Bioidentical HRT usually involves three hormones: Estrogens (estradiol & estriol), Progesterone, and Testosterone. Estrogens are wonderful hormones. They are responsible for development of feminine traits and are thus essential for sexual attraction and reproduction. Estrogens are necessary for brain function and involved in mood control. The down-side to estrogens is that they are pro-inflammatory growth hormones. Their message to the cells in your body is to “grow baby grow”! Thus they tend to be associated with weight gain, blood clots, and cancer. Estrogens are balanced by Progesterone. Progesterone is an anti-inflammatory, anti-growth hormone. So while estrogens are telling your cells to grow (especially breast cells), progesterone is telling your cells to grow up and be mature (sounds like me talking to my kids when they were teens). Mature cells are much less likely to spin out of control and become cancerous. Mature cells die when they are supposed to (a process called apoptosis). Remember, cancer cells are immortal. They are like vampires that can out live you and kill you too! I like to think of Progesterone as the wooden stake in the heart of the vampire breast cancer cell.
As women enter the perimenopause (around the age of 35), their Progesterone production begins to decline. This is due to anovulatory cycles and inadequate luteal phase progesterone production causing an increase in fertility problems as women age. Perimenopausal women become Progesterone deficient ( Estrogen dominant). Estrogen production in the perimenopause becomes erratic with both higher and lower levels during the cycle. These changes cause the common perimenopausal symptoms such as weight gain, fatigue, decreased sex drive, abnormal bleeding, and cyclic moods (PMS). Estrogen dominance is also an issue in uterine fibroids and endometriosis. Remember, Dr. Katharina Dalton, the inventor of the term PMS, recommended progesterone suppositories for the treatment of PMS. I spent a week with Dr. Dalton inLondon in 1985 learning about her theories. She came to Columbia and presented two talks. One was a private talk for physicians only. Two doctors attended; myself and a family physician no longer in private practice. The other presentation was for the general public and was at the Ramada Inn. Well over 500 attended and many were turned away for lack of room.
Check back for the continuation of Volume 2 of Dr Trumbower’s Hormone Diaries where he discusses more about the “Tres Amigos” and what happens to estrogen production at menopause.