Oestrogen – Should you take Pills or a Gel?

When the oestrogen/progestin (synthetic progesterone) arm of the Women’s Health Initiative (WHI) study abruptly shut down back in July 2002, women were shocked . . . stunned. It wasn’t only the study’s participants. It was equally devastating to the millions of other women around the world taking hormone replacement therapy (HRT), thinking they were doing something good for themselves.

The sudden knowledge that they might be risking coronary heart disease, breast cancer, stroke or pulmonary embolism so terrified women that many immediately quit their hormones, cold turkey.

Then in February 2004 came the aftershock: the oestrogen-alone (oestrogen replacement therapy, or ERT) arm of the study shut down when it became apparent that it not only failed to prevent heart disease ― it increased the risk of stroke.

Besides shock, fear and disappointment, the WHI failure sparked enormous confusion over the use of hormones to ease the transition into and through menopause.

Today, we understand a great deal more about hormones, and we have the option of bioidentical hormones (BHRT), but we still have confusion, especially about what kind of oestrogens to take. Sublingual drops? Patches? Pills? Injections? Pellets? Vaginal ring? Transdermal gels and creams (which are preferable and safer)?

It’s enough to make you dizzy! But to try and clear up some of the confusion, and to make things a bit simpler, I’m going to focus on only one question: Of the two most popular oestrogen-delivery systems, which is best ― oral (pills) or transdermal (applied to the skin)?

Oral oestrogens are used in ERT and HRT, and transdermal oestrogens are used in bioidentical hormone restorative therapy (BHRT), along with other natural hormones, such as progesterone.

But first, let’s clear up what makes ERT/HRT oestrogens different from BHRT oestrogens.

ERT/HRT vs. BHRT Oestrogens: What’s the Difference?

The most common form of ERT is Premarin®, a conjugated oestrogen obtained from the urine of pregnant mares. HRT, most often marketed as Prempro®, is a combination of, once again, horse oestrogens, and progestin, a synthetic substitute for progesterone.

Both come in a fixed-dose pill form. And they’re synthetic. That means these oestrogens are not of natural origin. They don’t replicate your own oestrogens ― they’re chemicals that merely imitate the natural hormone. They can’t function in your body the same way as the oestrogens created by your body.

To work properly, hormones have to bind with specific target receptor cells in your body, like a key in a lock. The synthetic form of hormones can’t completely bond with receptors because the key does not totally fit. Because of this, they can’t work as they should, they confuse the body, and therefore, can predispose you to cancer and other diseases.

On the other hand, BHRT oestrogens, like all bioidentical hormones, are derived from wild yam and soy plants. They have exactly the same molecular architecture as the oestrogens produced in your own body. That means they are fully equipped to do everything that your own ‘homemade’ oestrogens do ― including binding to receptors.

And as we will see, ERT/HRT and BHRT oestrogens are metabolized in completely different ways, which makes a world of difference in their safety and effectiveness.

What’s the Scoop on Oral Estrogens?

Unfortunately, what we’ve learned about oestrogens post-WHI has not attracted publicity anywhere near that surrounding the study’s sensational, premature end. As a result, many women are unaware of these advances. Nonetheless, we’ve gained a great deal of useful knowledge since then.

For one, we’ve learned about what happens when you swallow oestrogens in pill form ― specifically about what occurs in your body physiologically and how it affects the metabolism of the oestrogens you ingest.

Once you swallow an ERT/HRT pill, it makes a beeline for your liver. It passes through the gut, where it undergoes preprocessing. From there, it goes into the large portal vein and then on into the liver. There, it’s metabolised before it circulates throughout your system.

This route means that oral oestrogens enter the liver much more directly and in a much more concentrated form than the natural oestrogens created in your ovaries. With oral oestrogens, your liver is hit with a dose of around 1,000–2,000 micrograms of oestrogen instead of 100–200 micrograms.

It’s no exaggeration to say this is an overload that can stress the liver.

The effects of oral oestrogens can be erratic and unpredictable, varying with the dose and the individual. Oral oestrogens may:

  • Increase or decrease the synthesis of various proteins in the liver, either raising or lowering levels of blood-clotting factors, testosterone, oestrogens and thyroid hormones, potentially resulting in blood clots, strokes, blocked hormone function, elevated blood pressure and triglyceride levels, and suppressed thyroid function
  • Produce unwanted products of metabolism (metabolites) that increase risk of oestrogen-sensitive cancers

Initially, oestrogen-only fixed doses were set at high levels in order to relieve vasomotor menopausal symptoms such as hot flushes and night sweats. However, these doses have been shown to be excessive, causing adverse effects such as weight gain, water retention, fibrocystic breasts and the much more serious risks of breast and uterine cancers.

Later, when progestin (synthetic progesterone) was added to the horse oestrogens (as in Prempro), the uterine cancer risk lessened, but breast cancer risk increased, along with risk of blood clots, stroke and gallbladder disease.

What Makes BHRT Transdermal Estrogens Different?

Bioidentical transdermal oestrogen therapy comes in the form of a compounded (individually mixed) gel or cream that is applied topically. The dose is tailored to your test results, which show what is needed to restore your oestrogens to their optimal and proper levels.

Instead of being first metabolised by the liver, transdermal oestrogen acts exactly as the oestrogens produced by your ovaries. That is, it is transported through the bloodstream, reaches its target tissues, attaches to oestrogen receptors and is then metabolised in the liver. The liver is the end point, not the starting point. We are following nature here.

That completely alters how transdermal oestrogens works. Compared with oral oestrogens, BHRT transdermal oestrogens don’t:

  • negatively impact liver protein synthesis
  • produce unwanted metabolites that raise cancer risk
  • increase your risk for blood clots, heart disease, stroke, gallbladder disease, etc.
  • have unpredictable effects or
  • stress your liver

It is also worth noting that oestradiol produced in your ovaries is easily eliminated in urine within one day, whereas synthetic oestrogens can remain in your body for up to 13 weeks before elimination. Your body is designed to metabolise your own oestrogens and, in this case, bioidentical hormones which are an exact copy of your own, NOT horse hormones.

And the Winner Is…

In the United Kingdom and the United States, HRT oral formulations of oestrogens are more frequently prescribed than BHRT transdermal formulations. Why this is so is unclear, but it’s high time to clear up the confusion.

Hands down, transdermal oestrogens are far safer and more effective!

True, ERT and oestrogens found in HRT have been studied much more extensively than BHRT oestrogens but much of that research leads to the conclusion that these synthetic hormones are not something you want to put in your body.

The clinical evidence on BHRT oestrogens is persuasive and mounting: Transdermal oestrogens have a far stronger safety and efficiency profile than oral ERT/HRT oestrogens. It’s not even close.

In the end, it comes down to one thing. To avoid risk of chronic disease and other health problems, the molecular structure has to be the same as that of your natural oestrogens. The same holds true for progesterone, which should always be taken with oestrogen to ensure maintenance of the correct ratio.

To make sure you’re prescribed BHRT transdermal oestrogens (together with progesterone), make sure to work with a doctor specially trained in restorative medicine and bioidentical hormones who understands why this form of oestrogen is preferable.

SOURCES:

Estrogen Pill vs. Estrogen Patch ― Which Works Best? Virginia Hopkins Test Kits.
Gillson, G.R. and Zava, D.T. A Perspective on HRT for Women: Picking Up the Pieces After the Women’s Health Initiative Trial ― Part 1. International Journal of Pharmacological Compounding. Vol.7 No. 4, July/August 2003.
Liu, B. Is transdermal menopausal hormone therapy a safer option than oral therapy? Canadian Medical Association Journal (CMAJ). 2013 Apr. 16; 185(7): 549–550.
Which Type of Estrogen Hormone Therapy Is Right for You?

Why does BHRT Work for Everyone but Me?

We hear wonderful things about bioidentical hormone restorative therapy (BHRT), and those glowing reports foster high hopes ― but, sadly, sometimes the experience doesn’t live up to our expectations.

I’ve heard the above question many times, along with others:

  • How come I feel no improvement since taking the prescribed hormones?
  • How come I get more headaches?
  • How come my hair hasn’t returned to its full, healthy, shiny look, as promised?
  • How come my nails are still brittle and cracking?
  • How come I still suffer from mood swings, hot flushes and brain fog?
  • How come my breasts are tender? (A sure sign of oestrogen dominance)
  • How come this natural therapy doesn’t work for me? It’s just not fair!

How come, how come, how come . . . .?

Maybe the answer doesn’t lie in the fundamentals of BHRT. Maybe you just got the wrong doctor ― one who isn’t qualified in this specialty. The person you go to see may be a doctor, but if you experience no improvements or things get worse, then that doctor most certainly is not an expert in restorative medicine or bioidentical hormones.

It’s important to understand that bioidentical hormone therapy is a complex specialisation, and doctors need extensive training to practice it correctly. So the first thing you need to do is find a doctor with the needed knowledge, credentials and experience.

I can assure you that, when you are treated by a doctor trained and experienced in BHRT, it will definitely work for you, not against you. What is more, you will feel its enormous benefits almost immediately. Hot flushes will be calmed, foggy memory cleared, vitality and energy restored and enhanced, and positive thinking renewed.

In short, you will discover the old, familiar YOU, and most likely an even better version ― a better version because this is the time in life when we are at our best. We have everything. We’re experienced, mature, knowledgeable and at our peak intellectually. At this stage, only one thing can hold us back: our declining hormone levels!

Throughout life, we mature for the better through lessons learned and experiences gained. Who wants to lose their love of life, their vitality and/or their cognitive power at forty or fifty? It would be more than sad to let go of that experienced, sophisticated, intellectually mature woman you’ve become.

You don’t have to. You have an option: You can restore your hormones and get your life back. Life will be fun again.

What Happens Next?

Once you find your bioidentical hormone specialist, he or she will request specific blood testing to be done. Test results allow your doctor to understand the exact status of your hormones in order to prescribe the hormones you need in the specific amounts required to match your own personal physiological requirements.

Hormones have to adhere to specific hormone levels and ratios. If they don’t, harmony and balance within your body will remain elusive. The art of BHRT is finding that balance ― a balance that has meaning, the balance necessary to optimise your health status.

It isn’t something that can be done by just any doctor ― certainly not by a doctor who simply got up out of bed one morning and decided to become a ‘specialist’ in dishing out bioidentical hormones. Again, a true BHRT doctor must have extensive training and knowledge.

How Can You Be Sure BHRT Won’t Work Against You?

When prescribed correctly, your body is setup to accept these natural bioidentical hormones. On the other hand, HRT hormone molecules are synthetic and therefore cannot be effective.

Let me explain.

The major issue with synthetic hormones is that they are not like our own hormones. Because they are different in molecular structure, the body cannot understand, metabolise or excrete them easily. As a result, they cause a toxic build-up that increases cancer risk.

In contrast, bioidentical hormones are exact copies of the hormones we have in our bodies. Their molecular structure is the same.

Exact, not similar…

Exact. For this reason, the human infrastructure is ready and willing to accept these hormones. In fact, the body needs these hormones. The body knows what they are and recognizes them as their own.

If we think about it logically, of course bioidentical hormones will work when prescribed at the correct levels and ratios by a bioidentical hormone expert. Why wouldn’t they? They have the exact molecular structure as those naturally produced in our bodies ― only now, unfortunately, at lower levels because of our transition into perimenopause.

The truth is, to avoid the very uncomfortable, and in some cases debilitating symptoms we suffer in menopause, our hormone levels only need to be topped up and brought back into balance.

Symptoms such as depression, mood swings, headaches, hot flushes, weight gain, low libido, loss of confidence, hair loss, foggy memory, fatigue and more are, quite simply, withdrawal symptoms. In perimenopause, your hormone levels suddenly and quite drastically decline, leaving the brain and body very confused. Your body goes into a state of shock because it is missing those hormones it needs to get back on an even keel.

Symptoms are your body’s way of talking to you. Telling you something is wrong. We need to learn to listen to our bodies and restore those very precious missing molecules. Only when they are prescribed incorrectly will bioidentical hormones not work and potentially cause problems.

The key to successful BHRT is to find the right doctor ― one who is highly trained and experienced. When you find that doctor, it will work. Bioidentical hormones are safe and highly efficient when properly prescribed.

I can tell you from my own experience that restoring your hormones to their proper balance can give you back your happy, healthy self, free of debilitating symptoms. Best of all, you’ll learn that ‘the change’ in your life can be a truly positive change ― one that ushers in an exciting time of health, personal growth and productivity.

You can also understand far more by reading Jill’s book.

Bioidentical Oestrogen – Smooth Your Path Through Menopause

Smooth Your Path Through Menopause

When perimenopause arrives, it can turn your world upside down! It’s the first announcement that menopause is on its way, and even if you’re still having your periods, hormonal changes are going on. They can’t be seen, but they certainly can be felt.

In a worst-case scenario, hot flushes and night sweats arrive to disrupt your days and make sleep elusive. Fatigue becomes a constant companion and your brain feels wrapped in wet cotton wool. You may become more moody, more volatile . . . even slip into depression. And to make matters worse, the pounds seem to pile on, uninvited, and refuse to leave.

Who wouldn’t be depressed?

Up until that point, you probably hadn’t thought a lot about your hormones. Ever since puberty, they’ve gone along, unobserved and for the most part quietly doing their job in perfect harmony. But now their job is changing ― along with your life.

Let’s take a look at some of the culprits.

Meet the Oestrogen Trio

Many women think of oestrogen as a single hormone, but oestrogen is actually a general term that encompasses three distinct primary hormones: oestrone (E1), oestradiol (E2) and oestriol (E3).

During your reproductive years, oestradiol, which is secreted by the ovaries, is the most active of the oestrogens. It’s the predominant sex hormone and responsible for the characteristics that make you “feminine” ― sex organs, breast development and curvy fat deposits around the hips and thighs. It also plays a major role in your menstrual cycle and bone health.

At this stage, oestradiol is 12 times more potent than oestrone and 80 times more potent than oestriol.

Oestradiol keeps your uterine lining healthy and ― just in case ― prepared for pregnancy. If you become pregnant, oestriol, a weak oestrogen, steps in as the primary oestrogen and thickens the uterine lining, which provides blood to the placenta. Large quantities of oestriol are released for the baby’s well-being.

With menopause, oestrone takes over as the dominant oestrogen. Oestrone is a “danger” hormone because it carries the potential for increased risk of breast and endometrial cancer. For that reason, it needs to be monitored to ensure it remains in balance.

Menopause Disrupts the Harmony

Beginning with perimenopause (the onset of menopause), oestradiol begins a dramatic decline that often heralds the arrival of physical and emotional menopausal symptoms.

For many women, these symptoms include erratic moods, stress, inability to cope, frustration, sadness and, in the worst instances, severe depression and feelings of hopelessness. If a woman has hot flushes, night sweats, insomnia, vaginal dryness, low libido and other physical symptoms, these feelings are magnified.

It’s estimated that between 8% and 15% of women going through menopause experience some degree of depression, which is most common during the perimenopausal transition to menopause.

Dr Dzugan is one of the few doctors who recognises the true source of this kind of depression, which is hormone-induced. Unfortunately, many doctors often treat their patients with antidepressants, which are inappropriate and drive the situation from bad to worse.

Antidepressants just don’t work, and typically the dosage is then increased with, again, no improvement. As Dr Dzugan has told me more than once, “In these cases, quite often, a second or third antidepressant is prescribed, along with mood-stabilising and anti-epileptic drugs.”

If you think there has to be a better way, you’re right.

Oestrogens to the Rescue

When you arrive at menopause, oestrone replaces oestradiol as the primary oestrogen. However, oestrone is a weaker oestrogen and can’t combat menopausal symptoms, whether emotional or physical.

There is, however, a solution.

Bioidentical oestradiol, in the proper ratio with oestriol, can restore your hormonal equilibrium. It has been proven to reliably banish hot flushes and other physical symptoms associated with menopause nearly instantaneously.

Bioidentical oestrogen therapy also boosts your serotonin level. Although actually a neurotransmitter, serotonin is known as the “feel-good hormone.” It fights depression, elevates mood and promotes sleep. What is more, it increases your production of GABA, a neurotransmitter with calming effects. It also raises endorphins, which act to control pain, ease stress, relieve frustration and even slow the ageing process.

What Else Do You Need?

Your endocrine system ― that is, your hormones ― act interdependently, and for them to function properly, you need each one in the proper quantity. In other words, they have to be balanced.

That means you will also need progesterone and testosterone.

Progesterone:

Although your oestradiol levels decline rapidly as you transition into menopause, progesterone levels may fall even faster, and by the time you reach full menopause, your progesterone may be as low as it normally is in men.

As a result, your oestrogen level may top that of progesterone, resulting in a condition called oestrogen dominance. That simply means you have too much oestrogen relative to progesterone.

Oestrogen dominance may also result from exposure to hormone-disrupting toxic chemicals that mimic estrogens. Because these chemicals create false oestrogens, they can also throw your oestrogen/progesterone ratio off balance.

Symptoms of oestrogen dominance include severe headaches, depression, anxiety, fuzzy thinking, water retention, weight gain and digestive problems.

Even more concerning, oestrogen dominance increases your risk of breast and uterine cancers, so it’s extremely important to restore your oestrogen and progesterone to the proper balance.

Testosterone:

Many women are unaware that testosterone is as important for women as it is for men. If you have low-T during menopause, you’ll have trouble with concentration and energy. Your muscles will become flabby and your bones brittle. Your sex drive and fantasy will be in “sleep mode,” and you’ll lack confidence and determination.

Women’s testosterone levels can begin to diminish as much as 10 years before full menopause.

Oestrogen and testosterone levels are closely related, and adding testosterone to your bioidentical hormone therapy may be needed to bring these two hormones back into sync.

How Do You Get What You Need?

It’s important to remember that bioidentical hormone restorative therapy is a complex specialism, and doctors need extensive training to do it properly. So the first thing you need to do is find a doctor with the needed knowledge, credentials and experience.

When you find your bioidentical hormone specialist, you’ll need to do testing. Testing is what allows your doctor to understand the exact status of your hormones so he or she can prescribe the hormones you need in the specific amounts you require.

I can tell you from my own experience that restoring your hormones to their proper balance can give you back your happy, healthy self, free of debilitating symptoms. Best of all, you’ll learn that “the change” in your life can be a truly positive change ― one that ushers in an exciting time of health, personal growth and productivity.

SOURCES:

Estrogens: E1. E2, E3. Rx Compound Centre.

Hormones and Depression in Women. BodyLogicMD.com

Studd. J. When is depression in women a matter of hormones? TotalHealth.co.uk. Aug. 17, 2012.

Mandal, A. Estrogen Types. News, Medical Life Sciences.

Menopause. Progesterone Therapy.

Peterson, D. Three Stages of a Woman’s Life Require Three Different Estrogens. Wellness Alternatives.

Pick. M. Estrogen Dominance ― Is It Real? Women to Women.

Testosterone Deficiency May Exacerbate Menopause. Testosterone and Menopause. July 14, 2014.

How restorative medicine can overcome migraines

Your body needs balance within its interlinking systems in order to function normally. If an imbalance occurs as a result of stressor factors (from emotional stress to the physical stress of poor diet or lifestyle), it can result in symptoms such as migraines.

Migraines can occur in young adults, adults and mature people, and can be very debilitating, with pain ranging from mild to severe, acute or even chronic, and with symptoms recurring in some cases for years.

But restorative medicine can help you regain your body’s natural balance, together with a whole host of other benefits for your overall health and wellbeing, including overcoming migraines.

What is the bodily imbalance which causes migraines?

Almost all your organs are controlled simultaneously by the two nervous systems: the sympathetic nervous system, which is an energy-giver that controls ‘fight or flight’ and stress reactions; and the parasympathetic nervous system, which helps to calm your body back down and bring rest.

These in turn are influenced by four other systems: the neurohormonal system; the pineal gland (which balances production of the hormone melatonin and the neurotransmitter serotonin, both key to migraines); the digestive system; and the balance of magnesium ions (requiring a critical ratio of magnesium and calcium).

Migraines happen as a result of hormonal imbalance within the four subsystems, which then cause the sympathetic and parasympathetic nervous systems to go out of tune. This causes nerve endings in the nociceptive system (the brain sector that controls the feeling of pain) to become irritated, reducing your pain threshold and making you prone to migraines. When you restore balance to these critical systems, your nervous systems can in turn be harmonised and – hey presto – no more migraines!

It is worth noting that the searing pain of a migraine can also be an early indicator that the menopausal process has commenced (perimenopause), if you have not suffered from migraines previously. This is primarily due to the fluctuation of oestrogens and progesterone levels at this time; two important female hormones that have to remain within a specific ratio in order to maintain balance within the body.

How restorative medicine can get you migraine-free

As mentioned in Chapter 1 of ‘The Menopause Cure: Hormonal Health’, an effective and natural remedy based on restorative therapy and an enhanced lifestyle has been developed by Dr Dzugan, co-founder and Chief Scientific Officer of the Dzugan Institute of Restorative Medicine. Over 85% of his patients found complete relief of their migraine – even after 30 years of suffering. His cure also works to remove a host of other menopausal symptoms, improve quality of life and obtain positive longevity.

  • The migraine cure focuses on tweaking the four interlinked body systems, also adding lifestyle improvements to complete the cure.
    To tune up the neurohormonal and digestive systems, Dr Dzugan advises rebalancing specific hormonal levels using a bespoke bioidentical hormone restorative therapy programme, carefully tuned to each individual patient. Natural intestinal flora restoration and the cleansing of parasites is also paramount.
  • The pineal gland’s control of hormone and neurotransmitter production works on a natural cycle that needs to be re-set in order to restore balance.
  • Magnesium ion levels need to be tuned by balancing magnesium and calcium levels – both these critical minerals contribute towards migraines.

You can shake off the shackles of migraines by using bioidentical hormone restorative therapy in tandem with a healthy and balanced lifestyle. This requires a good diet, low stress and toxin levels, as well as an environment that is conducive to overall wellbeing.

Restorative medicine, when combined with a well-managed lifestyle, will not only remove debilitating migraines, it will correct menopausal symptoms, slow – and, in some cases, reverse – the ageing process, and help stave off chronic disease, letting you live life just the way you want to for a very long time!