Hormone Replacement Therapy – Part I: The Icing on the Cake

By: Dr. Matt Lewis, D.C., DACBN, CFMP®

Hormone replacement therapy has gotten a lot of press over the years — both good and bad. It all started in the 1960s, when women in their 40s and 50s were prescribed estrogen to alleviate the symptoms of menopause — hot flashes, night sweats, irritability, and mood swings. Then, studies appeared, showing estrogen promotes growth of the uterine lining, which increases the risk of cancer, so doctors began recommending the addition of progesterone to protect the uterus.

However, instead of providing patients with bioidentical estrogen and progesterone, pharmaceutical companies created a synthetic form of progesterone called progestin (which they could patent) and started combining it with various forms of estrogen — synthetic or derived from animals.

Hormone Replacement Therapy Doctor Matt Lewis

At about this same time (the late 1990s), theories emerged suggesting hormone replacement therapy (HRT) would be helpful for preventing certain age-related diseases in older women, and doctors began prescribing it for women in their 60s and 70s. However, in 2002, a large federal study by the U.S. National Institutes of Health called the Women’s Health Initiative linked the leading HRT medication, Wyeth’s Prempro, with an increased risk of cancer, stroke, and blood clotting. As a result of that study and others, many doctors and women abandoned hormone replacement therapy or now use it only to help alleviate symptoms during menopause.

The truth is that hormone replacement therapy is safe and effective for both men and women, as long as it is done right. Doing it right involves addressing other underlying health issues first and then using bioidentical hormones instead of synthetic hormones.

In my practice, I use hormone replacement therapy as icing on the cake; that is, I test for and treat other medical conditions first and then prescribe HRT only for those patients who need it and will benefit from it. For these patients, HRT takes their health to the next level and starts to restore their youthful energy and appearance. (Note: For more info on my cake analogy, please read my Feb. ’18 post Baking the Cake to Treat Low T (Testosterone).)

Understanding the Role of Hormones in Health

Hormones are part of the chemical messenger system of the body. They directly control blood sugar, sleep, sexual desire, hunger, stress responses, blood pressure, moods, and much more. Examples include:

  • Insulin and glucagon for controlling blood sugar
  • Melatonin for sleep
  • Cortisol for stress and immune system regulation
  • Sex hormones (estrogen, progesterone, and testosterone), which influence libido, brain function, motivation, sleep, moods, and energy, as well as fertility

However, hormones are only half the story. Hormones are the messengers. The body also has hormone receptors that receive the messengers. These receptors can be healthy or unhealthy, and they can change the way the hormones behave, and the way messages are received and processed.

As H. Maurice Goodman wrote in Basic Medical Endocrinology, Fourth Edition, “The role of the hormone is simply to excite the receptor by binding to it. All the biochemical changes initiated by the excited receptor derive from the properties of the receptor and not of the hormone.”

When there is a “hormone problem,” both the hormones and hormone receptors must be considered in treatment.

Recognizing the Causes of Hormone Imbalances

Hormone imbalance simply means that there is too much or too little of a hormone or too much or too little relative to a partner hormone. Hormones are secreted by glands throughout the body and can become imbalanced due to excessive or deficient hormone secretion or poor timing of secretion. They can also become imbalanced due to other factors, including the following:

  • Exposure to high levels of estrogen: Estrogen is not only made in the female body by the ovaries, but also found in the environment due to municipal, pharmaceutical, and hospital steroid estrogen waste. Exposure to estrogen-like compounds called xenoestrogens is also common; these endocrine disruptors are often found in personal care products, cosmetics, and plastics.
  • Aging: Hormones tend to decline with age, starting at around age 40. The potential for the largest decline is around the age of 50. Women experience menopause and men experience andropause. Hormone decline is very individual. Some people experience a sharp, abrupt decline, while others experience a gradual tapering off over the course of many years.
  • Genetics, diet, fitness, sexual activity, and stress: Each of these factors directly influences hormone levels and how the receptors respond to the presence of a hormone.
  • Medication history: Taking birth control for many years may create excess or deficiencies of hormones and vitamins.
  • Surgical interventions: Hysterectomy and thyroidectomy can influence hormone balance more severely.

Recognizing the Symptoms of Hormone Imbalances

Women and men both experience hormone imbalances. Symptoms for women include the following:

  • Hot flashes
  • Fatigue
  • Restless sleep
  • Weight gain
  • Dry skin
  • Hair loss
  • Loss of libido
  • Vaginal dryness
  • Tender breasts
  • Spotting between cycles, heavy bleeding, irregular cycles, painful cycles
  • Anxiety
  • Brain fog
  • Depression
  • Mood swings

Low testosterone (low T) in men produces the following symptoms:

  • Loss of libido
  • Difficulty maintaining an erection, loss of morning erection
  • Muscle weakness
  • Generalized fatigue
  • Loss of mental acuity
  • Lack of motivation
  • Anxiety or depression
  • Weight gain around the abdomen
  • Restless sleep

With the above information as a backdrop, I’m next going to dive into what’s involved with the process of hormone replacement therapy and how I go about it in my practice. But you’ll have to wait until next week’s installment, Hormone Replacement Therapy – Part II: Knowing What’s Involved, which will publish on Wednesday, May 30.

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Disclaimer: The information in this blog post is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from Dr. Matt Lewis, D.C., DACBN, CFMP®, nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.
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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Florida. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.

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