Bioidentical Hormones For Women’s Health

There are many challenges facing women as they age. In addition to decreased levels of estrogen, progesterone and testosterone, other hormones taper off during menopause such as DHEA, melatonin, human growth hormone and thyroid hormones. At the same time, different hormones, which include insulin, parathyroid hormone and cortisol, may accumulate in excessive amounts.

As these hormone levels decrease, women experience a magnitude of symptoms that affect the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin, brain and energy levels. Due to these hormonal imbalances, women experience hot flashes, loss of libido, weight gain, insomnia and emotional changes. There are also increased risks of osteoporosis and cardiovascular disease. With proper implementation of Hormone Replacement Therapy, these risks and symptoms can be greatly reduced and sometimes eliminated altogether.

Perimenopause and Menopause

Perimenopause and menopause are the names given to the time in a woman’s life when the ovarian production of estrogen, progesterone, and testosterone declines over a decade and culminates in the cessation of periods. Menopause typically occurs at an average age of 51, +/- 7 years.

Changes in a woman may begin long before the cessation of menstruation, due to a gradual decline in hormones after the age of 35, but it can also be accelerated with certain popular “healthy” diets and exercise programs as well as excessive stress. Hot flashes, irritability, anxiety, mood swings, and shortened or lengthened periods are the most notorious. However, even women without bothersome symptoms are not safe.

Fortunately, there is hope. Synthetic Hormone Replacement Therapy with CEE and progestins was used for many decades but was rejected by the medical community due to an increased risk of breast cancer, heart attacks, and strokes in certain groups. Bio-identical hormone replacement therapy can help offset the negative impacts of menopause, while one that is appropriately tailored may actually reduce the aforementioned risks as well.

With the availability of bio-identical hormones, supplements, modern dietary and exercise interventions, it is possible to work out an individualized approach to effectively offset the symptoms of menopause even in breast cancer survivors. At Forever Ageless, Dr. Kopyev will do a comprehensive genetic, hormonal, and metabolic evaluation. The result is an individualized plan that synergizes these areas to treat the current symptoms as well as placing women in the lowest risk category for development of cancer, heart attack, strokes, and other consequences of untreated menopause and perimenopause.

Bio-identical Hormone Replacement Therapy has successfully treated many symptoms of hormone decline, which can include:

Hot Flashes

Dysfunction of thermoregulation, more commonly known as hot flashes in perimenopausal women is predominately due to loss of ovarian production of inhibin. Hot Flashes could be completely and safely eliminated with Bio-identical Hormone Replacement Therapy.

Bone Health

The risk of osteoporosis increases as women age. Studies show that women are losing bone at a rate of approximately 0.5% each year. It is a well-known fact that close to 80% of patients will be dead within two years of their first hip fracture. Osteoporosis, like most degenerative diseases, is insidious–there are only a few symptoms that can suggest that you might have such a problem until it is too late. You may also be surprised to find out that some of the very popular types of “healthy” diets and exercises, common health conditions and frequently used medications may actually significantly aggravate bone loss. The mainstream medicine does recommend routine bone density scans for women. However, no matter the results of bone densitometry, it is important to take proper action for prevention. We have been taught that calcium aids healthy bones which is true. What people are often not taught is that calcium absorption into the bone does not happen just because we feed our body calcium. It takes the right mix of other vitamins and hormones that naturally occur in our bodies and are also gained from external sources to really make the calcium count.

Decreased Libido

Women suffering from excessive stress, postpartum depression, perimenopause, and menopause often experience a decrease in sexual desire. This may be caused from an imbalance of the multiple hormones, which include cortisol, thyroid, oxytocin, estrogen, progesterone, and testosterone. Furthermore, when women have a total hysterectomy, which is removal of the uterus and ovaries, sometimes referred to as surgical menopause, a decrease in testosterone levels of 50% and estradiol of 80% is frequently observed. Synthetic progestins, widely used in birth control pills and conventional hormone replacement therapy, antidepressants, blood pressure and painkillers as well as inadequate or imbalanced hormone replacement therapies can further aggravate the symptoms.

Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms related to a woman’s menstrual cycle. Most women of child bearing age (up to 85%) report having experienced physical symptoms related to normal ovulatory function, such as bloating or breast tenderness. The specific emotional and physical symptoms attributable to PMS vary from woman to woman, but each individual woman’s pattern of symptoms is predictable, occurs consistently during the ten days prior to menses, and vanishes either shortly before or shortly after the start of menstrual flow. PMS is thought to be a result of mismatch in the levels of progesterone in relation to estrogen. That disparity causes imbalances in other chemicals in the brain and body, which are responsible for regulation of blood sugar, salt, water, norepinephrine, GABA and endorphins.

Symptoms and Signs of PMS

More than 200 different symptoms have been associated with PMS, but the three most prominent symptoms are irritability, tension, and dysphoria (unhappiness). Common emotional and nonspecific emotional symptoms include stress, anxiety, difficulty in falling asleep, headache, fatigue, mood swings, increased emotional sensitivity, and changes in libido. Physical symptoms are associated with the menstrual cycle, such as bloating, abdominal cramps, constipation, swelling or tenderness in the breasts, cyclic acne, and joint or muscle pain. The exact symptoms and their intensity vary from woman to woman and even from cycle to cycle.

Accelerated Weight Gain

Beginning as early as 10 years before menopause, hormone levels in women begin to decline. In addition to decreased levels of estrogen, progesterone and testosterone, there are other hormones that taper off such as DHEA, melatonin, human growth hormone and thyroid hormones. At the same time some hormones, such as insulin, parathyroid hormone, and cortisol, may accumulate in excessive amounts.

Such hormonal changes result in increased cravings for carbohydrates. As women produce fewer hormones, lean muscle mass and the metabolic rate decline, as well as an excess of consumed calories is deposited in fat cells. This belly fat is well known to generate chronic inflammation. As a result, body aches, joint stiffness, arthritis, weight gain, fatigue and a lack of energy continue to add to the snowball effect, resulting in more and more weight gain. This hormonal imbalance makes it difficult to maintain a healthy weight and impossible to lose just mid-abdominal fat by dieting and exercising. Any weight loss without appropriate Bio-identical Hormone Replacement Therapy would cause simultaneous loss of muscle and bone as well as other structural tissues, resulting in unhealthy appearance, osteoporosis, sagging skin and wrinkles.

Night Sweats and Insomnia

Difficulty falling or staying asleep is especially common among perimenopausal and menopausal women. Sleep only occurs when the body temperature falls below a certain level, due to heat loss through the skin, causing us to become drowsy. Dysfunction of thermoregulation in perimenopausal and menopausal women is predominately due to the loss of inhibin along with other hormones. When women have hot flushes and night sweats, the body temperature does not fall. As a result, the sleeping pattern is disrupted, eventually causing insomnia, a lack of concentration, fatigue and irritability. This affects the production of other hormones (e.g. melatonin and cortisol), contributing to further sleep disturbances. On top of that, a decline in hormones predisposes women to weight gain, resulting in the development of sleep apnea, and eventually leading to chronic fatigue.

Fibrocystic Breasts

Fibrocystic breasts are characterized by lumpiness, due to small breast masses or breast cysts, and usually discomfort in one or both breasts. This condition is very common and benign, meaning that fibrocystic breasts are not malignant (cancerous). Breast cysts, by themselves, do not require treatment unless the cysts are painful or otherwise uncomfortable. However, the presence of fibrocystic disease is a sign of a serious mismatch of progesterone and estrogen. The treatments for the fibrocystic breast condition are directed at the correction of hormonal irregularities to bring relief of unpleasant symptoms, such as breast pain and tenderness. At Forever Ageless, we attempt to balance hormones with the goal to completely eliminate the symptoms and at the same time minimize the risk of breast cancer.

Memory and Concentration

Women who are perimenopausal or menopausal frequently suffer from a lack of quality sleep. As discussed in other sections, women experience many hormonal imbalances as early as 10 years before menopause. They undergo the same, but at an elevated level, during menopause or after surgical menopause. The decline of some hormones that include – inhibin, thyroid, growth hormone, progesterone, testosterone, DHEA, and melatonin, and the accumulation of others, such as cortisol and insulin interfere with overall sleep quality; it especially disrupts REM (rapid eye movements) sleep. REM is critical to mental health, problem solving and short-term memory, therefore a lack of REM sleep impairs cognitive functions, decreases the ability to focus and concentrate, and induces chronic fatigue and memory decline.

Vaginal Dryness and Thinning

Vaginal and urogenital dryness and thinning normally occurs in women after menopause and is primarily due to low estrogen level. Mucosal dryness significantly affects the defense systems of the body; this is why postmenopausal women frequently suffer from urinary tract infections. Thinning of mucosa and loss of urogenital muscles commonly result in urine and stool incontinence as well as bladder, rectum and uterine prolapse. Every primary care physician or gynecologist can share a sad case of an older woman who stood up after her birthday dinner in a fancy restaurant and found herself in front of all her guests in a large puddle of urine… That embarrassment could have been easily prevented! BHRT can effectively treat vaginal dryness, prevent vaginal and urogenital mucosa thinning, and reduce incontinence and urinary tract infections. There are multiple modalities and options available even for breast cancer survivors.

Decreased Energy

As hormone levels are altered, women experience a magnitude of symptoms that affect the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin, and brain. However, the most universal effect is the dramatic decline in energy level. We all see it; with each day that passes, parents are slowly lagging more and more behind their children and grandchildren. Unfortunately, this has come to be seen as the standard image, but at Forever Ageless, we seek to completely reverse the representation of aging. With proper implementation of hormone replacement therapy, body energetics can be effectively restored to youthful levels.


Some of the frequent complaints we hear at Forever Ageless include depression, feeling down, anxiety, unexplained sadness, and mood swings. Every woman experiences something similar after giving birth. At that time her hormones drop from an all time high to almost zero in a matter of few hours. Usually, it takes a few months for the hypothalamus, hypophysis, and ovaries to recuperate before hormone production returns to normal. Extreme cases are called postpartum depression.

Decreased Skin Health

Hormones are responsible for multiple functions in the organism, one of which is to provide moisture and elasticity to skin, nails, and hair. As women and men age and experience hormonal declines, their skin begins to lose elasticity and becomes thinner. The face and neck, in particular, have multiple different hormonal receptors. Low hormones are literally written all over your face, neck, arms, nails, and hair as levels decline during andropause and menopause. Loose, sagging, hanging, and wrinkled skin under the arms, eyes, and chin comes with age and weight loss due to a decrease in collagen and matrix protein production on top of muscle mass and tone loss. The skin also becomes drier during these years as the oil glands in the skin become less active. If a person can maintain youthful hormonal levels, the skin will be better off, and he or she will age more gracefully.

Bio-identical hormone replacement therapy in combination with an appropriate diet, supplements, and exercise allows Forever Ageless to treat the symptoms of hormone decline in a natural way. Once an evaluation is performed, Dr. Kopyev will prescribe a specific combination of hormones, which are prepared at a compounding pharmacy. As the patient takes the supplements over the next three months, changes are monitored and hormone dosages will be adjusted to yield more favorable results.