Chapter 2: Taking Hormones For Good Health

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Excerpted pages 8-12

Timing Matters

The inevitable decline in the ovarian secretion of estrogen and progesterone causes severe symptoms in about 25 percent of women as they age.555 Women vary. Progesterone imbalance is usually the first hidden change. Its consequence can be excessive bleeding. Estrogen changes usually occur next. For some women, an abruptly plummeting estrogen level occurs in the mid-forties, five to seven years before the average age of menopause. For others, the decline is gradual, or there may be huge spurts and troughs.174 These are signals. They tell you about your life and your hormone status.

If you have a regular sex partner, you are less likely to experience abrupt roller coaster–like changes in estrogen. But if you end a sexual relationship, your estrogen levels are likely to suddenly drop.169 If you begin a judicious prescription of hormones when the deficiency signals first start, you can eliminate symptoms within days. Starting early makes a big difference in preserving the health of your blood vessels, too.145

Symptoms of Declining Estrogen and Progesterone Levels

• Hot flashes
• Sweating/night sweats
• Mood swings
• Insomnia
• Vaginal dryness or atrophy
• Painful or uncomfortable intercourse
• “Abnormal” bleeding

The Innate Wisdom of Your Body

These symptoms of hot flashes, vaginal dryness, and sleep disturbances provide valuable signals. Uncomfortable intercourse due to vaginal dryness isn’t a wonderful experience, but it’s telling you to do something. Like an early warning signal of an impending hurricane, these symptoms are calling you to take notice so that you can avoid the storm. Listen to the signals your body sends, and you can take preventive actions that will enrich the second half of your life.

Of course, you can grit your teeth, be uncomfortable, and accept the inevitability of growing older and eventually disabled. But keep in mind that the majority of postmenopausal women who do not use hormonal-replacement therapy will not merely experience unpleasant symptoms; they will risk diseases brought about by loss of bone, loss of blood vessel elasticity, and decreased protection from cardiovascular disease.121, 555 You may not need hormones. You may have a body that produces all you need. Or you may not be a good candidate due to your family history. Ask your clinician to discuss options related to your own personal health history. But read this book first!

Hormone Therapies Are Just Better—for Some Deficiencies

Hormone-replacement therapies are obviously not the only route to good health. There are alternative paths to maximize your health that I describe throughout the book, such as exercise, weight loss, and quitting smoking. But for hot flashes, bone loss, atherosclerotic change, and sleep disturbances, correct hormone therapies appear to offer the most efficient, effective remedies. They have consistently outperformed alternative remedies, including placebos, tranquilizers, sedatives, herbal remedies, and other drugs.168, 171, 175, 759 Unlike other prescriptions from your doctor, they can be used to prevent disease. (Of course, exercise and other healthy habits are still important, with or without hormone therapy.)

Long-term hormone therapy is associated with lower death rates in older women.582 I believe that a powerful argument can be made against the current recommendation that hormones are all right but “as low a dose as possible for as short a time as possible.”582 The data published by hundreds of outstanding biomedical scholars convince me that carefully chosen long-term therapy may extend the length and the quality of your life leading up to menopause and for many years thereafter.