AGING PROCESS AND HORMONES

As We Age many things about our bodies change, one of the things that change is our hormones. Hormones determine how tall you grown and how you handle stress, they also regulate the functioning of your sex organs.

The normal aging process causes hormone production to decline in everyone, resulting in imbalances that have both physical and psychological effects.

The main hormones that regulate a women’s body are estrogen, progesterone and testosterone. Any time one or more of these hormones becomes out of balance, a woman starts to experience changes. These hormonal changes are broken up into different stages:

Pre-menopause refers to a time before a woman’ first regular menstrual to her last regular menstrual cycle. This is the period of “normal” reproductive function for a woman.

Perimenopause is the next stage. This refers to the “transitional” stage, which varies from 2 to about 10 years, prior to complete cessation of menstruation. This is usually experienced between the ages of 35-50 yeas of age. During this stage women can experience major hormone fluctuations which can cause typical symptoms, such as hot flushes.

Menopause is the third stage and marks the natural end of a woman’s reproductive cycle. It is at this point that the body’s ability to produce estrogen and progesterone naturally, decreases substantially. The ovaries stop producing eggs and a woman is no longer able to become pregnant naturally.

Post-menopause is the period of life after menopause. This phase is generally believed to begin after 12 full months have passed since the last menstrual period.

Andropause is often called the “male menopause.” As men age, their bodies produce less and less testosterone. This lack of testosterone can lead to a number of symptoms that many men just accept as the “normal aging process”. A lot of men do not realize that these symptoms can be reduced or eliminated through testosterone replacement therapy (TRT).

Numerous changes are associated with an age-related decline in testosterone. Men can go through these changes quickly, with a sudden change, or more typically, slowly over a period of time, with a gradual hormone decline. Men can start this decline as early as their 30’s, when the body’s production of testosterone starts to drop by 1 – 2% each year.

In the United States, it has been stated that there are over 25 million men (about 408 million worldwide) between the ages of 40 and 55 that may be going through what is termed “male menopause”, or “Andropause”. In the next twenty years, the number in the US is expected to increase to over 57 million (960 million worldwide).

HORMONE REPLACEMENT THERAPY

Like all medical therapies, Hormone Replacement Therapy (HRT) may not be appropriate for all patients. Is for this reason that in The Pellet Hormone Therapy we discuss both the benefits and potential risks of the therapy with our patients before beginning treatment.

 Testing for Hormone Levels

Given the current literature and sensitivity to the issues relating to HRT, the practice of routinely prescribing hormones without the appropriate testing for levels is highly questionable. To be accurate, our testing includes levels of free (bioavailable) hormones that are more significant indicators of true deficiency or imbalances. Our current testing choices include serum (blood) and saliva tests.

 Prescribing the Right Dosage 

We use hormone baseline test results to prescribe hormone replacement therapy and bring our patient’s hormones to their optimum targeted levels. Then, monitoring of hormone levels with periodic follow-up visits and re-testing is done to assess the effectiveness of the therapy and adjust as necessary.

 Estrogen Replacement Therapy (ERT)

Estrogen Replacement Therapy (ERT) restores declining hormone levels associated with menopause (women with a personal history or a family history of breast cancer may not be candidates for estrogen replacement). The principal estrogens in a woman are estrone (E1), estradiol (E2), and estriol (E3). Estradiol is the most potent of these estrogens and is produced by the ovary. Estrone and estriol are both metabolites of estradiol and are less potent, with estriol being the weakest. In the Pellet Hormone Therapy, we offer ERT with pellets and compound creams.

​Progesterone Replacement Therapy

Progesterone (P4) is a hormone produced in women by the adrenal glands, the ovaries and in the placenta during pregnancy. In men, smaller amounts of progesterone are produced in the testes and adrenal glands. Progesterone interacts with and mediates estrogen. Progesterone is known as a precursor hormone for estrogen, luteinizing hormone, and testosterone, among others. To a certain extent, progesterone controls the production of these other hormones and can help balance any deficiencies or excesses of them in your body. In addition to helping relieve the symptoms of menopause and PMS, progesterone is known to enhance energy and sexual libido, and to heighten feelings of well-being. Progesterone should not be confused with progestin. Progestin is a synthetic chemical and is unable to synthesize other hormones or help our bodies produce the other hormones it needs to function at full potential. Progesterone can be administered orally (powder or micronized in oil base as capsules, oral drops, or sublingual tablets), vaginally or rectally (with suppositories), through injections or topically with transdermal creams or gels. 

 Testosterone Replacement Therapy (TRT)

Testosterone, although a primary male hormone, also plays a role in women’s health. A decline in testosterone levels in men may be indicated by symptoms including loss of libido, erectile dysfunction, deterioration in ability to concentrate, poor muscle tone and strength, lack of endurance and mood swings. A decline in testosterone levels in women may accompany a decreased libido, irritability, weight gain, loss of lean muscle and osteoporosis. Testosterone contributes to higher energy levels and overall sense of well-being, increases lean body mass, and helps in building strong bones.

 For people not producing high enough levels of testosterone, Testosterone Replacement Therapy (TRT) may be appropriate. This therapy should be considered when hormone deficiency has been clinically proven through laboratory testing of blood serum or saliva.

 Testosterone can be administered orally, topically (through creams or gels), injectable, or via pellet implant (which is a pellet placed underneath the skin). The oral route is not considered to be a primary method of delivery. Topical application of testosterone is usually a good method for TRT. In the Pellet Hormone Therapy, we offer testosterone creams, gels, injectables and pellets in a variety of strengths. There are different advantages associated with different dosage forms, that can be discussed by our clinician with the patient to identify the appropriate dosage form that would most effectively promote patient compliance. 

​ Pellet Implantation

Pellets used for hormone replacement therapy are placed beneath the skin, typically in the buttocks or abdomen, to provide a reservoir for our patients. Implanting the grain-of-rice-sized pellets takes about five to ten minutes and should be repeated every four to six months. Pellet implantation offers stronger patient compliance due to not having a daily regimen of hormone dosing.

​Hormones for Men & Women

• DHEA – An adrenal cortex steroid hormone that raises levels of sex hormones and has been linked to increased lean body mass, improved immune and cognitive functions and skin tone.
• Estrogens –The primary female hormones consisting of Estradiol / Estrone/ Estriol
• Melatonin –Helps regulate a good sleep/wake cycle and is recognized as a powerful free radical scavenger.
• Pregnenolone – a steroid hormone produced by the adrenal glands and synthesized directly from cholesterol. It is a precursor hormone, from which all other steroid hormones are made.
• Progesterone –An ovarian hormone that helps maintain menstrual cycles, PMS and mediates other hormones.
• Testosterone –The primary male hormone.  
• Thyroid –the thyroid gland secretes two hormones, T3 and T4 which helps to regulate metabolism.  The thyroid-stimulating hormone (TSH) is produced by the pituitary gland which prompts the thyroid to produce T3 and T4.