The longevity movement has come in full swing and it’s becoming impossible to tell anymore whether someone is 30 or 80.
Well, I exaggerate… but just a bit.
There is a lot more to longevity and anti-aging than trying to stay young forever. While that may be part of the appeal for some, for others, longevity is about supporting the body through the natural aging process so they can continue to feel healthy, capable, and vital well into their 80s. To do that, they’re drawing from both ancient practices, like Chinese Medicine, and modern clinical breakthroughs to improve not just how long they live, but how well they live.
Embracing mortality and the wisdom that comes with having spent much time on Earth is one of the many pillars of wellness. It’s also a process. Metabolizing life and our role in a culture that often only values youth is an inevitable journey we all must go through.
At Kai Wellness, we are honored to support people every step of the way, from realizing your worth and value as an elder to supporting your vitality and living life fully.
One of the most important pieces to graceful aging is balanced hormones. It doesn’t matter if you’re a man or a woman, fluctuating hormones are a normal part of aging. However, painfully uncomfortable symptoms like hair loss, hot flashes, insomnia, low libido are not.
Yes, they are experienced by many as they age, and many folks consider it “normal”. But “normal” or “common” is not always synonymous with being healthy. The truth is, you can go through hormonal changes and still feel healthy, vital, and happy!
Hormone replacement therapy (HRT) is one way to ensure your hormones stay balanced even as you age. But is it right for you?
Let’s look at the process behind traditional HRT, and explore other integrative alternatives, so you can make an informed decision about whether you want to try HRT for yourself.
What Do We Mean By Hormone Replacement Therapy?
Before we go any further, let’s clarify the different types of HRT.
Traditional HRT uses prescription hormones to replace hormones that are low or deficient. Depending on your needs, this may include estrogen, progesterone, testosterone, or a combination.
Bioidentical HRT uses hormones that are chemically-identical to the hormones naturally-produced by the human body. Bioidentical hormones can be FDA-approved prescription products or custom-compounded formulations.
Integrative hormone support takes a broader approach. Rather than simply replacing a hormone that’s low, we look at the systems involved in producing, regulating, and metabolizing your hormones, and use tools like nutrition, lifestyle changes, herbs, acupuncture, and other therapies to support them.
These approaches aren’t necessarily mutually exclusive. For many people, the best option may be HRT alongside integrative support.
Traditional HRT In the Body
When you break it down to the essentials, most of the body’s systems work like an assembly line.
In the case of hormones, the line begins in the liver. Your liver produces cholesterol – the raw material for hormone production – and sends it out into the body. From there, your adrenal glands and reproductive organs take that cholesterol and turn it into pregnenolone, which can then be used to make hormones like estrogen, progesterone, testosterone, and DHEA.
Your body doesn’t just make random amounts of hormones. It’s constantly checking on what you have and what you need, and then adjusting your hormone production accordingly.
Your brain, especially the hypothalamus and pituitary gland, helps to coordinate the signals that regulate hormone production.
When you add a bunch of testosterone or estrogen to the mix, your carefully coordinated hormone systems don’t always react the way you’d expect.
You might think it’s like restocking an empty shelf: you’re low on estrogen, so you add more estrogen.
But actually, when you introduce the end product without concern for why your body isn’t producing enough in the first place, your body reacts by adjusting its own natural hormone production and signaling.
And because all of these systems are interconnected, those changes don’t necessarily stay contained to your hormones. They can ripple into other processes in the body, including the way your body manages cholesterol, how your liver processes fats, how your adrenal glands respond to stress, and how your body regulates blood sugar.
Honestly – most people do fine with bio-identical HRT. But usually those are the ones who go in for monthly monitoring and who are prepared to deal with the various strange side effects.
If traditional or bioidentical HRT don’t feel right for you, there are integrative alternatives, including herbal supports, acupuncture, and lifestyle shifts, which will help you maintain hormone production and balance your levels naturally.
Of course, all types of HRT require thorough and accurate testing to be effective, usually using a combination of blood, saliva, and urine tests.
Testing for HRT
Thorough testing pre-HRT tells us which hormones are in circulation, which hormones are in excess and which are deficient, and which systems need support.
The three types of hormone tests we use at Kai Wellness are blood, saliva, and urine.
Serum (acquired by drawing blood) tells us what hormones are currently in circulation. This is useful to determine baseline levels and to monitor bio-identical hormone therapy.
Salivary hormone testing reveals unbound, bioavailable hormones. While useful to monitor baseline levels and bio-identical hormone therapy, salivary testing offers the added benefit of measuring other important hormones such as melatonin and cortisol, essential for evaluating the functioning of circadian cycles and the HPA (hypothalamus-pituitary-adrenal) axis. This is essential in modern life to assess the toll stress is taking on the body and make necessary interventions to prevent adrenal burnout and other serious stress-related disorders.
Urine testing does all of the above and additionally (and perhaps MOST importantly), evaluates estrogen metabolites to assess risk to liver and likelihood of estrogenic toxicity. This is critical for anyone choosing hormone replacement therapy, as there are measures that can be taken to clear out the toxicity and prevent complications.
Hormones, particularly estrogen, can be toxic and even carcinogenic when not metabolized properly in the body. It’s essential to test your detoxification pathways – don’t do HRT without testing urine metabolites!
Schedule with Kai Wellness if you’re interested in any form of hormone testing before starting HRT.
The Integrative Approach to HRT
At Kai Wellness Integrative Medicine and Healing, the goal isn’t simply to increase a hormone that’s testing low. We want to understand why it’s low, how your hormones are functioning in relationship to one another, and which systems may need additional support.
That might mean supporting hormone production directly, or supporting the systems involved in hormone regulation and metabolism.
While sex hormones naturally decline as we age, the levels themselves matter less than how they function in relationship to one another. Their production, regulation, metabolism, and elimination depend on several interconnected systems throughout the body, including your gut.
Gut Health Matters
First of all, gut health equals hormone health, and none of us is exempt.
The gut microbiome regulates hormone levels through a specialized network of bacteria called the estrobolome, which metabolizes and recycles estrogen. While men produce less than women, estrogen is still a vital hormone for male health, and its regulation depends heavily on gut bacteria.
Your microbiome also plays a crucial role in communicating with your nervous and endocrine systems to regulate stress and support your metabolism.
Ancient Chinese medicine has proclaimed the link between gut and hormones for over 3,000 years, modern medicine is just beginning to prove what we already know to be true. A healthy microbiome means healthy hormones.
Gut support is only one of the integrative approaches offered at Kai Wellness. When used in combination with our other treatments like acupuncture, herbal remedies, and integrative coaching, you are well on your way to balancing your hormones with a system-wide approach.
Of COURSE Acupuncture, Chinese Medicine, and Functional Medicine Can Help!
At Kai Wellness, we work with you to create a treatment plan that suits your individual needs and goals. That usually includes a combination of physical body support (HRT, herbs, etc), emotional and mental support (Acupuncture, stress reduction, sleep support etc), and spiritual guidance (integrative coaching and counseling).
Acupuncture and Herbs: Studies show that Acupuncture and Chinese herbs can be helpful for menopausal and other endocrine “symptoms,” usually with fewer side effects than traditional HRT.
Herbs have been used for centuries and modern studies are starting to reveal that plant friends can be very effective in supporting the body’s hormone levels. Maca is known to increase estrogen. Ginseng and Fenugreek testosterone. Meanwhile, Chaste Tree balances hormones and increases progesterone. Of course, you should always consult with your provider before changing or adding herbs to your existing treatment plan.
Lifestyle considerations such as managing circadian rhythm, environmental toxin exposure, nutrition, sleep, sexual practice, household products, exercise, mindfulness practice and many others have profound implications on hormone health.
Functional Medicine: Functional Medicine looks at hormones as part of the larger picture. It prioritizes testing and will help you discover the root cause of your imbalances.
Integrative Coaching: The mental, emotional, spiritual piece of hormonal changes is often ignored in favor of the physical. However, cortisol production takes precedence over sexual hormone production, a survival mechanism that makes balancing your sex hormones more difficult. Let’s explore the other elements of your aging process to better balance the physical body.
Just like you can’t safely land a plane unless the wings are aligned to the landing surface, you can’t live a healthy and happy life, at any age, when there is imbalance in the hormones.
Is HRT Right For You?
The answer is unique to each person. Some people do very well with traditional HRT. Others may prefer an integrative approach that doesn’t rely on replacing hormones. And for some people, a combination may make the most sense.
The important thing is understanding what your body is doing before deciding how to intervene.
Please don’t hesitate to reach out for guidance – this is thick terrain to navigate and I’m happy to help you through the thicket!
Dr. Karina Menali
