The exact cause of Alzheimer’s is unknown. It may be a combination of factors, different for every individual, that contribute to the disease. During your lifetime, you lose approximately 20% of your brain cells, but in Alzheimer’s Disease brain cell death is so extensive that the brain can no longer direct the your bodily activities.

The chances of acquiring Alzheimer’s disease increases with age. Two to six percent of the population over age 65 is diagnosed with Alzheimer’s. Half of the population over age 85 has Alzheimer’s, and it is responsible for half the nursing home admissions in the United States.

Alzheimer’s is more common in women, and is four times greater if someone in your family has the disease.  In the early stages, a person becomes increasingly forgetful and has difficulty carrying out complex thought processes. The onset can take one to ten years with severe and continual decline for which no other cause can be identified.

Contributing factors to the disease may be genetic predisposition, abnormal calcium regulation in the brain cells, or toxic levels of aluminum, lead, iron, or some other heavy metal in the body. Malnutrition, decreased blood flow to the brain, extensive free radical damage, and environmental toxins also can have an effect.

Alzheimer’s patients have abnormal fibrils surrounding the brain cells eventually ensnarling the brain cells until they die. There are also dead cellular waste products called senile plaques composed of beta-amyloid.

Cognitive decline is not hopeless or inevitable. You can improve the circuitry in your brain by eating wisely, taking appropriate vitamins, minerals, and smart medications, exercising your body and mind, balancing your hormones, and controlling your response to stress in your life.  Certain pharmaceuticals (sedatives, painkillers, and anti-depressants like Valium, Darvon, Percodan, and Elavil), alcohol, cigarette smoking, environmental toxins, and allergic substances can harm the brain and should be avoided. Keep your brain busy and active to improve memory, awareness, alertness, and concentration.

Hormone replacement is important in preventing Alzheimer’s disease.

Hormones That Prevent and Improve Alzheimer’s Disease

Growth Hormone improves memory, mood, anxiety, tension, vigor, and cognitive performance. Growth hormone improves memory in Alzheimer’s disease.

It increases glucose utilization, neurogenesis, and blood vessels in brain. It decreases beta-amyloid neurotoxicity, especially in hippocampus.

The first improvement is in 2-4 months. The last improvement is in the next 3 years.

Melatonin deficiency can cause memory loss. Deficiency in melatonin produces reduced anti-oxidant activity in the brain. It protects the brain against toxic free radical damage.

Pregnenolone is a neurosteroid synthesized in the brain, neurons, and peripheral nerves by the neurons. Deficiency causes decreased memory and attention. Alzheimer’s patients have low pregnenolone.

Pregnenolone increases memory, increases spatial memory, decreases alcohol amnesia, and benzodiazepam (Valium, Versed, triazolam) amnesia.

It increases acetylcholine in the hippocampus, and decreases beta amyloid and glutamate neurotoxicity.

Thyroid Hormone – decreased thyroid hormone causes increased memory loss. Deficiency can also slow down mood reaction, fatigue, depression, excessive nervousness, decreased IQ, decreased attention, decreased space orientation, slow thinking, short and long memory loss, and decreased cognitive function. Alzheimer’s patients have low thyroid hormone.

Characteristics of thyroid memory loss are worse in the morning or inactivity, better in the evening, and slow to find word.

Mechanisms of memory enhancement with thyroid hormone are increased brain blood flow, increased brain excitability, increased dendrites and synapses.

With treatment, first improvement is in 2-4 months, and last improvement is in the next 8-12 months.

DHEA  - decreased serum DHEA causes increased memory loss. Alzheimer’s disease patients have decreased DHEA. DHEA therapy increases memory. It improves mood in depression and may protect against Alzheimer’s disease.

Mechanism of protection is that it enhances the survival and differentiation of neurons and glial cells by increasing the expression of protein.

It takes 4-6 months to get the first memory improvement. The last improvement is in the next 8 months.

Cortisol – decreased or increased cortisol can cause memory loss.

There is more memory loss during stress, especially at the end of the day. Memory is paralyzed or confused in stress situations, especially short term memory when you feel overwhelmed by what is happening and may have dramatized reactions. Improvement may occur in 24 hours with cortisone supplementation. The last improvement is in 2-3 months.

Chronic stress and increased cortisol can rob the brain cells and neurotransmitters of glucose causing brain cell death. Too much cortisol can damage your neuro-endocrine system which is the connection between your mind and body.

Estrogen – Decreased estrogen causes increased memory loss, disturbances of mood (depression, fatigue, poor libido), poor concentration.

Estrogen deficiency decreases the blood supply to the brain and reduces EEG electrical activity. Estrogen replacement reduces the incidence of Alzheimer’s disease. Estrogen increases memory in women, increases visual memory in men.

Characteristics of memory loss is short and long term memory poor throughout the day, permanent memory loss,  and talks less.

Estrogen increases brain blood flow, increases neuron connections, decreases  beta-amyloid production and neurotoxicity, decreases brain ischemia.

After treatment first improvement is in 2-4 months, last improvement occurs in the next 8-12 months.

Testosterone – memory loss is a frequent complaint of decreased testosterone. Alzheimer patients have decreased testosterone.  People with higher free testosterone have a lower incidence of Alzheimer’s. Testosterone improves memory in normal and Alzheimer patients. Testosterone improves learning, memory, spatial memory, mathematical performance.

Mechanism – increases neuron connections, increases the size and numbers of dendrites, increases the numbers of connections between neurons. Decreased testosterone causes decreased estrogen which produces cognitive complaints. Testosterone increases brain blood perfusion, decreases beta-amyloid secretion, and decreases beta-amyloid toxicity.

Memory loss from testosterone deficiency is worse in the second half of the day and after physical activity.  Memory is better in the morning. Hesitation with words is a characteristic of testosterone loss.

First improvement with treatment is 2-4 months. Last improvement is in the next 8-12 months.

If you are having memory problems or fear Alzheimer’s disease, it is crucial to have your hormones checked, and replaced if deficient.  

When you search Google for “bioidentical hormones”, what’s the first site to come up? It’s Women to Women. I find this astounding because Women to Women has nothing to do with bioidentical hormones.

“Women to Women” is a vitamin sales website that proclaims it’s devoted to women’s health. They say they use phytotherapy to achieve natural hormone balance. So what is phytotherapy? It’s vitamins and herbs. On Women to Women, they are basically saying you can rebalance your hormones with vitamins.

Hormones decline in women because our ovaries shut down with age. There is no vitamin in the universe that will bring back ovarian function or hormones once in the process of menopause.   Some vitamins may improve your symptoms and improve health, but no vitamin can replace the beneficial functions of estradiol, progesterone, or testosterone. As far as balancing your hormones, eventually they will all be balanced by being gone, and no vitamin will prevent that!

Don’t get me wrong. I am a devoted believer in using vitamins to help treat many problems including adrenal fatigue, adrenal stress, thyroid problems, hypertension, high cholesterol, osteoporosis and a number of other disorders. Vitamins and herbs can overall improve our general health.  But without hormones to direct your cells functioning, vitamins are limited in what they can do.  The fact is that you need both hormones and vitamins, and the way you get hormones just like with vitamins, is with replacement! Hormones can totally relieve your symptoms and keep you healthy. Vitamins, even with diet and exercise, cannot do this.

Women to Women has an extensive library of many legitimate disorders and there is a lot of good information there. However, most every conclusion is that there is no good hormonal treatment and the best treatment is to use their vitamins. Admittedly, those writing the articles are very skillful in coming round to this conclusion, but be aware that  the people writing the articles are nurses without any specialized hormone training, not doctors with bioidentical hormone training.

The fact is Women to Women is basically a site dedicated to making money by selling vitamins to women who are suffering from menopause. Granted vitamins may mildly and usually temporarily improve some symptoms of menopause like hot flashes, but they falsely claim that women can “rebalance women’s hormones without the use of drugs”.  O.K. I agree with balancing your hormone without the use of drugs; that is, without the use of pharmaceutical drugs like the synthetic hormones Premarin and Provera (HRT), but bioidentical hormones (BHRT) are not drugs. They are natural hormones with the exact same molecular structure as in the human body.

Women to Women goes on to say “We have found that about 85% can find relief through an approach that combines medical-grade nutritional supplements, gentle endocrine support, and dietary and lifestyle changes.” Relief of what and for how long? This is a fundamental misunderstanding or misrepresentation of menopause and hormone imbalance.

Menopause is a hormone deficiency of estrogen and progesterone caused by ovarian failure and cessation of ovulation that is genetically dictated by our life cycle. How can you balance hormones that are not there? Vitamins will not put back your hormones or keep you ovulating until you are 90. The symptoms, aging, and decline of menopause are due to losing your hormones. As you become deficient, the only remedy is to replace your hormones.

Estrogen is the woman’s hormone for health. It has 400 functions in the human female body. It is responsible for heart health, eye health, brain health, and bone health. When estrogen is started early (at least in your 50’s) the medical literature has shown it can help prevent heart disease, osteoporosis, cataracts, macular degeneration (blindness), Alzheimer’s disease, depression, colon cancer, wasting of our genital tissues, urinary leakage, cholesterol problems, loss of sexual desire, loss of skin beauty, loss of memory and other things. (Estrogen-Natural Bioidentical Hormone Replacement) The current medical literature has shown that bioidentical hormones are safe. They do not cause breast cancer. To prevent disease, bioidentical hormones need to be used on a long terms basis. At least 10 years use is needed to prevent Alzheimer’s. Current bioidentical experts recommend lifelong use to stay healthy and vital.

Women to Women has said bioidentical hormones are not the fountain of youth. Well that may be. None of us will get younger with hormones (except maybe with growth hormone), but we don’t have to experience the disorders of aging either that are more likely to occur without our sex hormones. Progesterone has its very own functions (Progesterone Deficiency) and is necessary to balance estrogen.

Women to Women staff  comes from a sect of alternative medicine that believes in aging naturally by allowing your hormones to decline and only alleviating, if necessary,  the symptoms (hot flashes, night sweats, etc.) of this slow and painful decline. But what about the diseases that occur due to hormone loss like Alzheimer’s, osteoporosis, and colon cancer? Why not try to prevent these diseases by replacing our hormones?

Women to Women recommends using vitamins first to treat the symptoms of menopause (remember vitamins don’t put hormone back). Why? Well maybe because they sell vitamins…that’s their business. They do not recommend bioidentical hormones. Why? Well, because they can’t sell a pharmacy product online with the click of a button and a charge of the card, and that would put their vitamin business out of business. Their articles minimize Suzanne Somers’s writings and claim that she is in the minority of women needing replacement. Why? Maybe because she writes about bioidentical hormones as the basis of health, and again, they can’t sell hormones online.

Let the buyer beware. The formula used by Women to Women is not anything special and can be easily duplicated at a lower cost. Their lifestyle coaching might prove beneficial if personal support is your goal

What’s my problem with all this? The vitamins won’t hurt, right? Wrong. It shakes confidence in real medical treatment, deters seeking treatment, and is a financial drain. I have had several patients that have come to me after trying Women to Women’s program which did not work. They spent a large amount of money with Women to Women without relief (of course you have to do the 3 month program). This financial loss discouraged and inhibited them from seeking medical advice from doctors trained in hormone replacement therapy. For about the same price of their premium plan you can get bioidentical hormones for replacement from a pharmacy.

So how does Women to Women get to the top of Google search for bioidentical hormones? They spend huge amounts of money on advertising with Google Adwords for one thing. In addition they have a large amount of content on their website which pushes them up in the page rankings.

There is a way to actually balance and replace your hormones that really works and has immediate and long term benefits – and that is natural bioidentical hormone replacement!

Botox is the most widely used facial injectable. A lifetime of facial expressions

of collagen in the crease and elimination of the lines.

Another great use of Botox is to relax hyper-contracted muscle that give the face and neck an aged look. Marionette lines and creases at the corners of the mouth can give it a down-turned, angry look with creases at the corners reminiscent of a marionette’s mouth. Well placed injections of Botox releases the muscles pulling down on the corners of the mouth, reversing the down-turned mouth look, and giving a more youthful appearance. Remember, in youth, features are generally pointing up not down. Facial filler may also be necessary to correct marionette lines.

Neck cords appear as sinew-like, vertical tissue in the neck. They are usually most prominent with smiling, facial expression, and neck movement. They appear as cords of tissue from the base of the jaw down the neck. These are neck muscles in a hyper-contracted state. Botox can erase this unsightly, aged look without weakness or change in function, producing a smooth, youthful neck.

“Jelly rolls” under the eyes are caused by increased muscle mass in the lower lid. This can be relaxed with Boot creating a smoother look.

Dimpled chins with an orange peel look can easily be relaxed and smoothed with Botox as well.

Custom effects, such as a mini –brow lift can be achieved with Botox, and can achieve a more feminine arched brow. Well-placed Botox around the mouth can enhance lip fullness. It can also be used in a dilute form to firm the skin.

Facial imperfections and asymmetries such as “gummy” smiles that show too much teeth and gums can be corrected with Botox.  In addition, it can be used to correct asymmetrical smiles, eyebrows, jaws, and facial movements.

 Botox is also used to treat excessive underarm or hand sweating by injecting it into the troublesome area.

The approved indication for Botox is for frown lines. Other uses are advanced applications and should be administered by health care professionals well-trained in the use of Botox.

Botox lasts from 3-6 months, and needs to be repeated to maintain the desired effect, but the results are well worth it.

Glabella

Forehead Lines

Crow's Feet

Neck

Lip Enhancement

Eyebrow Lift - Before

Eyebrow Lift - AfterBotox Skin Firming

Heather Locklear was arrested yesterday for driving under the influence of a controlled substance, presumably the pharmaceutical medication she is taking for anxiety and depression.

In July, she spent a month in a spa-like treatment facility in Arizona for anxiety and depression. Articles implied she was already on medication and needed it adjusted. Certainly her recent public divorce is a reason for situational depression.

With all due respect, I have one question. Has Heather had her hormones checked?  Now this might bring a collective groan, but think about it. Locklear is almost 47, well into the perimenopause and hormone loss. She looks young and beautiful, but our bodies have a relentless “biological clock” that cannot be ignored. We know that testosterone and progesterone are the first hormones to decline. Testosterone is linked to maintaining emotional shield and may prevent panic attacks. Progesterone deficiency causes irritability, mood swings, depression, and insomnia. Progesterone has a calming effect on the body by stimulating the calming GABA receptors in the brain. Add a little loss of estrogen which stimulates calming serotonin production (the same as those antidepressants are supposed to be doing), and emotional lability, weepiness, and depression can follow.

The FDA has warned that anti-depressants may increase depression and suicidality.

Medications like hormonal birth control or Prempro only make matters worse because progestins in these medications inhibit the production of the body’s progesterone and occupy progesterone receptors. I have had several patients lately on hormonal birth control come in with depression. They are on things like Mirena and Nuvaring, both of which secrete potent progestins (not progesterone) in the circulation that occupy progesterone receptors and deplete progesterone thereby preventing the calming effect of progesterone and natural hormonal balance. This effect may be more pronounced as we get older, since we are also losing our progesterone by our ovaries beginning to shut down. Post-partum depression is associated with a drop in progesterone after childbirth. Giving progesterone post-partum can prevent this depression.

Stress makes matters worse. When we have stress our adrenal glands increase our production of cortisol which is our hormone that controls our daily sleep-wake cycle and our fight or flight response. The body will use all its resources to make cortisol, a hormone we cannot live without.  The body uses progesterone to help make cortisol, so stress situations may make progesterone levels lower. This may be the connection between stress and infertility. Chronic stress gives way to fatigue as the body struggles to keep up with the stress demand. Both adrenal stress and fatigue can further intensify depression through fluctuations in cortisol and progesterone. Relaxation may allow temporary improvement, but the perimenopausal body still continues its relentless progesterone and estrogen decline.

Suzanne Somers’s has called anti-depressants, sleeping pills, and pain medicine, the “menopause cocktail”. As a former member of that club, I can attest to the truth of it. Initially, being uninformed and thinking I was still “young”, I did not put it together. It was only through proactive seeking that I found what was missing and that was my hormones. I recommend a good reading of Suzanne Somers’s “Breakthrough”. With bioidentical hormone replacement we can treat the underlying cause of our mid-life perimenopausal emotional changes and be ourselves again.

I have treated women who were able to throw their antidepressants and sleeping pills away and say “bye-bye” to their therapists once their hormone were replaced and balanced with bioidentical hormones.

Heather, check it out. Your body is changing and yes, you are getting older and losing your hormones. It happens to all of us. Replace and balance your hormones with bioidenticals and you might be able to get off all that pharmaceutical, controlled substance stuff, save yourself the embarrassment of negative publicity and mug shots, and be your lovely self again. What have you got to lose?

There is no doubt that there is improvement in the symptoms of menopause by using hormone replacement therapy. It includes elimination of symptoms such as hot flashes and night sweats, reversal of bone loss leading to osteoporosis, improved sleep, emotional stability, libido and quality of life.But extreme confusion revolves about the safety of taking hormones.

Some doctors are telling patients to get off all hormones. Some are prescribing Premarin and Provera, while others are prescribing “bio-identical hormones”.  Still others are switching back and forth between the two.

Hormone replacement therapy or HRT is a broad category. Some people use this term to refer to all hormone replacement therapy. When you hear this term in the media, they are generally referring to Premarin and Provera which are not natural to the human body. These drugs are referred to as synthetic hormones because they are synthesized with molecules that do not occur in the human body in nature.

Premarin is a type of estrogen obtained from horse’s urine. Although it is natural to horses, it is a different molecule than occurs in the human body. It is a very potent estrogen that can alleviate many symptoms but has negative effects as well.

Provera is a progestin used to prevent tissue from building up in the uterine lining while taking Premarin. A progestin is NOT progesterone. It is a different molecule. Progestins actually inhibit production of progesterone by the human body and have dangerous effects on the human body.

The new classification of hormone replacement therapy is called bio-identical hormone replacement therapy or BHRT. This therapy includes estrogens and progesterone that are made from soy and wild yams obtaining a compound that has the exact same molecular structure as these substances in the human body… therefore, bio-identical.

The dangers of Synthetic HRT (Premarin and Provera) were discovered in the Women’s Health Initiative Study in 2002.

This study analyzed the outcome of women taking Premarin (conjugated equine estrogen or horse estrogen from pregnant mare’s urine) and Provera (medroxyprogesterone acetate or synthetic progesterone) and found increased rates of breast cancer and cardiovascular disease.  Since the drugs used were not bio-identical hormones the results only apply to Premarin and Provera, not BHRT. 

Premarin is taken orally. Any oral estrogen can be a problem for heart health. It can activate coagulation and inflammation. Descenci in Circulation in 2005, found that transdermal estrogen does not have this effect.

The main breast cancer problem is the synthetic Provera (medroxyprogesterone).  When the Women’s Health Initiative patients who received only Premarin without Provera were analyzed the rate of breast cancer was not increased.  (Anderson, JAMA, 2004). This indicated that it was the Provera  that caused an increased incidence of breast cancer.

BHRT (bio-identical hormone therapy) does not increase the chance of breast cancer.  The main danger of synthetic HRT is the non-bio-identical progestin (Provera).

In the Fournier et al. study in the International Journal of Cancer, 2005 studied 54,000 women who were taking bio-identical estrogen and either bio-identical progesterone or synthetic progestin.  The women taking the bio-identical progesterone had a 10% decrease in risk of breast cancer and the women taking artificial progestin had a 40% increase in the risk of breast cancer.

The De Lignieres study from Climacteric 2002 could not show an increased risk of breast cancer with use of bio-identical hormones but showed an increased risk with the use of synthetic progestin (Provera/medroxyprogesterone). In fact, they could not justify stopping BHRT(bio-identical), which is beneficial for quality of life, prevention of bone loss and cardiovascular risk profile without activating coagulation and inflammatory protein synthesis as in users of oral estrogens.

The real problem with synthetic HRT is the synthetic progestin(Provera). In contrast, several studies document that higher progesterone levels during pre-menopausal years or during pregnancy are protective against breast cancer.  (Campanoli, Journal of Steroid Biochemistry and Molecular Biology, 2005).

In any case, estrogen should not be taken without progesterone which counters the proliferative tissue effect of estrogen on breast and uterine lining.

Bio-identical hormone therapy, which is different from Premarin and Provera, is safe, effective, and proven beyond any reasonable medical and scientific doubt.

          Radiesse is a safe, next generation cosmetic filler that sets a new standard for the correction of facial wrinkles, folds, depressions, and facial contouring. Clinical studies show that Radiesse lasts longer than former leading fillers like Restylane. Radiesse can last a year or more, which means less trips to the doctor.

            Radiesse is the first dermal filler with concurrent FDA approvals for both nasolabial folds and fat loss in the face. It can also be used by a trained physician to augment cheeks and chin, fill unwanted facial depressions, correct jowls and jaw lines, perform nasal contouring, rejuvenate hands, and reconstruct nipples.

            Radiesse is composed of calcium hydroxylappetite microspheres in a gel carrier. Calcium hydroxylappetite is natural to the human body, and is present in our bones in more concentrated amounts.  The gel and microspheres provide an immediate result, then stimulate the patient’s tissue to form new collagen in-growth. Radiesse breaks down into calcium and phosphate ions which are resorbed into the body through natural metabolic processes.

            In recent studies, at 9 months 79% of patients with Radiesse still had improvement verses 43% of patients with Restylane. Patients with Radiesse also had greater improvement at every time point.

            Radiesse can be used to volumize the face. As we age, we lose or drop the fat pads in the face causing cheeks to flatten and skin to sag.  Radiesse can fill features to give the face a fuller look and a resultant lifted look to the skin and features.

            A unique use of Radiesse is hand sculpting and rejuvenation. Aging hands may become bony looking with pronounced veins. Radiesse can be injected into the back of the hands to provide a smooth, fleshy look that makes bones and veins less prominent.

            The nose can be re-contoured without surgery. Radiesse can be added to the tip to give the nose a lifted or a turned up look. It can fill irregularities to give the nose a straighter appearance. Radiesse can also augment or lift the chin.

            Injection of Radiesse has minimal discomfort. New techniques using dilution with lidocaine make this injection the most comfortable of the fillers.  

            Radiesse has fewer nodules and zero granulomas compared to other fillers. It is not permanent so you get lasting results without the risk of permanent implants. Radiesse is not currently recommended for use in the lips.

 

Sly Stallone, in his last Rambo film, was as physical and dynamic as ever. In contrast, the last Indiana Jones movie disappointed me with the shuffling, slurring, grumpy old man that used to be Indy. My 17 year old dubbed Ford an old man, but pegged Stallone as in his 40’s.  Playing action figures, both men are in their 60’s. What’s the difference? Growth hormone and testosterone.

When Rambo came out in January 2008, Stallone publicly admitted to using growth hormone and testosterone. “HGH (human growth hormone) is nothing,” the 61-year-old actor told Time magazine in its Feb. 4 issue. “Anyone who calls it a steroid is grossly misinformed. Testosterone to me is so important for a sense of well-being when you get older,” he says. “Everyone over 40 years old would be wise to investigate it because it increases the quality of your life. Mark my words. In 10 years it will be over the counter.”

Thank goodness a prominent male celebrity has the guts to talk about hormone health for men!

Sly is right! Growth hormone is not a steroid and testosterone and growth hormone are very important to quality of life in men over 40. Both growth hormone and testosterone get a bad rap due to sports figures over-using them to gain unfair advantage. We are not talking about abuse with synthetic, liver-toxic poisons sold in the back rooms of gyms. We are talking about molecularly bioidentical growth hormone and testosterone native to the human body given in healthy physiologic amounts.

With age, men steadily lose both these hormones starting at about age 30. By the time a man is 60, he may have only ¼ the testosterone and growth hormone of a 25 year old man. This is nature’s way of shutting us down, except we stay alive due to our living conditions and disease-oriented medicine. You may have normal hormone levels for a 60 year old, but this is not optimal for health. The healthiest adults are in their 20’s, who have optimal levels of testosterone and growth hormone.

Human growth hormone is biosynthetic and has the exact same molecular structure as in the human body. It is responsible for growth, healing, immune function, increased muscle mass, minimizing body fat, controlling cholesterol, maintaining sexual energy, and increasing bone strength. It improves heart function and cognitive ability including memory, alertness, motivation, work capacity, speed of information processing and sociability. Growth hormone replacement at physiologic levels does not cause cancer. Growth hormone acts synergistically with testosterone in that their beneficial effects together are greater than either one alone. Growth hormone is approved for use in Adult Growth Hormone Deficiency, which is a common occurrence in adults over 40 years old.

Decreased testosterone in men results in increased aging of the heart and circulation including increased heart attacks and strokes. There is increased brain aging with decreased memory, decreased intelligence, increased dementia, and increased Alzheimer’s. Men lose their drive and competitive edge.  They get stiffness and pain in muscles and joints, decreased effectiveness in workouts, and a falling level of fitness. In addition they get more fat and less muscle, osteoporosis (yes, like women), and anemia. Fatigue, depression, mood changes and irritability (grumpy old man syndrome) are common. And of course, there is reduced libido and potency. Testosterone does not cause prostate cancer.

These declines in men happen more gradually than menopause and often become accepted as “just getting old”.  Sadly, some men perceive hormone loss as a matter of ego instead of health. Remember, we may get old, but do not need to feel old!

 Testosterone is an anabolic steroid produced by both men and women. Anabolic simply means it helps to build you up. Although women have testosterone levels that are only one-tenth to one twelfth the levels of men, it is an important hormone for women.

Testosterone is usually the first hormone to decrease in women in the pre-menopause and may start to decline in your thirties even before progesterone and estrogen decline.

Testosterone has many beneficial effects in women. Its most well-known effect is restoring libido and improving the ability to orgasm. It can increase the size and sensitivity of the clitoris.

Other important benefits are improving mood, reducing depression, and increasing energy. It may help to reduce panic attacks.

Testosterone increases physical strength by building muscle and improving muscle tone. This is an important effect since many women lose upper body strength with age. It also reduces fat and cellulite and increases fat-free mass.

It can reduce aches, pains, and fibromyalgia. It also helps fight fatigue.

Testosterone increases the bone mineral density of the hip and spine preserving bone mass. It improves osteoporosis.

Testosterone is a controlled prescription medication and must be administered as a cream or gel through the skin because oral testosterone can be toxic to the liver. Testosterone should not be taken by women in the absence of adequate estrogen levels because it may increase heart disease.

Testosterone applied to the clitoris can improve sexual sensitivity. Estriol and testosterone applied to the vaginal area can improve tissue quality and treat urinary leakage. Taking hormones transdermally can help urinary leakage as well.

As with all other bio-identical hormone treatments, the effects of testosterone must be monitored by a physician. Signs of too much testosterone are oily skin, acne, over-developed muscles, excess body odor, greasy hair, exaggerated aggression, and disruptive sexual desire.

When I first started testosterone, I got two speeding tickets in one month. At that point I stopped using it for a few weeks and started again at a lower dose. I have found testosterone to be helpful in overcoming panic attacks and fears (Is this why men are brave?) and helps increase emotional shield.

Testosterone has a place in all balance hormone replacement programs.

    

You need to think about starting natural estrogen bioidentical hormone replacement therapy when approaching menopause in your late 40’s and early 50’s. Why? Well, for relief of symptoms like hot flashes, night sweats, vaginal dryness, and low libido among others, nothing works better than estrogen.  Long term benefits of estrogen bioidentical replacement therapy include prevention of memory loss, maintenance of heart health, prevention of heart disease, bone production (prevention of osteoporosis), prevention of Alzheimer’s disease, prevention of cataracts and macular degeneration, maintenance of mood and prevention of depression, and quality and youthfulness of your genital tissues and skin. Vitamins and herbs cannot do all these things (although they may temporarily improve some symptoms like hot flashes). Quite simply, estrogen keeps women’s cells healthy. Only estrogen in women can prevent disease and improve quality of life…and only bioidentical transdermal estrogen!

There has been a lot of buzz about women’s hormones, but you hear very little about men. To make it worse, men do not seek or share this information as women do. How many men do you know who go out for coffee with their buddies and talk about their hormones? Few people appreciate the pervasive effects of testosterone on men’s general health.  

The fact is that as men age, they lose their testosterone. The loss of youthful levels of testosterone with the onset of its associated symptoms is sometimes called andropause. It is the natural diminution (or pause) in production of male hormone (an androgen) as men age.

Testosterone loss in men is a gradual process. Testosterone decline starts around age 30, and may drop 1% to 3 % per year depending on genetics and lifestyle. That means that men can sustain a 20% drop in testosterone by age 50, and a 50% drop by age 80. Each man may experience the symptoms of a decline in testosterone differently depending on what his normal was at his hormonal peak.  Often the symptoms are ignored or rationalized away until the resultant decreased functioning becomes a way of life.

The most obvious and disturbing changes for men are those of sexual function, but equally troubling symptoms of low testosterone may manifest as a decline in mental functions, musculoskeletal conditions, and metabolic or physical diseases.

Changes in mental functioning may manifest as spells of mental fatigue and inability to concentrate, feeling burned out, low energy, tiredness or sleepiness in the afternoon or evening, decrease in mental sharpness, attention, and wit, or a change in creativity like getting spontaneous new ideas. There may be a decrease in desire to start new projects, or a decreased interest in past hobbies or new work-related activities.  Competitiveness may diminish and irritability increase. Memory functions may become impaired with increased forgetfulness. Men can experience a sense of depression with a sense that work, marriage, or recreational activities have lost their significance.

Musculoskeletal symptoms may appear as sore-body syndrome with aches and joint and muscle pains. A decline in flexibility and mobility may be noticed with increased stiffness. Muscle size, tone, and strength may decrease. Physical stamina and athletic performance may decline. Some men experience back pain, neck pain, or a tendency to pull muscles or get leg cramps. Some develop osteoporosis or inflammatory arthritis.

Low testosterone levels correlate with more risk factors of heart disease than any other individual factor in the male body. Cardiovascular risk factors increase in men as testosterone decreases.  Cholesterol and triglyceride levels increase, coronary and major arteries constrict leading to a greater risk of cardiac events, and blood pressure rises. Insulin resistance increases with obesity, adult diabetes, and increased cortisol levels. There is increased central abdominal fat with increased waist to hip ratio. Estrogen levels associated with higher stroke and heart attack rates (and increased fat in the breast and hip area) increase. Another increase associated with decreased testosterone is in lipoprotein A and fibrinogen, which correlate with cardiac events. Also, human growth hormone output decreases leading to a decline in energy, strength, stamina, and heart muscle mass and output. Low testosterone levels are associated with increased incidence of death even after researchers adjust for age, medical problems, and variables.

Although not all signs and symptoms of aging are due to hormonal decline, many correlate well with a decline in hormones and can be alleviated by hormone adjustment.

Treatment of low testosterone should be administered by a doctor trained in hormone therapy after a full history, examination, and laboratory testing. Regular follow-up is important to control symptoms, prevent side effects, and to make sure hormone levels are optimal.

Dr. Candice Lane is a physician specializing in hormone replacement therapy. She is a diplomate and fellow of the American Academy for Anti-aging and Regenerative Medicine. Her practice is at 1250 La Venta Drive, Ste. 206, Westlake Village, Ca 91361.      805-496-7869     .