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By: Dr. Loren Hager
In my office over the last few weeks, we’ve been talking a lot about hormones. Specifically, why menopause has turned into such an “event” in women’s lives over the past 50-100 years and how that may relate to the new “low-T” epidemic in men as well. Right off the bat, I would like to point out that menopause (and andropause which is like menopause in men) is a NATURAL transition. Just like transitioning into puberty is supposed to happen, so is transitioning out of it. As we get older, it is natural for our reproductive hormones to lower, as we are no longer trying to reproduce. Those hormones, however are important for more than just reproduction, so they cannot and don’t completely disappear. To keep this discussion simple, we will focus on the 3 major and most well-known hormones Estrogen, Testosterone and Progesterone.
Let’s start with menopause.
During a woman’s cycling life the ovaries produce her primary hormones, estrogen and progesterone, in in response to hormones made in the pituitary gland. Pituitary hormones are made in response to hypothalamic hormones, which are made in response to the hypothalamus monitoring the blood for appropriate hormone balance. When a woman transitions out of her fertile time, the ovaries shut off their major hormone duties and her adrenal glands and fat cells take over hormone production. While the adrenal glands won’t and shouldn’t produce as much hormone as the ovaries did, the adrenal glands should produce enough to support the functions other than reproduction for which those hormones are responsible.
So, what else do progesterone and estrogen do if not help to make a baby?
Progesterone is neuroprotective and promotes neuronal healing, it’s a natural sedative and anti-depressant, it balances with estrogen to promote libido and is needed for new bone formation and deposition, it is anti-inflammatory and helps electrolyte balance. Estrogen is also neuroprotective, balances with progesterone to promote libido, promotes growth hormone secretion, limits long bone growth and prevents bone loss, increases number and size of fat cells (directs fat deposition into breast, buttocks and thighs), is immune activating (pro-inflammatory), promotes soft, smooth skin and improves insulin function.
As you can see, these hormones are important, even for a non-cycling woman. So, what happens when a woman has many issues during transition?
Well, unfortunately the answer is that as humans, we need to be preparing for these transitions throughout life. Remember, I said earlier, that the adrenal glands take over most of the hormone production? Well, if a woman’s adrenal glands are already stressed, fatigued or downright exhausted by the time she gets to her 50’s, they are going to have a hard time taking over their new job description. Additionally, there is a thing called the “pregnenelone steal”. All steroid hormones (including testosterone, progesterone, estrogen, DHEA and cortisol, the adrenal chronic stress hormone) are made from cholesterol. (Yes, you NEED cholesterol.) From cholesterol, pregnenelone is made, then pregnenelone becomes either DHEA or Progesterone. DHEA eventually becomes Testosterone and estrogen and progesterone eventually become cortisol – your stress hormone. (That’s the extremely simple version.) See hormone chart:
During times of stress, the body prioritizes survival and shunts all the pregnenelone down the path to make cortisol and practically shuts down the DHEA pathway. Now, try to transition into menopause. Your adrenal glands are tired and the stress of normal American lifestyle has them using all your body’s resources to make cortisol, with no time or energy to make progesterone and estrogen as your ovaries are shutting down that process. On come the classic menopause symptoms such as night sweats, moodiness, irritability, hot flashes, low libido, etc. So, what is really at play here? Poor adrenal gland health. Supporting and beefing up the adrenal glands, and adding in some deficient nutrients, is usually all that is needed to quell the modern symptoms of a woman’s transition.
What about men, though?
The pregnenelone steal happens to them too. Most men are also living with higher stress than our bodies are designed to handle. In addition, look at the diagram above and follow the arrows from testosterone. (FYI, this happens in all humans, not just men.) See where Estradiol (AKA E2, the most powerful estrogen) is made from testosterone? This is accomplished by the aromatase enzyme. Under times of stress, this enzyme is up-regulated. So, a stressed person (man or woman) is going to convert most of the testosterone they are able to make after the pregnenelone steal into estrogen. Of course men are suffering from low testosterone issues! And can you see why simply giving men a prescription for testosterone doesn’t work? Because if a stressed man has an upregulated aromatase enzyme, he’s converting most of his testosterone to estrogen. The aromatase enzyme doesn’t care if the testosterone was made in the body or was taken exogenously. So, when you give a man testosterone who is low because of these stress issues, he will feel like a king, for about a month or so, then all that testosterone will just get converted to estrogen. Then add all the exogenous estrogens we are all bombarded with from environmental toxins and we have the reason that breast cancer in men is on the rise and becoming a really big problem. Some of the signs that this may be going on (aside from your assessment of your current stress level) is decreased libido, weight gain, loss of “vitality”, insulin resistance, sluggish liver, loss of morning erections and prostate hyperplasia.
In conclusion, hormones work in concert with each other.
When one goes out of balance, the others follow. Learning how to manage your stress levels can be a quite effective way to bring balance back into this delicate system. Add in proper nutrition and hormonal balance, and the good health as we age that results, is extremely attainable.
Dr. Loren Hager is a chiropractic physician and applied clinical nutritionist (ACN). She focuses on the whole patient to help them find better health and vitality. Dr. Hager works with people who struggle with hormonal issues, fatigue, sleep problems, fertility and sex-drive issues, and other chronic problems to find relief and better health. She can be found at www.hagerhealth.com.