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We don't mind it when we become slightly irritable and intolerant - that is our right of passage for being over 40.  However, when it comes to losing our memory, losing our hair, not sleeping, and gaining weight - we want no part of it!  So what is happening?  Well, we are hearing a lot of news about bio-identical hormone therapy for many things such as for treating hot flashes, helping with bones, brain, and heart, improving our sex lives, skin, and energy, and for maintaining our optimal body weight.  So what is real?

First, and foremost, HORMONES IN BALANCE ARE GOOD, HORMONE IMBALANCE IS BAD.  What do I mean by that?  In healthy menstruating females, hormones cycle on a monthly basis.   Our first day of our period is cycle day one, progesterone and estrogen are at the lowest, this is the follicular phase.  At around cycle day 12 - 14, ovulation occurs and our progesterone levels increase awaiting a pregnancy, this is the luteal phase of the menstrual cycle, if pregnancy does not occur, progesterone drops and our period occurs again.  

moscowCommonly, in our thirties, our progesterone levels start to drop, more than our estrogen levels, creating something called estrogen dominance. This gives us:
irregular menstrual cycles, possibly heavier bleeding, increased pain with the menses and
PMS symptoms such as breast tenderness, irritability, bloating, etc.  

We may also begin to lose our sex drive and vaginal lubrication.  Our skin may become itchy, noticibly more wrinkles - sometimes this seems to appear overnight - welcome to hormone imbalance!

What can we do about hormone imbalances?  - It is not just one thing.  I always recommend a balanced head to toe approach.  My head to toe approach encourages every woman to take control of her health!  Where should the focus be?

Focus on the spiritual  - what is the mental atmosphere that a patient finds themself in and what can they do to gain some perceived control of it.

Environment - what are their personal and work environments - what could be interfering with their ability to achieve happiness

Nutrition  - our bodies are our temple and what should we be injesting to nurture our bodies

Digestion  - no matter how well we eat, we have to ensure that we have appropriate digestion - that means adequate acid and digestive enzymes in ur stomache and healthy bacterial flora in our intestines to absorb the nutrients

Detoxification  - since the 1950's, corporations have introduced greater than 500,000 chemicals into our environment.  Additionally, no matter how we get our hormones, whether it is from what our body naturally produces or from the xenoestrogens from the environment from pesticides, herbicides, food we eat, air we breathe, etc.,  how our body gets rid of it is even more important.  All my patients are introduced to my nutrient and protein base detoxification program that includes a modified elimination diet to remove foods, etc, that are likely to produce allergies.

Hormonal balancing - we need to consider the hypothalamic, pituitary, adrenal, and gonadal axis, i.e. the entire hormone web.  Each woman is hormonally unique and part of achieving our optimal health is in understanding this and achieving our own hormonal balance.

Structure and function - physical strength and exercise are the final and very important  aspects to achieving optimal health.

So, when I approach a patient who has symptoms of hormone imbalance, and this is my area of expertise for the last 10 years, we need to incorporate all of the above aspects into a balanced treatment program.  For hormone balancing, I consider the major hormones such as adrenaline, cortisol and thyroid, and the hormones estrogen, progesterone, testosterone, and DHEA.  My approach is to prescribe the lowest doses in the most balanced fashion, based on a patients symptoms and test results such as by saliva and serum hormone testing.  

Let me give an example:

Zoe is 43 years old and her periods have gradually becoming more frequent, she complains of more irritability prior to her periods and absolutely no sex drive.  And even worse than this - she feels out of sync.  She says that she used to organize all 4 childrens schedules and keep her bills organized and volunteer at the school, and now she felt that she can not even organize car pool.  She has 'lost her edge'.  

We always take an extensive history, covering all 7 topics above, and do serum and possibly saliva and urinary testing to evaluate hormones and detoxification.  She was definately progesterone deficient, estrogen dominant and also was fatty acid deficient, i.e. she needed more healthy fats, especially omega 3's in her diet.  I prescribed a bio-identical progesterone cream and a testosterone cream and in 3 weeks she returned stating she was "feeling better than she had in years!"  She had "gotten her edge back".  She was also sleeping better, her sex drive returned and her focus and stamina returned.  I had also recommended a balanced quality multivitamin, omega 3's, calcium,  and a few other nutrients based on nutrient testing such as Co Q 10, Alpha lipoic acid, and carnitine to improve her energy and weight as well.

Her periods became regular, in fact, she stated she couldn't even tell when her periods were coming - the PMS was entirely gone and her relationship with her husband became more satisfying and intimate again.

It is hard for women, especially because we have so many different roles and obligations to take the time for ourselves that we need in order to feel our best and perform our best for all those that we love around us.  

I encourage your questions, because we have so much to learn from each other and sharing and talking is the best way.  Please give your comments and experience, and remember to try and do as much naturally as we can do to achieve our optimal health.

[Link Removed] 


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Member Comments

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      Dennie05 wrote Feb 1, 2009
    • I just started on Estrogen patches (0.05 mg) and progesterone cream (20mg a day).  I have been on this regimen for 3 wks now and feel soooo much better.  The hot flashes have gone away. I can sleep all night with cover on again.   I had hormone levels drawn by my medical doctor, so I took those results with me to my appt.  He looked at them and started me out on this dose.  I go back next week and talk about if my symptoms are better.  He says he will do the saliva test to fine tune things.  He is also says he will test my testosterone level, cortisol and DHEA.  I regularily have my thyroid blood work done, so he has that level too. By your post...it sounds like he is doing everything right.  All I know is that it has helped and I love the fact that I am not putting large amounts of synthetic hormone through my body for my liver to have to metabolize.  Bioidentical hormones are definately an alternative to hormone replacement.



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    • 0 votes vote up vote up

      Anna Cabeca, D.O., FACOG, ABAARM wrote Feb 1, 2009
    • Hi.  This sounds like a very sound and conservative regimen!  Very good!  It does not take a lot to feel better!  The saliva test will be a good follow up because when we use transdermal  - that means applied to the skin or vagina - therapies you will better be able to analyze it in the saliva than the blood.
      Bravo - please also ask about testing your estrogen detoxification pathways - such at the Estronex test (more info at : [Link Removed] )
      Because no matter how we get our hormones, we need to make sure we are getting rid of our hormones safely.


      Dr-cabeca, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      Dennie05 wrote Feb 1, 2009
    • I will ask him about the detox. Thanks for your column and information!



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      Jackie Croasdale wrote Feb 2, 2009
    • My Doctor gave me clonindine to help me with hot flashes, mind fog, night sweats etc...  The have helped me a lot.



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      Cmrobert wrote Feb 15, 2009
    • Hi.  About 3 years ago I had my tubes tied and came off of birth control pills which I had taken for about 15 years.  Two months after having my tubes tied I developed a small rash in the center of my back (never ever had any skin problems prior) that was subsequently diagnosed as eczema.  Since then my skin is probably 90% covered with eczema.  I have seen many Dermatologists who have yet to help me.  My GYN doctor mentioned that this could be hormonal so she prescribed Prempro (smallest dosage) but I am afraid to take due to the warnings out there.  Have you ever encountered such a problem?  Any thoughts?

      Thanks,
      Cheryl



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      Anna Cabeca, D.O., FACOG, ABAARM wrote Feb 17, 2009
    • Hi Cheryl,
      I rather see you on bio-identical hormones rather than Prempro. I would recommend you ask your doctor to consider switching you to estradiol 1 mg and prometrium 100mg at bedtime on the 1 - 25th of each month.
      Regarding eczema, it is in my experience improved with my detox program and removing foods that could be potential allergens to you. First stop gluten and dairy. You can also order my detox online at:
      [Link Removed] - we will send the complete diet, supplements and instructions. I have one patient who had eczema for 25 years and it resolved completely in 21 days.
      Best wishes for health and happines,
      Dr. Cabeca


      Dr-cabeca, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      Anna Cabeca, D.O., FACOG, ABAARM wrote Feb 17, 2009
    • Dear Peeper,

       You may also benefit from iodine replacement which is so important for every hormone receptor in your body and especially the thyroid.  

       Also a reminder that we should have 25 hydroxy vitamin D levels in the 50 - 70 range.  This is very important form hormone balance as well.
      Best in health,
      Dr. Cabeca



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      Cat Valentine wrote Apr 24, 2009
    • I have been on bioidenticals for 3 months. I don’t understand the ratio that I am on though. Estrogen 6 out of 7 mornings, and Progesterone 6 out of 7 nights. Hot flashes have stopped. My Dr. gets very haughty with me when I ask her about the protocol that starts a womans’ period again. Should we have a rythmic cycle to mimic our youth?



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      Cat Valentine wrote Apr 24, 2009
    • I was wondering if you were familiar with the protocol that will have us revive periods. I haven’t had one in a year, but I’m reading that it’s best for us to start having one and to continue having one for the rest of our lives. What do you think?



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      Anna Cabeca, D.O., FACOG, ABAARM wrote May 4, 2009
    • Hi.  No I do not think it is beneficial to have periods for the rest of our lives because if we are then we are getting too high of doses of Estrogens for our bodies to process, detoxify, and eliminate, and we know that increases our cancer risk.  Rather our hormones should be balanced at healthy levels and balance estrogen, progesterone, and testosterone.  I usually do not induce periods in women older than 55 years old.
      Cheers!



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      Nita P wrote Jan 31, 2012
    • the more stable my diet, life and well being are the better my hormones. i have to ensure i eat correctly - from the different food groups, get some sleep preferable 8 hours, do a mental activity that keeps my brain vital, be physical - walking, hopping, dancing and lastly pamper, treat, luxuriate yourself, however that may be - spoil yourself wonderfully



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