Anthony J. Bazzan, M.D.
Jefferson-Myrna Brind Center of Integrative Medicine

It is estimated that 75% of women are in an estrogen deficient state within a few years after the onset of menopause. A relative few number of women continue to have sufficient endogenous estrogen. After decades of being advice to the contrary, women are now told to avoid hormone replacement and/or take drugs for their symptoms, because of the negative outcomes of the WHI and HERS studies. This has left many women feeling abandoned and distressed with symptoms of menopause and osteoporosis. We report high clinical success in treating symptoms and signs of menopause and estrogen deficiency.

First, there are ways of enhancing endogenous estrogen. For example, the adrenal gland produces estrogen and other sex hormones. The adrenal gland also produces the stress hormone cortisol. When stress levels are too high, the adrenal gland focuses on cortisol production and decreases production of estrogen. Therefore, stress reduction programs, such as mindfulness-based stresss reduction (MBSR), can lead to enhanced estrogen production from the adrenal gland. Other lifestyle interventions such as diet and exercise are important aspects of the overall treatment plan. In addition, the herb black cohosh has a potentially estrogenic effect, which can help with menopausal symptoms like hot flashes. Other nutritional supplements, such as flax seeds and a few specific homeopathic remedies might also provide some relief.

The above measures are not always sufficient to address distressing menopausal symptoms and other problems of hormone deficiency, such as osteoporosis. We have had tremendous success with bio-identical hormone replacement therapy, which is available as prescription gel, cream or injectible, slow-release pellets. We feel that this form of hormone replacement is potentially safer than the synthetic, non-human forms of estrogen that were the focus of the above-mentioned studies.