Hormone FAQ's
What are hormones and why do I need them?
Hormones are chemicaly messengers ("hormao" in Greek means "I set in motion")that control and regulate the activity of other cells or organs. Each hormone travels in the blood or extra-cellular fluid to one or more specific tissue or organ (containing target cells with special receptors) where it elicits a particular response. The hormones secreted by specialized glands such as the thyroid gland, the ovaries, the pancreas or the testes are essential for every activity of daily living, including digestion, metabolism, growth, reproduction, mood control, aging and sexual function. As we age our hormone production declines (menopause or andropause); it may also decline as a result of disease, exposure to toxins or trauma. This decline causes the aging process to accelerate and is responsible for a pronounced deterioration, both physically and mentally.
What hormones are typically prescribed?
Synthetic estrogen (Premarin® - conjugated estrogens equine)and synthetic progestins (Provera® - medroxyprogesterone acetate)are produced by a laboratory. They are chemically altered hormones that are patented by pharmaceutical companies. These hormones are not identical to biologically produced human hormones. They have been designed to try to elicit the same responses in your body as your natural hormones. Your body recognizes these hormones as foreign entities and may respond in a manner we call "side effects." Premarin® is a combination of many hormones obtained from pregnant horses, none of which are identical to human hormones. Provera® is a synthetic progestin that has been chemically altered specifically to be NOT identical to human progesterone. Both products (and the combination of the two - Prempro®) have been implicated in a potentially serious side effect profile.
How are natural estrogen and progesterone produced?
Precursors (sterols) to progesterone and estrogen are found in wild yams and soy but the human body does not have the ability to convert these sterols to hormones. Through a simple process (hydrolysis) these chemicals are converted into Bio-identical Progesterone, Estriol, Estrone, Estradiol and Testosterone. They are considered "natural" because they are identical to the hormones biologically made in the body and because they are derived from a natural supply. These hormones are then formulated by , a specialty compounding pharmacy, into a strength and dosage form recommended by your physician. Your body processes these hormones in the same manner it would those biologically produced.
What are the problems with synthetic hormones which are not Bio-Identical?
When first developed, synthetic hormones were well received because they provided some of the benefits of hormonal replacement: controlling the symptoms of menopause and fighting osteoporosis. However the long-term results have shown that synthetic hormones often elicit a negative metabolic response. Some women can't tolerate synthetic hormones, often suffering with side effects such as bloating, bleeding or mood swings. In some patients, synthetic estrogens and progestins can contribute to the development of breast and uterine cancer.

Synthetic hormones are not a perfect match in the body; they try to trick the body. A bio-identical hormone does not have to trick the body. Synthetic hormones produce abnormal metabolites that may also cause side effects and increase the cancer risk.

Why doesn't my gynecologist prescribe natural hormones?
Natural supplements such as vitamins and hormones are protected by federal regulation and may not be patented. Major pharmaceutical manufacturers are interested only in patentable drugs that are exclusive and profitable. A lot of what physicians learn is from the drug companies who are promoting their products. Therefore, your doctors are primarily taught only about synthetic products. Natural hormones do not come under specific brand names. Your physician must be self-educated and experienced to prescribe and monitor natural hormones. They probably just don't know a lot about them or must prescribe within the constraints of your health insurance.
What is the truth about the recent publicity about the risks of taking hormones?
The Womens' Health Initiative (WHI) was a study that evaluated the use of Premarin® and Prempro®. There were different "arms" of the study using different drug combinations. The arm of the study using Premarin® and Provera® (Prempro) was discontinued before completion because an increased risk of breast cancer was detected. This risk is attributed to the Provera® (medroxyprogesterone) portion of the regimen. This is not the first time synthetic progestins have been implicated in increasing risks for women. The arm of the study using Premarin® only was also stopped due to increased risk of stroke. These synthetic hormones are generally not well tolerated nor accepted by a woman's body.

Unfortunately, the media has misrepresented the facts of this study by targeting ALL hormone therapy. THIS IS WRONG! Again, the culprit is synthetic progestin, Provera®, and non bio-identical estrogen and not natural estrogen or natural progesterone. There are numerous studies showing the long term benefits of hormone therapy. You just need to make sure you are receiving the right hormones (bio-identical) in the right balance.

It is also important to begin hormone replacement as soon as you begin to lose their protective benefits. The Nurses Health Study reveals that women who began hormone therapy near the onset of menopause had significantly reduced risk of chronic heart disease.

What are the signs of low Progesterone and what are the health benefits?
Progesterone is responsible for balancing estrogen and the female reproductive cycle. Deficiency results in symptoms of PMS, bloating, headaches, cramping, mood swings, breast tenderness, and irritability. A deficiency in progesterone can be a factor in frequent miscarriages.

Research shows that natural progesterone stimulates bone building osteoblasts, thus providing protection against osteoporosis. Progesterone reduces the mitotic change in breast and uterine tissue, thereby offering some protection against cancer (Provera® has demonstrated the ability to do the opposite). Progesterone may also protects against heart disease and is essential for adequate sexual response, lubrication and vaginal vasodilatation. Progesterone should always be in physiologic equilibrium with estrogen. At menopause, women lose both estrogen and progesterone and both should be replaced. Progesterone replacement is important, even if you have had a hysterectomy because it does much more than just protect the uterus.

What if I have been taking synthetic hormones?
You need hormones, but you need the correct kind, the natural bio-identical hormones, in the correct balance. Don't tolerate the risks of the synthetic hormones when a safer alternative is available. Dr.Saxena can help make the switch.
Should I take estrogen and progesterone or not?
The risks of not taking hormone replacement therapy may include elevated cholesterol, increased risk of heart disease, strokes, osteoporosis, tooth loss, depression, Alzheimer Disease, and menopausal symptoms. The side effects of the synthetic hormones such as bleeding, swelling, weight gain and breast cancer can be ameliorated by using the bio-identical estrogen and progesterone instead. Overall health and well-being may be improved, long term survival can be greatly improved and the quality of life greatly enhanced. The risks of not taking hormones are tremendous. Just don't take the non bio-identical hormones.
What about over-the-counter creams and saliva tests?
Products purchased over-the-counter are not usually of a strength sufficient to produce a long term therapeutic difference. A sufficient dose requires a prescription. Over-the-counter products might give you some symptomatic relief, but it is necessary to maintain certain hormone levels to achieve the long term protective benefits.

Because hormones are delivered to the organs by the blood and not saliva, we rely on blood tests to determine accurate and optimal levels. Blood and saliva tests do not correlate. Saliva testing has consistently been shown to be inaccurate in medical studies.

How does one know whether they are receiving adequate amounts of replacement hormones?
Blood tests determine deficiencies. Symptomatic relief over the course of several weeks, as the body adjusts to its newly restored hormonal levels, is the first indication of proper replacement therapy. Subsequent blood testing and dosage adjustments will bring blood levels and tissue levels to proper norms for the patient to realize the full benefit of Bio-identical Hormone Replacement. Individual patients absorb, assimilate, metabolize and respond to hormones differently; we want hormone levels to be optimal and protective.
What about Evista® and Fosamax®?
Evista® (Raloxifine) is in a class of drugs known as designer estrogens. Studies show that these compounds are somewhat effective in increasing bone mass although not as effective as estrogen and progesterone. Designer estrogens do not relieve any of the side effects of menopause and might even increase them. Fosamax® is a non-hormone treatment to block bone loss and prevent osteoporosis. It has been associated with a multitude of side effects, especially gastrointestinal problems. Neither designer estrogens nor Fosamax® are as effective as natural estrogen and progesterone and testosterone at preventing osteoporosis.
Are there other hormones I should replace? What about hormones for men?
Other natural hormones that can be considered part of an optimal hormone replacement program are testosterone, thyroid, pregnenolone, melatonin and DHEA. Both men and women may need these hormones.