Running on Empty

Reader question of the week: “You recently started a friend of mine on bioidentical hormone replacement therapy using testosterone pellets. I was surprised to hear that her hot flashes and night sweats went away even though she isn’t receiving any estrogen or estradiol. Can testosterone fix all the menopause symptoms?”

Answer: Yes! Testosterone CAN fix most (if not all) symptoms associated with menopause as well as other non-menopausal symptoms. Menopause actually occurs because the body’s precursor hormones (testosterone and androstenedione) decrease to the point that there isn’t enough to convert into estradiol. Testosterone is converted to estradiol in fat cells by the enzyme aromatase. I do place a few patients on estradiol pellets if their estrogen symptoms (hot flashes, night sweats, vaginal dryness) are unbearable, but most patients have more relief when the body is allowed to naturally convert testosterone to replace estradiol.

The body typically responds better to natural processes. While my last article called for a paradigm shift in how physicians and patients both respond to medical problems, this week’s article will focus on how physicians can use medicine to restore normal function. To review- Physicians better serve their patients by treating symptoms and using laboratory and clinical tests to validate the symptoms (treat the patient and not the paper). Patients need to hold physicians accountable for providing good health care (ask questions, be involved, and expect wellness counseling). I would like to continue the call for change by discussing how we all can improve our response to aging or the loss of normal.

Aging is a natural process and certainly beats the alternative. Aging is NOT a graceful process. Aging entails a lot of negatives: decreased memory and concentration, decreased energy levels, decreased restful sleep, decreased libido, and for men, decreased erections. The increases? Increased risk of osteoporosis, increased cholesterol levels, increased blood pressure, increased anxiety, and increased depression. Feel free to add in a few of your own. Definitely a huge combination of NOT graceful!

What can we do to mitigate the negatives associated with aging? A healthier lifestyle is a great place to start. Better diet, more exercise, weight loss, and smoking cessation (if necessary) all contribute to a healthier you. Interestingly, the symptoms listed in the paragraph above which we typically associate with the aging process all respond to bioidentical hormone replacement therapy (BHRT).

As a nation we are using up our natural hormones faster than ever before. Our high stress lifestyle, which usually includes poor sleep, poor diet, and lack of exercise, causes a decrease in hormone production at an earlier age. While the standard of care isn’t to check women’s hormone levels prior to starting BHRT, I do need to look at a few lab tests for the guys. Similar to the military testing showing pre-pubertal testosterone levels in young men exposed to combat stress; I have seen men as young as 22 with low free testosterone levels. Our stress and sex hormone levels are peaking sooner and falling faster than ever before. At the same time, we have added to our average longevity. The result? We live longer feeling like we are dying.

Stress does bad things to your hormone levels. Adequate sleep, a good diet, and exercise all contribute to decreasing stress and maintaining normal hormone levels for as long as possible. Even when you are doing everything right, environmental factors beyond your control will likely cause you to outlive your ability to adequately produce the hormones you need. Feel like your body is running on empty? I can help!

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. While he doesn’t have a solution for the chronic shortage of petroleum products, he does have a solution for low hormone levels. Comments or questions? His email address is: