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Every day, millions of women suffer lifelong the uncomfortable symptoms associated to perimenopause, menopause and post – menopause. Until now they were thought to be unavoidable, but they already have a solution.

In Neolife we think about the importance of making diagnosis and prescribe differentiated treatments for women and men. Thus we count with a specific Unit for Woman.

We focus on treatment for women who are going through perimenopause -from the age of 40-45 approximately-, menopause and post-menopause.


What is menopause? Which are its symptoms?

Menopause is produced because the oocytes provision in the ovaries decreases along woman´s reproductive life until reaching this phase, with a result of a metabolic and hormonal imbalance. If to this we add life habits impact and the imbalance of other markers that start declining or increasing with age, the alterations increase.

Menopause produces changes in neuroendocrine (neurological and hormonal),, cardiovascular, immune and locomotive, systems, negatively impacting in the mood, memory, cognition and behavior. Moreover, produces cholesterol and triglycerides levels increase physiologically, failure in calcium in bones uptake, migraines or headaches and joint pains.

And this makes the appearance of different negative impacts in our health:

  • Emotional disorders: as mood changes, irritability, lowering of self-esteem.
  • Physical disorders: as vasomotor symptoms (sweating, hot flushes), uncontrolled weight increase, sexual desire decrease or loss, vaginal dryness.
  • Sleep disorders and rest difficulties.

Do you suffer menopause? Learn about your diagnosis

The slow but continuing hormonal levels declining is often the cause of the diseases (cardiovascular, neurocognitive, osteoporosis, cancer...) increase and of the associated to women´s age symptoms: menopause symptoms (hot flushes, irritability...), weight uncontrolled increase, sleep disorders, libido and self-esteem decrease...

The following questionnaire will help you to understand if your symptoms are due to a hormonal imbalance. Menopause an start insidiously even before the age of 40. Not all the below described symptoms are exclusively due to a hormonal imbalance, but their presence, together with low or sub-optimum hormonal analytic levels, may be the reason.

The following questionnaire will help you to understand if your symptoms are due to a hormonal imbalance. Menopause can start insidiously even before the age of 40. Not all the symptoms described below are exclusively due to a hormonal imbalance but their presence, together with low or sub-optimum hormonal analytic levels, may be the reason.



  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

  • Yes No

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Hormonal balancein women is the key to maintain good health. Estrogen, progesterone, testosterone, thyroid hormones, dehydroepiandrosterone, cortisol, insulin, melatonin... Each one has its specific function and moreover many of them interact in a synergistic way.

As hormonal values decrease, our health deteriorates, increasing chances to suffer diseases..

Hormones are chemical messengers secreted by different endocrine glands which intervene in our body metabolism. The incidence of the related to age diseases is largely controlled by our immune and endocrine systems, responsible, partly, for our changes in the aging process.

Hormones in women

Over time, all the symptoms resulting from the hormonal imbalance happen more due to the level decrease in most of the hormones – estrogen, progesterone, testosterone, melatonin… - and/or to the increase of others – insulin and cortisol -.

But the body does not work nor react the same in all women, consequently it is essential to be measured to find out the real imbalance causes and therefore achieve a successful and accurate diagnosis to be able to act accordingly.

Hereunder is a main female hormones, brief overview, their functions and the impact of its imbalance in the body.


Main hormonal functions in women
  • Estrogen
  • Progesterone
  • Testosterone
  • Thyroid Hormones
  • Melatonin
  • DHEA & Cortisol
  • Insulin

Estrogen

Estradiol is the most powerful estrogen of the ovaries. It is produced in the fat tissue, in the ovaries and in the adrenal glands.

Low estradiol levels are associated with negative effects in the cardiovascular system, bones, sexual life, skin smoothness, emotional well-being, sleep, cognitive capacity, mood and immune system.

Hormonas VS Envejecimiento

Progesterone

Progesterone is the hormone in charge of maintaining pregnancy. When ovulation takes place, the corpus luteum where the egg came from, begins to produce progesterone during the second part of the menstrual cycle, with the aim of maintaining the endometrium ready for a possible implantation of the fertilized egg. If this implantation is not produced, the corpus luteum stops producing progesterone and the endometrium disrupts and the menstruation is produced.

Hormones VS Aging

One of the first signs of perimenopause is the progesterone production decrease, making the endometrium unstable and engendering shorter than usual menstrual cycles.

Progesterone has also receptors in the breasts, bones and brain, therefore, this hormone decrease has negative effects over the bone system, the emotional well-being, the cognitive ability and the mood.

Testosterone

Testosterone s the main sexual steroid hormone. Although the thought that women do not have testosterone is common, the truth is that it is a key hormone in women´s health and welfare. However, its level is 10 times less than in men, so the virile signs do not appear in them.

In women, 75% is produced through DHEA conversion and 25% is produced in the ovaries.

Hormones VS Aging

Testosterone has a powerful anabolic effect on the muscle and bone tissue as well as on libido. Moreover, it affects mood and cognitive function.

Numerous studies confirm that, like what happens in men, in women, there is also a decrease in testosterone levels with age due to the decrease in DHEA production and to the increase of anovulatory cycles throughout life.

Low testosterone levels are associated with decreased libido, lowered mood, body fat gain, loss of muscle mass and strength, a decrease in bone mineral density and an increase in cardiovascular risk, among others.

Moreover, testosterone in women contributes to the relief of menopause symptoms and to skin improvement, increasing collagen and elastin.

Thyroid Hormones

Thyroid Hormones are produced in the thyroid and regulate the metabolic rates of all cells. There are receptors for the thyroid hormones in most of the tissues and, therefore, they affect the functioning of almost all organs and systems, especially the heart, bones and subcutaneous fat.

Their effects are to control body temperature and to boost the metabolism of fatty tissue which helps with fat weight loss and lowering cholesterol levels. They are cardio and neuroprotectors.

Low levels of thyroid hormones are related to uncontrolled weight gain, feeling blue, chronic fatigue, depression, thin and weak hair, dry skin, brittle nails, feeling cold, etc.

Melatonin

Melatonin is a molecule related to neuroendocrine physiology. It is involved in the regulation of circadian rhythms and the sleep/wake rhythm, also a hormonal modulator of immune system activity.

It is also a crucial hormone in the regulation of the mitochondrial function, for ATP production, which is the form of energy a cell uses for all its functions. Additionally, melatonin is a powerful antioxidant and anti-inflammatory.

Hormones VS Aging

The Lack of melatonin produces a loss in the capacity to regulate circadian rhythms, producing problems in the quantity and quality of sleep and rest.

A decrease in melatonin produces oxidative and nitrosative stress, which will intensify the bigger this hormone deficit is. This causes cell inflammation, weakening the immune system, and therefore, causes disease.

Moreover, as melatonin synchronises the rhythms of brain neurotransmit-ters, its decrease directly affects cognitive capacities.

DHEA (Dehydroepiandrosterone)

DHEA DHEA is a weak androgen produced by the adrenal glands, which is secreted in the liver and circulates in the blood in its sulfated form (DHEA-S). It is a a precursor of numerous sexual hormones, such as testosterone, estradiol and estrone.

In women, it is a precursor of 75% of circulating testosterone. Moreover, it has effects alone in arteries, bones and the immune system.

DHEA-S plasma levels are a good biomarker of ageing because they decrease between 10-20% per decade from the age of 20.

Hormones VS Ageing

A proper DHEA level promotes tissue reconstruction (stimulating protein metabolism), helps to control stress (countering the cortisol effect) and has positive effects on cardiovascular, bone, immune, sexual and mood levels.

Cortisol

Cortisol is produced in the outer layer of the adrenal gland, like aldosterone, DHEA and other hormones. It intervenes in the metabolism of protein, fats and glucose, and plays an important role in the immune system.

Like insulin, it is a hormone which increases with age and with bad lifestyle habits, producing medium and long-term problems.

It is known as the ‘stress hormone’ because it increases in situations of severe physical and/or psychological stress,in response to the hyperstimulation of adrenal glands in phase 1 or the Hans Seyle alarm, suppressing the immune system.

However, a chronic stressful situation produces a decline in this hormone and can reflect adrenal fatigue syndrome.

Insulin

Insulin is the hormone that is secreted by the pancreas when glucose levels increase after eating and allows its entrance inside the cells (especially in the liver, brain and muscle) to be used as energy.

The amount of insulin needed to maintain a certain level of glucose in blood is an indicator of resistance and sensitivity of the cells receptors to insulin.

Insulin, together with the rest of the indicators of the hydrocarbon profile, is correlated with the risk of developing type 2 diabetes and its related cardiovascular, renal, neurological complications and complications of the retina, as well as a lower life expectancy and quality of life.

Type 2 diabetes is a disease that corresponds to 95% of diabetes cases. It appears in adults and increases with age, sedentary lifestyle, overweight and obesity. It is characterised by a resistance of the cells receptors to insulin, hyperinsulinism at first and an exhaustion of the pancreas to release insulin in the most advanced stages.

Prediabetes can be detected years before the development of type 2 diabetes by monitoring the metabolism of hydrocarbon biomarkers.

Bioidentical Hormones. The Key.

Correct and safe hormone replacement therapy always must be done with bioidentical hormones.That is to say, synthetic hormones have to be avoided .

Bioidentical hormones have the same molecular structure as our own hormones and, therefore, are metabolised exactly the same as the hormones produced by our endocrine system, in a natural way, and without the possible side effects of synthetic hormones whose chemical structure differs from natural hormones to boost or inhibit certain effects or improve their storage.

These hormones are handmade and custom-compounded, with the necessary dosage for each woman, with the aim of ensuring they are biologically identical. Hormones that are sold in the pharmacy are all synthetic.

Moreover, properly used bioidentical hormones are directly absorbed and do not require the involvement of the liver so they do not interfere with medicines for heart diseases, hypertension, nephropathy or thyroid diseases, nor do they increase the risk of developing breast or ovarian cancer.

Routes of Administration

At Neolife, bioidentical hormone replacement therapy is done for women through different routes of administration - subcutaneous or delayed-release (pellets) implants, creams, gels or patches on the skin, oral capsules, sublingual tablets, vaginal suppositories, etc.

The method of application is determined according to the type of hormone and each patient’s specific characteristics:

  • Testosterone in women can be applied in a pellet form every three to four or daily with creams. In some countries, there are oral testosterone tablets but Neolife advises against this route because they must be processed in the liver, a process called ‘first step metabolism’. Like this, substances are released in the bloodstream (together with their by-products) and stimulation is generated which produces other substances in the liver such as clotting factors that can be harmful to liver cells, can cause fibrosis and loss of liver function.
  • 17 beta-estradiol is usually applied as cream, gel, pellet or suppository..
  • Bioidentical micronized progesterone, melatonin and DHEA are always administered in as anoral tablet.

Neolife is the first clinic in Madrid that implants pellets for women.

Hormonal replacement therapy with pellets has been used in the US since 1939 and was introduced by Doctor Robert Greenblatt.

It involves the subcutaneous placement of tiny estradiol and testosterone granules in the fat tissue, which is about the size of a grain of rice. This is an absolutely painless process.

It is the only route of administration of hormones which generates a constant bloodstream level of these hormones.

The Bioidentical Hormonal Replacement Therapy (BHRT) is a key pillar in anti-ageing preventive medicine and aims to restore hormonal levels which decrease with age towards their levels of excellence. The objective is to reach an optimal metabolic and hormonal balance in order to prevent related to age diseases and improve all the symptoms related to this phase.

Proper hormonal replacement therapy has to be:

  • Personalised – each individual needs a treatment adapted to his body.
  • Safe – with bioidentical hormones. Or in other words, the use of synthetic hormones must be avoided.
  • Monitoring key biomarkers over time – this way the necessary prescription will be made at each moment.
  • Monitored – under strict medical supervision.

The protocol for carrying out the programme has two clearly differentiated parts, the Initiation of the treatment and the programme monitoring and stabilisation.

Initiation the Treatment

The steps to be taken at the beginning of the treatment are the following:

  • Initial analytical profile – can be done at Neolife or someplace else.
  • Health and lifestyle questionnaire.
  • Complete gynaecological examination – mammogram, cytology and ultrasound scan done less than ten months ago. If not available, our gynaecologists can do the complete examination.
  • Cardiac imaging tests (optional) – although advisable, they are not necessary in all cases.
  • Rest and oxidative stress tests (optional) - if opting to start melatonin treatment.
  • Consultation to deliver results – the medical team will jointly review all clinical aspects of the tests carried out, providing a report with the diagnosis and personalised treatment.

Monitoring and Stabilisation of the Programme

Hormone replacement therapy treatment will always be done under strict medical supervision. Consequently, it requires a protocol that has been reviewed and measured, always adapted to the needs of each woman.

  • Peak test – five weeks after having started the treatment.
  • Analytic profile to monitor – during the first year, at least once every three months. From the second year on, according to the advice from the medical team.
  • Pellet insertion – if you opt this way to administer testosterone and estrogen, you will have to go to the clinic for it to be inserted. The estimated length of the consultation is 15 is 20 minutes. No preparation is needed.
  • Consultations for monitoring – Every three months during the first year, with an appointment. From the stabilisation of the treatment (second year onwards), when advised by the doctor.
Multiple medical and scientific articles confirm the positive effects bioidentical hormone replacement therapy – correctly prescribed by a specialist–have on the ageing stage.
  • Prevention of diseases like cardiovascular disease, diabetes, cancer, Alzheimer’s or osteoporosis.
  • Relief of menopause symptoms:: night sweat, hot flushes, breast tenderness, vaginal dryness, etc.
  • Increase in libido and sexual response..
  • Neurocognitive improvements – increase in performance and ability to concentrate and more mental agility.
  • Improvement in sleep and rest, emotional state and levels of energy and wellbeing.
  • Immune system optimisation.
  • Lipid profile improvement – a decrease in cholesterol and triglyceride levels.
  • Functional improvements – increase in energy and exercise capacity, strength, endurance and muscle tone.
  • Improved body composition – increase in the breakdown of fat, weight loss and a decrease in body fat reduction, mainly in the abdominal area.
  • Improvement of the hair, skin and nails , increasing collagen and elastin.
The benefits provided by comprehensive bioidentical hormone replacement therapy significantly improve if complemented by the rest of the anti-ageing preventive medicine pillars (exercise, nutrition, rest, nutritional supplementation, etc.).

Hormone replacement therapy is already supported by the scientific associations related to menopause and andropause, both in Spain and internationally.


Bioidentical Hormone Replacement Therapy Risks and Safet

Questions arise about if hormone replacement therapy (HRT) is safe, if it causes cancer, if it really prevents the emergence of diseases and if people will feel better.

If the peak in hormonal levels happens between the age of 20 and 30, a time when young people are fully functional with lots of vitality and without diseases, wouldn’t it be good to maintain these hormonal levels in an adult, replacing his deficit with hormones that are identical to those which our body produces? The answer is yes. Hormones have extremely important physiologic functions for the normal functioning of our bodies.

But the word hormone has a negative connotation in our environment, especially in our country: cattle with hormones, hormone doping in athletes, cancer caused by hormones, etc.

Even the non-qualified medical professionals in this area of medicine (and not familiar with the recent scientific literature and medical practices) voice their concerns. So, it is reasonable that many people have certain misgivings when thinking about starting HRT.

The strictest scientific literature and medical practice of leaders in this field ensure that proper bioidentical hormone replacement therapy under strict medical supervision does result in risks for women but the contrary: in most cases, it brings huge benefits to our health and quality of life.


Female hormones and breast cancer

Since the alarming news from the WHI until today, millions of women have lost the opportunity to prevent diseases and improve their physical, social and sexual quality of life by reducing the symptoms of menopause. Nowadays, more than 2 million women in the United States are benefiting from the HRT with bioidentical hormones.

The bad press about hormone replacement therapy for women started in 2002 when the WHI study (The Women´s Health Initiative) was suddenly stopped, due to an alleged increase in the incidence of breast cancer and thromboembolism in the women. It caused public alarm, causing millions of women throughout the world to quit their HRT during menopause.

Multiple posterior studies concluded that in that study, there was an error in the selection of women and also in the type of hormones that they were administered (a combination of estrogen from mares (Premarin) and synthetic progesterone (medroxyprogesterone), responsible for the increase in breast cancer).

  • An article published in 2012 in the BMJ (British Medical Journal) about postmenopausic young women (45-58 years old), demonstrated that women who did ten years of HRT had a lower rate of mortality (40% decrease), heart failure and myocardial infarction without an increase in breast cancer, thromboembolism or stroke. Even those women who started their HRT before the age of 50, showed a reduction in the incidence of breast cancer.
  • Another study published in July 2013 in the American Journal of Public Health,estimated that between 2002 and 2011, between 18,601 and 91,610 postmenopausal hysterectomised women, with similar characteristics as the women from the WHI study, died prematurely due to the alarmist withdrawal of HRT with estrogen.

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