Hormone Replacement



One of the largest concerns women encounter is hormone imbalance. Hormone imbalances often start as soon as menses begins. PMS is a variety of psychological, behavioral and physical symptoms which occur in the luteal phase of the menstrual cycle.

PMS – Categories of PMS Symptoms

  • PMS-C (Cravings): increased appetite, headaches, fatigue, dizziness
  • PMS-A (Anxiety): nervousness, tension,irritability, mood changes, anxiety
  • PMS-D (Depression): forgetfulness, crying, confusion, insomnia
  • PMS-H (Hyperhydration): fluid retention, weight gain, breast tenderness, bloating
  • PMS-P (Pain): aching pains, reduced pain threshold

Fortunately, there is good news. With the correct interpretation of the symptoms, a balance in hormone levels can be achieved by completely natural methods. Most of the time these symptoms can be reduced or eliminated with the use of a few herbs, and often in combination with other natural methods of healing such as acupuncture. They are completely safe, inexpensive, and very easy to use. The use of Black Cohosh, soy, and many other supplements has gained popularity these days and for good reason; they work. “The problem is knowing who needs what, how much, and in what combination” This is where someone who specializes in natural hormone replacement becomes invaluable.

Hormone Imbalance and PMS

PMS differs from all other disorders because the diagnosis does not depend on the type of symptoms you suffer from, but on the time when your symptoms appear and disappear. Dr. Katharina Dalton of the U.K. a leading specialist who first used the term “premenstrual syndrome” defines it as the presence of recurrent symptoms before menstruation with the complete absence of symptoms after menstruation. Doctors have identified at least 150 symptoms that occur in PMS but fortunately, because everyone is different, no one has all of them. Among the most common are bloating, headache, backaches, severe grouchiness, depression, breast tenderness, loss of libido and fatigue. These are also the symptoms of estrogen dominance.

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Dr. Dalton knew this back in the later 50s when she pioneered the use of natural progesterone to balance estrogen in PMS patients, with great success. Over the years she and physicians like Dr. John Lee in this country have treated thousands of women in this way. The great majority of patients report a remarkable improvement in their PMS symptoms including the elimination of premenstrual water retention and weight gain. Dr. Joel T. Hargrove of Vanderbilt University Medical Center published results indicating a 90 percent success rate treating PMS with oral doses of natural progesterone. We know too, that typical progesterone creams are equally effective. This has to do with progesterone’s potent balancing effect upon estrogen. Saliva testing can determine if your PMS is associated with estrogen dominance. Your saliva levels of estradiol and progesterone are measured during days 19-21 of your cycle. A low progesterone/estradiol ratio on your test report indicates estrogen dominance and the likelihood of PMS symptoms. If this is the case, I will talk with you about supplementing with natural progesterone to keep estrogen levels in check.


As women age, there comes a time when their bodies lose their ability to conceive children. This is a gradual process where the hormone levels in your body once again must find a delicate balance. For some women, this process is almost silent. For others, there are years filled with uncomfortable symptoms. Hot flashes, night sweats, heart palpitations, insomnia, forgetfulness, vaginal dryness, loss of libido and fatigue are a few of the major symptoms women experience.

Facts About Menopause and Hormone Balance Issues
Menopause and Hormonal Imbalance

In the years leading up to menopause (perimenopause) menstrual cycles that may once have been like clockwork start to become erratic. Bleeding may be heavier or lighter than usual — although menopause is not official until 12 consecutive months without a period are experienced. Erratic cycles are a sign of erratic ovulation leading to highs and lows in estrogen and progesterone, an effect many women describe as an emotional roller coaster.

And don’t let anyone tell you it’s all in your head. When the ovaries begin to sputter, hormone production sputters and so does the female body. Forgetfulness and foggy thinking, mental confusion, and mood swings are hallmark symptoms for many women. As are hot flashes and night sweats, tearfulness, unwanted weight gain, thyroid problems and declining interest in sex, no matter how much a woman loves her partner. Of course, not all women experience all these symptoms — each woman has her own individual biochemistry. But it is common to experience some degree of discomfort during the menopausal years. The degree to which one experiences discomfort is likely to be associated with the degree to which the hormones are out of balance.

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If you are a woman experiencing menopausal symptoms, we will test at least two hormones: estradiol and progesterone. If you want a more comprehensive picture, we recommend a five-panel test which measures: estradiol, progesterone, testosterone, DHEAs and morning cortisol.

The Anatomy of a Hot Flash

Is it hot in here or is it just me? This is a common refrain among the estimated 50 to 75% of women in the U.S. who experience hot flashes during menopause. Hot flashes can be very mild, or bad enough to have you opening every window in the house, even in the dead of winter. Also known as “vasomotor flushing,” the hot flash occurs when the blood vessels in the skin of the head and neck open more widely than usual, allowing more blood to shift into the area, creating the heat and redness. Perspiration is also common to the phenomena and in some women, the hot flash takes the form of a night sweat, followed by a chill. Besides hormonal changes, anxiety and tension magnify hot flashes and many women find that hot drinks and wine do the same.

Saliva testing identifies the degree to which the specific hormones linked to hot flashes are out-of-whack. Using test results as a guideline, natural hormone supplements can be prescribed to restore balance and cool the hot flashes. Many women also use Phyto (plant) estrogens, such as Dong Quai and Black Cohosh; optimal nutrition and relaxation exercises for added relief. In most cases, hot flashes usually go away a year or two after actual menopause and the cessation of menses.

Could you be in menopause?
“Tired but Wired” – Fatigue, Stress and Hormone Imbalance

Many people experience high levels of mental and emotional stress on a regular basis, which puts a significant strain on adrenal function. When stress is not well-managed the ability of the adrenal glands to do their job becomes compromised. The adrenals normally secrete cortisol in response to stress, with exercise and excitement, and in reaction to low blood sugar. The body normally secretes the highest amount of cortisol in the morning to get us going, with levels decreasing throughout the day. People with adrenal imbalance will often have normal cortisol levels in the morning with below normal levels at other times during the day. If stress remains too high for a prolonged period, the adrenals can’t keep up with demand and total cortisol output plummets leading to adrenal exhaustion.

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The hallmark symptoms of adrenal imbalance are stress and fatigue that is not alleviated with sleep – that tired all the timefeeling. Other common symptoms include sleep disturbances, anxiety, depression, increased susceptibility to infections, reduced tolerance for stress, craving for sweets, allergies, chemical sensitivities and a tendency to feel cold.

Saliva testing charts the extent to which cortisol levels are out of balance and can be used as part of a strategy that looks at the whole person and his or her lifestyle. It is helpful to work with a doctor who can design a complete program of hormone balance and then monitor your progress.

You can begin to support adrenal function on your own by avoiding hydrogenated fats, excess caffeine, refined carbohydrates, alcohol, and sugar. Get plenty of quality protein and eat regular meals of high nutritional value. Key to success is to discover and practice stress management in whatever form works for you personally. Take time out, evaluate the stressors in your life, and find ways of expressing yourself creatively. Get enough rest and sleep. And last but not least, keep a sense of humor!

All About Natural (Bio-identical) Hormones

Natural or “bio-identical” hormones (BHRT) are synthesized from natural plant substances to be identical in structure and function to those our bodies produced naturally before menopause. When hormone production starts to drop below normal levels in the years leading up to menopause, natural hormones are the best and safest way for women to supplement. They are available by prescription and tailor-made to meet your individual needs by a compounding pharmacist.

Please Note:Progesterone – not “progestin” – is the natural bio-identical form of the hormone as opposed to progestin, the synthetic version (the “pro” in Prempro). Natural, progesterone is just like the progesterone your ovaries make and it is available in a topical form over-the-counter and by prescription when compounded with natural estrogens and other hormones by compounding pharmacists.

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When hormone balance is restored and maintained using natural, bio-identical hormones there are far fewer side effects, symptoms, and cancers as that observed with synthetic HRT. Following natural physiology as closely as possible makes sense because in a sense natural hormones have undergone safety trials as long as humans have walked the earth. WHY NATURAL BIOIDENTICAL HORMONES?

  • ~Natural hormones match your own hormones exactly (are bioidentical).
  • ~Natural hormones leave the body more quickly than synthetics, thereby not posing the same health risk.
  • ~Natural hormones don’t have the side effects of standard HRT drugs if used at the proper dosage.
  • ~Natural hormones are natural mood enhancers; progesterone can provide this benefit, while progestin can’t.
  • ~Natural hormones can be individualized and custom tailored to meet individual hormone needs.
  • ~Natural hormones don’t interfere with your own hormone production.
  • ~Natural hormones don’t have the same long-term risks as synthetic and are therefore much safer.
  • ~Natural progesterone doesn’t inhibit the benefits of estrogen on lowering cholesterol, as does a progestin.
  • ~Natural progesterone will not cause you to bleed for the duration of use of HRT, as can progestin.
  • ~Natural progesterone may protect against breast cancer and reduces risks of endometrial cancer.
  • ~Natural hormones can relieve perimenopausal and menopausal symptoms.
  • ~Natural hormones restore hormonal balance to the body.

Still have questions about Natural Hormone Therapy?Please review this article Questions and Answers About Natural Hormone Replacement Therapy with Dr. John Lee

What is Progesterone and Why Do We Need It?

Progesterone can be thought of as a hormonal balancer, particularly when it comes to the estrogens. Progesterone is a steroid hormone made by the corpus luteum of the ovary at ovulation, and in smaller amounts by the adrenal glands. It is the precursor, or substance from which most of the other steroid hormones are derived, including cortisol, androstenedione, the estrogens, and testosterone. Progesterone has a remarkable repertoire of important jobs from normalizing blood sugar levels and facilitating thyroid hormone action to regulating menstrual cycles and maintaining a healthy pregnancy. The survival of the embryo in the womb absolutely depends on this vital hormone. Progesterone also has natural calming and diuretic properties and it enhances the positive effects of estrogen while preventing the problems associated with estrogen dominance.

Unopposed estrogen can build to unsafe tissue levels that can lead to a strong risk for breast cancer and reproductive cancers. While estrogen levels drop only 40-60% at menopause progesterone levels may drop to near zero in some women, resulting in estrogen dominance and the array of symptoms that go with it. Supplementation of natural, bio-identical progesterone has been shown to restore hormonal balance, especially during perimenopause and menopause.

Hormone Balance and Osteoporosis
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Saliva testing can easily test for imbalances in each of the major hormones that have an impact on bone health-particularly, testosterone, DHEA, cortisol, estrogen and progesterone. Bone is a hormonally sensitive tissue that is affected by an age-related decline in production of these hormones. Many studies show that both men and women as they age begin to lose bone as the androgens-testosterone and DHEAs in particular-start to fall off. And when these hormones are low and cortisol is high, bone loss increases at an even more rapid pace. We know that too much stress raises cortisol output, interfering with calcium absorption and bone-building activity, while at the same time stepping up the activity of bone-destroying cells. We also know that cigarette smoking, alcohol intake and a lack of physical activity are associated with bone loss. In a typical case study, a 63-year-old woman who had never taken hormones since her menopause at age 51 had a bone density scan which revealed osteoporosis in her hip and spine. Saliva testing identified an imbalance of androgens as well as low estrogen and progesterone levels. Supplementing with natural hormones brought noticeable improvement, but to gain full relief, a program of stress reduction, optimal nutrition, and weight-bearing exercise was introduced.

Estrogen Dominance and Low Thyroid: Weight Gain and Depression

More than 10 million Americans have been diagnosed with thyroid disease, but interestingly, women are at the greatest risk, developing thyroid problems seven times more often than men. Thyroid hormone regulates metabolic rate so low levels tend to cause unwanted weight gain, depression, low energy and cold intolerance. Excess thyroid causes higher energy levels, a feeling of being too warm all the time and weight loss. But it’s hypothyroidism or a low thyroid that is most common in women during the perimenopausal and postmenopausal years; in fact, some 26%of women in or near menopause are diagnosed with hypothyroidism.

In his book,What Your Doctor May Not Tell You About Menopause, Dr. John Lee discusses how, as he learned more about the condition of estrogen dominance, it became apparent that the taking of thyroid supplements among his women patients was especially common in those with estrogen dominance. This is because when estrogen is not counterbalanced with progesterone, the estrogen buildup blocks thyroid hormone creating hypothyroidism.

Saliva hormone tests show that women who are estrogen dominant often have menopausal symptoms intertwined with low thyroid symptoms. The most common are weight gain or being unable to lose weight and depression. Cold intolerance, thinning hair, sleep disturbance, fatigue, mood swings and low sex drive are also associated with low thyroid. If you are suffering from these symptoms, estrogen dominance may be a factor that can be identified through saliva testing.

Depression and Mood Swings

Many women experience mood swings and depression as their hormones begin to fluctuate erratically in the perimenopausal years and then decline to ever lower levels at menopause. Unfortunately, far too many women are put on anti-depressants when, in fact, natural hormone supplementation to smooth out the roller coaster of waxing and waning hormones during these years may be all they need. All of the sex hormones especially progesterone, estrogens, and androgens have a potent effect upon state of mind, mood, and memory. So when they are out of balance – too high, too low, or up and down-as is not uncommon in mid-life, the effects can range from less than desirable to devastating.

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Estrogen, the hormone that surges to highest levels in the first half of the menstrual cycle, has been shown to increase mood-enhancing beta-endorphins in menopausal women as well as in women who are still cycling. It is also known to boost serotonin and acetylcholine-the neurohormones associated with positive mood and memory. So a lack of estrogen can bring on tearfulness and anxiety. But an excess can also affect our mental state by holding sway over progesterone in the waning reproductive years. That’s because as women age, they ovulate less frequently which produces less progesterone. In this way the inherent calming and mood-stabilizing effects of progesterone are lost. The balancing power upon estrogen is also lost which then builds up, blocks thyroid action leading to low thyroid, and with it, depression.

The androgens, testosterone, and DHEA also play an important role in mental outlook and vitality. So it is not surprising that many women find they are in much better spirits once they are put on natural hormone therapy. Hormone balancing is vital after a hysterectomy, as the removal of the ovaries shuts down all hormone production, forcing a woman into menopause overnight. One of the immediate consequences of the surgery is depression, which can be more safely alleviated by restoring hormone balance than by taking Prozac. Saliva testing to identify hormone imbalances linked to depression can serve as a basis for restoring balance and with it a positive outlook on life.

How much would the quality of your life improve if you were on natural hormone replacement therapy?

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Infertility is becoming an increasingly common problem. There are many reasons for infertility, such as previous surgery, endometriosis, environmental toxicity, blood supply and hormonal issues. There are also many treatments. While In Vitro Fertilization is a treatment method chosen by many, it is very expensive and its success rates are quite low. There are natural ways to increase fertility, which are much less expensive, less invasive and equally or more effective.

Infertility treatments at the Center for Alternative Medicine are very thorough, and specific for the individuals. Too many times, infertile couples undergo treatments that are standardized to all infertile couples. This means, that everyone gets the same treatment. There are many different reasons for infertility. It could be the man or the woman. The uterus may be too thin or shed too easily for an embryo to implant. The reasons are innumerable.

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Treatments at the Center are much different. Dr. Leff gives a head to toe exam, looking at all the possible reasons for infertility. Both the men and the women will be checked for problems. (Often, even if the problem has previously diagnosed). Hormones will be checked via salivary hormone testing. The all-important, yet often overlooked, hormone ratios will be checked and fixed. Problems arising from environmental pollution and toxicity will be addressed, and a nutritional program will be prescribed once the problem has been discovered.

Another reason for infertility is fixed with acupuncture. In a nutshell, the organs of reproduction must receive adequate electrical flow in order to function properly. Acupuncture will redirect the flow of energy to the organs, and other traditional acupuncture points will be added as necessary. Acupuncture is so well known for the use of infertility, it has specific points, such as “The Palace of the Child,” for the female, and “Sperm Palace” for the male. Acupuncture has been used successfully for thousands of years, there are no side effects, and the cost is minimal.

  • ~Fibroids
  • ~Endometriosis
  • ~Bleeding problems (too little, too much)
  • ~Irregular menstrual cycles
  • ~Infertility
  • ~Acne
  • ~Polycystic Ovaries

In the prime of a man’s life, 95% of his testosterone is made by the testicles in response to signals from the brain. By the time he is 50, the signal to make more testosterone weakens, and the aging testes are less likely to respond. As the total hormone supplies decline, the growing shortage strikes at the core of the virility, stamina and drive we associate with the male. There are other complicating factors as well. An enzyme in fat cells changes testosterone into more estrogen. An excess of the stress hormone cortisol inhibits testosterone and DHEA, breaks down bone and muscle, blocks thyroid function, and decreases sex drive.

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The first thing a man usually notices as his hormones taper off is a subtle downward shift in strength and energy. He may lose his enthusiasm for the things he used to enjoy, the challenge of work, competition, and exercise. If fatigue sets in more quickly, and the only desirable bedroom activity is a good night’s sleep, chances are, the man is entering andropause.

As normal aging puts the brakes on androgen action, male hormones start to dwindle by about one to two percent per year. But the speed of decline and whether we age well, or prematurely, has a lot to do with lifestyle. The bottom line is balance. Take steps to restore and maintain it, and the zest for living rebounds.

Work with a doctor to monitor your hormone levels. If you need to supplement, request “bio-identical” natural hormones that are familiar to the body. Reduce testosterone robbers, such as caffeine, alcohol, and sugars. Counteract chronic stress with exercise, and boost testosterone levels with weight-bearing workouts. Eat organic foods, and get more rest.

Men are by no means immune to the downsizing of hormone levels with age. In fact, the most potent force underlying mental and physical energy in men, the testosterone drive, takes a major blow as total hormone output slows down. Deficiency symptoms come on gradually, and unlike the roller coaster ride, midlife women may experience, men don’t always know what hits them. Male menopause is nonetheless real, and it’s called andropause.