Bioidentical Hormones the Controversial Next Step in Fixing Aging Problems

By Jami Kunzer

This might make you squirm a little, but if Oprah can do it ... Let’s talk about menopause and perimenopause – the time leading up to menopause – and even andropause. What’s andropause? Male menopause. Yes, there is such a thing. You just don’t hear about it much. “Men don’t sit around and talk to each other and say, ‘Hey, I think my testosterone is low,’” said Dr. Joseph Mazzei of BodyLogicMD in Chicago. “I always joke with them, ‘There’s no Oprah for men.’” Considered an anti-aging physician, Mazzei helps both men and women through a combination of fitness, nutrition, stress-reduction and bioidentical hormone therapy. Because, as we age, we all experience a steady decline in hormones. This might lead to hot flashes, night sweats, mood swings, sleep disruption, bloating, loss of sex drive, anxiety and even depression. If exercise, stress relievers and diet don’t seem to help, hormone therapy can be necessary. Seems logical enough, but Mazzei’s use of bioidentical hormone therapy is quite the hot topic lately. Along with the Oprah show, bioidentical hormones were promoted in Suzanne Somers’ latest book on wellness, “Ageless: The Naked Truth About Bioidentical Hormones.” Amid the publicity, the use of the therapy remains highly controversial. “The biggest issue is there have not been any large studies on bioidentical hormones,” said Dr. Leonard Hering, an obstetrician and gynecologist with Centegra Primary Care.

What are bioidentical hormones?

Bioidentical hormones, as opposed to those prescribed as part of traditional hormone replacement therapy, are said to be an exact chemical match to those made naturally by humans. Even naturally occurring substances can pose as many risks as those identified with traditional hormone replacement therapy, such as breast cancer, heart disease and stroke, Hering said. “There probably is a role for use of bioidentical hormones, but we have to remember this is hormone replacement therapy and carries with it all of the risks ... there’s no big evidence that it’s any safer,” he said. Mazzei typically prescribes bioidentical hormones to men and women through creams absorbed into the skin. The therapy also can be given through pellets injected under the skin and absorbed into the body over several months. That way, the treatment bypasses the liver where hormones given in pill form tend to get broken down, potentially causing adverse effects, such as blood clots, Mazzei said. Either way, the goal typically is to help women, and in Mazzei’s case, even men, who are experiencing meno- or andropause or the symptoms leading up to it.

Andropause

About 15 percent of Mazzei’s patients are men. He has helped men in their early 30s, but generally men start to experience symptoms in their 50s when their testosterone levels dip. Low testosterone levels can lead to a loss of sex drive and energy, weight gain, aches and pains and an increased risk of cardiovascular disease, he said. He advises men on their diet, suggests ways to ease stress and checks their hormone levels, replacing the testosterone if necessary. Mazzei began studying the specialty when he started experiencing symptoms himself, such as apathy and a loss of energy, as an emergency room doctor. He also had heard from his sister about her experiences with perimenopause and the lack of treatments and doctors available to help her. “I didn’t realize it was such a problem,” he said.

Perimenopause and menopause

Perimenopause can start around age 35, long before women actually experience menopause, or the loss of a menstrual period. Menopause typically begins at about age 50 or so. Some women have no symptoms, while others can experience a wide range leading up to and during menopause. Forty-four-year-old Wendy, who asked that only her first name be used, began experiencing hot flashes and sleep disruption after a hysterectomy. She turned to Mazzei after doing her own research on hormone therapy. “I thought I just don’t want a blanket treatment,” she said. She has used biomedical hormone creams for several months and will see Mazzei about twice a year. “I feel normal and more comfortable than just taking the generic prescription they give you.” Hormone levels should be checked when symptoms occur. But because of the newly identified risks of hormone therapy, including the risk of breast cancer, it isn’t the automatic treatment these days, Hering said. “It gets to be a question of what are the symptoms bothering the patient,” he said. “We had to start looking at each symptom individually and figuring out ways to deal with it.” That could involve improving a patient’s diet by reducing the amount of simple carbohydrates and sugars. And in some cases, Hering said, anti-depressant medication can help. “Something that just makes everything better is exercise,” Hering said. “If they can do it on a daily basis, that improves just about all the things that happen with peri- and menopause.” Mazzei takes a similar approach to his patients. Stress, he said, can cause a wide array of physical symptoms, so he talks to his patients about ways to reduce the stress in their lives. “We treat hormone levels, but in addition, we want to treat your overall health, too,” he said. And both doctors agree that patients need to take charge of their health. “I think one’s body tells them when something is going on and when something needs to be checked,” Mazzei said. “There is a ton of information out there, and not all is accurate or correct. Find a doctor who can help you.”

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