Hormone Replacement: How to Balance Your Hormones Naturally. Dr. Cabot Sandra
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Название: Hormone Replacement: How to Balance Your Hormones Naturally
Автор: Dr. Cabot Sandra
Издательство: HarperCollins
Жанр: Здоровье
isbn: 9780008104641
isbn:
The issues of the moment for peri-menopausal women are:
How do I feel and look today?
How does my mind function?
Do I have energy and vitality?
Do I feel sexual, sensual and feminine?
Can I have a good sexual relationship with my partner?
How can I remain healthy for the next 20 years?
To help women achieve their goals and satisfy the above expectations, doctors have to think laterally, practise holistic medicine and have empathy with every individual woman. If this is not their area of interest, they can always refer to a doctor who is interested in this sub-speciality of medicine. Clinical trials are based upon large numbers of subjects, statistics and a generalized deduction and recommendation. However, many individual women do not really relate to this academic world – it can be frightening and confusing for women trying to relate to the academic ivory tower.
First we must be honest with women – they deserve it! They depend upon doctors and we want to keep their trust.
Women would like to know that:
Very few pharmacological treatments in medicine are perfect – most are a compromise between relief and possible side-effects. We need to weigh up all the pros and cons. If we do take HRT it will have a protective effect upon our bones and usually improve our sex life, however if we use a potent oral form of HRT for more than several years, it may increase our risk of blood clots, strokes and breast cancer.
There is a great difference between individual women – some women need HRT to enjoy their lives, while others feel well and function efficiently without HRT. We should not frighten all women off HRT – some types of HRT remain a viable and safe option for many women.
Nutritional medicine can work, especially for the prevention of long-term degenerative diseases; however it cannot simulate the effect of real hormones in the way we feel. For example, homoeopathic hormones do not work at all, and herbal hormones will not achieve the exact same effect of real hormones.
There is a huge difference in the effect induced in the body by different types of hormones. For example, hormones taken orally, as in the WHI Study, are absorbed from the gut and pass straight to the liver. The liver breaks the hormones down (metabolizes them) and only a certain amount gets past the liver into the general circulation; thus we must use higher doses of more potent hormones to gain a clinical result. This increases the workload of the liver, and induces the liver enzymes to make more clotting factors; thus we become more at risk of blood clots and heart disease. Also, because the progesterone that is commonly used in oral HRT is synthetic, it takes longer to be broken down by the liver, and may accumulate in the body, causing more side-effects. I have never thought that it was physiological (natural) to give hormones by mouth for this reason, unless we require oral contraception. It is much more physiological to give hormones in a way that bypasses the liver. To achieve this, we must administer hormones through the skin (which is called transdermal administration), via implants, sprays, vaginal creams or rings, or injections. Transdermal administration can be achieved by using hormone creams, gels or patches. Some doctors use lozenges (troches) that are designed to be placed between the upper gum and the cheek, so that the hormones they contain are absorbed directly into the blood vessels under the lining of the cheek. This way we are meant to avoid swallowing the hormones and thus absorbing them from the gut and then through the liver. Some women tell me that it is difficult to avoid swallowing some of the lozenge, especially since they come in several hundred delicious flavours!I personally feel more comfortable prescribing transdermally-absorbed hormones via the creams and/or patches, especially for long-term use or for women with risk factors for HRT. The beauty of the creams is that they can be tailor-made for the individual woman, to contain the combination of natural hormones that she needs as determined by her blood tests, medical examination and history.
Although there are some very favourable clinical trials evaluating the use of hormone creams for various hormonal problems, there are no very long-term studies available on their safety for use as HRT for the post-menopause.
The use of any form of HRT is the choice of the patient, and it must be based upon informed consent. Women need to know that we cannot give them 100 per cent guarantees of safety, and that, generally speaking, it is wise to find the lowest dose of HRT that will relieve unpleasant symptoms and improve well-being. This can be compared to taking the oral contraceptive pill – women know about the risks, as they are printed on the packet. However, millions of women choose to take the Pill, because its advantages often outweigh the disadvantages in the individual woman.
Communication is the key – doctors need to treat women as intelligent human beings. Women need to take some responsibility in helping their doctor to decide if they will use HRT. They can only do this if they know and understand all their options. Luckily you do not have to be a rocket scientist to work out the advantages of different types of HRT. Common sense and realistic expectations should be explored. It is always possible to prescribe HRT for a short period (less than a one year), choosing a transdermal application just to see if it really makes a difference. Then you can weigh up the absolute risks, if any, of long-term use before deciding whether to continue.
Just because yet another hormone controversy has raised its head does not mean that all women will stop wanting to take HRT. Today’s menopausal woman has a much longer life span, and totally different expectations of life, than women who lived 100 years ago. She does not want to –
age rapidly
stop being sexually alive
embrace old age mentally and physically at the tender age of 50.
There is no doubt that hormones can help us feel and look younger and keep us sexually young. Just imagine if men ran out of their sex hormones at the tender age of 50 – well, there would be a hormone shop in every suburb!
Yes, ‘hormones make the world go round’ and, controversial or not, they are not going to become strictly taboo!
The average age of the start of the menopause is 51; however, some women will go through the menopause many years earlier than this. Fertility starts to decline after the age of 35, due to the gradual reduction in the number of healthy follicles (eggs) in the ovaries. The incidence of hormonal imbalances is more common after the age of 35, simply because the ovarian follicles are ageing.
You are more likely to experience Premenstrual Syndrome (PMS) during the years from age 35 up to the menopause. This is because, after ovulation, the ovaries may not always produce adequate amounts of the female hormones called oestrogen and progesterone.
During the peri-menopause it is more common for progesterone production to be inadequate, which can result in symptoms СКАЧАТЬ