Question:
Do women need hormone replacement after menopause?

Answer: *Absolutely if you want to reduce your risk of memory loss, heart disease and other serious diseases.

*Menopause signals a significant decline in the production of estrogen as ovaries cease producing youthful levels of estrogen. After the loss of estrogen, skin can become thin and splotchy, bones can become brittle, memory can become a problem, hot flashes can disrupt a women’s days and nights and heart disease risk can increase dramatically. The risk of suffering from Dementia and Alzheimer’s disease has been shown to be reduced by 50% and more (one study said up to 85%) if estrogen and progesterone are started in early menopause. Early, according to the studies, means at least 10 years before the onset of symptoms.

*We also know from many studies and clinical observation, that thyroid and testosterone play a role in memory and cognitive functions. Most menopausal women will have low levels of each of these critical hormones. Studies show that low thyroid can directly affect memory even in younger adults and that testosterone can help protect against amyloid plaque build-up in the brain. Amyloid plaque is a protein that is linked to Alzheimer’s disease.

*At menopause, and frequently years before, the body’s production of all hormones decline. Estrogen is generally the last hormone to decline in women (unless a woman had her ovaries removed when younger by way of hysterectomy or other surgical procedure). Testosterone can be low even in younger ladies and is often declining in the peri-menopausal years. Low testosterone can mean low sex drive, decreased lean muscle and increased body fat. It can also mean low energy.

*Low progesterone can increase the risk of breast cancer and low thyroid can make it difficult to maintain a healthy weight and stay energetic. Post-menopausal women tend to have very low levels of progesterone and it is often so low that it is not measureable. Youthful levels of progesterone can help improve the quality of sleep, is neuroprotective, has a calming effect in most women and can reduce anxiety and increase sex drive. Thyroid affects every cell in our bodies and is critical to quality of life. DHEA, another important hormone, is also neuroprotective and helps protect against the effects of the stress hormone cortisol.

My recommendation? Start early and test your hormones. The longer you wait to restore low hormone levels, the less protection you receive. It is easier to prevent disease processes than to cure them.

Joseph NBH, M.D, FACOG, AACS, AACG.

Medical Director, NBH Lifetime Health Hormones & Weight Loss

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