Exploring the Hormone Heresy
An Interview with Women's Health Advocate Sherrill Sellman
Dr. Jerilynn Prior, researcher and professor of endocrinology at the University of British Columbia has conducted research that seriously challenges estrogen's key role in preventing bone loss. Her research confirmed that estrogen's role in combating osteoporosis is only a minor one. In her study of female athletes, she found that osteoporosis occurs to the degree that the athlete's became progesterone deficient, even though their estrogen levels remained normal.
Dr. Prior continued her research with non-athletic women. They showed the same results. While both these groups of women were menstruating, they had anovulatory cycles (not ovulating) and were, therefore, deficient in progesterone. As a result of her extensive research, she confirmed that it is not estrogen but progesterone which is the key bone building hormone. Such studies seriously challenge the estrogen deficiency- osteoporosis link.
When it comes to good bone health, there are many different nutritional requirements in addition to calcium which include magnesium, protein, essential fatty acids, boron, silica, copper, zinc, manganese, strontium, phosphorus, folic acid, Vitamin A, B6, B12, C, D, and K.
Good bone health comes down to eating a nutrient rich diet (it has now proven that organic foods have a higher nutritional content), including regular weight-bearing exercise, reducing the toxic and heavy metal load, reducing stress ( adrenal exhaustion leads to bone loss), having strong digestion in order to properly digest and assimilate nutrients and hormonal balance.
The real "Bone Thieves" are the following:
Given what is now known about early bone loss, I would recommend getting a bone density test done in one's forties. However, with such poor dietary habits and high stress levels, it may be advisable to start earlier in life, perhaps starting in one's twenties to use as a baseline throughout life. Ultrasound tests and urinary secretion tests are available. DEXA ( dual X-ray absorbtiometry) is the most accurate but uses radiation. I personally try to minimize radiation exposure of any kind to its cumulative carcinogenic effects. You can also get inexpensive pH strips from a pharmacy which you can test your acid/alkaline balance on a daily basis. A continual acid condition indicates mineral and nutrient depletion. It's an inexpensive way to monitor oneself daily and adjust the pH with diet.
The drug companies boast one other medication that promises to halt bone loss. This popular drug, Fosamax, is the only non-hormonal drug approved by the FDA to treat osteoporosis. Studies of this drug were cleverly stopped after four to six years. This is just the point at which the fracture rate for women taking similar drugs began to rise.
So, although Fosamax will superficially appear to increase bone density, in reality it decreases bone strength leading to a greater risk of fracture. Fosamax is a metabolic poison and will actually kill osteoclasts cells which are required to maintain dynamic bone equilibrium.
In addition, Fosamax can cause severe and permanent damage to the esophagus and stomach. It is also hard on the kidneys, can cause diarrhea, flatulence, rashes, headaches and muscular pain. Rats given high doses developed thyroid and adrenal tumors. Fosamax also causes deficiencies of calcium, magnesium and Vitamin D - all essential bone building the process.
To counter the well-deserved bad press about steroid hormones for the treatment of osteoporosis. a new class of drug have been developed. They are call Selective Estrogen Receptor Modulators (SERM) It is touted by the drug companies that they will protect bone without the risk of breast cancer. The most well know of these drugs is called Evista (raloxifene). However, it's effect on bone is not very strong. Animal studies have shown that it increased the incidence of ovarian cancer.
Since bone is made of dynamic tissue, it is possible not only to maintain healthy bones but also to increase bone density. However, good bone health requires a commitment to good eating and life style habits. Some products that support bone health include natural progesterone, maca (a South American medicinal plant), hydroxyapetitie (a form of calcium) with boron, magnesium, adequate essential fatty acids, digestive enzymes, a good multi-vitamin/mineral formula and Chinese herbs.
Mary Shomon: You are a firm believer that when women are suffering from perimenopausal and menopausal symptoms, the problem is far more often a deficiency of progesterone and excessive estrogen. Can you explain this?
Sherrill Sellman: For the past 40 years, women have been told that menopause is a time when the ovaries fail and cease to produce estrogen, thus creating the myth of the estrogen deficient woman. Is also justifies the rationale for a multi-billion dollar industry that is supplying estrogen (along with progestins such as Provera ) to women not only for the relief of hot flashes and vaginal dryness but also as an anti-aging drug that will supposedly prevent skin from wrinkling, bones from disintegrating and hearts from failing, etc. It has also found its way as treatment for the myriad of symptoms plaguing perimenopausal women to help boost their supposedly flagging estrogen levels. The Pill has also become a popular treatment for the perimenopausal woman.
So, first of all to make sense of what's really happening with women's cycles and their hormones, a few very powerful myths needs to be dispelled.
1. Hormone Replacement Therapy, i.e., estrogen and synthetic progestins, have a combined 120 possible risks and side-effects. They are not natural hormones replacing our own hormones but rather powerful drug therapies. Estrogen and progestins are carcinogenic substances initiating and promoting breast, ovarian and uterine cancer. They also cause blood clots, strokes and high blood pressure and much more.
The Pill is made up of the same steroid hormones as HRT but up to 4 times the strength. The Pill can not only predispose a woman to a life time of hormonal imbalances but also breast cancer, strokes, miscarriages, infertility and nutritional deficiencies. Women have paid a huge price for the Pill.
Why are healthy women going through a natural life transition prescribed powerful, carcinogenic drugs? At whatever stage of life a woman may be experiencing hormonal imbalance, there are literally dozens of safe, effective and natural solutions.
2. Nature did not make a design fault in women's bodies causing their health to deteriorate when then arrive at menopause. Menopause is not a downhill slide nor an "estrogen deficiency disease" as the medical world likes to call it. At menopause there is an adjustment in estrogen levels reducing the output by the ovaries by about 40-60 percent. Just low enough so that the menopausal woman won't be maturing eggs (the post-menopausal journey is a time to nurture our passion and creativity not to bear children). Nature has also provided a back-up system in the estrogen department..both the fat cells and the adrenals produce estrogen . If we have any "meat on our bones," menopausal women are generally making plenty of estrogen, even if they have had a full hysterectomy!
However, with menopause there is a cessation of ovulation. When we ovulate, the site, known as a follicle, from which an eggs bursts forth turns into an endocrine gland that makes progesterone. When there's no ovulation, the primary supply of progesterone is not available. Thus, there is a precipitous fall in progesterone levels at menopause. However, once again, nature's back system makes progesterone from the adrenals. When this essential and delicate balance between estrogen and progesterone is altered, causing low progesterone levels and high estrogen levels - the resulting imbalance is called estrogen dominance. When estrogen is in excess, it is toxic to the body.
3 The World Health Organization has found that an overweight post menopausal woman has more estrogen circulating in her body than a skinny pre-menopausal woman!! Western women now have some of the highest estrogen levels ever recorded in history. In fact, we are literally swimming in a sea of estrogen exposure due medication such as the Pill and HRT, the estrogen mimics found in pesticides, herbicides, and plastics, as well as the hormones injected into feed lot cattle and farmed fish (estrogen accelerates grow and increases weight gain in animals.... and in women, too!).
4. As a result of saliva testing, we now know that perimenopause is not a time of declining estrogen levels at all. But rather a time when the body is doing it's final hurrah trying to stir those ovaries into action thus making some of the highest levels of estrogen ever made by the body. Perimenopause is really a time of high but fluctuating estrogen levels along with low progesterone (perimenopausal women are irregular in their ovulation). High estrogen levels and low progesterone production causes an estrogen dominant condition. Thus, it is totally inappropriate and dangerous to give the Pill or HRT to perimenopausal women since they already have high estrogen levels circulating through their body. Adding even more estrogen can cause many uncomfortable side-effects as well as serious health risks.
5. Unfortunately what the medical experts believed were symptoms of estrogen deficiency are really estrogen excess symptoms. Estrogen dominant symptoms include: weight gain, migraines, fluid retention, high blood pressure, fatigue, aging skin, thinning hair, fluid retention, PMS, low libido, muscle aches and pains, memory fogginess, fibroids, endometriosis, depression, fibrocystic breasts and miscarriage. The more serious, life-threatening conditions of estrogen excess are: reproductive cancers, strokes, blood clots, compromised immune system, toxic livers, gall bladder disease, auto-immune diseases (lupus, MS, rheumatoid arthritis), glucose intolerance, pancreatitis, and interfering with the uptake of thyroid hormones.
Estrogen excess, progesterone deficiency and thyroid imbalance have a very intimate relationship. Correcting hormonal imbalance naturally can effectively assist the recovery of thyroid function.
Most women who have menopausal complaints are perimenopausal women in their 40's or early 50's who are still menstruating. Prescribing the Pill or HRT to these women is a disaster in the making since the vast majority really have progesterone deficiency and estrogen excess.
Mary Shomon: Some practitioners believe that women with hypothyroidism can benefit from natural progesterone treatment, that it helps improve thyroid function. Can you explain this further?
Sherrill Sellman: Due to the increasing sophistication of saliva testing, what is becoming apparent is that estrogen excess, not deficiency is the real cause of the vast majority of women's hormonal complaints. Also, a sluggish thyroid will worsen estrogen dominant symptoms and vice versa.
The use of natural progesterone has been shown to be most helpful to women with mild symptoms of clinical hypothyroidism.
Women who are estrogen dominant have poor thyroid efficiency. Without getting too technical, it is known that estrogen increases thyroxine-binding globulin - the transport system for both T3 and T4. Globulin-bound thyroid is inactive. The more thyroid hormones are globulin-bound, the less of the active form is available. Adequate amounts of natural progesterone reduce estrogen dominance and consequently, increase the biologically active form of thyroid hormones. For many women, using natural progesterone along with committing to a healthy diet, using nutritional support, reducing stress and adding exercise is most effective.
It is also most helpful to include a cleansing program to detoxify the tissues thus diminishing resistance to whatever circulating thyroid hormone is present.
Mary Shomon: What do you think the best way is to get progesterone? What about the over-the-counter progesterone treatments, such as the creams? Are they as effective as compounded natural progesterone by prescription?
Sherrill Sellman: A good quality natural progesterone cream is as effective as a compounded one. I, personally, like to use a natural progesterone cream that has organic ingredients. It is recommended to use a cream that has about 480 mg per ounce. When it is applied twice daily, morning and night, it is the appropriate physiological dose.
Mary Shomon: Should a woman be tested for progesterone levels before starting any form of supplementation? Basically, what I'm asking is, is there any danger to a woman who self-prescribes and takes progesterone, i.e., using the over- the-counter cream, without confirming that she has a verifiable progesterone deficiency?
Sherrill Sellman: The symptoms of estrogen excess are quite identifiable. A saliva test is not always necessary. Progesterone cream is quite safe. While it is recommended to use 1/8 -1/4 tsp. twice daily, each women must really adjust the dose to her body's needs and sensitivity. Some women only need a very small amount while other may initially start off with a little higher dose.
However, a saliva test is most helpful to get an overview of the entire steroid hormone profile. Many steroid hormones can be measured besides progesterone such as estradiol, estrone and estriol, DHEA, cortisol, melatonin and testosterone. Saliva tests are now most effective for measuring thyroid hormone levels. It would certainly be helpful to measure these hormones yearly as well as establishing a baseline. In the case of severe hormonal imbalance, it may also be prudent to measure hormones several times a year to asses your treatments effectiveness. It is most important that all the steroid hormones are in balance.
Mary Shomon: You typically don't recommend estrogen supplementation for most women, unless they have a demonstrated deficiency in estrogen. Can you talk a bit about why you think women should avoid conjugated estrogens, like Premarin, and instead ask for estriol?
Sherrill Sellman: We often hear the term "natural estrogens" when it comes to supplementation and think that they are a better choice than the synthetic ones, such as Premarin. What is really necessary to understand is that if a woman is truly estrogen dominant, any form of estrogen, whether from conjugated horse urine or plant sources, is inappropriate and will only increase the toxic and potentially harmful effects of estrogen dominance. I always emphasis the importance of getting a saliva test to check if estrogen/progesterone ratio is truly out of balance before ever considering the use of any estrogen. Unfortunately, blood serum testing, the gold standard of the medical profession, is notoriously inaccurate, leading to false readings of estrogen deficiency. The WHO now recognizes saliva tests as the most valid form of hormone testing.
There are several issues that surround the use of Premarin. First of all, Premarin is made from PREgnant MARres UrINe. There are approximately 45,000 mares in Canada and the US who spend 7 months out of their 11 month pregnancy in confined stalls with catheters attached for collecting their urine. They generally are dehydrated (for a more concentrated urine) and under great stress and duress. Premarin mare foals are sold when just a couple of months old to slaughterhouses. There is quite a big business in Premarin foals. That is the moral issue.
The other issue involves the ingredients of Premarin. There are 10 kinds of estrogens found in Premarin. Only two are identical to human female estrogen. The other 8 are horse estrogens, obviously, not natural to a woman's body. Premarin's carcinogenicity is stated in the package insert. Horse estrogens put the liver at risk of developing cancer. There is no reason to ever take Premarin.
If a woman is truly estrogen deficient, then estriol may be appropriate. Estriol is considered the safest of all the estrogens. It is the dominant form of estrogen made during pregnancy. It is often recommended for vaginal dryness and urinary problems. Estriol, in fact, governs the harmonious workings and the suppleness of the lower third of the urethra, located in the vagina. However, even then, women have a variety of vitamins and herbs to choose from to eliminate that problem. Some of the most effective alternatives include natural progesterone topically and intervaginally, the herb maca, vitamin E capsules, vitamin E suppositories (made by Carlson Laboratories), royal jelly, folic acid (10 mg) with a B-Complex, female tonic herbs and Chinese herbal medicine.
Mary Shomon: What are your thoughts regarding soy foods and soy isoflavone powders and supplements for menopausal symptoms? Do you have any thoughts regarding the effects of soy on people with thyroid disease? Are there food, supplements or natural options to deal with menopausal symptoms for women with thyroid disease who don't want to use soy products?
Sherrill Sellman: I used to be quite a big soy fan until I began to do more research into this subject. Now I err on the side of caution and actually advise women to cut way down on their soy intake. The most preferred kind of soy would be the fermented versions such as tempeh and mise because that is the most digestible form of soy. The fermentation process destroys the harmful toxins found in soy. Unfermented forms have potent enzyme inhibitors that block the action of trypsin and other enzymes needed for protein digestion.
Soy blocks the uptake of the essential minerals - calcium, magnesium, copper, iron and especially zinc - in the intestinal tract.
It is now known that soy, in it's unfermented forms, does have an inhibiting effect on the thyroid. It is also a very allergic food and hard to digest. Contrary to the popular myth, Asians do not eat soy as a staple food but rather only as a condiment. I have lived for several years in Southeast Asian and know this to be a fact.
From my 8 years of research into women's hormonal health issues, I have learned that all hormonal problems is do to a body that is out of balance.. The greatest hormone wreckers, as I like to call them, are sugar, caffeine, alcohol, dairy, refined carbohydrates, hydrogenated oils, fatty foods, margarine, aspartame ( diet drinks), pharmaceutical drugs, dehydration, lack of sleep, skipping meals. junk food, dieting, eating pesticide-sprayed foods and hormone laden meat. Long periods of emotional and physical stress are a sure recipe for hormonal imbalance.
To regain hormonal balance and support thyroid function, we really need to a commit to a healthy diet filled with adequate protein, essential fatty acids and good quality carbohydrates (mostly from fruits and vegetables).
It is also important to embrace a healthy life style filled with physical exercise, stress reduction, and a loving and supportive community of friends.
I strongly recommend that women find a competent holistic practitioner who can be a compassionate and qualified ally on in her quest for regaining hormonal health and well-being. Healing the thyroid, as with any health problem, is an holistic journey.
Mary Shomon: How can people find out more about your work?
Sherrill Sellman: My book "Hormone Heresy: What Women MUST Know About Their Hormones" is available from bookstores, or from my web site http://www.ssellman.com or by calling toll-free number 877-215-1721. I can be contacted via e-mail at firstname.lastname@example.org
I have also developed a personal one-on-one hormone coaching program through phone consultations called The HormoneWise Program. It is a unique program, designed to offer ongoing education, support, personal strategies, resources, referrals and counseling to women seeking hormonal balance and personal empowerment. For further information contact email@example.com or (918)437-1058.
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