Do I Need Hormones?Do I Need Hormones?

Dr Johnnie Ham, MDDr Johnnie Ham, MD

Coastal Prestige Medical Services and Coastal Prestige Medical Services and ClinicClinic

Pismo Beach, CaliforniaPismo Beach, California

What are Hormones?What are Hormones?

• Hormones are BioChemical Hormones are BioChemical MessengersMessengers

• Hormones control numerous Hormones control numerous functions in the bodyfunctions in the body

• One of the Two Major Controllers One of the Two Major Controllers in your bodyin your body

Unique Unique TargetsTargets

Where do they come from?Where do they come from?

Focus on the Major Sex Focus on the Major Sex HormonesHormones

• EstrogenEstrogen• Estradiol – the major playerEstradiol – the major player• Estrone – less active, post-Estrone – less active, post-

menopausalmenopausal• Estriol – the pregnancy estrogenEstriol – the pregnancy estrogen

• ProgesteroneProgesterone• ““pro” “gestational”pro” “gestational”

• TestosteroneTestosterone

EstradiolEstradiol

• Performs over 240 functions in the Performs over 240 functions in the bodybody• In contrast, Testosterone performs In contrast, Testosterone performs

about 110; Thyroid Hormone performs about 110; Thyroid Hormone performs about 15about 15

• Produced by the month’s stimulated Produced by the month’s stimulated follicles in the ovaryfollicles in the ovary• So, no stimulated follicles, no estradiolSo, no stimulated follicles, no estradiol

TestosteroneTestosterone

• improves oxygen uptake throughout the body improves oxygen uptake throughout the body • controls blood sugarcontrols blood sugar• regulates cholesterolregulates cholesterol• increases lean body massincreases lean body mass• prevents osteoporosisprevents osteoporosis• maintains immune function maintains immune function • maintains cardiac functionsmaintains cardiac functions• Stimulates neurological function and repairStimulates neurological function and repair

Prevalence of Hypogonadism Using Prevalence of Hypogonadism Using Bioavailable Testosterone and Free Bioavailable Testosterone and Free

Androgen IndexAndrogen IndexFrom Morley JE, Perry HM. Andropause: an old concept in new clothing. Clinics in From Morley JE, Perry HM. Andropause: an old concept in new clothing. Clinics in

Geriatric Medicine 2003; Vol 19, No 3.Geriatric Medicine 2003; Vol 19, No 3.

Table 2. Prevalence of hypogonadism in older men.Table 2. Prevalence of hypogonadism in older men.

Age (y) Percent HypogonadalAge (y) Percent Hypogonadal

Baltimore LongitudinalBaltimore Longitudinal Mayo Clinic Canadian Mayo Clinic Canadian

PhysiciansPhysicians

40-4940-49 32 32 3737 4141

50-5950-59 4949 6666 6161

60-6960-69 6464 7070 7676

70-7970-79 7878 9494 9595

80+80+ 9898 ---- ----

Symptoms of Testosterone Symptoms of Testosterone Deficiency in Women Deficiency in Women ANDAND

MenMen

• Decreased or absent libido Decreased or absent libido • Erectile or Sexual Erectile or Sexual

dysfunction dysfunction • Decreased muscle mass Decreased muscle mass • Decreased muscle strength Decreased muscle strength • Osteoporosis Osteoporosis • Heart disease Heart disease • Sleep disorders Sleep disorders • Memory failure Memory failure • IrritabilityIrritability

• Decreased energy levelDecreased energy level• Mood swingsMood swings• DepressionDepression• AnxietyAnxiety• Increased painIncreased pain• Cold intoleranceCold intolerance• Decreased self-Decreased self-

confidenceconfidence• Decreased cognitionDecreased cognition• Loss of sense of well-

being

Serum testosterone (a) and free testosterone concentrations (b) in patients receiving Serum testosterone (a) and free testosterone concentrations (b) in patients receiving

testosterone gel 5 (closed circles), 7.5(closed squares), and 10g/d(closed triangles). The testosterone gel 5 (closed circles), 7.5(closed squares), and 10g/d(closed triangles). The

dotted lines represent the adult male reference rangedotted lines represent the adult male reference range

Jockenhovel F et al. The good, the bad, and the unknown of late onset hypogonadism: the urological perspective. Journal of Men’s Health and Gender. September 2005, Vol 2, No. 3.

Is there anything I can do Is there anything I can do without taking hormones?without taking hormones?

• Lots….Lots….• ExerciseExercise• DietDiet• Herbal SupplementsHerbal Supplements• Stress Reduction techniquesStress Reduction techniques• Chiropractic careChiropractic care• Massage therapyMassage therapy

So Why Treat?So Why Treat?

Managing Hormones Managing Hormones Basic LevelBasic Level

• Start with symptomsStart with symptoms• Educate on risks, benefits, alternativesEducate on risks, benefits, alternatives• Begin therapy, monitor the resultsBegin therapy, monitor the results• Incrementally add or subtract whatever is Incrementally add or subtract whatever is

needed for your personal desired effectneeded for your personal desired effect• Once everything is “perfect” then Once everything is “perfect” then

measure to get a baselinemeasure to get a baseline• Generally, using Estradiol, Testosterone, Generally, using Estradiol, Testosterone,

and sometimes progesteroneand sometimes progesterone

How much does it Cost?How much does it Cost?

• If not covered by insurance:If not covered by insurance:• Testosterone and estradiol cream thru the Testosterone and estradiol cream thru the

Women’s International Pharmacy is $19.50 Women’s International Pharmacy is $19.50 per month eachper month each

• Most insurance companies cover estradiol for Most insurance companies cover estradiol for women and testosterone for men, including women and testosterone for men, including MediCareMediCare

• Most men are willing to pay $19.50 for Most men are willing to pay $19.50 for testosterone for their wives…testosterone for their wives…

More Info?More Info?

• Strongly Recommend:Strongly Recommend:• ““Perfect Balance” by Dr Robert Greene, Perfect Balance” by Dr Robert Greene,

featured on Oprah, bestsellerfeatured on Oprah, bestseller• ““The Life Extension Revolution” by Philip The Life Extension Revolution” by Philip

Lee Miller, MD, Los Gatos Longevity CenterLee Miller, MD, Los Gatos Longevity Center• ““Natural Hormone Balance for Women” by Natural Hormone Balance for Women” by

Uzzi Reiss, UCLAUzzi Reiss, UCLA

• Caution – be careful about what you Caution – be careful about what you read on the Internet!read on the Internet!