), if you just let us know what you share there that’s different or beyond what I shared in the post? I don’t have time today to watch a long video but would sure appreciate a synopsis. 🙂
Kelly
Chris says
What I teach is in line with your post except a little more on the science of hormones.
Hormone replacement is safe and life enhancing if done properly (both by the doc and the patient). Always risk in any medical tx but done correctly, more benefit than risk.
A synopsis of my anticancer talk can be found be in the video, Cancer Hates Cabbage.
Chris says
Yes, that is me. Trying to share the truths and facts on hormone optimization. A lot of misinformation out there.
Given your family history, you may be interested in my talk on YouTube, Breast Cancer Prevention – Keeping A Breast.
Chris says
Bioidentical hormone replacement is an effective treatment for both men and women. If administered properly, the benefits are numerous. If done poorly, the risks are increased.
Success in this arena requires the recipient to live a hormone healthy lifestyle (proper diet, exercise and supplementation).
So much misinformation out there. Synthetic hormones are risky. Use the hormones Mother Nature provides. Why would you (or your Doc) use anything else?