BY TRACY McCUBBIN, MD, ABOIM, ABEM
Have you noticed that life was so much simpler when we were kids? Now that we are all grown up, the chemicals in the environment and in our food are wreaking havoc on our hormones – both for men and women.
These chemicals are contributing to the rise in infertility rates. The US Government fertility statistics from 2019 show that fertility rates have hit a record low. The Centers for Disease Control (CDC) claims we have the lowest birth rate in 33 years. Let’s look at some reasons why and how to remedy this heartbreaking situation. Then we will touch on perimenopause, menopause and hormone replacement therapy (HRT).
Some women suffer from a luteal phase defect. This leaves their estrogen dominant and progesterone deficient during the second half of their menstrual cycle. This condition keeps the embryo from implanting in the uterus. Using a bioidentical progesterone on Days 14-28 helps rectify this issue.
Another reason infertility has increased is the popularity of the vegetarian diet. Protein is necessary to grow a baby. The amino acids in protein are the building blocks of our DNA. Many who follow a vegetarian eating pattern do not consume enough protein and are deficient in amino acids and choline necessary to grow a healthy baby.
Dads play a role here, too. We are seeing testosterone levels decline in younger men. Eleven percent of men of reproductive age experience fertility issues. Metabolic syndrome (insulin resistance or prediabetes) lowers testosterone levels and disrupts the endocrine system. Certain toxins in the environment act as endocrine disruptors and obesogens. These chemicals are hiding in everyday products – plastics, shampoos, cosmetics, canned foods and printed receipts.
These endocrine disruptors affect both sexes. They interfere with the normal functioning of the endocrine system, have been linked to a number of concerning fertility trends, ranging from increased numbers of miscarriages to declining egg quality and lower sperm counts. They also play a role in the development of breast cancer.
And they contribute to an autoimmune condition known as premature ovarian failure. Essentially, this is menopause below the age of 40 (and I would even suggest 45). In this situation, hormones should be replaced until the average age for menopause in the US of 52 years old.
Another condition that has become increasingly more common is polycystic ovarian syndrome (PCOS). It is estimated that 12% of women suffer from PCOS. These small cysts which form in the ovary result in hormone imbalance which can cause infertility, insulin resistance, cardiovascular problems and even some cancers. Recent studies have shown that PCOS likely has an autoimmune component. Up to 45% of women with PCOS are making antibodies against their ovaries. Calming and then re-educating the immune system to stop the targeted attack on our body can help control this situation.
So there is good news! There are tests available to determine some of these causes of infertility. And the “fix” can be quite simple once we know the problem. In the past year, 6 of our 9 infertility patients have gotten pregnant and delivered healthy babies!
Perimenopause and Menopause
As women approach their mid-forties, things begin to change. When sleep becomes more difficult. When we become moody, irritable even angry. And even though we eat the same, we cannot maintain our weight. And the list goes on….
In the year 1900, the average woman lived 49 years. She did not even make it to menopause! However, thanks to advances in modern medicine, in the year 2021, a woman will likely live to age 79. It turns out that our hormones are about more than just reproduction. They are important for the health of our brains, bones and heart. It turns out that we may need to keep them around for a little bit longer.
Estrogen protects the brain from cognitive decline or dementia. It helps keep our mind sharp as we age. It also keeps our bones stronger and prevents osteoporosis. And it protects us from heart disease and stroke. But HRT with estrogen got a really bad rap in 2002.
Hormone Replacement Therapy: When, Where, Why and How?
Prior to 2002, it was somewhat standard for woman to use synthetic, oral hormones to ease symptoms during menopause. This estrogen/progesterone compound was called PemPro. However, the Women’s Health Initiative study was stopped early due to an increase risk of breast cancer and stroke while using this type of oral, synthetic hormone therapy.
More recent research has shown that bioidentical hormones are safer than their synthetic counterparts. Other studies suggest that topical has fewer complications than oral administration of hormone replacement therapy (HRT). This research gives us some answers to the where and how of HRT.
It is important to keep in mind that menopause is a 10-12 year process. Progesterone is the first hormone to go. It begins to decline in most women by the age of 45. The ratio of progesterone to estrogen is important. Most women do not tolerate being estrogen dominant. I also recommend testing androgen levels at this time. About 25% of our female patients benefit from a low dose of testosterone. We feel it is important to test and not guess.
At Radiance Functional Medicine, we specialize in balancing hormones. If you are experiencing any of the symptoms mentioned or have been diagnosed with any of the conditions mentioned in this article please give our office a call. We would love to help!
Dr. Tracy practiced Emergency Medicine for over 20 years before founding the Centers for Complementary Medicine at Kaiser Permanente. She went on to become board certified in Integrative Medicine and pass her written exam for certification in Functional Medicine. This combination of knowledge makes her the perfect doctor to lead you in your journey to optimal health.