The Truth About Bio- Identical Hormones Vivian F. DeNise,DO Integrative Physician Patients Medical
Jun 23, 2015
The Truth About Bio-Identical Hormones
Vivian F. DeNise,DO Integrative PhysicianPatients Medical
Patients Medical
A holistic medical centerFull-service
www.patientsmedical.com
Patients Medical
Discover health, rediscover vitalityFocus on the root cause Integrate modern medicine, holistic
practices, and natural supplements
www.patientsmedical.com
Patients Medical
Our goal Promote healing and prevent disease
www.patientsmedical.com
Patients Medical
Physicians collaborate to approach each patient holistically.
www.patientsmedical.com
Patients Medical
Result: Gain health and nutritional wisdom
that can be applied for years to come.
www.patientsmedical.com
Patients Medical
Founder, Dr. Warren Levinbegan practicing his ground-breaking
holistic protocols in 1974.
www.patientsmedical.com
Patients Medical
Conditions Treated Menopause PMS Thyroid disease Chronic Fatigue Syndrome Multiple Sclerosis Osteoarthritis (OA) Rheumatoid Arthritis (RA) Diabetes Heart disease Crohn’s disease, IBS, IBD Alzheimer’s disease Lyme disease Auto-immune diseases Many other secondary medical conditions
www.patientsmedical.com
Patients Medical
Staff Medical Doctors▪ Internal Medicine▪ Family Practice▪ Gynecology▪ Osteopathy▪ Oncology▪ Alternative Pain Management▪ Pediatrics▪ Plastic Surgery
Nutrition Kinesiology Cranio-Sacral Therapy Reflexology Oriental Medicine and Acupuncture Homeopathy
www.patientsmedical.com
Patients Medical
Integrative Medicine
www.patientsmedical.com
Patients Medical
Introducing our speaker:
Vivian DeNise, DOIntegrative Medicine
www.patientsmedical.com
Patients Medical
Completed her medical degree at New York College of Osteopathic Medicine
Certifications in Integrative Medicine with the American Academy of Anti-Aging Medicine (A4M)
www.patientsmedical.com
Patients Medical
Specialties include Hormonal Imbalances Nutritional Deficiency Thyroid Disorders Gastro-Intestinal Problems Detoxification And many more!
www.patientsmedical.com
The Truth About Bio-Identical Hormones
Hormone Receptors
There are receptors everywhere in the body for estrogen, progesterone and
testosterone in both men and women.
www.patientsmedical.com
Where are they?
BrainBone, Muscle, JointsHeartBlood VesselsBladderLiverKidneyGenitalsNervesSkin and Hair Follicles
www.patientsmedical.com
What is our goal?
To achieve Balanced Hormone Optimization to that of a 25-30 year old level using Bio-Identical Hormones.
www.patientsmedical.com
What are Natural (Bio-Identical) Hormones?
They are identical to the molecular structure of hormones produced by human female or males.
They are NOT: Xeno hormones Horse hormones Synthetic hormones
www.patientsmedical.com
What Bio Identical Hormones Are
Atom for atom identical to human hormones Not horse hormones Not chemically altered
No increased risk for cancerLess risk for heart diseaseLess mortalityNeeded for Bone, Brain, Quality of
Life
www.patientsmedical.com
The Hormonal Symphony
TestosteroneEstrogens,
ProgesteroneDHEA, PregnenaoloneCortisolThyroid: T3, T4Vitamin DGrowth Hormone
www.patientsmedical.com
Your Libido is Affected By
Hormones Neurotransmitters Medications Emotions Diet Sleep
www.patientsmedical.com
Female Hormones
Estrogens▪ Estrone=E1▪ Estradiol=E2▪ Estriol=E3
ProgesteroneTestosterone
www.patientsmedical.com
Hormones
www.patientsmedical.com
Definitions
PMS (Premenstrual Syndrome)- Cyclical mental and physical symptoms
preceding the menstrual cycle.
www.patientsmedical.com
Definitions
Peri-menopause-Can begin to occur 10-20 years prior to menopause associated with cyclical changes in menses as well as mental/physical symptoms.▪ Early- changes occur rarely and resolve▪ Middle-changes occur often and for longer▪ Late-changes occur continuously.
Menopause-no menstrual bleeding for 1 year
www.patientsmedical.com
Female Hormones
Deficiencies can start years before menopause in peri-menopause Poor sleep, anxiety,
PMS-Progesterone Low Libido, decreased
memory-Testosterone Low energy, hot flashes,
vaginal dryness-Estrogen
www.patientsmedical.com
Bio Identical Hormone Replacement in Women
Balances Estrogens, Progesterone, and Testosterone
Every woman needs a unique balance
Not every woman needs estrogenProgesterone protects against breast
cancer
Unlike “progestins” natural progesterone does not have
androgenic or anti androgenic effects.
www.patientsmedical.com
Estrogen Deficiency
Hot flashesNight sweatsFatigueVaginal DrynessPoor memory
and Foggy thinking
Low energy
www.patientsmedical.com
Estrogen Deficiency
Depressed mood Decreased
concentration Decreased sexual
desire or libido Excessive daytime
sleepiness Stress incontinence and
UTI’s Osteoporosis,
Cardiovascular disease, Dementia www.patientsmedical.com
Excess Estrogen Side effects
Agitated Anxiety Weight gain Water retention Headaches Swollen or tender breasts Bloating Spotting or breakthrough
bleeding Mood swings Poor sleep Achy joints Excessive bleeding
www.patientsmedical.com
Synthetic Estrogen
Increase blood pressure Increase triglycerides Increase estroneCause gallstonesElevate liver enzymes Increase SHBG (decreases
testosterone) Interrupt tyrptophan metabolism
and consequently serotonin metabolism
Causes blood clots to formwww.patientsmedical.com
What Transdermal E2 doesDecreases HbA1cDecreases total cholesterolDecreases LDLDecreases HS-CRPDecreases IL-6 and TNF-inflammatory
cytokines implicated in autoimmune, cardiovascular, osteoporosis and Alzheimer's
NO increase risk of stroke or venous thrombosis
Protects against bone losswww.patientsmedical.com
Progesterone
Usually the first hormone to become deficient in peri-menopause.
www.patientsmedical.com
Progesterone deficiency symptoms
Agitation Irritability, aggressiveness Anxiety, anger Weight gain Water retention Headaches Swollen or tender breasts
www.patientsmedical.com
Progesterone Deficiency Symptoms
BloatingSpotting or breakthrough bleedingMood swingsPoor sleep, insomniaAchy jointsExcessive bleedingEndometriosisFibrocystic breasts
www.patientsmedical.com
Causes of Low Progesterone Impaired production Low LH Increased prolactin productionStressAntidepressantsExcessive arginine consumptionSugarSaturated fatDeficiency of vitamins A, B6, C, zincDecreased thyroid hormone
www.patientsmedical.com
Synthetic Progesterone
Called progestinsProgestins do not reproduce the
same actions of natural progesterone
www.patientsmedical.com
Side Effects of Synthetic Progesterone
Increases appetiteWeight gainFluid retention IrritabilityDepressionHeadacheDecreases energyBloatingBreast tendernessDecreases sexual interest
www.patientsmedical.com
Side Effects of Synthetic Progesterone
AcneHair lossNausea Insomnia Interferes with the body’s own
production of progesteroneDoes not help balance estrogenRemains in the body longerCan cause spasm of coronary arteries
www.patientsmedical.com
Wait there’s more…….
Stops the protective affects estrogen has on the heart
May make the symptoms of progesterone loss worse
Increases LDLDecreases HDLProtects only the uterus from cancerCounteracts many of the positive
effects of estrogen on serotonin
www.patientsmedical.com
Bio-Identical Progesterone Replacement
OrallyTransdermal cream
www.patientsmedical.com
Natural Progesterone Affects Not Seen With Progestins
Helps balance estrogenLeaves the body quickly Improves sleepNatural calming effectLowers high blood pressureHelps the body use and eliminate fatsLowers cholesterol
www.patientsmedical.com
Natural Progesterone Affects Not Seen With Progestins (Continued)
May protect against breast cancer Increases scalp hair Helps balance fluids in the cells Increases metabolic rate Natural diureticNatural antidepressant Is anti-inflammatory
www.patientsmedical.com
Natural Progesterone Affects Not Seen With Progestins (Continued)
Stimulates the production of new bone
Enhances the action of thyroid hormones
Improves libido Helps restore proper
cell oxygen levels Induces conversion of
E1 to the inactive E1S form
Promotes Th2 immunity
Is neuroprotective, promoting myelination
www.patientsmedical.com
Progesterone Decreases Breast Cancer Risk
www.patientsmedical.com
Synthetic progestins increase Breast Cancer Risk
Progesterone decreases Breast Cancer Risk
Effects of Too Much Progesterone Even with Adequate Estrogen
Increases fat storageElevates cortisol Increases insulin resistance Increases appetite and carbohydrate
cravingsRelaxes the smooth muscles of the
gut (This can cause bloating, fullness, and constipation. It can also contribute to gallstones.)
www.patientsmedical.com
Testosterone Replacement in Women
Testosterone is needed for a sense of well being
Strength especially upper bodyLibidoUsually decreased in peri-menopausal
and menopausal womenBody composition Bone densityDHEA can increase Testosterone in
women but not in menwww.patientsmedical.com
Testosterone
Increases sexual interest
Increases sense of emotional well-being
Increases muscle mass and strength
Helps maintain memoryHelps skin from saggingDecreases excess body
fatHelps maintain bone
strengthElevates
norepinephrine in the brain (tricyclic affect)
www.patientsmedical.com
Symptoms of Testosterone LossMuscle wastingWeight gainFatigueLow self-esteemDecreased HDLDry, thin skin, with
poor elasticityThinning and dry
hairDroopy eyelidsSagging cheeksThin lipsAnxiety
www.patientsmedical.com
Causes of Low TestosteroneMenopauseChildbirthChemotherapyAdrenal stress or burnoutEndometriosisDepressionPsychological traumaBirth control pillsHMG-CoA-reductase inhibitors
www.patientsmedical.com
Treatment of Low Testosterone Testosterone replacement P.O. or
transdermally. Use the bio-identical form.
Methyltestosterone has been associated with an increase in liver cancer.
If used transdermally must rotate sites. In order for testosterone to work well,
estradiol must also be optimized. Without enough estrogen, testosterone
cannot attach to brain receptors. If testosterone is given alone it can
increase plaque formation. www.patientsmedical.com
How Else Can Testosterone Levels Be Raised?
Decrease calorie intake Increase protein in the
dietTake the amino acids
arginine, leucine, glutamine
ExerciseGet enough sleepLose weightReduce stressTake zinc if deficient
(Zinc is needed for the metabolism of testosterone.)
www.patientsmedical.com
Testosterone Replacement Therapy Decreases Breast Cancer
When used in conjunction with BHRT there is even a lower incidence of
breast cancer compared to HRT alone.
www.patientsmedical.com
Follow-Up
Seen every 3 months or sooner if needed
Labs every 3 months initially and as needed depending on where patient is in life
May take up to 6 months to get full benefit
www.patientsmedical.com
Other Factors
StressDietEnvironmental
www.patientsmedical.com
www.patientsmedical.com
Get on track with your health!
www.patientsmedical.com
Do you have a question for Dr. DeNise? Ask it Now!
www.patientsmedical.com
You opinion is important to us.
Please fill out your pink event evaluation form and return it to us.
www.patientsmedical.com
Get on Track with Your Hormonal Health!
Get started TODAY by making an appointment with Dr. DeNise.
www.patientsmedical.com
Take Advantage of Your Coupon
www.patientsmedical.com
Give your whole family the gift of health!
Patients Medical’s Team of Holistic Doctors
www.patientsmedical.com
Give yourself the gift of health!
www.patientsmedical.com
Give yourself the gift of health!
www.patientsmedical.com
Give your whole family the gift of health!
To get more information or to schedule an appointment,
call 212-679-9667 or email [email protected]