Hormone Replacement: How to Balance Your Hormones Naturally. Dr. Cabot Sandra

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       excess facial and body hair (hirsutism)

       loss of scalp hair, especially in the male pattern of balding

       greasy skin and/or pimples

       difficulty losing weight, especially from the trunk and abdomen

       Weight loss from the upper body and abdomen will reduce the production of androgens from the fat tissue.

       Creams or troches containing natural oestrogens and progesterone can reduce the dominance of the androgens, thus making the hormonal profile more feminine.

       If the androgen excess is severe and is producing marked symptoms, the anti-male hormone called Cyproterone acetate can be prescribed. Cyproterone acetate comes in the form of 50-mg tablets. The dose of cyproterone can vary from 1/4 of a tablet (12.5 mg) to one tablet (50 mg) daily. Cyproterone also acts as a progestogen, and as such can be given along with oestrogen to balance the effect of oestrogen on the uterus. If cyproterone is given every day, then there will not be any bleeding; if you desire to have a regular period, then the cyproterone can be given cyclically, for 18 days of every calendar month, along with your oestrogen. You must avoid pregnancy while taking cyproterone acetate. Generally speaking cyproterone is well tolerated, especially if the dose is tailor-made to match the patient’s blood tests and the severity of her symptoms. If the correct dose is used, then cyproterone will reduce the action of the male hormones so that we achieve a big improvement in all the symptoms of excessive androgens. Interestingly, we find that in women whose obesity is associated with excess androgen levels, the use of cyproterone will aid weight loss. This is because high levels of androgens will aggravate the high insulin levels found in Syndrome X. Syndrome X is a chemical imbalance that makes your body store fat and prevents your body from burning fat. If too much cyproterone is given, the level of the body’s androgens will be reduced too much and the patient may complain of fatigue, depression and loss of libido. As with all forms of hormone therapy, it is vital to tailor-make the correct dose for each patient, and over time the dose may need further adjustment.

       To determine if you are menopausal. Blood tests are better for this initial test, to check your FSH levels and baseline levels of total sex hormones.

       During the pre-menopausal years, if you have heavy and/or painful menstrual bleeding, fibroids or irregular menstrual cycles, as this could indicate a progesterone deficiency. The best time to measure progesterone levels is seven days before your menstrual bleeding is due, although if your cycle has become irregular and/or infrequent, it can be difficult to pinpoint this exact time. Salivary and blood tests should be done to check progesterone levels.

       If you are on hormone replacement therapy, to indicate if your response to treatment is adequate. These tests can be blood and/or saliva tests. The blood tests are done every three to six months; the saliva tests can be done more often. The tests are more necessary if you are on HRT and you still feel that your hormones are out of balance. For women on higher-dose forms of HRT, such as implants or injections, blood tests can be helpful to check that you are not receiving an excessive dosage. We do not want to produce very high blood levels of hormones that are above the normal ranges, so blood and saliva tests can check for over-dosing as well as under-dosing. If you are on HRT and feel well, you may not need any hormone tests at all.