Hormone Replacement Therapy

(From Forever Health)

Hormone imbalances can occur in men and women of almost any age.(1) A variety of factors can be related to these imbalances, including high insulin levels from diets high in refined foods and sugar, exposure to environmental toxins (xenoestrogens), high consumption of hydrogenated fats, and lack of physical activity leading to weight gain.(2-5) 


Age is also a factor in reduced levels of hormones, creating feelings of imbalance in everyday pursuits. For example, testosterone levels in women begin going down after age 20. By age 40 a woman’s testosterone level will be half of what it was when she was 20 years old. This is why getting hormone levels checked even while in your 20′s may be necessary if you aren’t feeling yourself. For women between the ages of 40–60, testosterone levels can remain pretty constant. After menopause testosterone declines once again.(1)

How can you help hormones maintain balance?


The food you choose to eat can have a major impact on your health. If your diet is high in sugar, processed carbohydrates, hydrogenated fats, genetically modified foods, and conventional beef, dairy, and poultry, then you are more susceptible to obesity and all the associated diseases, plus an increase in hormone imbalances.(6-11) It’s important to maintain a healthy weight, as storing excess fat can lead to hormone imbalances and an increase in stored environmental toxins. Toxins have a negative impact on overall health and should be avoided at all ages of life, especially during pregnancy where the developing baby can carry the negative impact the rest of its life.(12-15)


Physical activity is important to hormone balance, not to mention overall health and a good mental state. Exercise helps to keep cortisol levels low and also helps maintain hormone balance by reducing the level of cortisol in the body and sustaining serum insulin levels. Cortisol levels can become significantly high when the body is experiencing stress, either real or imagined.(17) Exercise helps counter the effects of stress and regular moderate exercise can lower cortisol levels.(18-20) Moderate exercise for 30 to 60 minutes each day can have a profound effect on hormone balance.(21-23)

Bio-identical Hormones

Bio-identical hormone replacement therapy (BHRT) can balance hormone levels that become upset or deficient through lifestyle habits and aging. Unlike conventional HRT (HORMONE REPLACEMENT THERAPY – that uses synthetic hormones that are not the same as the hormones that your body produces), BHRT is derived from plant sources and are exactly similar to the hormones your body secretes and circulates.(24-26) Since the bio-identical hormones are recognized in the body, they are effectively assimilated and used. BHRT replenishes the body with the healthy hormone levels your body needs to function optimally. Forms of BHRT include progesterone, estrogen, and testosterone.

Blood tests are taken to determine hormone levels. If there is a deficiency or imbalance, BHRT is recommended to safely balance hormone levels. Restoring hormone balance can provide greater protection from chronic diseases and alleviate menopausal symptoms. Saliva testing of hormonal levels is used by some practitioners, but peer-reviewed studies from saliva testing are not nearly as prevalent. Serum hormone studies show the ideal levels to reduce the risk of heart disease and some cancers.

Compounding pharmacies specialize in producing BHRT. Doses are determined on an individual basis and available in different administrations (topical, oral, sublingual, etc.). A few studies show that topical BHRT has a better safety profile than the orthodox oral HRT.(27-29) It is important to note that most physicians are not trained in prescribing BHRT and they may be unfamiliar with the medical literature that supports this treatment. Fortunately, there are physicians specializing in age-management medicine who can help you determine which BHRT treatments are best for you.


1. Rohr U. The impact of testosterone imbalance on depression and women’s health. Maturitas.41 Suppl. 1 (2002) S25–S46.

2. Ruano M, et al. Morbid obesity, hypertensive disease and the renin-angiotensin-aldosterone axis. Obes Surg. 2005 May;15(5):670-6.

3. Masi AT, et al. Neuroendocrine, immunologic, and microvascular systems interactions in rheumatoid arthritis: physiopathogenetic and therapeutic perspectives. Semin Arthritis Rheum. 1999 Oct;29(2):65-81.

4. Nadal A, et al. The pancreatic beta-cell as a target of estrogens and xenoestrogens: Implications for blood glucose homeostasis and diabetes. Mol Cell Endocrinol. 2009 May 25;304(1-2):63-8.

5. Park SH, et al.  Cell growth of ovarian cancer cells is stimulated by xenoestrogens through an estrogen-dependent pathway, but their stimulation of cell growth appears not to be involved in the activation of the mitogen-activated protein kinases ERK-1 and p38. J Reprod Dev. 2009 Feb;55(1):23-9.

6. Kochan Z, et al. [Dietary trans-fatty acids and metabolic syndrome]. Postepy Hig Med Dosw (Online). 2010 Dec 27;64:650-8.

7. Biswas M, et al. Reduced total testosterone concentrations in young healthy South Asian men are partly explained by increased insulin resistance but not by altered adiposity. Clin Endocrinol (Oxf). 2010 Oct;73(4):457-62.

8. Kelly DM, et al. Testosterone: a metabolic hormone in health and disease. J Endocrinol. 2013 Apr 29;217(3):R25-45.

9. Pimentel GD, et al. Intake of trans fatty acids during gestation and lactation leads to hypothalamic inflammation via TLR4/NFκBp65 signaling in adult offspring. J Nutr Biochem. 2012 Mar;23(3):265-71.

10. Collison KS, et al. Effect of trans-fat, fructose and monosodium glutamate feeding on feline   weight gain, adiposity, insulin sensitivity, adipokine and lipid profile. Br J Nutr. 2011 Jul;106(2):218-26.

11. Duque-Guimarães DE, et al. Early and prolonged intake of partially hydrogenated fat alters the expression of genes in rat adipose tissue. Nutrition. 2009 Jul-Aug;25(7-8):782-9.

12. Lang IA, et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008 Sep 17;300(11):1303-10.

13. Markowski VP, et al. Tissue-specific and dose-related accumulation of arsenic in mouse offspring following maternal consumption of arsenic-contaminated water. Basic Clin Pharmacol Toxicol. 2011 May;108(5):326-32.

14. Blüher M. Adipose tissue dysfunction contributes to obesity related metabolic diseases. Best Pract Res Clin Endocrinol Metab. 2013 Apr;27(2):163-77.

15. Silva AP, et al. Dietary fatty acids early in life affect lipid metabolism and adiposity in young rats. Lipids. 2006 Jun;41(6):535-41.

16. Eliakim A, Nemet D. Exercise training, physical fitness and the growth hormone-insulin-like growth factor-1 axis and cytokine balance. Med Sport Sci. 2010;55:128-140.

17. Turakitwanakan W, et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai. 2013 Jan;96 Suppl 1:S90-5.

18. Broocks A, et al. Effect of aerobic exercise on behavioral and neuroendocrine responses to meta-chlorophenylpiperazine and to ipsapirone in untrained healthy subjects. Psychopharmacology (Berl). 2001 May;155(3):234-41.

19. Marc M, et al. Plasma cortisol and ACTH concentrations in the warmblood horse in response to a standardized treadmill exercise test as physiological markers for evaluation of training status. J Anim Sci. 2000 Jul;78(7):1936-46.

20. Scerbo F, et al. S. Effects of exercise on cravings to smoke: the role of exercise intensity and cortisol. J Sports Sci. 2010 Jan;28(1):11-9.

21. Hill EE, et al. Exercise and circulating cortisol levels: the intensity threshold effect. J Endocrinol Invest. 2008 Jul;31(7):587-91.

22. Cust AE. Physical activity and gynecologic cancer prevention. Recent Results Cancer Res. 2011;186:159-85. doi: 10.1007/978-3-642-04231-7_7.

23. Haff GG, et al. Force-time curve characteristics and hormonal alterations during an eleven-week training period in elite women weightlifters. J Strength Cond Res. 2008 Mar;22(2):433-46.

24. Watt PJ, et al. A holistic programmatic approach to natural hormone replacement. Fam Community Health. 2003 Jan-Mar;26(1):53-63.

25. Mahmud K. Natural hormone therapy for menopause. Gynecol Endocrinol. 2010 Feb;26(2):81-5.

26. Francisco L. Is bio-identical hormone therapy fact or fairy tale? Nurse Pract. 2003 Jul;28(7 Pt 1):39-44, table of contents.

27. Eilertsen AL, et al. The effects of oral and transdermal hormone replacement therapy on C-reactive protein levels and other inflammatory markers in women with high risk of thrombosis. Maturitas. 2005 Oct 16;52(2):111-8.

28. Kurtay G, et al. A comparison of effects of sequential transdermal administration versus oral administration of estradiol plus norethisterone acetate on serum NO levels in postmenopausal women. Maturitas. 2006 Jan 10;53(1):32-8.

29. Lazzeroni M, et al. The effect of transdermal estradiol or oral conjugated oestrogen and fenretinide versus placebo on haemostasis and cardiovascular risk biomarkers in a randomized breast cancer chemoprevention trial. Ecancermedicalscience. 2008;2:67.