Ask The Anti-Aging Expert: Dr. Donna Becker
By Alissa Reinhard
Aging is a part of life, but it doesn’t have to define your life. Did you know that the symptoms you experience as you age are directly related to a decline in your body’s production of hormones? At the Enhancement of Life Center, Dr. Donna Becker has been treating patients for over a decade, helping them understand that our hormones don’t decline because we age, we age because our hormones decline! Dr. Becker’s experience, compassion and expertise in the field of hormone replacement therapy have helped countless patients feel like themselves again – a priceless gift for anyone suffering from the effects of aging. Continue reading to learn more from the expert in anti-aging, Dr. Donna Becker, including hormone replacement therapy, bio-identical hormones, and the changes you can make to enhance your life today, tomorrow and for years to come. Here are questions that are frequently asked of Dr. Becker.
Q: What is hormone replacement therapy? Who needs it and why?
A: In antiaging, we believe that aging is a deficiency disease. Hormones levels begin to drop for some people in their 30-40s. For men, the decline in testosterone is gradual, about 1% per year after age 30, but for women the hormones drop off completely by age 51. Without hormones, many people may begin to experience signs of aging: weakness, loss of collagen in your skin, weakening bones, and weight gain. Other issues like shrinkage of the brain can occur, along with dryness of the mucus membranes. Our body degenerates. Things just don’t work as well anymore. Word search, decrease in stamina in the gym, and sexual dysfunction ranging from no desire to decreased enjoyment. That being said, not everyone experiences these losses in the same way. Some women during menopause have minimal complaints and perceive no change in bodily function or mental ability, while other men and women may have severe symptoms bordering on psychosis-cannot think, cannot sleep, accompanied by feelings of rage alternating with crying spells. A little or a lot, the vast majority of us, are, or will be impacted by lack of hormones. The bank executive who is suddenly flushing and sweating profusely in front of her client – she needs hormones. The woman who can’t sleep, tossing and turning, and no longer has a zest for life or for her partner – she would benefit from hormones. Even the man who is extremely fatigued and has problems with intimacy – he could possibly need hormones as well. What I do is unique – I draw everyone’s blood levels – an extensive panel that guides treatment. My goal is to match the hormone levels that occurred naturally in your body when you were in your twenties. I continue to draw blood to monitor hormone levels.
Q: What are bio-identical hormones? What are synthetic hormones?
A: Bio-identical hormones are an exact molecular copy of the hormones that your body made naturally when you were a young individual, specifically estrogen, progesterone and testosterone. Synthetic hormones, on the other hand, are intentionally created differently than what your body naturally produces so that they can be patented by a pharmaceutical company. If the urine of a young woman (who naturally produces hormones) and a woman in her seventies (taking bio-identical hormones) were to be analyzed, it would be impossible to tell the difference between the two. The metabolites of the 70 y/o and the 20 y/o would be the same. Metabolites are the spent products of the used hormones. If that same woman in her seventies were to take synthetic hormones, the difference could be easily detected. Synthetic hormones, like progestin (the synthetic form of progesterone) also can cause side effects like causes depression, bloating and weight gain. Progesterone, on the other hand, is a diuretic. It helps you lose excess water, experience calmness, and to sleep. Progestin has none of those effects. Progestin and bio-identical progesterone might both be made in a lab, but one is an exact copy of the human hormone and the other is completely unrelated, just cleverly given a similar sounding name.
Q: When should I start hormone therapy?
A: It’s very important that a woman began hormone therapy right when they stop having a menstrual cycle. This period of time is called perimenopause. This “critical window” of time, when periods stop, is when a woman experiences the greatest amount of loss – osteoporosis, pain during sexual intercourse, loss of skin elasticity, memory loss, even the gums shrink. To prevent these losses and maintain strength and energy, hormone replacement therapy may be the answer.
Q: Is hormone therapy safe?
A: The most comprehensive study done to date, the Women’s Health Initiative Study, revealed that the women in this large study who took synthetic estrogen actually had lower rates of cancer compared to women who took progestin+synthetic estrogen combination. In these women treated with oral estrogen alone, there was an increased risk of stroke and heart attacks. It is my belief that one can get cancer whether he or she takes hormones or not. Risk of cancer and other diseases is related to lifestyle choices and family history. The World Health Organization links all alcohol intake with an increased risk of all cancers-yes, even one drink per day. That being said, hormone therapy is a quality of life decision. Yes, you will live without hormones and one could suffer from cancer, stroke or heart attack if you take hormones. I recommend hormone therapy based on blood levels and the symptoms my patients describe. Not everyone needs or should receive hormone replacement therapy.
Q: Why doesn’t my regular doctor or OBGYN prescribe me bio-identical hormones?
A: Because it is a very individualized, detailed treatment. You have to draw and analyze blood levels and you have to really talk to the patient. Many doctors will prescribe hormones, but they will prescribe the same dose across the board for every woman without ever looking at labs. That’s when you’re going to run into side effects and people aren’t going to see good results. I draw blood levels and aim to copy the usual blood level of estrogen, progesterone, and testosterone in the young healthy adult at about the 10th day of their menstrual cycle. Right after the period, hormone levels are at a resting point (my term) and this occurs before the monthly spike of estrogen which happens at ovulation, day 10-14. I want to alleviate their symptoms, keep the blood levels within this desired range, and avoid side effects such as breakthrough bleeding, swollen breasts, or painful, erect nipples (this may come from too much testosterone!).
Q: Is hormone replacement therapy only for women?
A: No, I have many male patients who benefit from hormone replacement therapy. Low testosterone can affect mood, focus and concentration, and even weight. Did you know the number one reason seniors enter a nursing home is because of loss of upper body strength? There have been studies showing that testosterone can help increase muscle mass. Interestingly enough, some older men taking testosterone also eventually need less and less of their blood pressure medication. However, testosterone does have a negative feedback mechanism: if a young man takes testosterone, then his own body may stop making it!, so that he must always take it. This is not usually a problem with an older man who may not be producing enough anyway. Testosterone therapy has been associated with an increased risk of stroke and heart attacks in one large published study, but other papers reported that the initial study design was not correctly done.
Q: How quickly will I see results from replacement hormone therapy?
A: It almost unbelievably – for all it’s amazing benefits, HRT many patients see results immediately. For example, for those taking progesterone, the first time they take it, they sleep through the night and get deeper, more restful sleep than they had in years. Hormones traverse the skin or mucus membrane quickly. Vaginal dryness will usually be resolved enough for intercourse in less than a week, but fully thick and moist in about 2-3 weeks. Hot flashes resolve in 7-10 days usually. Sleep is restored the quickest.
Q: My doctor said to just take this pill which he gives to most of his patients who demand hormone therapy, and he said after about 3-4 months, symptoms are relieved. Why should I go through all this blood check and visits?
A: Would you take insulin based on if you are thirsty and weak? Would you tell your doctor your heart was pounding, so maybe you should take less thyroid? Remember, the only medication which can actually change someone’s gender – change a woman to a man or a man to a woman – is hormones. Do you REALLY want to guess on a dosage of such a powerful therapy? No, it isn’t standard therapy, but I believe it will be someday, to check hormone levels and prescribe precisely. Some women for example have a baseline estradiol of 20pg/mL while most women have <0.5pg/mL. The desired range is 35-75. Obviously, a different starting dose is required! Look at Wikipedia under estradiol for a general discussion on this subject of blood levels.
For the past ten plus years, I have been in my office analyzing blood levels and prescribing precise dosages of hormones. I don’t treat people with an illness associated with their hormones. I treat people to achieve peak mental, physical, and sexual performance as they age. I go to many seminars every year. In September, I am going to a seminar by a doctor from the Buck’s Institute for Research on Aging funded in part by UCLA about reversal (!) of cognitive decline in the elderly. (read: “Reversal of Cognitive Decline A Novel Therapeutic Program” by Dr. Bredesen and others 2014) I am going to learn more, so I can give this breakthrough knowledge to all my patients.