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Working Together Toward Health
American Association of Naturopathic Physicians

California Naturopathic Doctors Association

Oncology Association of Naturopathic Physicians

American Academy of Environmental Medicine
International & American Associations of Clinical Nutritionists 

The Sex Hormones & Graceful Aging


The balance of hormones is a critical component of a happy and healthy life.  For example, if you have too much or too little testosterone, too much or too little estrogen, the wrong ratio of testosterone to estrogen, or even the wrong balance of certain types of estrogen, it can upset the overall "rhythm" of your body and throw off many normal functions.

Hormone levels, or the balance between different hormones, can vary along daily cycles, monthly cycles, or even as part of the long term changes that happen "normally" over time as we age.  Although the very definition of healthy hormone function is balance, it is especially true when we are discussing the sex hormones.

What are the sex hormones?

There are three true "end stage" sex hormones: estrogen, progesterone, and testosterone.  Despite the fact that estrogen and progesterone are the dominant sex hormones in women and testosterone is the dominant sex hormone in men, all three play an important role in both sexes.  And, it is just as important to have the proper balance between the different sex hormones as it is to have the right individual hormone levels.

There are actually multiple subtypes of sex hormones.  For example estrogen has three.  E1 = estrone, which in high amounts, can inhibit the function of the other estrogens. E2 = estradiol, which, despite the fact that it is produced in the smallest amounts, is the most powerful estrogen and has the greatest known number of functions (like making the bones hard and keeping the skin wrinkle resistant).  E2 is also considered the most pro-cancer of the estrogens.  And finally E3 = estriol, which is the least potent and certainly the most limited of the estrogens.  E3 is usually only present in significant amounts during pregnancy and is considered the most protective against cancer.

To make it more complicated, once the life of a estradiol molecule is over, it heads to your liver where it is degraded into two main components, 2-hydroxyestrone, and 16-hydroxyestrone.  These two differ only in the placement of a hydroxyl (OH) group, but they have markedly different effects in the body.  The "good" one, 2-hydroxyestrone, interacts weakly with the estrogen receptors without triggering growth-promoting genes.  In contrast, the "bad" one, 16-hydroxyestrone, strongly activates the estrogen receptors, prompting cell proliferation in susceptible tissues, such as breast tissue and prostate tissue.  Having the proper ratio between the two estrogen break-down components is criticial for cellular health.

Other sex hormones include DHEA (dehydroepiandrosterone), LH (lutenizing hormone), & FSH (follicle-stimulating hormone).  In addition, levels of other hormones that are not "sex hormones", like thyroid-stimulating hormone, cortisol, & HGH (human growth hormone) are intricately involved in the balancing act.


Andropause is the result of decreased androgens also known as "male menopause".

Starting at about age 30, men's testosterone levels drop by about 10% per decade.  A recent World Health Organization study showed that by age 70, the average man's testosterone level is about 10% of their youthful level.  In addition to lowered testosterone production, sex binding hormone globulin (SBHG) increases with age.  And SBHG binds testosterone and makes it unavailble to the body.

Like female menopause, it is a normal part of aging.  However, it can be accompanied by a gradual and undesired decline in libido, energy, and mood changes.  There are also studies indicating a correlation with an increase in heart disease and weaker bones.  However, it is important to keep in mind that testosterone declines in all males as they age, and it is not possible to predict who will experience difficulties with this normal transformation.
There is a huge discussion going on now about hormone replacement, especially in menopausal women.  While natural aging includes menopause (and andropause), questions abound about the effectiveness, safety, and philosophical use of hormone replacement to alter the natural aging progression.  Naturopathic medicine offers a valuable choice to individuals struggling with these problems and decisions.  Diet, exercise, and stress reduction give relief to many individuals.  In addition, there are natural herbal choices available and this gentle option is often a big help for the majority of individuals. 
Historically, the majority of women didn't live to the age of menopause.  Because of increased life span, many women are spending fully half of their life in the post-menopausal state.  Smilarly, although not as dramatic, men also live many more years of life with decreased hormones. These facts bring legitimacy to the efforts of discovering how to maximize the quality of life without the hormones of our youth.  When problems arise and a decision is made to go to the next step of hormone replacement therapy -- it is critical to emphasize the importance of using only bio-identical hormones.
What are Bioidentical Hormones?

Bioidentical hormones are identical to the hormones made in our own bodies.  It must be emphasized that, while they are bio-identical, it does NOT mean that they are risk free.  Testing to date indicates that they are safer than those made synthetically or derived from horse urine.  This only makes sense.

If needed, a customized bioidentical hormone program will be developed for you based on laboratory tests (including thyroid and adrenal in addition to your sex hormones), your symptoms, nutritional status, and specific needs.  The program will be monitored closely and periodically adjusted to reflect your body's changing hormonal balance.  In addition, indications for slowly tapering off the use of any supplemental hormnes will always be examined.

Currently, there is a lot of interest in "anti-aging".  This is a term that is wrong on so many levels.  We are all aging and the concept of not aging is not only misleading, but unreasonable expectations can be a hinderance to the concept of healthy aging.  We prefer the concept of optimizing health, at all stages of life.  A great disservice has been done by implying that youthful looks are valued more than living a full and natural life.  

Longevity; Etymology: Late Latin longaevitas, from Latin longaevus long-lived, from longus long + aevum age.

In a naturopathic perspective, long life is important, but certainly not everything.  Long life is only a part of what we mean when we use the term longevity.  A long life full of pain, fatigue, depression, and countless other problems is not only undesirable, but to many may not be worth living.  To get to the point where longevity is even relevant, it has to be built upon a foundation of a "healthy life".  And a solid foundation means getting down and working on the basics.  If health is optimized, the quality of life will improve, life will be worth living, and the length of life will also be increased.