Not so long ago, hormone replacement therapy (HRT) was routinely prescribed for menopausal women to alleviate menopausal symptoms such as hot flashes and insomnia, as well as to protect against osteoporosis, heart disease, dementia and aging. Even women who were content to age naturally were sometimes pushed into taking hormones. For example, my mother decided against hormones, and was told by her doctor, “All right then, you can just let your skin sag and watch your body age quickly.” Unfortunately for women, hormone replacement turned out to have unexpected negative consequences, as long-term clinical studies showed that HRT increased the risk of cardiovascular disease, stroke, blood clots, and hormone-related cancers such as breast and ovarian cancer—even with short-term use. HRT is also associated with a significant increase in lung cancer and death from lung cancer. It’s almost unthinkable, but HRT has even been prescribed for women with breast cancer, with the result being double the reoccurrence rate of cancer (J Natl Cancer Inst 2008; 100: 475-482).
Why Hormone Replacement Isn’t A Good Idea
Concerns about HRT spurred the development of “bio-identical” hormone therapy, which alternative doctors and women enthusiastically embraced. Bio-identical hormones are identical in molecular structure to natural hormones. Sounds good in theory, doesn’t it? But these hormones do not occur naturally in nature, and must be synthesized from plant chemicals extracted from yams and soy. The truth is that supplementing with hormones, whether synthetic or bio-identical, has harmful effects. When we supplement with hormones, we’re overriding our body’s natural wisdom and interfering with hormonal balance, with unintended and deleterious results.
Although exogenous hormones are frequently used to ameliorate menopause and aging in general, this creates more problems than it solves and does not support long-term health. In my clinical practice, I strongly advise against both HRT and bio-identical hormones. Instead, I recommend a supportive approach to aging, using botanicals and nutrients that nourish the endocrine glands and organs and help to restore an appropriate hormonal balance, while simultaneously boosting the innate production of hormones, and most importantly, addressing the issue of hormone resistance.
The Intricate Web Of Hormonal Balance
As we age, our ability to generate enough Essence (hormonal energy) not only dwindles, but transfer, signaling, and cell receptor sensitivity becomes progressively less efficient because of aging, lifestyle, diet, and exposure to endocrine and epigenetic environmental disruptors. A comprehensive protocol of carefully chosen botanicals and nutrients restores hormonal and endocrine health to a place of optimal response and health. Although this may occur slowly—generally over a period of weeks to several months—the results are impressive, and occur naturally through the synergistic effects of our innate life force and the life force of the herbs. This approach gradually but surely enhances and maximizes the body’s ability to maintain healthy levels of hormones, while utilizing and disposing of them in an optimal manner. In this way, we support the process of aging gracefully.
The process of hormone regulation is a delicate dance of balance. There is a constant struggle between the process of adaptation, which prioritizes hormones for the short-term survival of immediate crises, and the process of adaptation that re-establishes normal hormone status for long-term health and survival. During prolonged periods of stress, hormonal balance shifts and alters allostasis, the adaptive processes that restore homeostasis. As we age, establishing allostatic balance becomes more difficult. An individual often displays too much of a stress response, not enough, or has an initial overreaction followed by a deficit and is unable to return to a healthy baseline.
For example, older people are less efficient at shutting off an acute stress response even after the triggering event is no longer present, and therefore remain in a state of hyper-response. This, in turn, requires other hormones to become hypo-functional. Ultimately, these types of hormonal shifts accelerate aging. Although the precise way in which this process unfolds varies among individuals, a progressive weakening in the ability to adapt—and a parallel deterioration in health—is the result. Aging-related hormonal imbalances contribute to many common diseases including depression, heart disease, loss of libido, obesity, and osteoporosis.
Any type of stress—physical, mental, or emotional—causes an energy shift away from reproductive hormone balance in order to meet the stressor with the specific energy response required (in the form of stress hormones or immunological response). When vitality is strong and stress is short-term, there isn’t any real problem. But if vitality (in particular Kidney Essence) is low or stress becomes chronic, the result is reproductive hormone imbalance. Replacing hormones is not the answer. It’s important to understand that there is no such thing as “bio-identical” hormones. Hormonal balance is dependent upon the endocrine system, beginning with what I call the hub conductor, the hypothalamus-pituitary-adrenal (HPA) axis. The energy generated from the HPA axis is what I refer to as Kidney Essence, particularly in regard to the relationship of the HPA and reproductive hormones.
In modern day life, most people experience increased stress and stimuli, and at the same time, spend less time relaxing and sleeping. To help us adapt and survive, the neuroendocrine system shifts into a state of chronic hyperactivity. Over the long term, endocrine health suffers, including the hormones involved in reproductive health. While menopause or andropause are inevitable life passages and a drop in hormone levels is normal as we age, for many people hormone resistance exacerbates the issue. This occurs when the signaling, sensitivity of the receptors, and the efficiency of hormone transfer all become compromised. Underlying the problem is the “junk” that binds to the receptors, and the decreased ability of the body to remove and detoxify the accumulated junk. The junk I’m referring to includes drugs, environmental hormone mimicking chemicals (endocrine disruptors) and years of eating an unhealthful diet, all of which can plug up hormonal receptor sites. This not only diminishes healthy hormones but also increases the risk of cancer, obesity, and other chronic diseases.
The last important age-related change that takes place is the increase in estrogen created from androgen hormones via the enzyme aromatase. This in turn causes a reduction in testosterone in order to meet the increased need for estrogen because the ovaries slowly make less until they cease production all together. Woman and men with increased body weight tend to have more aromatase in comparison to thin women and men. Aromatase inhibiting drugs are now the gold standard for treating post-menopausal estrogen related breast cancer. This is just one more issue in the complex web of hormonal changes that needs to be addressed to maintain optimal health. In my experience, all of these concerns can easily be managed with a good botanically based protocol. In my post next week, I’ll offer specific suggestions for maintaining healthy and balanced hormones.
11 Replies to “Optimizing Hormones Naturally Versus Hormone Replacement Therapies: Part I”
Thanks for this helpful article. I am passing it on to some of my clients. I liked your line, “When we supplement with hormones, we’re overriding our body’s natural wisdom and interfering with hormonal balance, with unintended and deleterious results.”
I was wondering about your thoughts with the new research on MTHFR. Many people are creating new supplements to “make up” for genetic polymorphisms that are turned off–or as some are calling them- defected. What are your thoughts on this research and is HRT similar to the concept of supplementing a gene that is turned off- needed for proper metabolic function?
Hi Stephen – Hormones are created not just by the ovaries, but also peripherally in a balanced endocrine system. Surgical removal of the ovaries is always a shock to the system, and sometimes a minimal amount of HRT is helpful for the individuals well being while restoring the body with primary adaptogens and kidney enhancing herbs. With signs of improvement, I will gradually wean off the HRT and continue to customize a botanical medicine program for the individual.
I am wondering if you would be able to address in this discussion how to best handle surgical menopause in women in their 30s and 40s. Is there a reliable non-HRT approach for this group of women, or are the ramifications of early loss of estrogen on bone, heart and cognitive health enough to warrant a period of HRT?
Many thanks for any insight you could provide for this subset of women.
Hi Julie – Hormones are created not just by the ovaries, but also peripherally in a balanced endocrine system. Surgical removal of the ovaries is always a shock to the system, and sometimes a minimal amount of HRT is helpful for the individuals well being while restoring the body with primary adaptogens and kidney enhancing herbs. With signs of improvement, I will gradually wean off the HRT and continue to customize a botanical medicine program for the individual.
Thank you so much for this explanation and suggestion for women and men to create health and balance without the use of synthetics that often lead to serious issues.
I love getting your posts and send them out to our students and friends.
Thank you for the article.
What can we do in practicality instead of taking bioidentical hormones? What would the step by step approach be? What to be taken and when?
Hi Barbara – This is a very individual process depending on hormone levels and where deficiencies are. My book, Adaptogens in Medical Herbalism, is a great resource to learn more.
Two basic points to begin with are:
1. Adaptogenic formulas to help balance the entire system
2. Determine from hormone labs if there is a Yang or Yin deficiency and prescribe accordingly.
After that, address individual symptoms with botanical medicine. If someone is already on Rx hormone and want to discontinue, a tapering off with monitoring is much more advisable than stopping abruptly.
Does your book outline ways to combat low progesterone, low testosterone also?
I am currently on HRT and it is really throwing off my body. I need to get off it asap so I have been tapering but I am extremely tired. PLease let me know !
Hi Adria – Thank you for your comment. Low testosterone is addressed in the cardiovascular chapter of my book. Note that balancing hormones is a very individual process depending on levels and where deficiencies are, but my book is a great resource to learn more. Two basic points to begin with are: 1. Adaptogen formulas to help balance the entire system 2. Determine from hormone labs if there is a Yang or Yin deficiency and prescribe accordingly. After considering these two points, address individual symptoms with botanical medicine. If someone is on HRT and want to discontinue, a tapering off with monitoring is much more advisable than stopping abruptly.