What is aging and the diseases that accompany the aging process? Aging is closely tied to the endocrine system when hormones start to decline and the internal organs have decreased functioning. In early states, the changes include decreased protein synthesis, a decline in immune function, a loss of muscle mass, bone density and an increase in fat mass. The increased fat mass contributes to insulin resistance and cellular oxidation. Slowly, chronic disease states are manifested with diabetes, hypertension, high LDL, low HDL, dementia, degenerative arthritis, osteoporosis, coronary artery disease, and cancer. The end result is overall declining health and eventually death.
Hormones are produced by the endocrine glands with the decline starting around 35 years old in both men and women. The symptoms can have an insidious onset in each sex. In men, there are erection problems, low libido, fatigue, low energy, insomnia, depression and male balding pattern. In women symptoms can range from increasing premenstrual syndrome distress, fatigue, irritability, weight gain, insomnia, irregular periods, heat or cold intolerance, increased hair shedding, loss of sexual desire, vaginal dryness, dry wrinkling skin and depression.
In Allopathic Medicine, we are problem oriented to treat the disease state but in Age Management Medicine we focus on prevention of diseases and increase the healthspan to a lifespan in individuals. This is accomplished through restoring all hormones to a 25-30 year old level with blood level monitoring. Natural hormones are prescribed which have identical molecular structure to the human body. These are extracted from yams and soy and compounded to a individualized dosing regimen for Estradiol, Progesterone, and Testosterone. The thyroid is optimized with Armour throid which is more bioavailable than Synthryoid and Levoxyl. DHEA is replaced and optimized by blood monitoring. Pregnenolone and Melatonin are replaced for sleep and memory but do not require blood monitoring.
American College of Gynecology guidelines for hormone replacement therapy have unfortunately confined its use to short-term symptom treatment only, using the lowest dose possible. A better understanding of the conflicting evidence in hormone therapy suggests that hormone replacement provides significant health benefits and disease protection for many women if begun early in menopause. The PEPI trial in 1990 with 875 postmenopausal women proved the safety and efficacy of natural micronized progesterone combined with estrogen for the best cardiovascular protection. Other health benefits from this trial were less weight gain with women taking hormones after menopause, an increase in the HDL and protection against endometrial cancer. Later studies with natural Estradiol and natural micronized Progresterone have shown protection against cardiovascular disease, osteoporosis, alzheimers disease, urogenital atrophy, colon cancer, endometrial cancer and hypercholoesterolemia. Also, hormone therapy helps to prevent depression, fatigue, incontinence, weight gain and the loss of feminity.
When hormones are started and titrated to acceptable levels withing the parameters of a 25-30 year old range there is no need to stop; unless, there is a new cancer development. If hormones are stopped it is psychologically deteriorating and it induces symptoms of menopause and andropause. Also stopping hormones reverses the aging process with risk for adult onset disease states. When providers practice under evidenced based guidelines for Age Management Medicine they are providing improved health for their patients.