Hormones and Aging: Doctors Weigh In

The FoodTrients team and I attended the American Academy of Anti-Aging Medicine World Congress (A4M), which was held in Las Vegas in December. It’s three days of speakers, workshops and exhibits presenting clinical education and advances in the most recent research, studies and healthcare practices as they relate to wellness and aging successfully. Many of the sessions were geared toward medical professionals, but we were able to distill information to share with you in ‘civilian’ terms.

There was a series of presentations on what hormones—male and female—do for the body in terms of anti-aging. Some of the presentations were a little blush-worthy, but overall it was food for thought, especially with the often-contradicting information out there on hormone replacement therapy (HRT). Remember, no matter how beneficial HRT seems, always work with your practitioners to determine if it is right for you.

Here are summaries of some of the presentations:

Dr. Enrique Jacome presented on Identifying Candidates for Pellet Hormone Replacement Therapy. Though the main gist of his presentation was for under the skin pellets to deliver HRT, he identified HRT’s benefits.

Facts:

In Women

• 27 million women between 25-64 suffer menopausal symptoms such as rapid heartbeat, hot flashes, vaginal dryness, loss of muscle tone and bone mass, dry skin and more.
• Heart disease is the number-one cause of death in women. Pre-menopause, it’s one in seven; post menopause, it’s one in three.
• Studies show there is a 35% decrease in cardio vascular disease (CVD) in women treated with HRT:
  • LDL (bad) cholesterol is lowered
  • HDL (good) cholesterol goes up
  • Resistance to insulin goes down, which prevents diabetes
  • Reduced chance of blood clots

In Men

• Low testosterone affects 2.4 million American men, yet only five percent of those receive treatment.
• Symptoms of low testosterone include loss of bone and muscle mass, increased chance of heart disease, fatigue, increased chance of Alzheimer’s disease and low sex drive.
• One in every four deaths in men is due to CVD. HRT can help prevent it by
  • Raising levels of HDL (good) cholesterol
  • Lowering the risk of diabetes and metabolic syndrome
  • Replacing testosterone lowers the rate of CV events in men by 50% compared with those who are untreated

Benefits of Under the Skin Pellets vs. Oral or Patch HRT

• Keeps hormone levels more consistent
• Long term treatment—up to three months
• Convenient
• Eliminates the need to remember to take medication or replace patches, eliminating patients’ missing or irregular doses

Dr. Lisa Vuich made a presentation on Combination Therapies for Sexual Wellness. A short and animated Janeane Garofolo look-alike, Dr. Vuich practices the relatively new category of Aesthetic Medicine in New Hampshire. She takes an integrated approach to anti-aging that includes skin care, body sculpting, and sexual wellness and rejuvenation.

The focus of Dr. Vuich’s talk was on platelet rich plasma (PRP) therapy, which involves, “The application of concentrated doses of platelets rich in bioactive proteins, which release growth factors and other mediators, to stimulate cellular regeneration and accelerate tissue repair.”

She explained that platelets are cellular mediators that orchestrate mechanisms of tissue repair. They release growth factors that control recruitment, proliferation, and activation of fibroblasts, neutrophils, monocytes and other cells involved in wound healing.

The way this is done is by means of blood draws using specialized FDA-approved equipment and delivering platelets collected from the patient’s blood. Depending on what the patient needs will depend on the number of platelets delivered. PRP therapy is being used in many areas of medicine to promote healing with the patient’s own platelets.

Applications for PRP

Orthopedics and Sports Medicine

Dentistry / Cosmetic Dentistry

Facial Surgery

Neurosurgery

Cardiothoracic Surgery

Wound Healing / Burn Centers

Common urogenital applications for women include treating incontinence, interstitial cystitis (chronic bladder infection), vaginal atrophy and female sexual dysfunction.  In men it can help solve erectile dysfunction, Peyronie’s disease, premature ejaculation and problems associated with post prostatectomy.

Studies show promising results in women with chronic bladder infections who are injected with their own platelets and experience healing of bladder tissue. PRP therapy has also been effective for a rare but stubborn condition called lichen sclerosus, which presents as very itchy patches and tears in tissues of the genital area.

Dr. Vuich also discussed some more experimental techniques for rejuvenating genital health including light therapy and shock-wave therapy. These therapies may be very beneficial one day and there are studies being done, but I suspect most medical practitioners suggest taking a wait and see approach.

Angela DeRosa is a doctor of osteopathic medicine (DO). Like doctors of medicine (MD), osteopaths attend medical school and are licensed. The difference is that osteopaths are trained to focus on muscular and skeletal systems to treat problems throughout the body. They often take a more holistic approach to healing, factoring in things like nutrition and exercise as they relate to wellness. In her slide presentation, Dr. DeRosa included the following quote from Andrew Taylor Still, MD, DO, a surgeon and founder of osteopathic medicine: “To find health should be the object of the doctor. Anyone can find disease.”

Dr. DeRosa’s presentation was on Changing the Paradigm of Women’s Hormone Health in America. In summary, she stated that it takes a decade for the ovaries to shut down fully and that women are now living one-half to one-third of their lives in menopause; a combination of estrogen and testosterone is necessary for a good quality of life throughout a woman’s lifespan. Some highlights:

• When working properly, a woman’s body makes 60 percent estrogen and 40 percent testosterone.
• A healthy man’s body makes 95 percent testosterone and 5 percent estrogen.
• As women age, both estrogen and testosterone levels decline, but testosterone will deplete more rapidly because
  • Women have less of it to begin with
  • Unlike estrogen, testosterone is not stored in fat cells

The average age for women to complete menopause is 52, but perimenopause takes place 10-15 years earlier. Women in perimenopause experience three stages of hormone deficiency:

• Testosterone deficiency – hallmarks include:
  • Low libido
  • Weight gain
  • Anxiety
  • Mood swings
  • Memory loss
  • Sugar cravings
  • “Beer belly” appearance from the weight gain. Instead of carrying our weight in the thighs, it moves to the belly.
  • Low libido (intentional emphasis)
• Estrogen deficiency (perimenopause) symptoms include:
  • Hot flashes
  • Insomnia
  • Migraines
  • Night sweats
  • Irregular periods and PMS
• Menopause is characterized by:
  • No periods for 12 months
  • Lack of FSH hormone as determined by a blood test
  • Insomnia, forgetfulness and hot flashes

Long-term consequences of hormone deficiencies:

• Insulin resistance and diabetes
• High levels of cholesterol in the blood
• Cardiovascular disease
• Osteoporosis
• Cancer
• Dementia

According to Dr. DeRosa, HRT is not just to treat those pesky symptoms of menopause, but for a better quality of life. She argues that a century ago, women’s life spans weren’t as long, so they didn’t live as long in menopause. Now that women commonly live into their 80s and 90s, why shouldn’t they live those 30-40 years as comfortably as possible? There have been messages in the media that HRT can cause increases in heart disease and breast cancer, but it is Dr. DeRosa’s belief that this is a, “Triumph over long odds vs. common sense.”

“HRT can help us achieve a more comfortable menopause, so why is it so hard to get? Unfortunately, when it comes to women and their health and reproductive issues, misinformation and misogyny continue to be dominant forces. Then there’s the issue of cost and access to affordable health insurance.” Dr. DeRosa concludes, “It’s well past the time that we start taking control of the conversation and of our own health, or women will continue to be dismissed.”