The Truth About Bio-Identical Hormones

Vivian F. DeNise,DO
Integrative Physician
Patients Medical

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patient holistically.


Result:
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be applied for years to come.


Founder, Dr. Warren Levin
began practicing his ground-breaking holistic
protocols in 1974.


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Integrative Medicine


Introducing our speaker:

Vivian DeNise, DO
Integrative Medicine


 Completed her medical degree
at New York College of
Osteopathic Medicine
 Certifications in Integrative
Medicine with the American
Academy of Anti-Aging
Medicine (A4M)


 Specialties include
 Hormonal Imbalances
 Nutritional Deficiency
 Thyroid Disorders
 Gastro-Intestinal Problems
 Detoxification
 And many more!


There are receptors everywhere in the body for
estrogen, progesterone and testosterone in
both men and women.


 Brain
 Bone, Muscle, Joints
 Heart
 Blood Vessels
 Bladder
 Liver
 Kidney
 Genitals
 Nerves
 Skin and Hair Follicles

To achieve Balanced
Hormone Optimization to
that of a 25-30 year old
level using Bio-Identical
Hormones.


 They are identical to the molecular structure
of hormones produced by human female or
males.
 They are NOT:
 Xeno hormones
 Horse hormones
 Synthetic hormones


 Atom for atom identical to human hormones
 Not horse hormones
 Not chemically altered
 No increased risk for cancer
 Less risk for heart disease
 Less mortality
 Needed for Bone, Brain, Quality of Life


 Testosterone
 Estrogens, Progesterone
 DHEA, Pregnenaolone
 Cortisol
 Thyroid: T3, T4
 Vitamin D
 Growth Hormone


 Hormones
 Neurotransmitters
 Medications
 Emotions
 Diet
 Sleep


 Estrogens
▪ Estrone=E1
▪ Estradiol=E2
▪ Estriol=E3
 Progesterone
 Testosterone


PMS (Premenstrual Syndrome)-
Cyclical mental and physical symptoms
preceding the menstrual cycle.


 Peri-menopause-Can begin to occur 10-20
years prior to menopause associated with
cyclical changes in menses as well as
mental/physical symptoms.
▪ Early- changes occur rarely and resolve
▪ Middle-changes occur often and for longer
▪ Late-changes occur continuously.
 Menopause-no menstrual bleeding for 1 year


 Deficiencies can start years
before menopause in peri-
menopause
 Poor sleep, anxiety, PMS-
Progesterone
 Low Libido, decreased
memory-Testosterone
 Low energy, hot
flashes, vaginal dryness-
Estrogen

 Balances Estrogens, Progesterone, and
Testosterone
 Every woman needs a unique balance
 Not every woman needs estrogen
 Progesterone protects against breast cancer

Unlike “progestins” natural progesterone
does not have androgenic or anti androgenic
effects.

 Hot flashes
 Night sweats
 Fatigue
 Vaginal Dryness
 Poor memory and
Foggy thinking
 Low energy


 Depressed mood
 Decreased concentration
 Decreased sexual desire or
libido
 Excessive daytime sleepiness
 Stress incontinence and UTI’s
 Osteoporosis, Cardiovascular
disease, Dementia


 Agitated
 Anxiety
 Weight gain
 Water retention
 Headaches
 Swollen or tender breasts
 Bloating
 Spotting or breakthrough bleeding
 Mood swings
 Poor sleep
 Achy joints
 Excessive bleeding


 Increase blood pressure
 Increase triglycerides
 Increase estrone
 Cause gallstones
 Elevate liver enzymes
 Increase SHBG (decreases testosterone)
 Interrupt tyrptophan metabolism and
consequently serotonin metabolism
 Causes blood clots to form


 Decreases HbA1c
 Decreases total cholesterol
 Decreases LDL
 Decreases HS-CRP
 Decreases IL-6 and TNF-inflammatory
cytokines implicated in
autoimmune, cardiovascular, osteoporosis and
Alzheimer's
 NO increase risk of stroke or venous
thrombosis

Usually the first hormone to become deficient
in peri-menopause.


 Agitation
 Irritability, aggressiveness
 Anxiety, anger
 Weight gain
 Water retention
 Headaches
 Swollen or tender breasts


 Bloating
 Spotting or breakthrough bleeding
 Mood swings
 Poor sleep, insomnia
 Achy joints
 Excessive bleeding
 Endometriosis
 Fibrocystic breasts


 Impaired production
 Low LH
 Increased prolactin production
 Stress
 Antidepressants
 Excessive arginine consumption
 Sugar
 Saturated fat
 Deficiency of vitamins A, B6, C, zinc
 Decreased thyroid hormone


 Called progestins
 Progestins do not reproduce the same
actions of natural progesterone


 Increases appetite
 Weight gain
 Fluid retention
 Irritability
 Depression
 Headache
 Decreases energy
 Bloating
 Breast tenderness
 Decreases sexual interest


 Acne
 Hair loss
 Nausea
 Insomnia
 Interferes with the body’s own production of
progesterone
 Does not help balance estrogen
 Remains in the body longer
 Can cause spasm of coronary arteries


 Stops the protective affects estrogen has on
the heart
 May make the symptoms of progesterone loss
worse
 Increases LDL
 Decreases HDL
 Protects only the uterus from cancer
 Counteracts many of the positive effects of
estrogen on serotonin

 Orally
 Transdermal cream


 Helps balance estrogen
 Leaves the body quickly
 Improves sleep
 Natural calming effect
 Lowers high blood pressure
 Helps the body use and eliminate fats
 Lowers cholesterol


 May protect against breast cancer
 Increases scalp hair
 Helps balance fluids in the cells
 Increases metabolic rate
 Natural diuretic
 Natural antidepressant
 Is anti-inflammatory


 Stimulates the production
of new bone
 Enhances the action of
thyroid hormones
 Improves libido
 Helps restore proper cell
oxygen levels
 Induces conversion of E1
to the inactive E1S form
 Promotes Th2 immunity
 Is
neuroprotective, promotin
g myelination www.patientsmedical.com

 Synthetic progestins increase Breast
Cancer Risk
 Progesterone decreases Breast Cancer
Risk


 Increases fat storage
 Elevates cortisol
 Increases insulin resistance
 Increases appetite and carbohydrate cravings
 Relaxes the smooth muscles of the gut (This
can cause bloating, fullness, and constipation.
It can also contribute to gallstones.)


 Testosterone is needed for a sense of well
being
 Strength especially upper body
 Libido
 Usually decreased in peri-menopausal and
menopausal women
 Body composition
 Bone density
 DHEA can increase Testosterone in women
but not in men

 Increases sexual interest
 Increases sense of emotional
well-being
 Increases muscle mass and
strength
 Helps maintain memory
 Helps skin from sagging
 Decreases excess body fat
 Helps maintain bone
strength
 Elevates norepinephrine in
the brain (tricyclic affect)

 Muscle wasting
 Weight gain
 Fatigue
 Low self-esteem
 Decreased HDL
 Dry, thin skin, with poor
elasticity
 Thinning and dry hair
 Droopy eyelids
 Sagging cheeks
 Thin lips
 Anxiety www.patientsmedical.com

 Menopause
 Childbirth
 Chemotherapy
 Adrenal stress or burnout
 Endometriosis
 Depression
 Psychological trauma
 Birth control pills
 HMG-CoA-reductase inhibitors


 Testosterone replacement P.O. or transdermally.
 Use the bio-identical form. Methyltestosterone has
been associated with an increase in liver cancer.
 If used transdermally must rotate sites.
 In order for testosterone to work well, estradiol must
also be optimized.
 Without enough estrogen, testosterone cannot
attach to brain receptors.
 If testosterone is given alone it can increase plaque
formation.


 Decrease calorie intake
 Increase protein in the diet
 Take the amino acids
arginine, leucine, glutamine
 Exercise
 Get enough sleep
 Lose weight
 Reduce stress
 Take zinc if deficient (Zinc is
needed for the metabolism of
testosterone.) www.patientsmedical.com

When used in conjunction with BHRT there is
even a lower incidence of breast cancer
compared to HRT alone.


 Seen every 3 months or sooner if needed
 Labs every 3 months initially and as needed
depending on where patient is in life
 May take up to 6 months to get full benefit


 Stress
 Diet
 Environmental


Please fill out your pink event evaluation form
and return it to us.


Get started TODAY by making an appointment
with Dr. DeNise.


Patients Medical’s Team of Holistic Doctors


To get more information or to schedule an
appointment,
call 212-679-9667 or
email media@patientsmedical.com


The Truth About Bio-Identical Hormones

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