Tips & Advice

From Dr. Liz Herself

April 21, 2017
How Young Should People Start Taking Hormones?
Blog Post | The RIght Time to Start Hormone Therapy

“How young should people start taking hormones?”

Bioidentical hormone therapy helps women and men feel their best well into midlife and beyond. I am often asked, “How long do I have to stay on hormones?”

I gave a short answer to this question in a previous blog. I plan to give a longer answer in my next book.

Today I want to answer the question,

“When is the right time to START hormone therapy?”

There are many answers out there to this question, ranging from “never” to “way before hormone deficiency symptoms begin.” The truth lies between these two extremes for most people.

The American College of OB/GYN recommends that women use hormone replacement therapy only to alleviate menopausal symptoms, and only until those symptoms are resolved.

The problem with this recommendation is that although many women begin to experience symptoms due to hormone deficiency as early as their 30s, and certainly in their 40s, the hormonal cause of these symptoms is rarely recognized and corrected.

Progesterone is the first hormone to start to decline, usually when a woman is in her 30s, often resulting in sleep and mood problems. When a woman is in her 40s, ovarian production of estrogen changes (up AND down), which combined with less progesterone can make her period irregular and her mood even worse.

As you know, most doctors treat symptoms with “Band-Aid” medications, so these women are prescribed sleeping pills, antidepressants, and oral contraceptives, rather than fixing the underlying cause – hormonal imbalance.

What about men?

Most doctors are still unaware of the long list of health benefits for men of optimizing testosterone levels. They, along with many men, think testosterone is only to help with sex drive or sexual function, and are unaware of the health benefits of an optimal level of testosterone (at least over 600 ng/dl).

Just like the belief that estrogen causes breast cancer in women, too many people think testosterone causes prostate cancer.

Pop quiz: Who gets prostate cancer more often – young men (with high testosterone levels) or old men (who usually have much lower testosterone levels)?

I hope you guessed correctly – older men get prostate cancer way more often than men in their 20’s. Although treating prostate cancer often involves lowering testosterone, there is abundant data showing that good levels of testosterone can prevent this male hormonal cancer.

So when should men consider testosterone supplementation?

Men usually do not go through a sudden drop in testosterone level comparable to the roller coaster changes of women going into menopause. It’s more of a gradual decline starting around age 30.

Low T symptoms include fatigue, low motivation/drive/libido, abnormal weight gain, irritability/depression, and cognitive decline (like lack of focus or concentration).

Why do people wait to start hormones?

Some women wait for years before starting HRT, either because they are afraid of hormones, or because their doctor tells them it’s not menopause if they are still having their period.

Because male testosterone levels decline gradually, men often do not realize they are getting symptoms of low testosterone until their levels are really low.

When did I start using hormone supplementation?

I went into menopause when I was 43 years young.

Because I knew the data and was not afraid of hormones, as soon as I had that first hot flash I reached into my sample cupboard in my office and put on an estrogen patch. I started feeling better within hours.

An easy, non-prescription way to start hormone supplementation is to use an over-the-counter progesterone cream at bedtime; this can help mood and/or sleep problems. Progesterone can even help temperature change symptoms (such as hot flashes or night sweats).

When should anyone start hormone supplementation?

Even a family history of hormonal cancer, including breast, prostate or colon cancer, does not mean you cannot safely use bioidentical hormone therapy to feel better.

Start hormone therapy as soon as necessary to safely alleviate symptoms and help you “feel like yourself again.”

I welcome your comments!

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