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ByJudiGerstung, D.C

The ManyManifestations of

H H ormone imbalance is the rootH H of health concerns ranging from^ ^ ^ ^ ^ J monthly migraines, bloating,^ ^ ^ ^ ^ ^ mood swings, weight gain andH H under-active thyroid to osteo-H H porosis, heart disease and bothH H benign and malignant processes

of the reproductive system. Men are also subjectto hormonal imbalance issues including hairthinning and balding, loss of bone density andeven prostate conditions. Women and men alikeare now caught between their desire to avoid orminimize the impact of these seemingly inevi-table problems versus their concern to avoid therisks and side effects of treating them with thesynthetic solutions given to us so quickly by the

mainstream medicopharmaceutical approach.The recent release of the fourth edition of my

book, "The Estrogen Alternative (A Guide toNatural Hormone Balance)," which is co-au-thored by Raquel Martin, examines the mul-titude of disorders tbat women deal with frompuberty to PMS to post-menopause. For all toolong, the physiological effect of estrogen has beenmisunderstood and the advocacy of estrogenicsolutions—whether they're synthetic, bioidenti-cal or phyto-estrogens, such as soy—have beenoversold to the public. A paradigm shift is sorelyneeded.

The book examines the multitude of factorsinvolved, but focuses on tbe relative ratio be-tween estrogen and progesterone in both men

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and women. It explains the underlying causes.environmental as well as endogenous, that leadto estrogen dominance and its counterpart—progesterone deficiency. Based on extensivedocumentation, research reports and clinical re-sults, I have found that progesterone deficiency,not estrogen deficiency, can underlie a myriad

Many doctors, as well

as the patients they

treat, a re unaware

that bioidentical,

botanical progesterone

acts to oppose

the many negative

consequences of

chronic estrogen

dominance.

of disturbances. The amount of these hormonesthat the body produces can vary from day-to-day and month to-month depending on a wholehost of factors such as: stress, exercise, nutri-tional habits, spinal subluxations/misalign-ments and even the body's level of acidity. Manydoctors, as well as the patients they treat, are un-aware that bioidentical, botanical progesteroneacts to oppose the many negative consequencesof chronic estrogen dominance.

"The Estrogen Alternative, 4th Edition," de-tails the latest research on natural hormone bal-ancing, including alternatives to synthetic birlhcontrol. It gives a rationale for the dangers in-volved in menstrual suppression, be it via shots,pills or implants, and encourages women to lookinto natural contraceptive approaches ratherthan the more convenient, quick-fixes that arebeing promoted through expensive advertis-ing campaigns. It also explains the profoundimpact of cumulative chemical saturation at the

cellular level due to the molecular breakdownof pesticides, plastics, petrochemicals and themany synthetic compounds found in personaland household care products. In this article, I'lladdress the synthetic therapies versus naturalhormone approaches regarding the many mani-festations of hormonal imbalance.

ENVIRONMENTAL ESTROGENMIMICKER & XENO-ESTROGENSAn estrogen mimicker is any molecule that canbind to an estrogen receptor site and create anestrogenic cellular response, thus acting as anendocrine disruptor. These molecules are foundin a multitude of commonplace substancesfrom pesticides to fertilizers and growth addi-tives to all of the various plastic and petroleumproducts. One of the main physiological actionsfrom such estrogenic stimulation {be it exog-enous or endogenous) is cellular replication orproliferation, which can lead to unwanted cellovergrowth. Unfortunately, we are continuallyintroducing more chemical estrogens (xeno-es-trogens) into our environment—including ourfood supply—tbus setting our bodies up for amultitude of disorders.

ESTROGEN DOMINANCE AND/ORPROGESTERONE DEFICIENCYThere is an alarming "epidemic" of estrogendominance and/or progesterone deficiencyamong women (as well as children and men too)in industrialized nations that use petrochemi-cals and wbose food supply has been subject tochemical fertilizers and growth hormones. Overthe past 13 years of investigation in the areaof hormone imbalance, we found women whoexperience tbe uncomfortable symptoms asso-ciated with PMS through post-menopause, mayactually have a condition of estrogen dominancein combination with progesterone deficiency—not estrogen deficiency as they are most oftentold. It's easy to see how estrogen has the upperhand and is doing a lot of damage without itsessential partner, progesterone, to balanceand oppose it.

True, estrogen does declinewith biological aging; how-ever, in most cases, pro-gesterone is lower thanestrogen when a womanbecomes symptomatic.This then creates a func-tional hormone imbal-ance and can manifestas hot flashes, night

sweats, menstrual or menopausal migraines,anxiety, depression, excessive uterine bleed-ing—the list goes on. Unfortunately, instead ofrecommending a bioidentical progesterone tocorrect these imbalances, doctors typically pre-scribe synthetic hormones such as an oral con-traceptive or Premarin (Pregnant Mares Urine,containing powerful estrogens), with or withouta progestin (synthetic progesterone). The bodycannot properly utilize these synthetic hormon-al substances. These factors may account for un-comfortable symptoms such as bloating, weightgain, the risk of blood clots, and the possibilityof future benign or malignant cell proliferationin the breast, uterus, ovaries and/or cervix.

BIOIDENTICAL & BOTANICALPROGESTERONE THERAPIESSurprisingly enough, the wild yam is the origi-nal source material for hormonal therapies. Dr.Russell Marker, a pharmaceutical chemist, dis-covered it in 1938. He went to Mexico to find theplant that was rumored to be a possible ingredi-ent source for a synthetic birth control prepa-ration. Since natural food substances cannotbe patented, and because of the extraordinaryhealth benefits of the wild yam plant, the phar-maceutical industry wanted to be able to make ita prescriptive medicine. Unfortunately, duringthis pharmacological processing, it is denaturedand in its synthetic form gives rise to the poten-tial for many risks and side effects. However,in its natural state, the Mexican wild yam isremarkable for its progesterone-like effect whenextracted, concentrated and hydrolyzed. It tookseveral decades for the natural health care in-dustry to come into its own and to develop aneffective delivery system for the active hormonalform of the molecule as is now found in bioiden-tical progesterone. Today we have the benefit ofmany such pure and/or organic transdermat orsubiingual formulations.

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SYNTHETIC PROGESTINS VS,NATURAL PROGESTERONEProvera, (medroxyprogesterone acetate) a syn-thetic progestin, is often erroneously called pro-gesterone by some doctors, and prescribed main-ly for its ability to induce shedding of the hningof the uterus when its dose is halted (as on day 26of birth control pill use). Although this chemi-caliy-induced menses results in uterine bleeding,it should not be considered the equivalent of a bi-ologically-induced menses that comes as a resultof a woman's own hormonal biorhythms. Thesecyclic patterns, synthetic versus natural, are ex-tremely different and should not be equated. Un-fortunately, Provera, and other synthetic proges-tins, are also prescribed when women complainabout the side effects of estrogen dominancesuch as bloating, weight gain, breast tenderness,anxiety, mood swings and sleepless nights. How-ever, the addition of progestins to estrogen is likeadding fuel to an already hot fire.

Such was the evidence of the 2002 WorldHealth Initiative study which resulted in Prem-Pro (the combination of synthetic estrogens withsynthetic progestins) being pulled off the marketafter only three years into what was supposed tobe a 10 year longitudinal study, which would bethe largest investigational study of HRT to date.It can't be stated often enough that Provera, orother progestins, are dangerous and have graverisk factors as the body cannot properly utilizethese artificial substances. Unfortunately suchuse often results in side effects far worse than theoriginal complaints. The 2002 study was halteddue to cases of stroke, heart disease and breastcancer occurring far earlier than is consideredappropriate. On the other hand, natural pro-gesterone has a broad spectrum of physiologicalbenefits in the restoration of hormonal balancewith no such risk factors to worry about.

CHOOSING A BIOIDENTICALHORMONAL THERAPYI think it is very important to point out that dur-ing any/all our life stages and ages, we can feelthe effects of an imbalance between estrogenand progesterone. In almost all cases, we are es-trogen dominant, rather than estrogen deficient,in combination with a deficiency in our levels ofovarian progesterone. Bioidentical progester-one use has been found to alleviate symptomsranging from puberty to PMS to peri-and post-menopause. It has many physiological roles andis welcome for its ability to normalize thyroidfunctioning and thus to help the body burn fatfor energy; to act as a natural diuretic and thus

reduce the symptoms of premenstrual bloating;to provide an anti-spasmodic effect and thushelp in thetreatment of fibromyalgia;and for itsrole as a calming agent, thus helping to relieveanxiety and depression. It has been found usefulin dealing with the following:

• irregular menstrual flow, severe cramping,endometriosis

• hypoglycemia, chronic fatigue syndrome,yeast infections

• bloating, irritability, mood swings and otherPMS symptoms including menstrual migraines

• infertility issues, first-trimester miscarriag-es, premature labor and delivery

• hot flashes, night sweats, insomnia, vaginaldryness

• osteopenia and subsequent osteoporosis• heart palpitations, high blood pressure and

other cardiovascular disorders• cellular overgrowth and proliferation in the

breast, uterus, ovaries and/or cervix.

SUPPLEMENTING WITH PROGESTER-ONE OUTSIDE OF MENOPAUSEProgesterone deficiency usually begins in theearly to mid-40s. However, in some women,progesterone levels begin to decline in the mid-20s to early 30s. This is often the case due tostress from accidents, surgery or other traumas(from fetal chemical exposures to environmen-tal toxins), which can hasten the decline of thisessential hormone. Another huge factor in ac-celerating the decline of ovarian progesterone isthe widespread use of synthetic contraceptives.Young women are not informed that to protectthem from unwanted pregnancies, the syntheticform of progestin is used to trick the ovary intothinking that conception has already occurredand that you are, in fact, pregnant. Thus,it does not release an egg due to the highlevels ofcirculating synthetic progestins.in this manner, ovulation isprevented—which mayvery well be the desiredeffect. Unfortunately, andbecause it is dependenton the release of the egg,no ovarian progesteroneis then released during thesecond two weeks of thecycle and consequently estro-gen dominance is assured.

Should thiscontinue monthafter month (and now yearafter year) as in the case ofshots of "DepoProvera", the

use of the oral contraceptives "Seasonal" or "Ly-brel," or the surgical insertion of the chemi-cal-filled rod "Implanon," this important andvital event in the natural cycle is suppressed.These latest devices in the marketing of birthcontrol create a chemiciilly induced suppressionof ovulation for anywhere from three months tothree years. Given that the definition of meno-pause is one year without ovulation, all of theseunsuspecting young women are entering intoa condition that I have termed as "chemical"menopause. In a very short time such use givesour 20- and 30-year-old females the same hotflashes, nighf sweats, and bone loss issues facedby their mothers. This is an extremely danger-ous trend. My hope is that this message is sharedand women everywhere begin to question thistype of physical, emotional and energetic sup-pression. It has gone on for all too long.

PROGESTERONE DEEIGENCY,CHRONIC ACIDOSIS & BONE DENSITYOsteoporosis is a debilitating consequence ofchronic acidosis in combination with lack ol ad-equate hormonal stimulation {via bioidenticalprogesterone) along with long-term deficienciesin the micro and macro minerals. U is a majorpublic health problem in the world today affect-ing both women and men and is the result of theprogressive loss of bone mineral density. A sur-prising, and generally unknown fact, is that thegreatest loss of bone density in women occursthe five years before and the five years after theonset of menopause. This comes as quite a rev-elation as most of us feel that osteoporosis is an"old person's disease" as opposed to one that bitsus, in what could be, the prime of life. Unfor-

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tunately, it is during this transition period thatthe bone loss is insidious <ind all too often goesundetected. !t is not until several decades later,when our hone density falls close to or below thefracture threshold, that we hegin to experiencethe deep bone pain that marks the onset of themicrofractures that preceed the inevitable grossfractures to come.

It's very likely that

what appears to be

preservation and

protection is just a false

promise—one that is

limited and temporary

in nature.

An often overlooked ratio in bone health isone's pH, or one's acid/base balance. The cur-rent body of evidence suggests that with thestandard American "fast food" diet and ourhigh, chronic stress levels, we live in a conditionthat is more skewed to the acidic end of thisscale. As such, we are setting ourselves up tobe host to many degenerative conditions. Withrespect to our bone density, a chronically acidicmetabolic state is one that cannot be toleratedfor too long. When this is the case, the bodysearches for a way to buffer this situation inorder to quickly neutralize the pH of the blood.It does so by stimulating the osteoclasts to breakdown the stored alkalinizing minerals (espe-cially calcium) and releases them back into thebloodstream. As this is the predominant processrelative to chronic acidosis, this sets the stage forthe unfortunate onset of osteoporosis with all ofits consequences.

The other overlooked, but fundamental in-gredient in the maintainance of bone density, isthe proactive role that bioidentical progesteroneplays with respect to bone health when comparedto the more passive role of estrogen. Throughoutour life, osseous breakdown {via osteoclasts)and buildup (via osteoblasts) is continually oc-

curring and is known as bone remodeling. Aslong as these two processes are kept in balance,our bone density is maintained. Whenever theovaries discontinue their production of proges-terone and the osteoblasts are no longer directedto build new bone tissue, osseous breakdownis actively stimulated and we have the onset ofosteopenia and eventually, osteoporosis.

A reduction in progesterone levels with itssubsequent decrease in osteoblastic activity oc-curs during several conditions:

• during the transition from perimenopauseto menopause

• with a surgically-induced menopause• with exercise-induced bone loss• with the long-term use of birth control• OR, in men, with the age-related decrease in

the testicular production of progesterone.Yes, men do produce progesterone at the rate

of 9-10 mgs per day whereas ovarian productionis limited to the second two weeks of the femalecycle and is produced at the rate of 18-24 mgs.per day Thus, both men and women produceapproximately the same amount on a monthlybasis. As such, progesterone is not a "female"hormone but one that has numerous physiologi-cal benefits for both men and women. For thisreason, both sexes can support themselves withregular application of bioidentical progesterone.

ESTROGEN AND OSTEOPOROSISEstrogen was long advocated due to the fact thatit keeps the existing bone in place by slowingdown bone loss. This gives the appearance ofholding off osteoporosis but, in fact, old bone isbrittle bone and over time will eventually frac-ture. However, for many years estrogen was pro-moted as the gold standard in the treatment ofosteoporosis as it was thought that It would begood enough just to slow down the rate of boneloss. But unless the osteoblasts are stimulated,there is no active new bone buildup as therewas when the ovaries/testicles were producingadequate amounts of progesterone. This is ex-actly what supplying the body with transderma!progesterone can accomplish.

As of 1998, Fosamax was the only non-hor-monal drug available for the treatment of os-teoporosis and is still widely prescribed in spiteof the risks associated with its use. It continuesto be utilized in spite of the fact that its long-term studies were manipulated to make it ap-pear that its use would prevent osteoporosis.The official studies were stopped just prior tothe point (four to six years) at which fracturesbegan for women taking similar medication

(Didronel). Up to this point, bone density testslook positive as Fosamax slows down bonebreakdown by the osteoclasts and thus keepsthe old, more dense bone around. However, oldbone is brittle bone and eventually, if this datawere collected, it is probable that the fracturerate would increase sharply.

If Fosamax had no side effects or risks associ-ated with its use, perhaps this delay in the onsetof fractures would warrant its use. However,the story doesn't stop here and unfortunatelyincludes:

• the caustic and abrasive nature involved inthe very swallowing of this toxic drug has beenreported to cause severe, permanent damage tothe esophagus and stomach especially if you Hedown after taking it;

• the development of deficiencies of the verynutrients required in the prevention of osteopo-rosis (calcium, magnesium and vitamin D);

• the onset of multiple side effects such as "di-arrhea, flatulence, rash, headache and muscularpain" plus possibility of damage to the kidneys,thyroid and adrenals;

• and, as of 2006, we have documentation thatsome women using Fosamax developed osteo-necrosisofthe jaw.

We must seriously begin to question the ad-visability of taking any drug that is prescribedunder the guise of "protecting us from osteo-porosis" and which, at the same time has, as apossible side effect, the destruction of the jaw.If Fosamax, or any of the other bisphospho-nate derivatives, carries such a risk, why is itprescribed to women to ostensibly preserve thebones of the skeleton? It's very likely that whatappears to be preservation and protection isjust a false promise—-one that is limited andtemporary in nature; one that has far moreconsequences than most women bargain forwhen they are told to use such drugs to "pro-tect" their bone density. TO.

Dr. Judi Gerstung is a chiropractic consultant aswell as a personal wellness coach and nationalspeaker on hormonal and nutritional issues. Toorder copies of "The Estrogen Alternative, 4thEdition," please visit at estrogenissues.com. Youcan contact her with further questions or to setup patient wellness consultations at: dr.judi.dc^gmail.com. Fora more in-depth account and fullydocumented references, please refer to: "The Es-trogen Alternative (A Guide to Natural HormoneBalancing), 4th edition, 2006" published by InnerTraditions International, Rochester, VT.

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