FAQ: Bio-Identical Hormone Replacement

1. What are the typical hormonal changes that occur as a woman ages?
Progesterone declines start early in life in our modern world and typically accelerates around age 35. By the age of 45-50, the average woman is estimated to have an 80% reduction in progesterone levels. Declining progesterone is associated with many of the symptoms of PMS and Peri-Menopause and is one of the easiest and safest hormones to replace. Additionally, it is imperative that Progesterone (not synthetic, non bio-identical progestins) be replaced to lower Breast cancer risk, to increase thyroid hormone activity, and to improve symptoms such as water retention, bloating, sleep disturbances, and heavy menstrual bleeding.

Estrogen declines accelerate as a woman gets into her 40's and 50's as ovarian production declines. Estrogen declines produce a wide range of symptoms also that are detailed below.

2. What are the symptoms of Hormonal Decline?

Symptoms of Estrogen Deficiency may include the following:

• Breasts lose fullness and/or begin drooping
• Skin dries out.
• Foggy thinking (especially in the morning) mind confused, mildly depressed and/or a feeling of 'Just don't care'
• Difficulty sleeping, restless, night sweats
• Vaginal dryness, urinary urgency
• Decreased Libido
• Anxiety/Depression

Symptoms of Progesterone Deficiency

• Diminished Muscle Mass
• Osteopenia and Osteoporosis
• Decreased Libido
• Mild Depression
• Poor Recovery from Exercise

3.What are the causes of hormonal declines? I eat a perfect organic diet so my hormones must be fine, right?
The list of hormonal disrupters grows longer each day! Each day we face numerous environmental toxins from petrochemicals in our oceans, to heavy metals in our fish, to pesticides in our vegetables. Additionally, the make-up used by our women have parabens, the water we drink has fluoride or plasticides, all of which disrupt our hormones and likely contribute to the increased incidence of chronic disease and cancer in our world. Studies show these toxins are ubiquitous in our society and are at similar levels whether one lives in an urban or rural area and whether one eats healthy and organic or not (though obviously you will get less pesticide exposure by eating organic and Dr. Camp strongly recommends organic over conventional produce).

Additionally hormones are depleted by disruptions to our sleep and wake cycles, alterations in our stress hormones, and by dietary and nutritional deficiencies. Common medications including SSRI's, Statin based lipid medications, and numerous others disrupt our hormone production and are even present in our water supply at amounts that are likely high enough to cause us long term damage.

4.What hormones does Dr. Camp typically replace in a patient?
Dr. Camp diagnoses first and then treats each patient uniquely to provide the exact hormonal replacement that each of his patients needs. In general, many of his patients need adrenal hormone support including DHEA and Pregnenolone, sex hormone support including Progesterone, Estrogen, and Testosterone (yes women do need Testosterone too), and thyroid hormone. Some women need only one or two types of hormone replacement, and some need all of them to be replaced to get the full benefit of hormone replacement.

5. What if my doctor says all of my labs are "normal" yet I have all of the symptoms of a hormonal imbalance?
Unfortunately this is a common complaint that we hear at our center. There are many reasons for this including:

• Poor Testing: Not having the correct test done at the correct lab at the correct time of the menstrual cycle at the correct time of day.
• Mis-Interpretation: Most doctors have an over-reliance on the "normal range" of labs. Dr. Camp prefers to use optimal ranges that are based on a healthy population. Few people know that the "normal range" of labs is generated statistically based on the average of all those who are getting labs drawn. This has nothing to do with ideal or optimal or even healthy.
• Personal Variation: Most doctors do not take into account personal variation based on genetics, body type, personality, etc. For example, curvier women with larger breasts typically feel better with a higher estrogen level than does a smaller woman. Similarly, athletic and physically toned women generally feel better with higher testosterone levels.
• Poor Doctor-Patient Relationship including inadequate physical exam, history, and general decline in the doctor patient relationship.
• Misinformed Physicians: Inadequate education of the average doctor on hormonal imbalances at least in part explained by an over-reliance on prescription medications used to treat symptoms only.

6. Does Bio-Identical Hormone Replacement increase Cancer Risk?
Cancer risk should not be increased at all, and Dr. Camp finds the exact opposite to be true. If all of the hormones are balanced properly, in the correct ratio and proportion, then cancer risk should either stay stable or even decrease. For example, most research shows that progesterone (not to be confused with progestins, which are synthetic and non bio-identical) has a cancer protective. Clearly, too much estrogen, not balanced with Progesterone, and in the wrong form will increase cancer risk. If you have a high risk of cancer due to a strong family history, then Dr. Camp can test to see how you are actually metabolizing the estrogen, and to look at the ratios of estrogens and progesterone in your body.

7. How does Dr. Camp diagnose Hormonal Imbalances?
Dr. Camp uses a combination of blood tests, urine tests, and salivary tests to assist in the diagnosis. He also takes a very thorough history, takes the time to get to know you, and knows what to look for on your body that will give him clues about your hormonal status. In this way, Dr. Camp looks at you as a whole person and takes many factors into account to help him in the diagnosis.

8. How long will it take me to feel better after treatment with Bio-Identical Hormones?
On average, each patient will take two to three months to achieve a state of hormonal balance. There are many patients who feel much better much faster, and others who may take longer. Obviously, each of us are unique and will respond differently. The key is that Dr. Camp will work with you until you reach a state of balance.

9. I have a low libido. What kind of treatment options can Dr. Camp provide for me?
Dr. Camp believes that a healthy sex drive is a sign of good health. Commonly patients with lowered sex drive need either Estrogen and/or Testosterone replacement

10. Aren't we messing with Mother Nature by treating Hormones?
Many of the attributes that we prescribe to "old age" are simply declining hormones. In todays' toxic world, we are all facing hormonal changes and challenges that have never before been seen on our planet. Dr. Camp believes with 100% confidence that adequate hormone balance is the most important aspect of one's health that must be maintained to achieve and maintain optimal health and longevity.

11. What are the side effects of replacing Hormones?
As many hormones interact with other hormones, it is important that any hormone evaluation be thorough, and testing should be done to insure that as one hormone is being replaced it is not causing adverse changes in other hormones. Side effects are very specific to each treatment and are not really side effects, but usually too much or too little of the needed hormone. Therefore as a result of hormones being brought into balance, one should expect only to feel better, and any "problems" or adverse reactions should be reported at once to Dr. Camp and your dosing will be adjusted appropriately.

12. Are Bio-Identical Hormones Synthetic?
In general, hormones only come from two sources: animal sources or synthetic sources. The goal with bio-identical hormone replacement is that we are replacing exactly what the body is missing. So in fact the source is less important actually as long as the goal of re-producing natural and healthy hormone levels is kept intact. As an example, many "natural" hormones such as the now famous Premarin are far from bio-identical (Premarin is the most common form of Estrogen replacement and it is taken from the urine of pregnant horses). So the question is not really relevant as Premarin is clearly natural, but is far from Bio-Identical. Having said that, Dr. Camp of course prefers to use "natural" hormones over synthetic versions as long as they are bio-identical.

FAQ: Bio-Identical Hormone Replacement