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MENOPAUSE.... "The Climacteric"

SEX HORMONES: What they are, what they do

Ever stop to wonder what makes a man look "male" and a woman look "female"? (Gender-neutral hairdos and clothing not withstanding!) The answer: sex hormones.

Sex hormones are chemical messengers made and released by the gonads (ovaries in women, testicles in men), and adrenal glands in both sexes.

In both sexes, these hormones are responsible for maintaining fertility. They also give men and women characteristic features of their sex. For example: estrogens cause breasts to develop, while testosterone causes muscles to accumulate more protein.

Sex hormones have other roles in the body, many of which have only recently been discovered. The sex hormones play a role in bone growth and strength. In females, a decline in hormone levels is sometimes associated with an increase in cardiovascular disease. Scientists believe that there are other unknown functions of the sex hormones.

Surprisingly, men and women have the same sex hormones. (Women have testosterone, men have estrogen). It is the relative amounts of these hormones that make a difference in physical characteristics. And while we used to believe that the role of "opposite sex" hormones was minimal, modern medicine has begun to recognize the importance of all hormones to both sexes.

Facts & Myths about "The Climacteric"

Myth: only women go through menopause (a decrease in production of sex hormones).

Fact: Both men and women have decreased hormone outputs with advancing age, but the decrease is not as rapid in men as it is in women. Men may have hot flashes, psychogenic changes, bone mineral loss and other symptoms identical to the female menopause.

Myth: If sex hormones are taken after the climacteric, they will help maintain youthfulness.

Fact: Science doesn’t know. Children are youthful before their sex hormones develop. Once the sex hormones come into play, they mature —- in other words — age.

And there’s much we don’t know about the long-term negative consequences of hormone-replacement therapy.

For example: the total number of years that a female breast is exposed to estrogens, especially the more potent estradiol, is directly related to an increased risk of breast cancer. The more estradiol, the greater the risk.

In males, higher levels of dihydrotestosterone (DHT), a hormone derived from testosterone, is associated with benign prostate hypertrophy (BPH) and possibly prostate cancer. Increased levels of estrogens in males also appear to play a role in the development of BPH.

Myth: Conventional hormone replacement is safe and effective for women and men who need hormone replacement therapy (HRT).

Fact: Conventional HRT uses a "one size fits all" approach to hormone replacement and often employs high doses of semi-synthetic hormones. (Which are different from the hormones the human body produces).

A presumably safer and more effective approach to hormone replacement therapy is used by holistic physicians. This involves testing the patient’s personal hormone levels and prescribing pharmaceutical or herbal hormones that are custom-tailored to the individual.

Few holistic physicians, whether N.M.D., M.D., or D.O., believe that a "one-size-fits-all" approach is desirable. Most are doing individual testing and custom prescribing, myself included.

The Climacteric is not always a simple hormone decrease

Most people assume that "menopause" (whether in men or women) is caused by a simple decrease in hormone levels. While this is often the case, there are many other changes that cause the "climacteric."

Changes in liver function cause a shift in the relative amounts of various hormones. That is because the liver processes most sex hormones. I have found many menopausal-aged people, both men and women, who still had normal or even high levels of the circulating sex hormones. Additional mammalian hormones in this instance are inadvisable, because they can create an excess of hormones with the attendant problems.

Safety and Effectiveness of Herbal "Hormones"

Let’s be very clear on this: herbs do not contain significant amounts of human hormones. What many herbs DO have are chemicals that are structurally similar to human hormones — similar enough to bind to human hormone receptors and have an effect on hormone levels. These plant substances are called phytohormones, meaning "plant hormones."

Phytohormones have a unique effect that prescription hormones (mammalian hormones) do not, in that they are amphoteric. This means that plant hormones can act to balance hormone levels regardless of the direction of imbalance. It’s really an eloquent process.

Plant hormones are much weaker than human hormones, but they will bind to human hormone receptors. In the climacteric, when hormone levels are low, there are "empty" hormone receptors. Plant phytohormones will bind here, and although their effect is weaker (about one-fifth that of human hormones) it is a hormone effect.

Without a laboratory test, it is difficult to know exactly which hormones are out of balance and by how much. But there are still good self help measures that you can take.

First, remember that overall good health is critical to the body’s production of hormones. Inadequate nutrients from diet is a major factor in hormone imbalance. Excesses of certain foodstuffs, especially alcohol, refined carbohydrates (sugars), and fats, can all change hormone levels for the worst.

Faulty liver function, as evidenced by high cholesterol levels, contributes to inadequate transformation of hormones. Improving liver function is a key step in normalizing hormones and the body’s response to hormones. (It is possible to have adequate hormone levels and still have symptoms of deficiency or excess if the liver is not working properly).

Normal weight is crucial to hormone balance. Fat cells manufacture estrogen. This can lead to an excess in both men and women. Ever see a man with a "beer belly" and breast-buds? (Female-like development of breasts)? This is caused by an estrogen excess made by the fat cells. Maintaining normal weight is important for balanced hormones.

When taking hormones without a doctor’s assistance, be sure to take an herb formula that is balancing. (See the following recommendations). It is HIGHLY INADVISABLE to take actual hormone supplements, even if they are sold without a prescription, without the advice and laboratory testing that a doctor can offer. Such "hormones," available without prescription, include DHEA and progesterone. (Many health food store brands of progesterone creams do not contain the hormone, and the body cannot convert wild yam (dioscorea) into progesterone, no matter how much the lady at the health food store argues otherwise!)

Also remember that other non-sex-hormone factors can create imbalances in the sex hormones. An excess or deficiency of thyroid hormone will change sex hormone levels, and no amount of sex hormone replacement will correct the problem until the thyroid function has been compensated for.

Diet And Lifestyle Recommendations

  • Diet: eat a nutritious diet high in nutrient-rich foods. Increase consumption of soy products (both sexes) if tolerated.
  • Achieve and maintain a normal weight
  • Exercise regularly. 30 minutes, 3 times per week minimum.
  • Don’t smoke! The climacteric occurs sooner in people who smoke

Primary Support for Women

  • Maxi Multi: 3 caps, 3 times per day with meals. Optimal (not minimal) doses of vitamin E, C, B6, B12, folic acid, calcium, magnesium, boron, and vanadium are particularly important for peri or post-menopausal women.
  • Omega 3 fatty acids:
    Flax seed meal, 2 teaspoons per day with food
    Flax seed capsules
    : 2-4 caps, 3 times per day (target dose range: 6-12 caps per day)
    Flax seed oil
    : 1 tablespoon per day
    Max EPA
    (Omega-3 rich fish oil): 1-2 caps, 3 times per day with meals (target dose: 3-6 caps per day).

Primary Support for Men

  • Maxi Multi: 3 caps, 3 times per day with meals. Optimal (not minimal) doses of vitamin E, C, B6, B12, folic acid, magnesium, selenium, zinc and bioflavonoids are particularly important for "menopausal" (40+ years) men.
  • Omega 3 fatty acids:
    Flax seed meal, 2 teaspoons per day with food
    Flax seed capsules
    : 2-4 caps, 3 times per day (target dose range: 6-12 caps per day)
    Flax seed oil
    : 1 tablespoon per day
    Max EPA
    (Omega-3 rich fish oil): 1-2 caps, 3 times per day with meals (target dose: 3-6 caps per day).
  • Super Saw Palmetto: 1 cap, 2 times per day. May be increased to 3 times per day if symptoms of BPH are present.

Additional Support

See Female Menopause or Male Menopause for additional recommendations.

Dr. Myatt's Comment

A hormone profile is the first step toward making a good prescription for individualized, natural hormone replacement therapy. Hormone tests can take the guesswork out of this process and make correction surer and safer. If you do not see noticeable improvement in six to eight weeks with self-help measures, consider a telephone consultation with me. You will feel better and delay the aging process by maintaining a youthful hormone profile.


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