Menopause Archives

Oct

2020

Irregular Periods are Linked to Premature Deaths

By Ray Schilling | Hormones, irregular periods, Menopause, prostate cancer

A review in CNN describes that irregular periods are linked to premature deaths. This review is based on the original publication in the British Medical Journal published on September 30, 2020.

Essentially, the researchers followed 79,505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes for 24 years. The researchers recorded 1975 premature deaths. The definition for a premature death was someone dying before the age of 70. There were three age groups that the researchers followed separately for 24 years.

ages 14-17 years
18-22 years
29-46 years

The most common causes of death were 894 from cancer and deaths from 172 strokes and heart attacks.

Death rates after 24 years for the three subclasses just mentioned

The researchers noted that there were differences in survival for different age groups. But there were also differences in survival for irregular periods versus prolonged intervals between periods. Crude mortality rates for 1000 person years of follow-up for women with normal versus irregular periods were as follows.

Normal periods Irregular periods

14-17 age : 1.05 14-17 age: 1.0

18-22 age: 1.23 18-22 age: 1.37

29-46 age: 1.0 29-46 age: 1.68

Women with a cycle length of 40 days or more had a higher mortality rate. The researchers compared this to women with a normal cycle length (26-31 days). Here are the data in detail for two age groups at the outset of the study.

Women with a cycle length of 40 days or more

Age 18-22: 1.34

Age 29-46: 1.40

Heart attacks and strokes followed these death statistics closest.

Discussion

The researchers concluded that teenagers and women in their middle-age were at the highest risk. This risk was for premature mortality, if they had irregular periods or a cycle length of 40 days or more. There was also an association between irregular periods and a prolonged cycle length and type 2 diabetes, ovarian cancer and coronary heart disease. In addition, mental health problems were also related, the study said.

Dr. Adam Balen, a professor of reproductive Medicine at Leeds Teaching Hospitals in the UK said: “Young women with irregular periods need a thorough assessment not only of their hormones and metabolism, but also of their lifestyle so that they can be advised about steps that they can take which might enhance their overall health”.

Too much estradiol in women and men can cause cancer

In this context it is interesting that other studies have shown that unopposed estradiol may be the culprit for both irregular periods and larger intervals between periods. When estrogen is elevated in females, irregular periods can result. Unopposed estradiol can cause breast, uterine and ovarian cancer.

In males who also have a small amount of estrogen in their blood, it is important that a larger amount of testosterone balances the two hormones. Otherwise there is a risk of prostate cancer.

In addition, cardiovascular disease has been described as a side effect of standard hormone replacement therapy (HRT) in women with synthetic hormones.

The good news is that treatment with bioidentical hormones can treat these abnormal periods. This eliminates premature mortality and in many cases prolongs life.

Conclusion

Researchers followed 79,505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes for 24 years. They found that there is a linkage between irregular periods and premature deaths. There were three age groups that the researchers followed. Some of them suffered from irregular periods and others had periods that were 40 days or longer apart. The researchers recorded the premature mortalities. At an age of 29-46 there was a 68% higher mortality in women with irregular periods. The scientists compared this to women who had regular periods. In addition, women aged 29-46 with a cycle length of 40 days or more had a 40% higher mortality.

Estrogen dominance could explain premature deaths

The researchers compared this to women with a normal cycle length. It is possible that women who died prematurely were having too much estrogen in their system, which can produce cardiovascular disease and cancer of the breast, uterus and ovary. Further studies need to clarify the mechanism behind irregular periods and why a cycle length of 40 days or more causes mortality.

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myths about aging

Oct

2020

Medical Myths about Aging

By Ray Schilling | andropause, cholesterol, Circadian rhythm, Dementia, diet, exercise, fractures, heart attack, High Blood Pressure, Hormones, lung cancer, Menopause, Mortality, Obesity, Pain, Smoking, Stroke

Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier. Here I discuss 7 common myths about aging.

Myth 1: Everyone will experience physical deterioration

It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

But you can maintain good cardiovascular function and good muscle strength with a regular exercise program. This study showed that men and women can reduce mortality by exercising regularly, even in older age.

Myth 2: Older adults cannot exercise

There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

Myth 3: As we age, we need less sleep

For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

This will also slow down our aging clock.

Myth 4: Your brain slows as you age

Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

Physical activity reduces risk for dementia

Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

Myth 5: Osteoporosis occurs only in women

There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

Myth 6: People stop sex as they age

With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

Myth 7: It is too late to stop smoking now

One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

Medical Myths about Aging

Conclusion

There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

The truth behind the medical myths about aging

I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

Apr

2020

Side Effects of the Birth Control Pill

By Ray Schilling | autoimmune disease, birth control pill, breast cancer, Cancer, Cardiovascular disease, cervical cancer, depression, headache, heart attack, Hormones, Menopause, Osteoporosis, Stroke

Dr. Jolene Brighten gave a lecture about side effects of the birth control pill. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. Her exact title was “Your Body on Birth Control- What Prescribers Should Know About the Effects of Birth Control on the Female Body”.

Most commonly the oral contraceptive pill is prescribed to prevent pregnancy. But the long-acting reversible contraceptives like the IUD and progestin implants are also popular. Depot Provera, the ring and the patch are the least popular ones.

Why women use the birth control pill

Women age 15 to 49 are often on some form of birth control method. 58% of women who use the birth control pill use it for reasons other than to prevent pregnancy. They use it to control symptoms of various conditions.

31% use it for menstrual cramps
28% want to regulate their periods
14% hope to improve their acne
4% use the pill for menstrual pains associated with endometriosis
11% for other reasons

What the birth control pill does

The birth control pill exerts a negative influence on the hypothalamus and the pituitary gland. This is called “functional hypothalamic amenorrhea”. The birth control pill is not suitable to treat polycystic ovarian syndrome. Symptoms of bleeding may improve for 3 months, but after that the original symptoms return. Thyroid disease that may be present needs separate investigations.

The hormones that are part of the birth control pill are synthetic hormones. They do not quite fit the body’s hormone receptors. For instance, the progestins, artificial analogues of progesterone behave like estrogens, not progesterone. This causes clotting problems cancers of the uterus, breasts and cervix. It can also cause heart attacks and strokes.

List of side effects of the birth control pill

From depression to liver health

The list of side effects of the birth control pill (BCP) is long. The BCP can worsen symptoms of depression and anxiety. The deeper the depression is, the higher is the risk for suicide. There is increased risk of hair loss. The BCP depletes nutrients in the body that the thyroid gland needs to produce thyroid hormones. This can result in hypothyroidism.

It also increases thyroid binding globulin, a protein in the blood that binds thyroid hormones. As a result, there are fewer thyroid hormones available to the body cells. Breasts may become tender and enlarged after the start of the BCP. In some women with fibrocystic disease of the breasts the BCP may improve her cyclical breast changes. The BCP changes the liver both structurally and genetically. As a result, there is a higher risk of developing benign liver tumors and liver cancer.

From gallstones to blood clots

Women with a history of gallstones may experience faster gallstone formation on the BCP. The pill also can elevate your blood pressure. You should have blood pressure checks from time to time to prevent a stroke. Weight gain is common on the BCP. However, some women experience weight loss. Usually the BCP is 99% effective for the prevention of pregnancy. Pain from heavy periods or menstrual cramps are often relieved by the BCP. There is an increased risk to develop diabetes, because insulin resistance is gets worse in patients on the BCP. In postmenopausal women on HRT there is an even higher risk of developing diabetes. Blot clots are a common side effect of the BCP. Being a smoker, having a heart or liver condition, a history of genetic risk of blood clots, having migraines with an aura or being overweight are all additional risk factors for developing blood clots.

From effects on the brain to cancer risks

The BCP can change brain function and structure. This may lead to a different mate selection and production of neurotoxins. Some women get relief from hormonal headaches; but others experience exacerbations of migraines and headaches. In some women acne improves on the BCP; in others acne gets worse. When it comes to stress, some women experience an altered hypothalamic-pituitary-adrenal gland response from the BCP. The BCP reduces some cancer risks, like the risk of ovarian, uterine and colorectal cancer. But the risk for breast cancer, brain cancer and liver cancer are higher. The BCP increases gut permeability, leads to leaky gut syndrome and the disruption of the microbiome. There is often overgrowth of yeast in the gut. In addition, people with a genetic predisposition for autoimmune disease of the gut can develop immune diseases. Multiple studies have shown malabsorption of vitamins, minerals and antioxidants when on the BCP.

From vaginal yeast infections to osteoporosis and autoimmune diseases

Many women develop vaginal yeast infections. Women on the BCP often complain about low or a lack of libido. There can be vaginal dryness and pain with sex.

Teenage women on the BCP often develop decreased bone density. Synthetic hormones lack the specificity to the natural hormone receptors, which leads to decreased bone density. On the other hand, bioidentical estrogen and bioidentical progesterone will indeed build up bone mass. In the past it was thought that hormones would be good for the bones and this is still true with the use of bioidentical hormones.

A number of autoimmune diseases have been identified to be directly related to the use of the BCP. These are Crohn’s disease, multiple sclerosis, lupus, interstitial cystitis and ulcerative colitis.

Synthetic hormones will always have side effects

The body is a complex organism with various hormone receptors built into its cells. In order to be able to cash in on patented modified hormones Big Pharma introduced progestins to replace natural progesterone and various synthetic estrogen products to replace natural estradiol. However, the Women’s Health Initiative has shown in 2002 that these artificial hormones produced heart attacks, strokes, blood clots, colorectal and endometrial cancer and hip fractures. There was an increase of mortality of 15% over 5.2 years compared to controls who did not take artificial hormones within the same timeframe.

Bioidentical hormones have a perfect fit to the natural hormone receptors

In contrast, when bioidentical hormones are given in menopause, there is a 10 to 15 year extension of life expectancy and researchers did not see any of the above mentioned side effects that were noted with synthetic hormones. Many people in Europe have elected to stick to bioidentical hormones for decades; they did not use the synthetic hormones. As a result, there are good data going back to the 1960’s about the safety of bioidentical hormones. In this study several thousand postmenopausal women were followed for 9 years or more and showed no increase in the rate of heart attacks or any cancer. Their postmenopausal symptoms were optimally controlled. I conclude from this that bioidentical hormone replacement in menopause will protect the women from missing hormones safely. There are no side effects and for this reason the bioidentical hormone replacement should become the standard of care.

Side Effects of the Birth Control Pill

Conclusion

Synthetic hormones have a long list of devastating side effects. Yet, Big Pharma managed to influence general practitioners and gynecologist to prescribe them to postmenopausal women. The Women’s Health Initiative has changed everything. The promise was that synthetic hormones would show heart-protective effects, cancer protective effects and healing effects for osteoporosis. These have been empty promises! None of this occurred with synthetic hormones- to the contrary! Many physicians are now prescribing bioidentical hormone replacement for women in menopause.

No good alternative for teenage girls

However, for teenage girls there is no good alternative for the traditional birth control pill, even though the catalogue of side effects is of serious concern. One compromise is to limit prescribing the birth control pill for up to 5 years only and then switch to several years of a copper T or other intrauterine device (IUD). Suicide in teenage girls on the BCP is of real concern. Despite the list of side effects many doctors continue to prescribe synthetic hormones for decades to the same patients, who trust that it will benefit them. In time patients will know about the side effects, and unfortunately many will experience them. As a result, it is only a matter of time, till this will be exposed as malpractice!

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Mar

2020

Telomeres are Important

By Ray Schilling | Alzheimer’s disease, andropause, Anti-aging medicine, Cancer, Cardiovascular disease, Diabetes, exercise, fasting mimicking diet, fish oil, Fitness, food, heart attack, High Blood Pressure, Hormones, Menopause, Nutrition, Obesity, omega-3 fatty acids, Smoking, Stress management, telomeres

In the first place, Dr. Joseph Raphaele reviewed why telomeres are important at a Conference in Las Vegas in December 2019. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15, 2019. The actual title of his lecture was: “Telomeres in 2019; clinical developments and cutting-edge applications”.

Notably, Dr. Raphaele reviewed how various animals have quite different life expectancies. First, the Aldabra giant tortoises, for instance can live up to 152 years. Second, the house mouse can at the most live up to 6 years, but its predator, the cat lives up to 38 years. Finally, humans can live up to 122.5 years.That is to say, the average mortality rate doubling curve of man is 8 years. Dr. Raphaele introduced the terms “lifespan” and “health-span”.

Lifespan versus health-span

The first thing to remember is that our lifespan is defined by the number of years we live. On the contrary, the health-span is defined by the number of years you do not have any disease and your physical and mental health are good. Dr. Raphaele explained that for the most part the body’s organs have a limit of functioning after 80. For this reason the kidneys, the maximum heart rate, the maximum breathing capacity and the maximum work rate (oxygen uptake) all decline after the age of 80. It is important to realize that in 1961 Dr. Leonard Hayflick showed that there is a limit of how often cells can divide. After 60 doublings cells in tissue culture either die or just stop dividing. The built-in molecular clock resides in the telomeres. The telomeres are the caps at the end of the chromosomes in the cell’s nucleus.

Telomeres and their function in aging

In a word, what is the function of telomeres? In essence, the telomeres protect the integrity of our genes. For the most part, they protect the chromosomes from deteriorating, prevent DNA fusion and massive instability of the genes. In addition, the telomeres allow the cells to divide in an orderly fashion, but only up to the Hayflick limits. In short, the bottom line is that telomeres prevent cells from mutations of the DNA, from senescence and from death.

Shortening of telomere length with age

Dr. Raphaele said that one of the important findings was that telomere length is shortening with age. Notably, he showed a slide similar to this. To clarify, this graph shows telomere length as a function of the lifespan in years. The telomere length is obtained by a blood test. This determines the length of the telomeres in white blood cells. At a young age it has a length of between 8 and 10 kb. kb stands for kilobase. A kilobase consists of 1,000 pairs of nucleic acid sequences. So, 10 kb means 10,000 pairs of nucleic acid sequences. Around the age of 80 people have much shorter telomeres, only 4 to 6 kb. There is an enzyme, called telomerase that can elongate telomeres by approximately 10%. But this may not be desirable as too much telomerase activation can also stimulate cancer growth.

Age changes telomere length

Dr. Raphaele explained further that a telomere loses about 100 base pairs per cell division. But there are other factors that shorten telomeres. Smoking, sedentary lifestyle, high blood pressure, stress and a low antioxidant status all can shorten telomeres. Certain congenital conditions can shorten telomeres by 28%. Dyskeratosis congenita is such a condition where 80% patients die by the age of 30 due to aplastic anemia. This is associated with bone marrow failure. 10% of these patients die from cancer. Apart from age, which shortens telomeres slowly, lifestyle factors are very important. A good lifestyle where you exercise regularly, you don’t smoke and you eat a healthy diet will slow down the shortening of your telomeres. Controlling your stress, sleeping enough hours per night and taking supplements also delays telomere shortening. Certain medications that control diabetes, high blood pressure or thyroid medication that treats hypothyroidism also delay telomere shortening.

Telomeres and shortened lifespan

Researchers could show that good lifestyle practices work by increasing telomerase to a certain degree. This results in lengthening of telomeres and translates into up to 10 years of increased life span. Jerry Shay, PhD said in 2011: “While the aging process is complex and certainly cannot be explained solely on the basis of telomere biology, there is a growing consensus that in some situations telomere biology and telomere tests may have important utility similar to cholesterol assays or blood pressure monitoring measurements.”

Telomeres are not just a biological clock inside our cells. They have a great influence on the function of mitochondria and on how many mitochondria multiply inside cells. This latter process is called mitochondrial biogenesis. In addition, telomeres regulate gene expression.

Chronic diseases associated with shortened telomeres

Here is a list of chronic diseases where all the patients have shortened telomeres.

High blood pressure
Hardening of the arteries (atherosclerosis)
Cancer
Chronic obstructive pulmonary disease (COPD)
Alzheimer’s disease
Diabetes and obesity
Chronic stress
Metabolic syndrome

Telomeres in cardiovascular disease

Telomere length was found to be shortened in those who developed a heart attack. Researchers compared the telomere length in coronary artery disease (CAD) patients to people with no history of heart attacks. In comparison to this normal group the heart attack victims had telomeres typical for people who are chronologically 11.3 years older than the healthy controls. The researchers calculated that people with telomere shortening had a 3-fold higher risk of coming down with a heart attack.

Telomere length enhancers

Lifestyle changes can have positive effects on telomere length. Examples are smoking cessation, weight loss and stress reduction.
Dietary changes: we know that fish oil (omega-3 fatty acids) supplements elongate telomeres as does a low-fat diet.
Supplements like vitamin D3, antioxidants (vitamin C and E) and astragalus (TA-65) elongate telomeres as well. The astragalus supplement, TA-65 showed a significant elongation of telomeres after 12 months while controls lost telomere length.
Exercise: in a 24-week experiment of care workers regular aerobic exercise increased the telomeres by 67.3 base pairs.
Bioidentical hormone replacement in aging people: when hormones are missing after andropause and menopause, the natural hormones need replacing, or the telomeres are shortening.
High cortisol levels cause telomere shortening.
Human growth hormone elongates telomeres via telomerase activation.
The fasting mimicking diet (FMD) was shown to extend life and telomeres as well.

Therapeutic rationale for telomere lengthening in CAD and AD

Patients with coronary artery disease (CAD) are at risk for developing heart attacks and other cardiovascular diseases. Here is an overview of many clinical trials that have been done in humans with CAD. It shows shortening of telomeres in these high-risk patients. But the review also shows that telomeres can lengthen by changing the risk factors of cardiovascular disease. Researchers were increasing the enzyme telomerase that indirectly lengthens telomeres. Both approaches prevent serious cardiovascular disease and increase life expectancy significantly. In severe cases of telomere shortening the physician can consider TERT gene therapy.

Alzheimer’s disease (AD) also is a condition where telomeres are shortened compared to normal controls. Time will tell whether TERT gene therapy is possible to prevent Alzheimer’s disease.

Telomeres are Important

Conclusion

Telomeres are the caps of the chromosomes in our cells. In the past the word “telomere” appeared obscure and only scientists discussed this among themselves. Now we know that telomere shortening is often the reason for chronic illnesses like high blood pressure, hardening of the arteries (atherosclerosis), cancer, chronic obstructive pulmonary disease (COPD), Alzheimer’s disease, diabetes and obesity. Patients who have these conditions often have shortened telomeres in their white blood cells. Over the years we have learnt that lifestyle changes can have positive effects on telomere length. Smoking cessation, exercise, weight loss and stress reduction are elongating telomeres.

Additional factors elongating telomeres

In addition, supplements like antioxidants (vitamin C and E), vitamin D3 and astragalus root (TA-65) elongate telomeres as well. By elongating telomeres, a person can add 10 to 11 years of disease-free life to the normal life expectancy. Researchers showed that telomerase activation by human growth hormone increased telomere length without causing cancer. Dr. Thierry Hertoghe, an endocrinologist from Belgium spoke about HGH replacement in aging people on other occasions. He said that cautiously treating patients with low doses of HGH when blood tests showed deficiency, adds about two decades of life-expectancy to these patients’ lives.

Oct

2019

Breast Cancer Risk Persists After Hormone Replacement Therapy

By Ray Schilling | blood test, breast cancer, Cancer, Hormones, Menopause, Osteoporosis

New research showed that the breast cancer risk persists after hormone replacement therapy (HRT). This is described in this CNN article. It is common knowledge for some time that female patients who use synthetic hormones as hormone replacement in menopause, have a 1.6-fold to 1.8-fold risk to develop breast cancer. However, since the abrupt ending of the Women’s Health Initiative (WHI) in 2002 the truth about the risks of HRT became known and made HRT more confusing. After all, in this trial they wanted to show once and for all that HRT would be beneficial. The expectation was that HRT would prevent osteoporosis, heart attacks and breast cancer. But the results were quite different. Instead the study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease and a doubling in the risk for blood clots.

Missing information about synthetic hormones

What the authors of the study did not explain was the fact that it was the properties of the synthetic hormones, progestagen and Premarin, that were responsible for the negative effects. Had researchers insisted to perform the study with bioidentical hormones, the results would have been quite the opposite! With bioidentical hormone replacement we see the prevention of heart attacks and clots; cancer rates are lower than controls, and the prevention of osteoporosis is another benefit. The end result is a reduction in mortality rates. These horrifying results from the use of synthetic hormones still frighten many women. This is particularly so when it comes to replacing hormones after menopause.

Breast cancer risk study with HRT in more details

The research study described in the CNN article is based on a more comprehensive Lancet study. The researchers did a Meta analysis of 58 prospective studies. Unfortunately all the hormones given were synthetic hormones (not bioidentical ones) that had the same configuration as in the WHI. On average women became menopausal at age 50. This is when the physicians commenced HRT. The prospective follow-up showed that 108,647 postmenopausal women developed breast cancer around the age of 65. 55,575 women (51%) had used HRT. Postmenopausal women who used estrogen/progestagen combinations during years 1–4 had a relative risk of 1.60-fold to develop breast cancer. This risk increased during years 5–14 after exposure to estrogen/progestagen with a relative risk of 2.08-fold to develop breast cancer.

More details about breast cancer risks

The risk of developing breast cancer was lower when women took estrogen only as a form of HRT. For years 1-4 the relative breast cancer risk for patients on estrogen alone was only 1.17-fold. Regarding years 5-14 with estrogen-alone replacement the breast cancer risk was 1.33-fold.

Women of average weight who started their HRT of estrogen/progestagen pills at age 50 with menopause one woman in 50 users developed breast cancer between the ages of 50 and 69. In women who used estrogen regularly, but progestagen only irregularly, one in 70 users developed breast cancer. For estrogen only users one in every 200 women developed breast cancer.

Discussion of the above results

Dr. Wright and Dr. John Lee have pointed out years ago that there are alternatives to taking synthetic hormones as HRT. Taking oral synthetic hormone preparations is problematical. First, the pharmaceutical company attached chemical side chains to the synthetic hormones. The women’s estrogen receptors recognize the synthetic hormones only partially. Hormone researchers developed progestagen to mimic a woman’s progesterone. But it turns out that the estrogen receptors read progestagens like an estrogen. This is the reason why there are higher breast cancer rates with the combination of estrogen/progestagen than estrogen alone. Secondly, there is a problem of estrogen dominance, which causes a higher likelihood that the patient develops breast cancer or heart attacks.

Avoiding estrogen dominance reduces breast cancer risk

If estrogen is balanced with progesterone, the cancer promoting effect of estrogen is counterbalanced, and the women on bioidentical hormone replacement are protected from the serious side effects women of the WHI had to endure.

Bioidentical estrogen applications are available through creams that women apply to the skin. This avoids the problem of the first-pass effect; if estrogens are absorbed from a pill in the gut they have to pass through the liver, which is the organ that metabolizes them.

Bioidentical hormone replacement as an alternative to HRT

In Europe there has been a strong resistance to using synthetic hormones. As a result long-term studies were able to show that there is no danger when bioidentical hormone replacements therapy uses creams that are applied to the skin or intravaginally. This avoids the first-pass effect in the liver, as is the case with synthetic estrogens and progestagens taken orally as pills.

John Lee stated that physicians should measure hormones and identify those women who are truly hormone deficient. These are the ones who need hormone replacement. However, physicians should use only bioidentical hormones in a hormone replacement therapy. And they should also replace only as much as necessary to normalize the hormone levels. This is also the level where postmenopausal symptoms disappear. Dr. Lee noted: “A 10-year French study of HRT using a low-dose estradiol patch plus oral progesterone shows no increased risk of breast cancer, strokes or heart attacks”.

How is bioidentical hormone replacement done?

The best method is usually a bioidentical hormone cream application to the forearms or to the chest wall once per day. A woman on bioidentical hormone replacement applies bioidentical Bi-Est cream and progesterone cream to the skin of her forearms or chest wall. The hormones get directly absorbed into the blood stream and can do their job without interference. The treating physician can prescribe different amounts of the bioidentical hormones depending on saliva tests or blood tests. 1 or 2 months later repeat blood or saliva tests can follow to verify that the amounts of the replacement hormones and their absorption are adequate for the patient’s need.

Difficulties to measure progesterone levels

Dr. David Zava, PhD gave a talk on breast cancer risks. This was a presentation at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. Dr. Zava, who runs the ZRT laboratory, spent some time to explain how to measure progesterone in a physiological way.

Blood (serum) progesterone levels do not adequately reflect what the hormone tissue level is like in a woman’s breasts. On the other hand saliva hormone levels are giving an accurate account of what breast tissue levels are like.

Progesterone blood levels versus progesterone tissues levels

Dr. Zava gave an example of a woman who received an application of 30 mg of topical progesterone. Next, laboratory tests observed hourly progesterone levels in serum and saliva. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level. Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream based on a misleading low blood test. This leads to overdosing progesterone. With salivary progesterone levels it is possible to see the physiological tissue levels, which is impossible with blood tests. Dr. Zava emphasized that testing blood or urine as progesterone hormone tests will underestimate bio-potency and lead to overdosing the patient.

Breast Cancer Risk Persists After Hormone Replacement Therapy

Conclusion

A new Meta analysis of 58 prospective studies with a large amount of participants showed that standard hormone replacement therapy (HRT) for postmenopausal women causes breast cancer. Postmenopausal women who used estrogen/progestagen combinations during years 1–4 after menopause had a relative risk of 1.60-fold to develop breast cancer. This risk increased during years 5–14 after exposure to estrogen/progestagen with a relative risk of 2.08-fold to develop breast cancer. Unfortunately all of the patients had received the standard Premarin estrogen and synthetic progestagen combination. The body’s estrogen receptors read both of these synthetic hormones as estrogen, which led to estrogen dominance. Estrogen dominance (with missing natural progesterone) is known to cause breast cancer.

Comments and discussion of bioidentical hormone replacement (BHRT)

I have explained in my comment that the investigators should have used bioidentical hormone replacement therapy (BHRT) instead of making a similar mistake as in the Women’s Health Initiative, where synthetic hormones caused cancer, heart attacks and blood clots.

Bioidentical hormone replacement is started with progesterone creams first in order to avoid estrogen dominance. After hormone tests estrogen is gradually introduced as Bi-Est cream applied to the skin and balanced with the progesterone. The physician orders blood estrogen levels and progesterone saliva hormone tests from time to time to monitor the hormone levels. No cancer occurs with bioidentical hormone replacement. It also protects from osteoporosis, heart attacks and strokes.

Part of this blog was published here before.

Aug

2019

The Best Ways To Prevent Cancer

By Ray Schilling | alcohol, andropause, breast cancer, Cancer, Cardiovascular disease, coffee, Diabetes, diet, exercise, fiber, food, green tea, heart attack, Hormones, lifestyle, lung cancer, Menopause, Nutrition, Obesity, omega-3 fatty acids, Prevention, Processed food, prostate cancer, sleep, Smoking, Stroke, sugar, testosterone, Vitamins and supplements

Cancer is the second leading cause of death, that’s why it is important to learn about the best ways to prevent cancer. Generally speaking you want to remove cancer-producing substances (carcinogens) from your diet. But diet is only part of your lifestyle that can contribute to cancer. I shall list some of the more important dietary factors below and briefly touch on important other factors.

Avoid burning your meat

When you use the BBQ, you should avoid burning your meat. Even though the marks of “charring” are considered desirable on meat from the grill, this is really burnt! As a matter of fact it is a lot better to use a slow cooker at low heat and simply cook your food longer. This way you don’t create carcinogens. Avoiding to burn your meat is particularly important for the red meats.

Sugar and an overabundance of starchy foods can cause cancer

You never thought that sugar and an overabundance of starchy foods could cause cancer, but they do. The reason is that the metabolism of cancer cells is using 10- to 12-times more sugar than the metabolism of normal cells. The worst thing a cancer patient can do is to over-consume sugar. Replace sugar by stevia, which is a harmless, plant-based sweetener and does not lead to an insulin reaction. Avoid all other sugar substitutes, as there are other heath problems with most of them.

Avoid phthalates

Those who have a craving for macaroni and cheese are out of luck. This food contains phthalates that are part of the ingredients of almost every sample of cheese powder used to manufacture macaroni and cheese. Phthalates can cause infertility and breast cancer. So you must definitely avoid macaroni and cheese, at least the stuff from the box. Prepare your own!

A high fat diet

What does a high fat diet do? It increases the risk for breast cancer. But it can also increase colorectal cancer risk. Limit your fat intake to about 10% of saturated fat. That is the recommendation of the FDA. Increase your consumption of fish and seafood. Only one proviso: predator fish like shark, marlin, tilefish, swordfish and grouper are high in mercury. But wild salmon, sardines and oysters are low in mercury. You can also enjoy shrimps and prawns.

Take high dose vitamin D3 supplements

High dose vitamin D3 supplements help you to avoid cancer. There are strong statistics showing that vitamin D3 is a powerful tool to lower your risk of developing cancer. Your family doctor should take a blood test called 25-hydroxy vitamin D level to make sure that you absorb enough vitamin D3. There are slow and fast absorbers and the only thing to know how well your gut absorbs vitamin D3 is in doing this blood test.

Also, curcumin (turmeric) 500 mg once per day is good for cancer prevention.

Take enough fiber

Make sure you take enough fiber, which does not only reduce colorectal cancer, but also many other cancers. When you eat plant-based food, you automatically get fiber in it. North Americans are not consuming enough fiber in their diet.

Avoid processed meat and too much red meat consumption

Processed meat and red meat cause cancer.

Beef, lamb and pork seem to contribute to causing cancer according to the WHO. Use common sense and eat fish, chicken and turkey. Reduce your beef consumption. My grandmother served beef as a Sunday dish.The rest of the week simple, plant-based foods appeared on the table. Ask your grandmother, what she used to cook. Or ask your mother what she ate as a child.

Eat moderate amounts of fruit and vegetables

The claim that fruit and vegetables would protect you from cancer is not as solid as researchers thought of in the past. Newer research has shown that a basic intake of fruit and vegetables is needed for nutrients, but consuming more than that will NOT protect you from cancer.

This link explains that eating more vegetables or fruit beyond a certain point will not do harm, but will not protect you further from cancer.

Drink green tea or black tea

If you like tea, drink green tea or black tea. Sweeten it with stevia, but not with sugar. Tea has been shown to have cancer prevention properties.

Avoid alcohol consumption to prevent cancer.

Coffee is a healthy drink and it has mild anti-cancer effects as well. It does not matter whether you drink it caffeinated or decaffeinated.

Other lifestyle issues

Quit smoking

If you are still smoking, quit smoking! Smoking is by and large the biggest risk for developing lung cancer, throat cancer, esophageal cancer and pancreatic cancer.

Watch your calorie intake

Eat smaller meals more often. This way the production of your digestive juices will consume some calories. In addition your taste buds are satisfied, so your hunger for food is more controlled. The end result is that you will not gain weight.

Prevent obesity and type 2 diabetes

This will help prevent obesity and type 2 diabetes, both of which are established risk factors to develop cancer. Here is a review that shows you, which cancer types are caused by obesity. With regard to diabetes, there is a strong association to developing liver cancer, pancreatic cancer and endometrial cancer (=uterine cancer). There is a lesser risk (only 1.2 to 1.5-fold) to develop cancer of the colon and rectum, breast cancer and bladder cancer.

Pollution

Poor air quality with pollution can also be a factor in causing cancer. Pollution does not stay local, but travels through the stratosphere around the globe. The result is that now 10 to 15% of lung cancer in the US occurs in patients who never smoked. This translates into 16,000 to 24,000 deaths annually of never-smokers in the US. In certain cities such as Beijing lung cancer rates have doubled in 9 years between 2002 and 2011. Lung cancer in non-smokers can be caused from exposure to radon, to second-hand tobacco smoke, and other indoor air pollutants.

Bioidentical hormone replacement

When males do not replace missing testosterone in andropause they are much more prone to develop prostate cancer. Similarly, when women are menopausal and do not get progesterone supplementation, they develop a higher amount of breast cancer due to estrogen dominance. It follows from this that bioidentical hormone replacement in menopause and andropause will help to prevent prostate cancer and breast cancer.

The Best Ways To Prevent Cancer

Conclusion

There is strong evidence that certain foods can cause cancer. Other foods including supplements like curcumin and vitamin D3 can help prevent cancer. Basically, you want to avoid all that is known to cause cancer and eat more of the healthy foods that do not cause cancer. This will help to decline your cancer risk. I suggest that in addition you should quit smoking, avoid pollution as much as possible, reduce excessive alcohol intake and watch your calorie intake. By doing this you prevent obesity and type 2 diabetes, and you will move into the low-risk cancer group. We all need to work on this on an ongoing basis.

Practical hints regarding the best ways to prevent cancer

The best ways to prevent cancer is to avoid processed red meat and all other processed foods. Eat more vegetables, fruit, wild salmon and other seafood. Don’t eat red meat more often than once a week and make it red meat from grass fed animals. In addition exercise regularly, get enough sleep and practice some form of relaxation (yoga, Tai Chi, self-hypnosis etc.). This lifestyle will not only prevent heart attacks and strokes, but also the majority of cancers.

Previously published here.

Mar

2019

Exercise For Different Age Groups

By Ray Schilling | Arthritis, back pain, Cancer, Cardiovascular disease, exercise, Fitness, fractures, Health, heart attack, lifestyle, Menopause, Osteoporosis

In a health article CNN reported about exercise for different age groups.

Exercise has profound positive effects on the body. First it strengthens the lungs and the heart. Secondly, it conditions your muscles. Thirdly, exercise can protect you from chronic diseases like heart disease, type 2 diabetes and many cancers. Each age group needs different exercises, as follows.

Growing up years

During childhood exercise helps to grow healthy bones, regulate weight and build up self-confidence. In addition the child sleeps better, when exercise is part of the course of the day. Children should try out various sports. They should learn how to swim and how to handle a ball. They should also play in playgrounds together with other kids. Several studies have shown that during the teen years exercise levels decline steadily, particularly for girls. Especially during the teen years regular exercise builds a healthy body image and helps adolescents to manage stress and anxiety. Parents should encourage teens to keep one team sport regularly. For those who are not into team sports, swimming and any kind of sport is a good substitute.

Exercise for different age groups: in your twenties

In your mid twenties you are at the highest performance level in your life. You have the fastest reaction time and your heart pump capacity is the highest. Exercise physiologists measure this by an expression, called VO2 max. This value decreases each year by 1%. Your reaction time also decreases every year. The good news is that you can slow down the decline by exercising regularly for the rest of your life. If you train your body regularly during this time, your lean body mass will be preserved and your bone density will stay dense until your later years. To make it more interesting, vary your training with various sports.

If you are a regular exerciser, talk to a trainer about interval training, which intermittently pushes your exercise limit to the maximum. This type of training releases human growth hormone from your pituitary gland. The effect of this is that you increase your stamina and endurance. It also builds up lean muscle mass, decreases body fat content and provides you with more energy.

Exercise for different age groups: in your thirties

Family life and stress at the job can be a reason that you forget about exercise. But right now there is a particular need to maintain a regular exercise program. You may want to get up early, work out at a gym and go to work from there.

Some employers encourage those who work at a desk to get up every 30 minutes and have a brief exercise break for only 2 or 3 minutes. There are computer programs that show you what to do and all you have to do is copy what you see on the screen. Keep good posture while you sit. When you need a rest room break, you may decide to use the rest room downstairs. This gets you to climb some stairs and use the muscles that were resting when sitting at the desk.

As already outlined for those in the twenties, high-intensity interval training is a tool where you can exercise for only 20 minutes intensely. You do a burst of maximum exercise that brings you up to 80% of your maximum heart rate. This can be done cycling or sprinting and is alternated with low intensity exercise.

Women should do Kegel exercises (pelvic contractions) following labor to prevent incontinence.

Change exercises around to keep them interesting.

Exercise for different age groups: in your forties

This is the time when a lot of people put on extra weight. Resistance training is a way to counteract this by burning fat and preventing the loss of 3-8% of muscle mass per decade. As this link shows, 10 weeks of resistance training increases muscle mass by 3 pounds (1.4kg), increases the resting metabolic rate by 7% and decreases fat by 4 pounds (1.8kg). Exercise machines in gyms or Pilates equipment in Pilates centers will give you this type of training.

Exercise for different age groups: in your fifties

Many people develop joint aches when they are fifty and older. Also, chronic diseases like heart disease, type 2 diabetes and others are starting to get more frequent. In postmenopausal women, where estrogen is on the decline, heart disease is getting more common. Bioidentical hormone replacement can reverse these problems. Strength training twice a week will counter muscle loss that you would get otherwise without any regular exercises. Do weight-bearing exercises like a fast walk where you breathe a bit faster and where you break out into a sweat. This will make your bones and muscles stronger and prevent osteoporosis. Tai Chi, yoga and Pilates are all exercises suitable for this age group.

Exercise for different age groups: in your sixties

This age group is characterized by the fact that multimorbidity is getting more prevalent. People often have mental and physical illnesses. Or they have diabetes and heart disease. They often are on multiple drugs for various conditions. Aging is also a strong risk factor for developing many cancers. But regular exercise can prevent many cancers. For instance post-menopausal breast cancer, colon cancer and cancer of the womb are cancers that can be prevented to a certain extent with regular exercise. Heart disease and type 2 diabetes will also largely improve with regular exercise.

Physical exercise tends to decline in this age group for various reasons. Some reasons are obesity, various diseases that make individuals more sessile and general disability. It is important to resist this trend as much as possible. Take ballroom dance lessons and join the dancing community. Any other dance type (Latin, Bachata, Salsa, Kizomba, Argentine dancing etc.) is good exercise and enjoyable as well. It is a fun way to socialize and exercise at the same time. Aqua-aerobics is a great way to keep your joints and muscles in good shape. People with arthritis will tolerate this. Use brisk walking to maintain your cardiovascular fitness. Do strength and flexibility exercises twice per week to maintain your muscle mass and your balance.

Exercise for different age groups: in your seventies and beyond

Frailty and falls are common in the 70’s and 80’s. Many fractures are happening needlessly. Keep exercising regularly and your muscles will be strong enough to prevent falls. Walk and talk with friends instead of sitting around a table. It is good for your friends to walk as well. If you have several chronic conditions, talk to a physiotherapist or exercise professional what type of exercises you should do. You need some strength, balance and cardiovascular exercises. Enlist the help of a trainer. Sustained exercise is what benefits you most. Think of brisk walks, swimming and aqua-exercises.

Exercise For Different Age Groups

Conclusion

We are born to stay active. Movement is life. As long as we live, we need to do regular exercise. This way a lot of chronic diseases will be prevented and even many cancers as well. I have summarized that for different age groups there are different activities that are appropriate. But the key in all age groups is to move and keep your lean muscle mass from shrinking. As explained, this will automatically make you also lose a few pounds. Strength exercises (also called resistance exercises) are the key to achieving this. When you get older, you are not exempt from exercising. Now even more than before your well being depends on exercising regularly. You want to prevent osteoporosis, falls and fractures. You want to avoid chronic diseases, heart disease and diabetes, and exercise is one valuable key to achieve this.

Feb

2019

Hormones Helping In Menopause

By Ray Schilling | Alzheimer’s disease, heart attack, Hormones, Menopause, Stroke

Dr. Filomena Trindade presented a talk about hormones helping in menopause. This talk was part the 26^th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas from December 13 to 15, 2018. The exact title of her talk was “Women and cognition: insulin, menopause and Alzheimer’s”. Above the age of 80 Alzheimer’s disease in women becomes much more common compared to men. PET scans of the brain of postmenopausal women in comparison to PET scans of premenopausal women, often show more than 30% slow down of metabolism after menopause. Literature regarding that finding showed that it was mostly the decline in ovarian estrogen production that was responsible for the slow down in brain metabolism. Other factors that lead to Alzheimer’s disease are central adiposity (abdominal) and inflammation in the body.

Brain insulin resistance and Alzheimer’s

Older women with Alzheimer’s have more IGF-1 resistance and IGF-1 dysfunction. Other studies showed that minimal cognitive impairment (MCI) progressing into Alzheimer’s disease (AD) might be due to type-2 diabetes. One of the studies stated the following:

“We conclude that the term type 3 diabetes accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 DM and type 2 DM.“

Another publication said that type 3 DM is a neuroendocrine disorder that represents the progression of type 2 DM to Alzheimer’s disease.

Dr. Trindade presented several hormone studies in postmenopausal women who started to develop Alzheimer’s disease. Older women with existing Alzheimer’s did not respond to estrogen hormone replacement. They did not recover with regard to their memory loss. However, younger women who just entered menopause responded well to estrogen hormone replacement and many recovered from their memory loss.

Hormone changes in menopause

There are a number of hormones that experience changes with the onset of menopause. Estrogen production ceases in the ovaries. The production of progesterone in the ovaries also ends. In addition thyroid and adrenal gland hormone production decreases. Often insulin production is increased, but insulin resistance is present at the same time.

Stress can interfere with progesterone and aldosterone production as pregnenolone is the same precursor molecule for both hormones.

How stress interferes with Selye’s general adaptation syndrome

Stage 1 of Selye’s adaptation syndrome, called arousal, involves elevation of cortisol and DHEA. When stress is over, the patient recovers on his/her own.

Stage 2 is the adaptation stage, where cortisol is chronically elevated, but DHEA is declining. The patient feels stressed, has anxiety attacks and may experience mood swings and depressions.

Stage 3 is the exhaustion stage. The underlying cause of this stage is adrenal insufficiency. Both cortisol and DHEA blood levels are low. Patients often suffer from depression and chronic fatigue.

Other hormones and menopause

DHEA and cortisol (stress) have the same precursor (pregnenolone). This means that when a patient is stressed, DHEA production tends to suffer as most of the pregnenolone is used for the production of cortisol.

Dr. Trindade spent some time explaining the complicated details of thyroid hormones during menopause. In essence stress can interfere with the normal metabolism of thyroid hormones with respect to T3, T4 and reverse T3. The end result is that not enough functioning thyroid hormones are present and hypothyroidism may develop.

Both estrogen and progesterone are lower in menopause. In a longitudinal French study with over 80,000 postmenopausal patients the women that received replacement with bioidentical progesterone and estrogen did the best in terms of low Alzheimer’s rates and lower heart attack rates. You achieve optimal Alzheimer’s prevention best starting hormone replacement at the time when menopause starts. You need both estrogen to control hot flashes and to give you strong bones, and progesterone for preservation of your brain, your hair growth and a good complexion.

Hormones Helping In Menopause

Conclusion

Hormones are missing in menopause and this becomes the starting point for many postmenopausal complaints of patients. The sooner the physician does blood tests to diagnose hormone deficiencies, the better. Various studies showed that the best result in terms of Alzheimer’s prevention is possible, when estrogen and bioidentical progesterone are replaced right at the beginning of menopause. This approach prevents neuroinflammation. There are no extracellular beta amyloid protein deposits and no intracellular tau protein deposits that typically are present with Alzheimer’s disease. In addition the cardiovascular system stays healthier for longer. It contributes to preventing heart attacks and strokes. A longitudinal French study with over 80,000 women who have received treatment with a combination of estrogen and bioidentical progesterone have excellent survival data. The women also enjoy excellent mental health, no cardiovascular complications and less cancer than controls without hormone treatment.

Nov

2018

When you are sleepless

By Ray Schilling | andropause, Anxiety, Drugs, Insomnia, Menopause, Mortality, sleep, stress, telomeres, testosterone

You are not alone when you are sleepless. Insomnia is a widespread problem in society.

Previous review of the topic of insomnia

I have reviewed the topic of insomnia before in a blog.

Briefly I pointed out that in some people there is a mutation of the gene that controls the circadian sleep rhythm. It is called the CRY1mutation. Some people have sleep disturbances from working night shifts. I mentioned the blue light of electronics that is produced by the TV screens or computer screens. The more you are exposed to it, the more it stimulates the brain to produce serotonin. This undermines the melatonin production, and as a result the person finds it extremely difficult to fall asleep. Children playing with i-phones, tablets or watching children’s programs on television can have sleep disturbances from the blue light. Blue has the frequency that over stimulates the brain and interferes with melatonin production. Drug and alcohol abuse can also interfere with the normal circadian sleep rhythm and cause insomnia.

Hormone factors of insomnia

For natural sleep to occur, we need melatonin which the pineal gland releases in the evening. It initiates and maintains sleep during the night. The natural opponent of melatonin is cortisol, the stress hormone, from the adrenal glands. Both hormones need to be in balance to allow you to sleep normally. Shortly before we wake up in the morning melatonin production goes down and cortisol production is up. Cortisol levels are low at night and high during the day. So it is cortisol that keeps us going throughout the day. But an excess of cortisol from chronic stress can also interfere with falling asleep and sleeping through the night.

Stress and insomnia

When we feel stressed, cortisol production goes way up. This has consequences regarding our sleep pattern. It can interfere with falling asleep, causes us to wake up from a deep sleep in the middle of the night and can give us problems falling asleep again. Chronic stress exposure leads to high cortisol production by the adrenal glands, which in turn will lower melatonin and cause sleep disturbances. Older people (above the age of 50) have very little melatonin production left, as there is an age-related decline of melatonin production. The melatonin production is highest in younger years and lowest in older age.

What to do when you are sleepless

There are several over-the-counter remedies, which in combination can be quite effective.

Melatonin for when you are sleepless

Melatonin (3 mg at bedtime) is a good start to see what it does for your sleeplessness. Taking a small amount of melatonin at bedtime we can re-establish the balance between cortisol and melatonin, which helps the circadian hormone rhythm and sleep pattern to come back. Some people wake up in the middle of the night and find it difficult to fall asleep again. If this happens at 3 AM, a good remedy at this time is to take another 3 mg of melatonin. Melatonin stays in the system for about 4 hours. Light during the day de-activates the effect, when light hits the retinas upon opening your eyes. You should not exceed 6 mg of total melatonin overnight. Otherwise it will interfere with the balance of cortisol and melatonin, lowering cortisol levels, which would rob you of energy during the day.

Phosphorylated serine (Seriphos)

A supplement that is freely available in the US (but not in Canada) consists of a simple amino acid. As this link shows (second item in the link) phosphorylated serine Seriphos) helps to down-regulate cortisol levels (lowering them). This means that melatonin gets the upper hand and you can sleep again.

The dosage for phosphorylated serine (Seriphos) varies from person to person, but will be in the range of 1000 mg to 3000 mg in the evening. After about 30 days the circadian rhythm may have recovered and you can stop the Seriphos. A one-day pause is required once a month for resetting the hormone receptors. Should you still have problems sleeping, you can continue with it for another month and pause again for a day. Seriphos has very few side effects.

Valerian root capsules

Another useful sleep aid is valerian root (as capsules). 500 mg to 1000 mg will help you to relax. It does not have the side effect of feeling groggy the next morning.

Other considerations when you are sleepless

Hormone problems like thyroid abnormalities (too much or too little thyroid hormones) are issues that your doctor has to investigate. Women in menopause often have sleep disturbances due to a lack of estrogen and progesterone. A knowledgeable healthcare professional is able to take care of that by prescribing bioidentical hormone creams.

When men approach andropause (the equivalent of menopause in women), they lose testosterone production. This can cause insomnia. The doctor can verify the hormone loss by a blood test. Replacement with either bioidentical testosterone cream or injections will rebalance testosterone levels. Insomnia may disappear. It is essential not to overdose testosterone, as this can also cause insomnia.

Sleep lab for when you are sleepless

When home remedies do not help, it may be time to check into one of the sleep labs to diagnose the kind of sleep disorder you are suffering from. Here is an overview what is happening there.

Essentially you get hooked up to monitors and are encouraged to just sleep as you would normally do. The physician in charge of the lab will later explain to you what the monitors showed, and tell you what type of sleep. According to the findings your doctor will recommend what measures are appropriate to remedy the situation.

Treatment for insomnia when over-the-counter remedies fail

Short acting benzodiazepams

When anxiety is not a problem, but only insomnia is (falling asleep or staying asleep) lorazepam 1 mg (Ativan) or temazepam 10 mg (Restoril) are shorter acting benzodiazepams that will help. It is not a permanent but a short “emergency break” for intermittent use, so that the GABA benzodiazepine receptors have time to recover. Otherwise, with continuous use tolerance would set in. This means higher and higher doses of the sleep medication would be necessary to achieve the same effect. Another non-benzodiazepine is Zolpidem 5 mg (Ambien). Even though this medication is not a benzodiazepine, it works on stimulating the same GABA benzodiazepine receptors.

Longer acting benzodiazepams combined with antidepressant Trazodone

For several years the combination of a small amount of the longer acting benzodiazepams, clonazepam (Rivotril) at 0.5 mg combined with a small amount of the anti-depressant trazodone (Oleptro or Desyrel) at 50 mg at bedtime has been has been in use quite successfully.

But there is a concern of drowsiness caused by Rivotril as this link shows.

Trazodone, which is an antidepressant has a sleep cycle restoring effect at low doses and has less side effects, because it is used at ¼ the dose for a full-blown depression. Males are often complaining that it reduces their sex drive, and it may cause erectile dysfunction.

Clonazepam side effects

Rivotril was originally in use to control epileptic seizures and anxiety. The combination therapy for sleep disorders uses Rivotril at ¼ of the regular dose. Although it is good as a sleep aid, it has a long half-life and stays in the system well into the next day. This may present as sleepiness and cause falls in elderly patients because of clouded attention. Replacement by one of the medium long acting benzodiazepams could be the solution. A drug pause for 1 day will help to reset the GABA benzodiazepine receptors and prevent tolerance from happening. Knowing all those effects and side effects it is wiser to reserve the use of these medication strictly when everything else has failed!

When you are sleepless

Conclusion

As I mentioned before, you are not alone when you are sleepless. Insomnia can present as having problems to fall asleep, but it may present in others as a problem in the middle of the night waking up and having problems going back to sleep again.

I described non-conventional methods to help you to sleep using melatonin, Seriphos and valerian root capsules. If this fails, a sleep lab investigation may be necessary to get to the bottom of your insomnia problem. Physicians often prescribe short acting benzodiazepams like lorazepam (Ativan) and temazepam 10 mg (Restoril).

Other possibilities to treat insomnia

There are other possibilities to treat insomnia, with a combination of a low-dose antidepressant (trazodone, brand name Oleptro in the US) and low-dose anti-seizure and anti-anxiety drug clonazepam (Klonopin or Rivotril). Anxiety can often be a big component in insomnia and this treats both. On the other hand, anxiety is a separate problem, which needs professional treatment. There can be side effects of sleepiness from clonazepam and men complain of a lack of sex drive and erectile dysfunction from trazodone. Help is available when you are sleepless. But you need professional help to work on the problem and find the solution.

Incoming search terms:

https://www askdrray com/when-you-are-sleepless/

Dec

2017

Birth Control Pill Increases The Risk Of Breast Cancer

By Ray Schilling | alcohol, breast cancer, diagnostic X-rays, heart attack, Hormones, Menopause, Stroke

A recent study showed that the birth control pill increases the risk of breast cancer. This publication did research on 1.8 million of women of Denmark who took various forms of contemporary birth control pills (BCP). They were under the age of 50 and the observation of the participants continued for about 11 years.

Risks for breast cancer

When a woman took the BCP for less than one year, the risk of developing breast cancer was 9% higher compared to controls. But this rate increased even more to 38% after the use of the BCP for over 10 years. Women who had used progestin only intrauterine devices had a risk of 21% to develop breast cancer. It did not make a difference whether the BCP was a mix of estrogen and progestin or progestin. Researchers expressed the risk in the following fashion:

Less than one-year exposure to BCP: a 1.09-fold risk to develop breast cancer
Over 10-years use of BCP: a 1.38% risk to develop breast cancer
IUD with progestin in uterus: a 1.21% risk to develop breast cancer

Strokes and Heart attacks from the BCP

At the 86th Annual Meeting of the Endocrine Society in New Orleans/Louisiana a Canadian delegation presented this data. They had done a meta-analysis of 14 trials regarding side effects of the birth control pill (BCP). These women had taken the BCP on a prolonged basis (Ref. 1). The researchers monitored the risk of heart attacks and strokes. They found an association with the prolonged use of the low dose estrogen BCP. Researchers examined all of the studies between 1980 and October of 2002. 14 independent studies qualified for the meta-analysis.

Metaanalysis of BCP caused heart attacks and strokes

The strength of such a meta-analysis lies in the pooling of data and the fact that the data comes from a much larger patient population, which generally makes the results more reliable. Dr. J. Baillargeon from the Centre Hospitalier Universitaire in Sherbrooke, Quebec/Canada, stated that they found a

85-fold risk for developing heart attacks with long-term use of the BCP and at the same time there was a risk of
54-fold of hemorrhagic strokes with long-term use of the low-dose BCP.

It is important that women who contemplate going on the BCP know not only about the dangers of developing breast cancer, but also about the dangers of heart attacks and hemorrhagic strokes.

Lessons learnt from the Women’s Health Initiative

The Women’s Health Initiative in 2002 showed that women who were on Premarin and progestin for hormone replacement in menopause came down with breast cancer, heart attacks, stroke, and thromboembolic events. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127562/

They were using the synthetic hormones, namely conjugated equine estrogen and medroxyprogesterone acetate. The reason these women had to suffer these side effects was because their physicians insisted on using “pure hormones that a drug company had manufactured”. But these synthetic hormones were not pure hormones; they were hormones adulterated with side chains so that pharmaceutical companies could patent them.

Misfit of synthetic hormones with hormone receptors

These side chains made the synthetic hormones not fit the body’s hormone receptors. And this is the reason why the synthetic hormones created chaos in the body with breast cancer, strokes and heart attacks. In essence the mix of conjugated equine estrogen and the medroxyprogesterone were functioning like estrogens. So, there was an overdose of estrogenic hormones when taking these hormones and this use resulted in the development of breast cancer, heart attacks and strokes. The BCP is very similar to these hormones that are in the medication for hormone replacement therapy in menopause, but the hormone dosage in the BCP is much lower.

Other high-risk settings for women taking the BCP

There are other higher risk subpopulations of women who should avoid the BCP:

Had 1st degree relative with breast cancer on one breast :5-fold relative risk ; there is a genetic reason for breast cancer here
1st degree relative with breast cancer on both breasts : 9.5-fold relative risk ; genetic risk more obvious.
No relative, but patient had history of breast cancer : 4-fold relative risk ;
First child born later than 30 years of age : 1.9-fold relative risk ; in comparison with a woman who has her first child prior to age 20
If woman consumes 3 oz. of alcohol per day : 2-fold risk; in comparison with woman not using alcohol or BCP
Prior radiation for Hodgkin’s disease (age 10 to 19) : 10- to 75-fold risk; radiation exposure during time of breast development leads to an enormous risk ratio about 15 years later

Mechanism of the BCP

The BCP or OC (oral contraception) utilizes the fact that ovulation (=release of a fertile egg) requires a complex interaction between hormones to occur. The gonadotropin hormones LH and FSH from the pituitary gland must stimulate the ovaries. The right mixture of estrogen and progesterone from the ovaries achieves this. Without that proper hormonal interaction ovulation will not take place leading to an infertile cycle. With contraception scientists were able to suppress ovulation for as long as patients are taking the birth control pill regularly. By giving a small amount of estrogen and progesterone like substance (called “progestin”) in the oral contraceptive form (the birth control pill) ovulation stops, the lining of the uterine cavity becomes stable through estrogen, and the mucous plug in the cervical canal thickens, making it much more difficult for sperm to enter.

Estrogen dominance from the BCP

The Women’s Health Initiative has taught physicians a tough lesson: you cannot mess with nature’s hormones or else you create a risk of strokes (41%), heart attacks (29% more), blood clots (twice as many), breast cancer (26% more), colorectal cancer (37% more) and the patient will have a higher risk for Alzheimer’s disease (76% more often). This was a trial involving over 16,000 postmenopausal women.

Although the hormones used in these women were slightly different in concentration, structurally they were very similar to the ones used for birth control purposes. What nature seems to tell us is that you cannot mess with hormone receptors, or you set up the body for one of the diseases mentioned.

Hormonal disruption

The truth is that the combination of synthetic estrogen-like and progesterone-like substances in the BCP are not bio-identical hormones. They suppress ovulation, which means they are creating progesterone deficiency in the woman who takes these synthetic hormones. The end result is that physicians create estrogen dominance in these women, which according to Dr. Lee is the reason for the above listed complications (Ref.2).

It makes more sense to use less invasive alternatives for birth control methods instead of the BCP. A well-fitted IUD (inserted by a gynecologist) is a good alternative. This will not create havoc with the woman’s hormones and will not create infertility after contraception is no longer needed. Bio-identical progesterone replacement using creams is being used to rebalance the original hormones when the BCP is discontinued.

Birth Control Pill Increases The Risk Of Breast Cancer

Conclusion

The birth control pill (BCP) is a popular form of contraception. But there are significant risks of breast cancer, heart attacks and strokes associated with its use. According to the previous literature the risk of complications associated with the BCP was between 1.3- and 1.6-fold. The present study with smaller concentrations of hormones in the more modern BCP still showed a risk of 1.38-fold regarding breast cancer. It did not mention heart attacks and strokes as additional risk factors. The Danish study was supported by a grant from the Novo Nordisk Foundation. Novo Nordisk is a major producer of BCP’s in Europe and in the world. It would be in their interest to minimize the risks associated with the BCP. Any woman using the BCP should use it only as long as she really needs it. Ultimately she would be better advised to use alternatives like IUD’s and condoms.

References

https://www.askdrray.com/birth-control-pill-increases-strokes-and-heart-attacks/
John R. Lee, David Zava and Virginia Hopkins: “What your doctor may not tell you about breast cancer – How hormone balance can help save your life”, Wellness Central, Hachette Book Group USA, 2005. Page 360 to 374 explains xenohormones.

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