Hormonal Health

  • 5 Jul 2009
  • Reading time 7 mins
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Dame Shirley Bond, one of London's top doctors specialising in hormonal health, discusses how to deal with hormonal issues around the time of menopause.

Hormones in Havoc

The main cause of menopausal symptoms is a decline in the production of both oestrogen and progesterone. One of the biggest medical mistakes in the past century was to give women oestrogen on its own, and in dosages that were much too high. Oestrogen-only HRT has since been found to increase the risk of breast and endometrial cancers. That’s why current conventional HRT drugs generally include progestins, which are synthetic progesterone-like hormones. However, it’s now well-established that these too can increase breast cancer risk. Progestins, by the way, are completely different from the natural progesterone produced by your body. And while synthetic progestins can increase breast cancer risk, natural progesterone tends to decrease it.

Natural Solutions for Menopause
So what’s the natural solution to menopausal problems if conventional HRT is out of the picture? First, there’s no doubt that a decline in both oestrogen and progesterone is linked with hot flushes and sweats. Dr Bond likes to start by running a salivary hormone test. This is very good for identifying whether or not a person is deficient in either oestrogen or progesterone, as well as if there’s oestrogen dominance (a relative excess of oestrogen to progesterone). In most cases, there’s both a deficiency in oestrogen and oestrogen dominance (meaning very low progesterone). Since the body can make oestrogen from progesterone if it needs to, the first option is to use a transdermal progesterone cream.

I asked Dr Bond what she recommends. “I start with a 3% progesterone cream, giving a dollop (the equivalent of 20 to 40mg) per day in the second half of the menstrual cycle,” she says. “If there’s no menstrual cycle, then I recommend three weeks on progesterone and one week off. Hormone expert Dr John Lee used to say that progesterone was good for sweats and hot flushes. I don’t find that it always works. Some women do better with a combination of progesterone and isoflavones – a red clover supplement, for example.” “If that doesn’t do the trick, then I give Uterogestan, which is a progesterone pill, combined with Hormonin. Hormonin is a combination of estradiol, estrone and estriol, which are the three types of oestrogen that a woman’......

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