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Hormonal Imbalance and the use of Bio-Identical Hormones

By: Dr. Maggie Yu, M.D


Hormonal Health

Hormones effect all states of a woman’s and man’s life. In women, before menopause, the imbalance of hormones can cause heavy, irregular and painful periods, low libido, depression, anxiety and premenstrual syndrome (PMS).

Peri-menopause, the time when a woman’s hormone production begins to fall starts around the mid 30s. During this period of time, the ovaries decrease the production of estrogen, progesterone and testosterone. Most commonly, progesterone decreases faster than estrogen and testosterone creating, a syndrome called estrogen dominance. Symptoms of estrogen dominance can include headache, fatigue, irritability, unstable moods, brain fog, depression, hot flashes, weight gain, insomnia, heavy or irregular periods, fibroids, endometriosis, and abdominal bloating.

As estrogen falls, low estrogen symptoms can include memory loss, fuzzy thinking, changes in hair and skin, vaginal dryness, difficulty with orgasm and loss of libido. Low testosterone can contribute to bone loss, decreased libido, low energy, weight gain, depression, and difficulty with building muscle even with strenuous workouts.

Adrenal gland function, thyroid gland function, blood sugar level and vitamin levels all can further contribute to hormonal imbalance as well.

Traditional hormone therapy in the past mostly gave women estrogen and sometimes progesterone. These were synthetic hormones. Large scale studies that showed an increase in breast cancer risk, stroke, and heart attack risks were done on women who used synthetic hormones. Further, doctors in the past gave women these synthetic hormones without doing baseline hormone panels and also didn’t do any follow up hormone panels to assess their levels. Testosterone supplementation was all but ignored as levels of testosterone in women just weren’t tested. Women would ask their doctors to have their levels of hormones tested, only to have the request denied, to have the wrong hormones done, or to be told their hormones were in the “normal range.” The fact is, it’s not whether they’re in the normal range or not, it’s whether they’re balancing each other out as they should and how are other hormone making organs like the adrenals and thyroid contributing to the imbalance. This is why hormone panels are crucial and needed pieces of data to help treat a patient’s symptoms. This is also why at our clinic you’ll get a full thyroid panel (not just a TSH) and we usually also recommend saliva adrenal testing to understand how your hormone making organs are interacting with each other.

Dr. Yu does comprehensive hormone evaluations in our clinic. Dr. Yu will sit down with the patient to go over the myriad of symptoms experienced. Then during the proper time in a woman’s cycle if she is cycling, a saliva or blood hormone profile will be done.  A hormone profile can be done anytime on a man but certain times of day is better depending on reason for the test.  After the results are received, the provider sits down with the patient again to review the entire profile. Along with the typical hormones, we review the thyroid panel, the adrenal profile, and other crucial labs along with other factors that are contributing to the patient’s symptoms. The more we can help a patient identify the root cause(s) affecting their hormonal systems, the more we can help a patient become educated about their own health and help themselves, too.  Dr. Yu has undergone advanced integrative training and have years of experience behind us focusing on hormonal health. We understand how these pieces of the puzzle all fit together. Educating our patients about how all the pieces fit together and what they can do along with what we can do is the key to our philosophy.

Dr. Yu presents the full gamut of treatment options. We discuss medications for hormone therapy if needed, however, we focus in the prescription and evaluation of bio-identical hormones. We opt for the most natural and the lowest dose in general to achieve proper hormonal balance.  Bio-identical hormones are hormones extracted from plants then replicated. They are natural estrogen and progesterone from soy and yams. They are identical to what our bodies make, so they do what one’s natural hormones would do.  Besides being able to get it at the standard pharmacy, individual hormone combinations can also be made at compounding pharmacies that can be a mixture of several hormones and be in a form like cream or lozenges that bypasses liver metabolism, unlike orals, thus lowering dose and further increasing safety.  This individualizes the hormone therapy for each person’s hormone imbalance while minimizing risks.

Dr. Yu's philosophy on hormonal health is an integrative and holistic approach to hormonal care.  “Proper balance is crucial, and the most natural and lowest dose is always the goal. We always search and address root causes to help patients also help themselves.” With this philosophy in mind, we have helped thousands of men and women discover the balance that is necessary through all phases their lives.

Additional patient education information on hormones and hormone testing is available at ZRT LABS.

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