Living Longer and Better with Hormones: Bioidentical Hormone Replacement Therapy

Written by Dr. Rand McClain

At approximately age thirty-five, perimenopause (for women) and peri andropause (for men) begins and people experience a decrease in hormone production. Stress can also catalyze hormone deficiencies.

No matter the cause, the symptoms of decreasing hormone levels are the same and may include a loss of libido and energy, a diminished sense of well-being, less ability to control body composition (i.e., difficulty getting rid of a stubborn layer of fat around the middle), decreased cognitive function, anxiety, and insomnia—just to name a few.

This is when bioidentical hormone replacement therapy (BHRT) is very useful. We’ve learned how to restore hormones to youthful levels and restore patients’ vigor and vitality with few side effects (which we’ve also learned how to manage).

Cheating Hormonal Decline in Both Men and Women

On the surface, the logic of BHRT is simple: we lose hormones as we age, but now we can restore these hormone levels to where they were when we were younger. It’s not just about numerical hormone levels, though. As I’m fond of saying, we treat the patient, not the numbers. The goal is to restore that sense of well-being, energy, libido, and ability to control body composition, among other aforementioned abilities and feelings.

The word bioidentical in BHRT is important, since we’re focusing on hormones the body produces naturally throughout life. These include sex hormones made from cholesterol (testosterone and estrogen) as well as those made from protein (thyroid and growth hormones). The hormones used in BHRT are made synthetically in labs, but they’re the same structure as those synthesized by our bodies, as opposed to hormones that aren’t bioidentical and are obtained from other sources like horse urine. In managing signs and symptoms of estrogen deficiency, human bioidentical estrogens such as estriol and estradiol are used to avoid the risks associated with estrones and non-bioidentical hormones.

BHRT is designed to control or eliminate symptoms that come with having low levels of certain hormones. Specifically, deficiency in the following hormones produces these symptoms:

Testosterone. Low libido and energy, diminished sense of well-being, body composition changes such as loss of muscle mass and gain of fat mass, erectile dysfunction, cognition difficulties, slow recovery after exercise, and insomnia are other symptoms.
Thyroid hormones. Chills, fatigue, sluggishness, dry skin and hair.
Estrogen. Hot flashes, vaginal dryness, night sweats, anxiety.
DHEA. Decrease in energy, reduced immune function, increased systemic inflammation.
Pregnenolone. Decrease in cognitive function and ability to appreciate
color.
Progesterone. Decreasing health of vasculature, anxiety, insomnia.

Many people don’t recognize these symptoms as stemming from hormone deficiency. Because they often develop gradually, people ascribe them to a particular event (“I haven’t been getting much sleep, that must be why I’m lacking energy”) or resign themselves to the aging process and figure there’s not much they can do about these symptoms beyond taking a pain reliever or drinking a double espresso for energy.

Why Do We Experience Hormone Deficiencies?

While aging is the primary reason we experience hormone deficiencies, stress can accelerate the decline. Most people start losing hormones at age thirty-five, but people under significant stress can start losing them even earlier. Given the society in which we live and the pressure many of us are under, it’s not surprising that people today lose hormones faster than hundreds of years ago in an agrarian society.

Lack of deep sleep can also hamper hormone production. For instance, the anterior pituitary gland releases growth hormone and prolactin, and the pineal gland produces melatonin, when we are sound asleep. If we’re not sleeping well because of aging or stress, we’re creating less than the optimal amount of needed hormones.

We also can stress ourselves physically. Over-exercising can stress the body and accelerate hormone loss. In my experience, athletes typically don’t produce more testosterone (or other hormones) than the average person, contrary to what many people believe. In fact, they may produce less if they place too much stress on their bodies by working out harder and longer than they should. It’s not always over-exercise that’s the problem but, rather, under-recovery. We may work out regularly and effectively, but we don’t recover properly. We fail to get adequate sleep, don’t eat or hydrate properly, and fail to do stretches or use other techniques to help our soft tissues loosen after intense exercise. All of these factors can contribute to hormone loss.

The term sick thyroid refers to how the thyroid gland reduces its hormone production because of overwork. Many years ago in human societies, the thyroids of people who couldn’t hunt and gather because of injury or illness reduced hormone production in order to save energy. Today, if we overtax our bodies, the thyroid responds similarly.

Detection

Doctors rely on two methods to determine if hormone deficiency is occurring. First (and foremost), we look for the signs and symptoms just described, factoring in the age of the patients and how much stress they’re under. Second, we take blood samples to measure hormone levels that support why an individual might be experiencing their symptoms.

Though hormone replacement isn’t the only option when we determine a deficiency exists, it’s often the best one.

About Dr Rand McClain

Rand McClain, DO, is a dedicated regenerative & sports medicine specialist providing insightful patient treatment and education at Regenerative & Sports Medicine in Santa Monica, CA. He is the Author of bestseller, Cheating Death: The New Science of Living Longer and Better and is an active member of the regenerative medicine community. Dr. McClain is the Co-founder and Chief Medical Officer at Live Cell Research, an organization dedicated to the innovation and development of medical technology that is designed to enhance people’s health and quality of daily life through epigenetic manipulation. Dr. McClain is a medical advisory board member at American Cryostem Corporation, Z.E.N Foods and The National Veteran Foundation.

Dr. Rand McClain

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