Dear Dr. Blanscet,

I’m a 45-year old woman and for the last year I have not really been feeling all that great. I don’t feel sick or anything, I just don’t feel right. I have gained about 15 pounds in 12 months. I often have trouble sleeping now, which was never a problem before. I’m tired a lot lately and get headaches more than what I think is normal. I’m not really interested in intimacy with my husband and we seem to be arguing a lot. I just feel like things are off. When I told my primary doctor this, he did some tests and said everything is fine. Is this just a normal part of aging?

-Sarah H.


Sarah,

picture of Dr Laurie Blanscet
After going through some of those symptoms myself, I decided to get further education on bioidentical hormones and healthy aging. Helping men and women achieve optimal health is something I’m very passionate about.

When a primary doctor looks at your blood tests, they are often only checking to see whether your results are “normal.” The problem is, in our society “normal” is based on people who are overweight, fatigued and in general not feeling that great. You don’t necessarily want to be normal; you want optimal health.

Trust your intuition. If you are feeling like your body is “off,” then it probably is. If you’re doctor isn’t trained in bio identical hormones, you should really find someone who is. Bio identical hormones are usually plant based and are made to be biologically equivalent to the natural hormones your body produces. It just makes sense that a product with the exact chemical structure as your body makes will be safer and more effective.

Problems that are associated with hormonal changes in women include a decrease in energy, lack of sleep, night sweats, low libido, weight gain, migraines, hot flashes, vaginal dryness, mood swings, a general feeling of malaise, and more. Men also experience many of these symptoms and feel like they have passed their peak even though they are only in their 40′s or 50′s.

Experts in bio-identical hormone replacement therapy strive to achieve optimal results by working with each individual’s unique biochemistry. Every person is different and will receive a plan customized to their needs. It takes time to properly evaluate your symptoms, interpret your lab work, and be educated on treatments. There are several ways to restore hormone balance in men and women: creams, oral capsules, implanted pellets, etc.

It is unfortunate, but current medical insurances do not cover the expense of a proper hormone consultation and treatment. This may change in the future, but you if you are experiencing hormonal imbalance, it’s best not to wait.

Aging Well

Aging is inevitable but aging well is not. The good news is that you have more control over that than your genetics does. It is also never too late to do something about how you age. Living full of vitality until the end of your life is much more preferable than lingering for 10-20 years—getting sick and frail. There are some fairly simple things that you can do in order to enhance the quality of your life.

Happy Couple

Everyone knows that they need to exercise in order to lose weight but you may not think about it as helping you to age more gracefully. When you get regular exercise it helps your heart and lungs while also helping your musculoskeletal system. When you strengthen your bones and muscles this helps to prevent falls and fractures plus it enhances your overall mobility. You are able to get up and move around much easier. Regular exercise also helps your brain to stay younger and your cardiovascular system to stay in shape. Many people give up on exercise if they don’t lose weight fast enough. Refocus your goal of exercise as a way to live a vital life not just as a means to lose weight. Get at least 150 minutes of exercise a week–that is easy for the majority of people.

A healthy diet is another thing people thing about as a means to lose weight. A healthy diet gives your body the nutrients that it needs in order to build healthy bones and muscles, to keep your heart functioning well, to improve your mental clarity, and to give you energy; among other things. A healthy diet is one that focuses on protein and vegetables. Fruit is ok but limit your intake to one or two per day. Live by the 90/10 rule: 90% of what you eat should be for your health and it is ok to have 10% of what you eat be a little more “fun”. Whole foods that are organic are the best source of nutrition in your 90%.

Getting adequate sleep is critical to feeling energetic and rejuvenating your body. You should get enough sleep that you wake up refreshed. Keep your bedroom dark, quiet and cool. Turn off the TV and computer at least an hour before your bedtime. If you have trouble falling asleep melatonin, yoga stretches, and Epsom salt baths are wonderful natural things you can do to help you sleep better. Better sleep means better aging.

Organic Foods

There are people who say that your hormones should decline as you age but there is also a school of thought that believes you age because your hormones decline. Both men and women can benefit from bio-identical hormone balancing to help them live optimally and age more gracefully. Balancing your hormones (this includes Progesterone, Estrogen, Testosterone, and Thyroid) helps you to feel stronger and more vital, think clearer, and prevents overall deterioration of your health. Bio-identical hlormone balancing is not just for women with hot flashes–it is for men and women who want to age well.

Take control of your aging process and control the things that you can. There are other things that you can do but the four things I mentioned above are often overlooked and yet fairly easy to do. The little things you do each day do add up. If you want to live a full and vital life it starts with a decision to make some changes towards that goal.

Mood and hormones

Anxiety, depression, and irritability is something that can affect both men and women. There are different causes of mood disorders and they sometimes do require an anti-depressant or anti-anxiety medication. However, hormonal imbalances are an often overlooked cause of feeling “off”.

Andropause - Menopause For Men

Progesterone, Estrogen, and Testosterone are produced in every man’s body and every woman’s body. Obviously men and women have different amounts of each hormone but all three are important to both sexes. If these hormones get out of balance they can affect how you think and how you feel. It can be a gradual onset over many years or a more abrupt onset. It can be difficult for a traditional physician to pinpoint hormones as the cause of your mood disturbance.

Balancing your hormones involves the use of bio-identical hormones that are customized to your specific needs-this is done by a physician specializing in hormone balancing and can never be done correctly within the constraints of health insurance. Once your hormones are balanced you feel happier, more energetic, and overall you feel mentally balanced. Now you are able to sleep better and you have the focus and energy to eat a healthier whole food diet and to exercise more—all factors that help you to optimize your hormones which in turn, optimizes how you feel, think, and move.

Is It Menopause Or Am I Just Wacky?

Sylvia (name has been changed for privacy) sat down in front of me and said “I am whacked”. “I feel like I am crazy–I fly off the handle at little things-it is so easy to get irritated. Also, I am not depressed but I just don’t have any joy or energy anymore. And I worry about little things. My regular doctor thinks I need an anti-depressant but I don’t think that is the answer. I never had these issues until I turned 46.”

What Are Hormones?

I actually hear stories like this quite often from women age 35-55. This is the time in a woman’s life when her hormones really start to change. It is so sad that women are made to feel like they are in need of an anti depressant automatically. Many health care providers, and patients, fail to look at the possibility that a hormonal imbalance can be the cause of feeling “wacky”.

It is a common misconception that hormonal changes are only felt as hot flashes or night sweats. Your hormones (specifically Progesterone, Estrogen, and Testosterone) have so many more functions in your body than just preventing hot flashes or giving you a sex drive. These hormones perform hundreds of different functions in your body. One of those things is helping you to feel emotionally balanced and to have better energy and vitality.

In Sylvia’s case I found that she lacked Testosterone, Progesterone, and B-12. I gave her a bio-identical Progesterone capsule at night which helped to calm her and enhance her sleep quality. I also inserted a bio-identical Testosterone pellet which also helped her to balance her mood and gave her back her vitality. She was counseled to eat an organic whole food based diet and to eliminate gluten (gluten has been found to be a hormonal disrupter and she was found to be sensitive to it). She was also given methyl-B12 injections (B-12 is important for the proper functioning of hormones) and this also helped her energy.

Feeling emotionally out of balance can be caused by hormonal imbalances and Sylvia’s case shows this perfectly. Feeling “whacked” is a thing of the past and without the use of an antidepressant.

Testosterone and Fatigue

“Mark” a 48 year old gentleman came to my office complaining of fatigue, an increase in aches/pains, an increase in irritability, and a decreased ability to build muscle. He still ha a good libido but had noticed a decrease in morning erections. He had seen his regular doctor who told him his labs were normal and that he needed to exercise more but he was too tired to do that. Mark knew there was something else going on.
When I reviewed his symptoms and his lab results we both agreed that he suffered from low Testosterone. At first he was concerned about the risks associated with replacing Testosterone based on recent news releases. We went over the study that the news was citing. The news reports were telling men that Testosterone replacement increased heart disease risk.

Andropause - Menopause For Men

However, the study being cited had tested older, high heart disease risk men whose Testosterone level was never in an optimal range and they were treated for too short a time to even show a benefit. Optimal Testosterone levels are around 600-1400 depending on the male, men in this study were averaging levels in the 300 range. This was a poorly done study and it is a shame that it was used to scare men away from seeking help.

In fact, there are many studies showing that when Testosterone levels are optimized and given enough time to work, that Testosterone actually is protective for the heart as well as the brain.
Remember that the normal Testosterone lab values are not optimal–they are simply the expected values based on testing the male population—both ill and healthy. You want optimal levels if you want a life of vitality.

Hormone Pellets

Optimizing a man’s Testosterone level involves replacing his Testosterone along with starting healthy lifestyle changes. Testosterone is best replaced with bio-identical Testosterone–biologically identical to what your body is designed to respond to. Mark was given the choices on replacing his Testosterone. Creams which are applied twice a day. There are synthetic gels and patches on the market but they are not bio-identical-using them can cause unforeseen complications since they are chemically different from what your body is designed to work with. A compounding pharmacy makes the bio-identical Testosterone. You can not buy it at a regular pharmacy. A quality compounding pharmacy offers safe and effective bio-identical creams.

Creams are painless but you do need to remember to apply them daily and there can be a pulse like absorption after application. In addition you do need to be careful about getting the Testosterone cream on others.
Testosterone injections are another possible form of Testosterone replacement and they tend to be more effective than creams but your liver has to process it into a bio-identical Testosterone. There is also a pulse like absorption and you need an injection once to twice a week. This mode of replacement requires the most monitoring by lab work.

Testosterone pellets are bio-identical and are absorbed on a more constant level with a natural increase when your cardiac input increases–similar to your natural physiology. They work very effectively. Testosterone pellets have been well documented to protect the heart, bones, and brain as well as resolve symptoms. It does involve an in office procedure where the pellets are inserted in the fatty tissue of your buttocks and it is the more costly of the three choices.
Which form of Testosterone replacement a man chooses depends on the individual.

Mark chose Testosterone pellets and after about 2-3 weeks he felt better-he has energy, is able to build muscle, feels mentally balanced and can pole vault out of bed again. He also has the focus to get back into the gym and fine tune his diet to include more vegetables (organic) and less processed foods.

Male Menopause?

Even though there is more public talk about women and menopause, men also encounter a hormonal imbalance as they age (andropause). Because women tend to have a more abrupt hormonal change they are more likely than men to realize that their symptoms are from a hormonal imbalance. Men tend to have a more gradual change–with symptoms slowly appearing over 20 year period. Often the symptoms are not seen as a hormonal decline.

Andropause - Menopause For Men

Male menopause (called andropause) has many different symptoms. These symptoms come from a drop in Testosterone. These symptoms include depression, irritability, decreased morning erections, longer recovery time from workouts, stiffness and pain in joints and muscles, decreased concentration, decreased ability to build muscle, lowered mental acuity, loss of the competitive edge, overall loss of vitality, fatigue, sleep disturbances, etc. A man may still have a good libido (sex drive) but be suffering from a decrease in his Testosterone levels because he does not realize that Testosterone perfor.s many functions in the body. Testosterone is not just a “sex” hormone.

There are also strong associations between low Testosterone and bone loss (osteoporosis), dementia, type 2 diabetes, elevated LDL cholesterol, and arthritis. There is a lot of incorrect information about the negative side effects of Testosterone and when you research the studies you will find that when bio-identical Testosterone is prescribed and monitored by a hormone specialist, Testosterone is a benefit to the overall health and vitality of men and has not been shown to cause cancer or heart disease. Proper hormone balancing for men results in a man who feels great, thinks clearly, moves easier, and enjoys life better.

Testosterone And Thyroid

J.T., a 47 y/o lady, came into my office complaining of constipation, low energy, poor sleep, the inability to lose weight, and an overall decrease in vitality. She was even considering leaving her husband of 22 years. Luckily her friend told her to get her hormones checked and she was advised to see someone who specialized in bio-identical hormones and customized care. Her regular doctor had tried putting her on an antidepressant and told her to go exercise-she knew there had to be something else she could do.

Person with no energy

After evaluating her history extensively and her lab work, I found that her Thyroid was sub optimal, her Testosterone was non existent, her Progesterone was quite low, and she had some food allergies.

The medical system is broken and the choice is to complain about it, suffer silently within it, or realize that you must go outside of the system in order to achieve optimal health. To treat you to optimal levels requires special training, spending time getting to know you, and being willing to treat you–not just lab values. This simply can not be done under the current health insurance system.

J.T. fortunately realized this and sought help outside of her insurance plan. She is now able to function optimally. It took us a few months but she now sleeps well, has regular bowel movements, has great energy and is eating better and exercising regularly. She was able to rekindle her marriage by improving her own wellbeing by balancing her hormones and by going to couple’s counseling. Optimal health is an obtainable result!

Bio-Identical Hormones For Women

What to expect after a bio-identical hormone pellet insertion for women –

You will have had a local anesthetic before the bio-identical pellets are inserted. You will receive one to two bio-identical Testosterone pellets and possibly one bio-identical Estrogen pellet depending on your specific needs. The majority of women find that the actual pellet insertion is quite painless. You may feel a slight pressure at times but no sharp pain. The only possible discomfort during the procedure is when the local anesthetic is placed (it can sting a little).

Woman Stretching

It is important to ice the area where the pellet was inserted over the following 4 hours. It is best to place an ice pack on the area for about 10-15 minutes and then have a period of 20-30 minutes with no ice, then repeat. This will minimize any swelling and discomfort that you may have.

You must avoid immersing the area in water for 4 days. Showering is fine. No baths, pool, or hot tub use. You must also avoid heavy exercise for the next 4 days. Walking is fine. Any action that causes your buttocks muscles to contract strongly has the potential for pushing the pellets out. This is only a precaution for the first four days. After that time period you are free to do whatever you wish in regards to activity and water exposure.

You may have some tenderness in the area (buttocks area, above where pants pockets are) for a few days. Rarely some women feel a slight discomfort for up to two weeks. If you follow the instructions listed above this will decrease any discomfort. If you do experience tenderness it should not interfere with your daily activities.

The majority of women barely notice any discomfort after the procedure. You are able to go back to work after the procedure as long as you can follow the precautions given.

Testosterone and Estrogen perform many functions in the human body–they are not just there to help us feel better. It can take up to 3-4 weeks to feel the benefits of the pellets. If you feel no different by four weeks after the pellet insertion, it is important to get your hormone levels done so that we can assess your needs. Sometimes you need a booster bio-identical pellet insertion after your first insertion because your hormone stores were so low.

Each woman uses up their bio-identical pellets at a different rate. You will typically need a re-pellet at 3-5 months from the time of insertion. Get your re-pellet done at the first signs of your symptoms slightly recurring.

Communicate with the hormone specialist who inserted your pellets if you are unsure of what to do or if you have any questions. It is important for us to know how you are doing so that we may help you.

Menopause Or Wacky?

Sylvia (name has been changed for privacy) sat down in front of me and said “I am whacked”. “I feel like I am crazy–I fly off the handle at little things-it is so easy to get irritated. Also, I am not depressed but I just don’t have any joy or energy anymore. And I worry about little things. My regular doctor thinks I need an anti-depressant but I don’t think that is the answer. I never had these issues until I turned 46.”

Woman having an emotional migrane

I actually hear stories like this quite often from women age 35-55. This is the time in a woman’s life when her hormones really start to change. It is so sad that women are made to feel like they are in need of an anti depressant automatically. Many health care providers, and patients, fail to look at the possibility that a hormonal imbalance can be the cause of feeling “wacky”.

It is a common misconception that hormonal changes are only felt as hot flashes or night sweats. Your hormones (specifically Progesterone, Estrogen, and Testosterone) have so many more functions in your body than just preventing hot flashes or giving you a sex drive. These hormones perform hundreds of different functions in your body. One of those things is helping you to feel emotionally balanced and to have better energy and vitality.

In Sylvia’s case I found that she lacked Testosterone, Progesterone, and B-12. I gave her a bio-identical Progesterone capsule at night which helped to calm her and enhance her sleep quality. I also inserted a bio-identical Testosterone pellet which also helped her to balance her mood and gave her back her vitality. She was counseled to eat an organic whole food based diet and to eliminate gluten (gluten has been found to be a hormonal disrupter and she was found to be sensitive to it). She was also given methyl-B12 injections (B-12 is important for the proper functioning of hormones) and this also helped her energy.

Feeling emotionally out of balance can be caused by hormonal imbalances and Sylvia’s case shows this perfectly. Feeling “whacked” is a thing of the past and without the use of an antidepressant.

Optimizing Your Hormones

Hormonal balance means feeling great and being able to enjoy your life. It would be great if it were as simple as just taking bio-identical hormones. They help tremendously but they are not the complete answer.

No Energy - Low Thyroid

Think of your optimal health and well being as a circle and this circle has several pieces. Getting your Estrogen, Testosterone, Progesterone, Thyroid, and Cortisol balanced through the use of bio-identical hormones and proper supplementation is a piece of that circle. Optimizing that piece can give you more energy and focus which hopefully helps you to address the other pieces.

The other pieces to address are your nutrition, your stress, your toxin exposure, your sleep (often helped with hormone balancing), and your exercise. Focus on a whole food organic diet full of vegetables and healthy protein sources. Drink water and consume minimal, if any, alcohol and caffeine. Do yoga and breathing exercises–work on your response to stress. Develop good sleep habits and take time out daily to move your body and exercise.
These things will take time but are well worth it. I have seen the most amazing results when my patients utilize bio-identical hormones and take an active role in improving all of the pieces. Your life is worth it!!