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Sunday, November 15 2015

Perimenopause and Andropause

Both men and women undergo changes somewhere in the 4th and 5th decade of life when the major sex hormones diminish for each.  In women it is estrogen and in men it is testosterone.  In a previous newsletter I talked about the role that the dominant form of estrogen, (estradiol) played in maintaining bone health.  It turns out that estradiol serves to protect more than just bones in women, and testosterone does more than just maintain physical strength for men. 

Here are some of the conditions that increase when there are lower levels of estradiol and testosterone.

Cardiovascular disease
Osteoporosis
Dementia and Alzheimer's disease
Arthritis
Autoimmune disease
Depression and Irritability
Sleep disturbances, night sweats
Weight gain


How do those two hormones sometimes referred to as sex steroids have anything to do with conditions that are seemingly unrelated such as Sleep disorders, Autoimmune disease, Arthritis and Dementia?  Simply put, by controlling inflammation.  These two hormones before reaching middle age, act as a bouncer at the doorway of a bar keeping unsavory chemicals and toxins from reaching their destination.  Estrogen and testosterone keep barriers intact in both the gastrointestinal tract and the brain.  In the gastrointestinal tract, this barrier when breached is called intestinal permeability and can lead to leaky gut syndrome.  In the brain it is called the blood brain barrier and if breached it can result in cerebral inflammation.

The inflammatory state that many of us have from leading a stressed and unhealthy lifestyle doesn't catch up to us until our mid life when these hormones decline.  Most attribute it to "just getting older",  but that isn't true once you understand the bigger picture. 

The Bigger Picture

As estrogen and testosterone decrease in the body, inflammatory chemicals called cytokines increase. Inflammatory cytokines are released when someone has any stress to their bodies such as food sensitivities, chemical exposure from pesticides, air pollution, and blood sugar stress.

As estrogen and testosterone decrease in the body, protective antioxidants such as superoxide dismutase and glutathione peroxidase decrease along with a lowering of T lymphocytes.  These are the key components that prevent unregulated inflammation and immune system problems. 

As estrogen and testosterone decrease in the body there is an increase in Microglial cells.  These cells are the first and main form of immune defense in the central nervous system.  They constitute 10-15% of the cells found within the brain.  If there is a compromised blood brain barrier, these cells help fight off a problem, but if it is ongoing, these cells can cause collateral damage to brain tissue. 

As estrogen and testosterone decrease the adrenal glands in both sexes secrete these same sex hormones along with progesterone in essence "picking up the slack" of the natural decline of ovarian and testicular production.  If the adrenals are not up to task because of stress from other sources then the precursors for sex steroid production are shifted to cortisol production, the level of sex hormones falls precipitously, and the symptoms of deficiency are magnified.  Cholesterol is what is needed to make estrogen and testosterone, so one bad consequence of cholesterol lowering medications, is the reduction of sex hormones. 

Body weight is important in this discussion too.  Excess adipose tissue (fat), secretes aromatase enzyme which converts testosterone into estrogen, an obvious  problem for men!  Aromatase also causes an increase in SHBG (sex hormone binding globulin) which binds to the free unbound testosterone (the active form of testosterone) thereby decreasing testosterone and increasing the abnormal ratio of estrogen to testosterone in men.  In women, excess body fat can lead to the same estrogen dominance however it does not bring the healthy estrogen back to normal, it instead raises an unhealthy estrogen (16 OH estrogen) (an artificial environmental estrogen) held in fat  that increases estrogen receptor related cancers. This is why many cancer therapies use aromatase inhibitory drugs.     

Summary and suggestions

In order to circumvent the onset of perimenopause and andropause symptoms it is prudent to:
1
. Follow a low glycemic diet that is hypo allergenic and to live a life that limits our exposure to artificial chemicals. 
2. Reduce emotional stress. 
3. Detoxifing just like any other preventative act like brushing your teeth should be done on a regular basis. 
4. Regular exercise and maintaining a lean body mass is essential. 
*5. Taking appropriate supplements to either naturally increase deficient hormones, antioxidants to limit inflammation or products to block aromatase.

*Diagnostech Labs offers a saliva profile that can test adrenal function along with female and male hormones to see what is out of balance.  If you or someone you know fits the descriptions here in this newsletter then a test can be run from my office, and the appropriate supplements can be recommended to restore health to this vitally important area.

Posted by: AT 02:00 am   |  Permalink   |  Email
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Dr. Paul B. Goldstein D.C. C.C.S.P.
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