Dr. Sklar, what are you up to these days?
I have entered an exciting new phase of my career. As many of you know, I am passionate about taking care of women and did so as an OB/GYN doctor for over 25 years. Of course taking care of women means taking care of women’s hormones and that is what I devote all my time to now.
Not only do I spend time on hormone balancing for women, I am also practicing what I call the NEW MEDICINE. Others have variously called it anti-aging medicine, rejuvenative medicine, restorative medicine, or functional medicine.
I just call it plain and simple the NEW MEDICINE. This is, in fact, a totally different way of looking at health and disease than what I had done for the previous 25 years of my practice.
This type of medicine is about restoration–restoration of proper cellular function, restoration of balance in the body, and it ends up being restoration of how you feel physically and mentally. It also means reducing risk of chronic disease and decline that can happen to all of us as we age.
Tell me more about the hormone issues. Why are they so important for women?
Over my many years of practice I had untold numbers of women come to me with problems such as depression or fatigue or low sex drive or weight problems and ask “Dr. Sklar, do you think this could be due to my hormones?” Within my limited scope of view at that time, sometimes I said “yes.” A lot of the time I said “no.”
Now with a full understanding of the role of hormones in health and disease I would say yes to all of those women. Of course there are other factors that enter into health and disease but hormones are a huge part of it.
Hormones are important chemical communicators in our bodies. They provide communication between our nervous system, our immune system, and our endocrine system. What does this mean for us? It means they are involved in how we feel, how we think, what our weight is, and risk of chronic disease, just to mention a few things.
Our hormone levels decline as we get older. Our hormones are at their optimum levels when we are in our 20s. And I hate to tell you, it’s all downhill from there.
By the time are in our mid-40s some of our important hormones are present at half the amount that they were in our 20s. Added to this gradual decline with age, is the decrease in hormone levels due to stress. And who isn’t stressed? Stress plays a devastating role in our physiology.
Stress and aging changes in hormones affect both men and women, but women have an additional very important factor in how hormones affect them. That factor is their reproductive cycles, both the monthly cycle and the reproductive lifecycle.
The reproductive lifecycle starts at puberty, goes through the childbearing portion of a woman’s life and on to the perimenopause, menopause, and then into the postmenopausal periods.
Every month during the reproductive time of the woman’s life, hormones fluctuate up and down. Alterations in the smooth function of our cycles result in problems like premenstrual syndrome, heavy or painful menstrual periods, and the growth of fibroids.
Then, towards the end of the reproductive part of a woman’s life cycle she enters what is called perimenopause. This is another time of fluctuating hormone levels that can be very erratic. This can wreak havoc on a woman physically and mentally and emotionally. This is time that I call the “hormone storm.”
Then women enter menopause. In menopause hormone levels are low consistently. This creates another entire set of problems with hot flashes, low sex drive, vaginal dryness, mood changes, weight gain and a host of other issues.
Dr. Sklar, what can we do about our hormone problems? Is there a solution?
Yes, there is a great solution. And that’s what’s so exciting about the NEW MEDICINE. There are hundreds of hormones in the human body, but in the NEW MEDICINE we’ve picked a few of the most important ones to restore and balance.
I have personally witnessed amazing transformations in my patients. Women who were initially depressed, haggard looking, and exhausted become transformed into vibrant, energetic, and happy people.
What are Bio-identical hormones?
I have to be honest with you. When I was practicing gynecology as a traditional type of doctor I said that Bio-identical was a marketing term used to sell hormone programs.
Now that I understand the scientific bases of this NEW MEDICINE approach, I have a clear understanding of the benefits of Bio-identical hormones versus other types of hormones. Bio-identical means that the hormones are chemically and molecularly identical to the hormones in the human body.
Why is this important?
This is important because the risk of using Bio identical hormones is less than using other types of hormones. The other types of hormones are pharmaceutical products that have been developed by drug companies in order to patent them and profit by their sales.
Some of these are bioidentical products, but some are not. The non-bioidentical hormones include some naturally occurring ones such as Premarin(conjugated equine estrogens) which is made from pregnant mare’s urine and some completely synthesized ones such as Provera (medroxyprogesterone acetate) which is found nowhere in nature.
Using hormones that are exactly like our own human hormones, and using them in balance with each other, maintains the benefits while reducing side effects and risks. So you can see Bio-identical is far more than a marketing term.
Exactly what hormones are you talking about?
Let me describe to you the hormones that I use in my hormone balancing program and what each of them does:
THYROID: Most people are familiar with thyroid and know that thyroid regulates the speed of our metabolism. This is absolutely true. What you probably don’t know is thyroid also regulates how you think, your intestinal functioning, the texture of your skin, hair, and nails, to mention a few.
Typical signs of low thyroid are fatigue, feeling cold all the time, having cold hands and feet, chronic constipation, thinning hair on the top of the head. There is one more sign of low thyroid that is very specific for thyroid deficiency: the loss of the outer one third of the eyebrows.
Now, may have been to your doctor and had thyroid testing, and were told it was all normal, so you accepted that your problems were not due to your low thyroid function. In fact, you need to have the correct thyroid tests taken, and they need to be interpreted properly.
What is considered the normal range is not necessarily the optimal range for you and how you feel and how your body functions. When we restore thyroid functioning, we use a combination of two important thyroid hormones T4 (thyroxine) and T3 (triiodothyronine).
T3 is the active thyroid hormone which is responsible for all of the important physiologic processes described above. T4 is not an active thyroid hormone, it serves as a reservoir of available hormone that can then be converted into the active form, T3.
When thyroid function is properly restored, even in people who were previously told they had normal thyroid function, I have seen lifelong constipation get resolved. I have seen women with painfully cold hands and feet feel comfortable for the first time in years.
MELATONIN: Most people are familiar with melatonin as the sleep or jet lag hormone. And while this is true, melatonin has a number of other important functions. First of all, melatonin levels decline as we get older which accounts for the sleep disorders that we see increasing as people age.
Melatonin is also important for its immune and anti-cancer function. It is a mood enhancer and can help with migraine headaches and high blood pressure.
Do you use STEROID HORMONES as part of your hormone balancing program?
Next I’m going to talk about STEROID HORMONES. Some people get nervous when I talk about the term steroid. That’s because they’ve heard about steroid abuse as it relates to athletes.
And while it is true that steroids can be dangerous when they are abused and when they are used in their synthetic forms, steroid hormones are essential to life. The following hormones are steroid hormones: estrogen, testosterone, progesterone, DHEA, pregnenolone, and cortisol. In a hormone balancing program, these are the steroid hormones we are dealing with.
DHEA (Dehydroepiandrosterone): This is a very important hormone with a long name. DHEA is our vitality hormone. It is the most abundant hormone in our bodies. When we become stressed, DHEA levels decrease.
DHEA also has many important functions besides energy. DHEA is a mood enhancer and has been used in clinical studies as an antidepressant. It is a potent anti-inflammatory hormone and helps to reduce pain from inflammatory disorders like arthritis.
DHEA has powerful immune functions. DHEA increases energy and improves mental and emotional health. DHEA curbs insulin resistance and enhances ability to lose fat and gain muscle.
DHEA is part of the increase in vitality and energy that I witness in my patients and I know it’s part of their improved resistance to colds and flu.
PREGNENOLONE: Pregnenolone is a hormone you probably never heard of. It is the origin, metabolically speaking, of our other steroid hormones. It is an important part of hormone restoration because levels decrease as we get older and levels decrease when we are under stress.
Pregnenolone has one function that makes it especially important. In the memory center of our brains, pregnenolone works as a chemical neurotransmitter. Declining levels of pregnenolone is one of the reasons why we encounter memory problems as we age.
Most of your doctors will say there’s nothing you can do about age-related memory loss but I have seen improvements in memory that my patients are actually able to quantitate.
TESTOSTERONE: Most people think of testosterone as the “male” hormone. And although it is the main hormone in men, it’s very important for women. It produces feelings of well-being, increases energy, and helps to build muscle and lose fat.
It also aids in clarity of thinking. Testosterone has been called the hormone of desire. Decreased levels are responsible for the lack of interest in sex that many women feel starting in perimenopause.
When applied to the vulva, it can increase sexual sensitivity. Testosterone may be what you’ve been looking for to put the spark back in your relationship.
ESTROGEN: Estrogen is what makes us women. It is responsible for monthly cycling, our ability to have children. Hot flashes and depression are due to decreased estrogen levels.
Breast tenderness, bloating, and fluid retention are due to high levels of estrogen. Estrogen levels fluctuate monthly during each menstrual cycle. When estrogen levels become erratic, such as in the perimenopausal period, we notice tremendous changes emotionally and physically.
By adjusting estrogen levels and properly balancing it with progesterone, women finally can stop being slaves to their hormones. Perimenopause is one of the best times to get on a hormone balancing program.
You can end up saving yourself a lot of mental and physical distress, and life disruption by keeping your hormones balanced during this time period and beyond.
PROGESTERONE: Progesterone is our other very important female hormone. Its levels vary during our monthly menstrual cycle. Its levels can also decline as the result of stress.
This causes menstrual disturbances such as premenstrual syndrome, heavy bleeding, painful periods, and the growth of uterine fibroids. Progesterone decline is also the first change during the perimenopause transition which can happen as early as the mid-30s.
By the time a woman is menopausal, she has no detectable levels of progesterone. One of progesterone’s most important functions is its balancing role with estrogen. This helps to prevent certain hormonally related cancers such as uterine cancer. Progesterone is a natural diuretic, or water pill. It is a mood enhancer and has anxiety lowering effects.
VITAMIN D: What is vitamin D doing in a discussion of hormones especially steroid hormones? Recent research has shown that vitamin D functions in our bodies like a steroid hormone. It is involved in over 400 metabolic processes in our system.
Adequate vitamin D has been correlated with lower risk of many serious chronic diseases such as breast cancer, colon cancer, prostate cancer, and cardiovascular disease. Sufficient levels have also been correlated with a lower risk of Alzheimer’s disease.
It is an important part of our immunity and may help us resist colds and flus. Vitamin D is manufactured by our skin using light from the sun. Almost everyone I see as a patient, even here in sunny Southern California, is deficient in vitamin D.
We use sunscreens and cover ourselves from the sun in an effort to decrease skin cancer. Also, as we age, our skin is less able to convert sunlight into vitamin D. All of this adds up to vitamin D deficiency. So vitamin D restoration is an important part of the hormone balancing program.
Are Hormones Safe?
Let me address some concerns that I hear frequently. One is the question of hormone safety. To answer this question adequately I have to explain some of the history of pharmaceutical development in the United States.
Natural products such as estrogen, progesterone, pregnenolone, DHEA cannot be patented. For this reason the pharmaceutical companies were not interested in the development and clinical use of these substances.
They worked industriously to produce synthetic alternatives that were patentable. This has resulted in widespread risk to patients and untold suffering due to restriction on the use of hormones because of safety concerns.
In the 1940s, pregnenolone was used as an anti-inflammatory treatment for arthritis. It is safe and effective but it was not patentable. Witness the evolution of Prednisone, a potent steroid hormone with numerous side effects. Although Prednisone is effective in reducing inflammation, it also has serious side effects such as osteoporosis, skin changes, fat deposition, muscle wasting, and fluid retention.
Natural estrogen was not patentable. So Premarin was developed. Premarin stands for “pregnant mares urine.“ Pregnant horses are lined up and their urine is collected for the purpose of extracting estrogen-like components.
These components are then put into pills for women to take. The problems with Premarin use are multiple. First of all they contain estrogen that is natural to horses not humans. Many of these estrogens are more risky and carcinogenic. In addition, Premarin was put into a pill to be taken by mouth. In this form, estrogen causes increased risk of blood clotting.
When estrogen is taken orally it gets processed through the liver. This processing results in increased production of clotting factors. These increased clotting factors result in an increased tendency to have heart attacks and strokes. This was seen in older women in the results of the Women’s Health Initiative, a large study conducted by the National Institutes of Health.
The other, very frequently prescribed synthetic steroid that was produced was Provera (medroxyprogesterone acetate), a pharmaceutical substitute for progesterone. Medroxy- progesterone acetate has some progesterone-like effects in a woman’s body, but it also has a number of undesirable effects.
The Women’s Health Initiative clearly showed an increased risk of breast cancer with women who used Provera. The conclusion following the release of these results was that Provera, not Premarin, was the cause of an increased risk of breast cancer in women who are on this type of hormone replacement therapy.
So, when you ask the question “are hormones safe,” the answer is “yes” but it depends upon the hormones. Bio-identical hormones have a proven safe track record as seen in numerous studies.
Are there other benefits to hormone restoration besides feeling better?
Possibly one of the biggest benefits of hormone restoration is the reduction in chronic disease and decline with aging. We know that hormone decrease accounts for a large part of the decline that we see in elderly people. Hormone restoration along with a lifestyle program that supports healthy hormones results in a longer health span–that is, span of healthy longevity not simply an increase in lifespan.
How come more doctors aren’t doing this?
There is a saying that doctors are down on what they’re not up on. This means that many doctors have a negative view of bio-identical hormones and this type of restorative program. This is comes from a place of lack of knowledge.
I would not be involved in the field of medicine were it not for hard, scientific evidence. Doctors also need a clear-cut understanding of the role the pharmaceutical industry is playing in healthcare.
Drug companies are interested in developing new blockbuster drugs to promote their profits, and they are not interested in what really makes people healthy. What really makes people healthy is preventive care, which does not create profits for pharmaceutical companies.
The point of view of pharmaceutical companies has had tremendous influence in the way doctors treat patients, as well as the way patients expect to be cared for, and in the way we look at health and disease.
Many people look for a solution to their problems outside themselves and expect to get help in a pill. Fortunately, large numbers of Americans are realizing that they need to take their health into their own hands and look for solutions that really address their problems.
Many people come to see me after reading books by Suzanne Somers, or listening to Oprah talk about hormones. They know there’s a solution out there even though they’ve been told that nothing can be done. I salute those persistent and courageous people who are seeking out the doctors and healthcare they truly need.
Where do I find out more?
Come to one of my in-house classes. You can register through the website or by calling 562-596-5196.