Hormones are powerful chemical messengers that coordinate nearly every cell, organ, and function in the body. They are secreted by the endocrine glands and travel through the bloodstream, communicating vital information to tissues and organs.
When hormone levels deviate too far from normal ranges, whether too high or too low, there can be profound effects on physical and mental health. Many factors can throw off this delicate balance and lead to a state of hormonal imbalance or hormone deficiency:
Some common signs and symptoms of hormonal imbalance in both men and women may include:
When multiple hormones are out of balance, the effects can seriously undermine quality of life and wellbeing. Understanding the role of hormones and options for hormone replacement therapy is key.
There are dozens of vital hormones in the human body, but some play larger roles than others in maintaining good health.
Often called the "male" hormone, testosterone is important for both men and women. It:
Testosterone levels generally peak in the late teens to early 20s in men, after which they gradually decline by 1-2% per year. Many men begin experiencing low testosterone symptoms from their 30s and beyond. Factors like obesity, medications, chronic stress, and medical issues can accelerate this decline.
Restoring balanced testosterone levels can reverse many unwelcome symptoms of aging and "andropause" (the male version of menopause), greatly improving physical vitality and quality of life.
The primary "female hormone" estrogen plays a key role in women's:
Estrogen levels rise and fall through adolescence, peak in the 20s and 30s, then start to wane 5-10 years before menopause. During perimenopause and menopause, estrogen levels become much more erratic.
Maintaining balanced estrogen as women age can help prevent troublesome menopausal symptoms like hot flashes, insomnia, vaginal dryness, anxiety, and bone loss.
Along with testosterone and estrogen, levels of other key hormones like progesterone, DHEA, melatonin, thyroid, growth hormone, and cortisol also frequently decline with age and hormonal imbalance:
Balancing all key hormones together is important for overall vitality and slowing the aging process. This is the premise behind anti-aging and regenerative medicine approaches that focus on hormone optimization.
Since low hormone levels rarely cause symptoms in isolation, diagnosing a true hormone deficiency requires specialized blood testing. This should be done through an accredited medical lab under doctor supervision, not through at-home hormone test kits of questionable accuracy.
What hormones should be tested? Recommended panels include:
Testing cortisol requires either multiple saliva samples or special urine hormone testing over 24-48 hours.
Along with the above hormone blood tests, a complete blood count (CBC), metabolic panel, and blood lipid panel should also be assessed.
Once a true hormone deficiency is properly diagnosed through testing, there are three main treatment options:
For serious hormone deficiencies, prescription bioidenticals and pharmacy compounded hormones tend to work best and be safer than herbal products.
With either approach, hormone dosing should start low and be continually adjusted based on follow-up lab testing to keep levels optimized in the healthy range—avoiding both deficiency and excess. Periodic bloodwork helps ensure therapy is working safely and effectively.
Finding an experienced hormone specialist to guide this process is strongly advised.
Prescription bioidentical hormones are chemically identical to the testosterone, estrogen, progesterone, and other hormones produced naturally in the body. They are rigorously tested for safety and purity.
Delivery methods for bioidentical hormone replacement include:
The choice depends on the specific hormones needed, convenience, and doctor recommendation based on the patient's health profile.
Specially trained pharmacists can also custom-compound bioidentical hormones in creams, gels, capsules, sublingual drops, inserts, suppositories, etc., based on each patient's needs. These personalized formulas are not commercially available.
Compounded bioidenticals allow very precise dosing and mixture of multiple hormones tailored to lab results and symptoms, avoiding unnecessary components. Quality standards may vary between pharmacies, however.
Some over-the-counter supplements like DHEA and melatonin can provide mild hormonal support without a prescription when deficiency is mild. Herbal remedies may also help alleviate hormone-related symptoms along with diet and lifestyle adjustments.
More research is still needed on the efficacy and safety of "natural hormones" like the isoflavones in soy and red clover. OTC supplements lack quality testing compared to prescription bioidenticals and can have questionable ingredients.
As men get older beyond age 35-40, declining testosterone and other hormones often will not sufficiently improve with herbs alone. Lab testing and prescription therapy become necessary for most.
Starting any hormone replacement regimen requires some preparation, patience, and monitoring.
Here is a general overview of what to expect when beginning properly-managed testosterone replacement therapy (TRT), estrogen replacement, or other hormone replacement protocols.
Adjusting dosing to keep hormone levels in the healthy range for your age prevents adverse effects. Too high or too rapidly elevating certain hormones poses risks.
With an experienced specialist guiding therapy based on testing and feedback, ongoing management is generally safe, convenient, and effective.
The key premise behind hormone replacement therapy (HRT) is that restoring hormones depleted by age or other factors back to more youthful levels can help reverse associated declines in physical and mental functioning that impair quality of life.
Clinical research combined with decades of medical practice strongly supports this concept of "turning back the biological clock".
But what are some realistic goals and tangible benefits of properly managed HRT?
Through comprehensive programs of hormone optimization, patients in their 40s through 70s and beyond often report feeling healthier, more energetic, and years younger on all levels. For many, it represents a new lease on life.
While medication plays a pivotal role, certain lifestyle changes also facilitate getting the best and safest results from treatment.
Following an anti-inflammatory diet, exercising regularly, getting restorative sleep, actively relaxing, taking key supplements, and moderating alcohol intake all facilitate achieving excellent results from treatment.
One of the most transformational forms of hormone replacement for aging men is testosterone therapy. As the activity levels, body composition, sexual function, and psychology of older men often resemble those of men 10-15 years their junior who take prescription testosterone medications, it has sometimes been called the "fountain of youth" for men over 40.
After age 30, testosterone decreases in men by about 1-3% per year. Research has found a 50% prevalence rate of abnormally low testosterone (medically termed "hypogonadism") in American men over age 50.
Declining testosterone after "andropause" accounts for many unwanted signs and symptoms associated with male aging, including:
Restoring testosterone levels in men over 35-40 experiencing the above symptoms to more youthful ranges with bioidentical testosterone therapy can help reverse this age-related deterioration in many cases - essentially "turning back the biological clock".
Prescription-strength testosterone medications are available in injectables, skin gels/creams, pills, and pellet implants that surgically release testosterone over months. Patches and nasal gels are also sometimes prescribed.
These testosterone replacement options have been proven safe and effective for men when properly managed based on lab testing under medical supervision.
Despite common concerns, research shows prescribing testosterone therapy does not increase prostate cancer or heart disease risk if hormone levels are carefully maintained within normal ranges for a man's age. Finding an experienced hormone therapy specialist is key.
Positive changes patients experience with properly-managed testosterone therapy may include:
Through patient accounts and empirical data, the expansive benefits of testosterone therapy on energy, body composition, sexual function, and psychology are clear when properly implemented and monitored.
No. Studies show testosterone therapy alleviates irritability while boosting self-confidence and calm decisiveness for most patients.
Potentially if testosterone levels greatly exceed maximum normal ranges, but this is avoidable through periodic blood testing to ensure ideal balance is maintained long-term via dosage adjustments.
After 12-18 months of treatment, many patients can lower maintenance doses by improving diet, stress management, exercise, sleep, etc., but some lifelong therapy is often still required.
Science reveals no increased cardiovascular risks if dosage keeps testosterone levels within healthy ranges. Elevated hematocrit from excess testosterone is avoidable via blood donation and dosage adjustment.
If genetically predisposed to male-pattern baldness, it may accelerate loss. This occurs rarely, however, and many patients report hair re-growth from increased scalp circulation, nutrition delivery, and follicle stimulation stemming from higher testosterone.
Yes, studies indicate testosterone therapy reduces arthritis, back and neck pain, migraine headaches, and fibromyalgia symptoms in both sexes by increasing dopamine levels, which regulate pain perception. Testosterone therapy has been clinically proven to safely enhance masculinity, strength, confidence, health, and quality of life when properly implemented and monitored under medical guidance.
Parallel to testosterone's role in supporting men's biology as they age, maintaining healthy estrogen balance is vital for women's vitality with advancing years before and during menopause.
Declining and fluctuating estrogen underlies unwelcome symptoms like hot flashes, night sweats, insomnia, vaginal dryness, anxiety, depression, and learning/memory issues experienced by up to 80%
