Women demand better hormone options

By Keri Brenner

OLYMPIA - All of a sudden, hormones are hot.

I don't know whether it was my recent column on bio-identical hormones or that there's been some national magazine publicity of late.

Maybe it was that my colleague at the newspaper, Tammy Stevens, who writes the blog "Hot Flashes, Cool Dates," has been addressing midlife mood and body changes for men and women. (Check out her blog at www.theolympian.com/living).

For whatever reason, South Sound women, in particular, are demanding more information and better options for easing premenstrual, peri-menopausal and post-menopausal symptoms and for feeling more vibrant and less moody.

Shucks, that could include women starting as young as 30 on up through age 65 or older, said Dr. Natalie Kather of Advanced Family Wellness in Olympia.

"I've even worked with moody teenagers," Kather said.

Kather said some women might be dissatisfied with the standard prescription hormones that are given out with only brief office visits - or sometimes even by long-distance.

Lab tests and symptom checklists don't always provide enough information for the best hormone diagnoses or prescriptions.

"I really encourage people to create a one-on-one, face-to-face relationship with a physician who can do an objective, interactive assessment of your clinical signs," Kather said. "At least 80 percent of that is, 'What's your experience, a nd how's your life going?' and only 20 percent i s labs."

Kather is one of three Olympia physicians offering a seminar Nov. 17 on women's hormones.

Joining Kather are Dr. Evan Hirsch of Hirsch Holistic Family Medicine in Olympia and Tom Griffith, a naturopathic doctor with Vital Health Care in Olympia.

The three physicians said they want to go outside the box to open up the spectrum of possibilities for regulating hormones.

Hirsch said he likes to keep all options open and is not fixed on one type of prescription or supplement.

Besides synthetic, natural or bio-identical hormones (the latter made from soy or wild yam), there are other ways of boosting hormone levels, he said.

Those include herbal supplements such as black cohosh, red clover, soy or chaste tree berry (vitex), and vitamin and mineral supplements including fatty acids such as those in fish oil. Certain supplements are more helpful for the sex hormones - estrogen, progesterone and testosterone - and others work to affect metabolic "energy" hormones such as thyroid and DHEA, he said.

"What's most important is quality of life," Hirsch said. "You can talk about statistics, but if there's no quality of life, it's not working."

Griffith said lifestyle choices such as diet and exercise also affect a woman's estrogen metabolism.

"The main thing people don't understand is the depth and complexity of this issue," he said.

As I noted in an earlier column, many women have been up in the air about hormone replacement therapy since the Women's Health Initiative - a national study of thousands of post-menopausal women - was halted in 2002 because of a higher incidence of heart attacks and breast cancer among the participants.

The women were taking Premarin, a synthetic form of estrogen made from the urine of pregnant horses, and Provera, a synthetic form of progesterone.

Although few if any long-term clinical studies have been done on bio-identicals, many holistic physicians are recommending them instead of synthetics because they more closely match the hormones the body produces.

Bio-identicals are available by prescription from compounding pharmacists, who custom-make the hormone formulas in creams, capsules or suppositories, according to each woman's needs.

The downside is that the bio-identicals are not usually covered by conventional health insurance - although the doctor's visit often is covered.

The biggest change, from my perspective, is the awareness that we have choices. We don't all need the same prescription or the same type of treatment, and we each can decide what works best for us.

For some people, that leads to alternative therapies, but lots of conventionally trained physicians also are making extra efforts to encompass the full spectrum of possibilities.

"Holistic medicine, where you look at the whole picture not just symptoms, is way more empowering," Griffith said. "If you don't want to go on hormone replacement therapy, there are so many other options."

Keri Brenner writes for The Olympian. Contact her at kbrenner@theolympian.com.

Conference

Three Olympia holistic physicians will conduct a for um from 9 to 11 a.m. Nov. 17 to answer questions on various types of hormone replacement therapy , bio-identical hormones, natural alternatives, and other topics related to estrogen, progesterone, testosterone, DHEA and thyroid hormones.

The event, which costs $20, will be at Advanced Family Wellness, 1115 West Bay Drive N.W., Olympia. Reservations can be made at www.eventbrite.com/ event/77205925. For details, call 360-570-8010.

Speakers include:

n Dr. Natalie Kather of Advanced Family Wellness; 360-570-8010, www.metabolicadvancedwellness.com.

n Dr. Evan Hirsch of Hirsch Holistic Family Medicine, 1017 Fourth Ave. E., Suite 6, Olympia; 360-480-0353, www.doctorevan.com.

n Tom Griffith, N.D. (naturopathic doctor) of Vital Health Care, 200 Lilly Road N.E., Suite B-3, Olympia; www.docgriffith.com.