I have been treating women for hormone disturbance in my Chicago area office for almost 20 years. I was prescribing bio-identical hormones way back then. Giving grand rounds at various Chicago area hospitals on the subject, often taking loads of flack by the OB-GYNs who would attend.
Of course, that was then. Now, the OB-GYNs have jumped on the band wagon. It seems whatever those of us are doing in the natural, integrative medicine world, eventually makes it’s way into the mainstream 15 years or so, later.
What the mainstream physicians are still behind on, is the need for hormone balancing and the concept that peri and menopausal symptoms aren’t always due to low estrogen levels. Often, they’re due to unopposed estrogen levels.
Progesterone balances estrogen and it is progesterone that diminishes first, while our cycles become anovulatory. In addition, the brain has many times more receptors for progesterone than estrogen. And, progesterone is the best tranquilizer we have. It is the addition of progesterone that often prompts my patients to call me just to say “thank you for saving my life”. Please note, bio-identical progesterone should not be taken orally, it needs to bypass the liver. A sublingual lozenge is the preferred method when taking it to affect sleep.
So while your OB-GYN might be prescribing you bio-identical estrogen, she probably isn’t giving you bio-identical progesterone. Synthetic progesterone is completely different from a chemical structural point of view and is associated with an increased risk for breast cancer.While bio-identical isn’t.
I often find that my patients actually don’t need the estrogen at all. Aside from analyzing the symptoms, I look at hormone levels along with their metabolites. Hormones are all metabolized into other hormone structures and how well one’s liver works and what bowel flora is at play are both extremely important in the function of how your body breaks down hormones. Without testing for levels of hormones and their metabolites, there is no certainty that a build up of an undesired substance is not occurring. In some cases, the prescribed hormones can be metabolized into androgens or more estrogen. It is very important to clean up metabolic pathways that may be overly stressed from diet or medications.
In the old days (1990-2005), most OB-GYNs didn’t test hormones at all. Now, they often will test for E2, or estradiol and perhaps testosterone, but, they don’t often follow up after prescribing hormones. It is vital to follow up with levels when taking any exogenous (outside) source of hormones as doing so, shuts down one’s own production and sets in motion metabolic pathways that need monitoring.
So while you might be feeling crazy, it might be a simple imbalance which has an easy and safe fix but be sure that someone is following the effect in your body as you may be throwing yourself out of balance even more, or worse.