In the last blog, I mentioned the importance of progesterone to a woman’s health – especially after menopause. The biggest question for a woman to ask is…How do I know which of my hormones are low and by how much? Venous blood values after menopause are virtually useless when talking about monitoring estrogen and progesterone levels because they do not accurately represent the amount of hormone active in the target tissues. The current way to measure the “functional” hormone level is by saliva or urine test. Both are non-invasive and simple to do. In general, saliva testing measures the “free” or “active” forms of the tested hormones at the tissue level directly, while urine testing measures the excretory metabolites of the hormones (from which the hormone levels are extrapolated). I usually use the urine testing at least once during hormonal therapy – as it is important for the physician to monitor the ratio of certain estrogen metabolites for the patient’s protection. I believe that it is important for every woman over 30 to have urine metabolite testing done at least once every five years to assess her tendency to certain cancers – whether or not she is considering natural hormonal therapy options or hormone replacement outright.
Taking hormones or substances that affect hormones must always be taken in the context of general health and the functioning of other glands in the body that affect the reproductive hormones. Adrenal function and thyroid function should always be evaluated before any therapy is prescribed. I usually suggest that a four-point cortisol saliva evaluation be completed at the same time as the saliva female hormones – as this determines the adrenal/stress response of the person. As we have stated before, over-or-under functioning adrenal glands influence the production and/or the action of the female hormones. In other words, chronic stress can affect a woman’s hormonal balance. The saliva hormone evaluation is usually used before any therapy is prescribed. I also recommend a thorough naturopathic workup to evaluate the current state of the body and the organ functioning– especially if the woman is considering Bio-identical Hormone Replacement Therapy (BHRT) –
When the saliva results are known the first line of defense is to attempt to stimulate the natural production of hormones if at all possible. There are many herbal and homeopathic combinations, for example, that claim to “balance” female hormones, and many of them do reduce or alleviate troublesome symptoms like hot flashes and so on. It is important, in my mind, to do a follow-up saliva test or urine test to make sure that the tissue levels of the estrogen, progesterone and testosterone are now within normal levels. If not, the woman may be still be at higher risk for heart disease, and will not get the full benefits and protection that the right amounts of estrogen, progesterone and testosterone can give for the brain, heart and nervous system. Many of the symptoms and signs of aging are related to, or made worse, by hormonal decline. Therefore, optimizing your hormonal function as you age just makes sense – as long as you do it safely and under the supervision of your health care professional.
Until next time….
Dr. Gatis
