History of Hormonal Therapy

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Dear Health and wellness seekers,

Use of hormonal therapy has been documented since ancient times. Aging women, especially of noble descent were known to ingest the urine of younger females to reap the benefits of estrogen excreted in the urine. In the 1960s a book called Feminine Forever by Dr. Robert Wilson, recommended that taking estrogen therapy could quell the symptoms of menopause. During the 1960s it was also determined that giving unopposed estrogen therapy increased the risk of endometrial cancer. As a result, progestin(synthetic progesterone) was added to estrogen therapy. The drug Prempro was born which combined synthetic progesterone and premarin which was a combination of estrone, equalin, and equilenin, hormones derived from horse urine. The three estrogens were referred to as conjugated equine estrogen (CEE). Although they were natural hormones they were not identical to estrogen receptors found in the human body. For many years this was a standard menopausal treatment.

In 2002 a study was published by the Women’s Health Initiative which included 16,000 postmenopausal women. The major conclusions of this study found an increased risk of breast cancer and heart attacks for women taking prempro. Some benefits identified in the study were decreased risk of hip fracture and colorectal cancers. This study changed the standard treatment of
menopause hormone replacement therapy. For many years hormone replacement therapy declined.

In the last 10 years, the pendulum has swung in the direction of alternative therapies, anti-aging medicine and plant based hormone replacement options. Testosterone pellet therapy has actually been in use since 1938 but not widely accepted. Pellets can either be Testosterone or Estrogen and are made by compounding pharmacies. Size of the pellets are comparable to Tic Tacs, and are delivered in sterile glass vials. They are ordered at specific doses for each patient. In women pellets placed in subcutaneous tissue last 3-4 months, and in men due to larger doses, last 4-6 months. Pellets release low levels of hormone every day and relieve symptoms of menopause and andropause. Common symptoms of menopause and andropause include insomnia,
decreased libido, migraines, low energy and poor concentration. After pellet therapy patients report improved overall wellbeing and energy. Men and women need adequate levels of testosterone for optimal physical and mental health. Pellet therapy has been associated with decreased risk of Alzheimer’s Disease and Heart Disease.

If women receive estrogen therapy and still have their uterus, it is important to treat with progesterone therapy as well, either micronized progesterone pills or vaginal therapy. Women may experience hormonal changes at any age and therapy is adjusted depending on age and menopausal status.

Hormone levels and routine labs should be checked prior to any type of hormonal treatments and about six weeks after initiating therapy. As always, it is highly advised that people complete routine health screenings including Pap smears, PSA, MMG, colonoscopy. There are multiple studies documenting the benefits of hormone replacement therapy in men and women. Other means of hormone replacement therapy include creams and injectable products. Post menopausal women often get relief of their menopausal symptoms by simply replacing testosterone. Contact us for a consultation and recommendation session. Please see attached article with objective evidence of hormone replacement therapy.

Wishing you wealth in health,

Dr. Michelle Mendoza
Diplomate American Board of Internal Medince
Member American Academy of Anti-Aging Medicine