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Bioidentical hormones and chinese medicine for women's health
1. Bio-identical Hormones and
Chinese Medicine
for
Women's Health
Dr. Helen Wai-Ngan Ng Schreiber
Hong Kong 1. Sept. 2012
2. Contents
• Introduction: Role and image of women, east & west,
in changing times
• Biology of Hormones
• Physiology of Female Reproductive System
• Clinical aspects, Women's health issues
• Shanyao and Chinese Medicine for Women's Health
• Our clinical study and case examples
3. Hormones
• Chemical messengers (sending signals)
• Produced by cells or a “gland”
• Transferred to “target cells“ with “receptors“
• Binding & activation leads to cell-specific responses
(cell metabolism). Thus the biochemical structure is
decisive!
• Small amounts, big effects on vital functions, also
emotional reactions.
23. Estrogen – the hormone of beauty
• Estradiol (E2) – strongly effects growth
Estriol (E3) – Effects on mucous
membranes and bladder
• Estrone (E1) – the storage Estrogen
24. Estrogen (s)
• Sexual hormonse specific for the female, produced
mainly in the ovaries
• 3 in this subclass are especially important: E1 Estrone, E2
Estradiol, E3 Estriol
• Effect the growth & development of the femal body
• Responsible for the healthy state of the female
reproductive organs and also of the bones, blood
vessels, urinary tract…
• Loosen connective tissues, effect water retention, und fat
accumulation in cells, increase blood clotting
27. Progesterone
• Sexually neutral. Produced mainly in the “yellow body” (corpus luteum) of
women & in the placenta during pregnancy. „pro gestra“ = supporting
gestation (pregnancy)
• Precursor for Cortisol, Testosteron & the estrogens. Complementary &
balancing factor of estrogen and terstosterone
• 20% of receptors in the brain, important for emotional balance, improves
concentration, memory and sleep
• Heart and blood vessels, bones, skin and connective tissues. Supports the
thyroid gland
• Increases energy metabolism, excretion of connective tissue fluids,
regulates blood pressure and blood clotting
34. Artificial C-21/ C 19 Gestagene / Progestine
Norgestrel Megestrolacetat Norethindronacetat
More Progestines:
Medroxyprogesteronacetat
Lynestrenol
Norethynodrel
Norethisteron
Nach John Lee, M.D. und Wikipedia Human Progesterone
37. Substances used in „HRT“
- Progestines (e.g. Provera) + CEE (conjugated
equine estrogens)
- Premarin = pregnant mares urin (CEE) (Presomin)
- pills, injections, suppositories, subdermal
implants, skin patches, gels
- dosages, systemic / lokal effects, side effects,
constant/ cyclical level of hormones in blood
- oral intake estrogens: increased risk of
thrombosis, especially ethinyl estradiol (pill)
38. Bioidentical Hormones
• Biochemical structures are identical with our own
hormones in the body
• When applied properly – gentle and without side effects
• Over 70 years of experience: (Dr. K. Dalton, Dr. John Lee,
Dr Michael Platt, Dr. V. Rimkus, Frau Dr. A.
Scheuernstuhl), no known side effects
• from Diosgenin, extracted from the roots of the mexican
wild yams (Dioscorea villosa)
39.
40.
41.
42. 7 Decades in the life of a Woman
Childhood
Puberty
Young womanhood
Middle age
Old age
Senile
43. Developments and Roles of the Female
• 经 jing Menstruation
• 孕yun Pregnancy
• 产chan Birth
• 育 yu Nursing, education
44. Disturbances of Menstruation
• Onset of puberty – early/ late? Amenorrhea
• Irregular cycles – too short, too long
• Irregular bleeding – too little, too much
• Premenstrual Syndrom (PMS) – lower abdomenal pains,
tension in the breast, mood changes (Estrogen
dominance)
• Related problem of puberty: acne
45. Effects of the contraceptive Pill
2 components: an estrogen derivative (e.g. ethinyl estradiol,
estradiol valerate), a progestine
The two hormone like chemicals turn off the production of
FSH and LH through the feedback mechanism on the pituitary
gland – no ovulation! (purpose of contraception)
Thus no „Yellow body“ & no production of progesterone.
Consequences of Progesterone deficiency
They simulate the effects of estradiol and progesterone on
the uterus, giving rise to an artificial menstrual bleeding
46.
47. Amenorrhea, Infertility
• Delayed maturity
• Consequence of the pill
. Psychic and emotional Stress
• Thyroid function deficiency
• Other chronic illnesses
• TCM: Kidney deficiency, cold
48. Disturbances of Pregnancy
Pregnancy sickness (Progesterone
Habitual Abortion Deficiency)
Water retention
Excessive weight gain
Increased blood pressure
Gestational diabetes
Postnatal depression
50. Climacterium / Menopause
• A natural stage of life
• Decrease of important hormones of the body
• Symptomes, perception, feelings, attitudes
• „ Women in middle age should not be sad – also in
history there came after the Middle Ages the New Age !“
• Indications for treatment
51. Symptoms of hormonal imbalance
Mood changes, depressive, irritable, loss of interest and
joy
General feelings of unwell, undue tiredness, not coping
with life
Sleep disturbances, insomnia
Hot flushes, excessive sweating, night sweats
Oedema, generalised swelling
Headaches, generalised muscle and join pains
Nervous anxiety, panic attacks, heart complaints
52. Hormone Replacement Therapy (HRT)
- Treatment of surgically, peri- and post- menopausal women,
for discomfort caused by diminished circulating estrogen and
progesterone hormones
- Mixtures of conjugated equine estrogens (CEE) and
progestins vs. “unopposed estrogen therapy”
- Via patches, tablets, creams, troches, IUDs, vaginal rings, gels
or injections
- “sequentially” vs. “continuous” combined HRT
- Side effects: Headache, weight changes, fluid retention,
changes in menstrual flow
53. Women's Health Initiative (WHI)
- Initiated by the US NIH in 1991
- Study effects of HRT: CEE + Progestin,
CEE only (women after hysterectomy)
- Findings: subjects had a greater incidence
of coronary heart disease, breast cancer,
stroke, pulm. Embolism
- Trial was ended in 2002
54. Bioidentical Hormones
• Biochemical structures are identical with our own
hormones in the body
• When applied properly – gentle and without side effects
• Over 70 years of experience: (UK: Dr. K. Dalton, USA: Dr.
John Lee, Dr Michael Platt, Germany: Dr. V. Rimkus, Dr.
A. Scheuernstuhl), no known side effects
• from Diosgenin, extracted from the roots of the mexican
wild yams (Dioscorea villosa)
55.
56.
57.
58. Bioidentical Hormones
Extraction from Mexican Yams roots: Diosgenin
Further process in lab to give Progesterone
Further process in lab from Progesterone to other
hormones e.g. estradiol
Dispensed according to individual prescription by
„compound pharmacies“
Available as cremes, gels, capsules, troches
(sublingual, oral, transdermal application)
64. Physiological Characteristics
以 血 为 本 Xue (Blood ) is the basis
以 血 为 用 Xue is consumed
阴 常 不 足 Yin is often not enough
阳 常 有 余 Yang is often in (relative) excess
82. Our clinical Study 2012
About 90 patients, 70 + women, 10 men, 8 children
Hormone profile of 3 groups: thyroid hormones, sexual
hormones (estrogens, progesterone, testosterone), Insulin,
DHEA, cortisol, Andrenalin (blood sample on 21. day of cycle)
Most common problems: Overweight, gynaecological
symptoms, depressive moods, exhaustion, palpitations,
insomnia
Findings: low Progesterone levels, Estrogen dominance, Insulin
resistance
Treatment: BHRT, Progesterone good for moods, PMS,
estrogen good for hot flushes, sweating, balance is important,
Thyroid function also
83. Case example 1 (A.G.)
23 f, Student (Sport)
Aug. 11: Mood changes, depressive, irritable; hot flusches,
excessive sweating, since about 2 months
has the „Nova Ring“ recently, the pill since few years, saliva
test: low progesterone, high testosterone
No more such symptoms after removal of the ring
But, amenorrhea still after 1 year
Recent blood test: low T4
Treatment: Thyroxin 50 mcg.
84. Case Example 2 (D.R.)
- 50 f., owner of Fitness Studio
- Hysterectomie 12 years ago because of heavy menstrual bleeding,
Myoma
- 2 y. later, hot flushes, sleep disturbance, depressive to aggressive mood
changes, hair loss, weight gain (in spite of sport)
- prescribed different estrogen preparations and pill, T4 75mcg., still
severe depression 2005, weight gain ++
- 2011: discovered the literature about bioidentical hormones, importance
of progesterone
- started treating herself with progesterone creme, stopped estradiol, T4 +
T3, Testosterone cream for stress incontinence. Weight loss.