Female Hormone Restoration
Age-Related Hormone Decline and Associated Health Concerns
During the postmenopausal period, when female sex hormone levels have decreased significantly, aging women are at increased risk of several diseases including heart disease, osteoporosis, Alzheimer disease, and dementia compared with premenopausal women.
Heart disease is the leading cause of death in American women (CDC 2017), and women’s incidence of coronary heart disease increases sharply after menopause (Tandon 2010; Clearfield 2004). Compared with premenopausal women, postmenopausal women have higher blood pressure and higher levels of low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, and homocysteine levels, as well as markers of chronic inflammation and metabolic disturbance (Saha 2013; Fonseca 2017; Lee 2009). In addition, high-density lipoprotein (HDL) cholesterol levels drop significantly after menopause (Saha 2013; Fonseca 2017). Estrogenic activities are vital for maintaining the integrity of the vascular endothelium, where atherosclerotic changes begin (Arnal 2009). HRT may combat some of these changes. In a clinical trial, 75 peri- and postmenopausal women given compounded transdermal (topical) bioidentical estrogen therapy, with or without progesterone, experienced improvements in cardiovascular risk and inflammatory markers over 36 months (Stephenson 2013).
Menopause and perimenopause are associated with bone loss, which can lead to osteoporosis and increased fracture risk. Inadequate estrogen signaling contributes to increased production of pro-inflammatory cytokines, which disturb the balance between bone formation and bone breakdown and cause bone loss (Pietschmann 2016; Weitzmann 2006).
Hormone loss is also associated with neuronal degeneration and increased risk of dementia, Alzheimer disease, and Parkinson disease (Depypere 2016; Blair 2015; Rocca 2008). Estrogen stimulates degradation of the toxic protein beta-amyloid, which contributes to Alzheimer disease (Liang 2010). Deficiencies in pregnenolone and dehydroepiandrosterone (DHEA), which are both neuroprotective hormones, are also linked to memory problems and brain cell death associated with Alzheimer disease (Vallee 2016; Yao 2002). These two hormones appear to play an important role in regulating neurotransmitter systems involved in learning and memory, stress, mood, and motivation (Maayan 2008; Zaluska 2009; Vallée 2001; Zheng 2009).
Menopause often causes disrupted sleep patterns and associated symptoms such a night sweats (Jehan 2015). Importantly, disordered sleep is linked to increased cardiovascular risk in menopausal women. One study showed that sleep disorders in menopausal women were associated with arterial stiffness—stiff, inflexible arteries are less healthy (Zhou 2017). Evidence from an observational cohort study suggests bioidentical HRT may reduce sleep disturbances in postmenopausal women, but more study is needed (Ruiz 2014).