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Calvin Wilson, M.D.: Treating Hormonal Changes As We Age

We should think about the benefits of bioidentical hormone therapy

Many women assume the hot flashes, mood swings and weight gain they experience as they approach middle age are normal signs of the hormonal changes associated with menopause, and that they just have to accept them. And many men often don’t associate thinning hair and other problems they experience as they age with hormonal decline. We’re both wrong. Calvin Wilson, M.D., of Living Great Medical Associates in Dover, Delaware, explains why we need to change our thinking and explains how we can use bioidentical hormone therapy to treat these issues.

What are bioidentical hormones?

Calvin Wilson, M.D.: Bioidentical hormone therapy has been used in this country since 1939. In fact, it was the primary method of hormone replacement therapy until pharmaceutical companies came out with synthetic hormones. Bioidentical hormones are identical or equivalent to what is produced in the body. Synthetic hormones have to be changed in some way so they can be patented. They are absorbed differently in the body because of that.

How do bioidentical hormones work?

Dr. Wilson: Bioidentical hormones are given by creams or pellets that slip under the skin. Every dose is customized by a person’s age, weight and hormone levels. Because of that, the person gets treatment designed for them rather than designed for the population in general.

Why do we need them? And who needs them?

Dr. Wilson: The “change of life” used to mean a woman had about five years left of her life. Now women live years after the change with increased risk for cancer, heart disease, diabetes, weight gain. Osteoporosis—the most serious of which is hip fracture—is predicted to increase 330 percent by 2020.

Men have a decrease in testosterone. We used to think there was no such thing as andropause, that men were good throughout their life. But we’re seeing lower performance, lower sexual drive in men. We’re seeing more thinning of the bones in males now than at any other time in history. Men over age 50 have suboptimal hormone levels.

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There’s a misconception that women don’t need testosterone. But around the age of 28 to 30, we all lose lean muscle mass every year. The main cause of admission to nursing homes is being frail. That’s because of loss of muscle mass, not illness. The change of life causes that loss of muscle mass to accelerate.

There was that dust-up about synthetic hormone replacement therapy some years ago. Are bioidentical hormones safer?

Dr. Wilson: A study showed an increase in several illnesses related to synthetic hormones. The suggestion was that women should not continue hormone therapy beyond five to 10 years because of an increased incidence of heart disease, specifically heart attack and stroke, due to an increase in clotting. There were increased incidences in that study, but that was more a manipulation of the statistics. At any rate, we do not see the incidence of clotting with bioidentical hormones because they are not taken by mouth. Bioidentical hormones are safer than synthetic hormones.

What are the side effects?

Dr. Wilson: They are fairly minimal if levels are calculated and followed correctly. When correctly balanced, bioidentical hormones will cause a decrease in the risk of uterine cancer. But if they are incorrectly prescribed, they can cause a slight increase in the risk of uterine cancer.

There’s always a concern with breast cancer. So far there’s been only one study—a long-term study that followed women for up to 30 years—and it found no increase in breast cancer in the general public.

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For men, prostate cancer is actually twice as common as breast cancer. But one study showed that when testosterone therapy is used and maintained at proper levels, there’s not an increased risk in prostate cancer.

Outside of that, the side effects are fairly small. Some women complain of abnormal hair growth on their chin and chest, but that’s very uncommon. I have some patients who have never taken a hormone in their life—that’s including birth control pills—who have a full goatee and mustache—and others who take hormones who have no abnormal hair growth. I believe genetics plays a large role in that.

How do we find a doctor to prescribe bioidentical hormones correctly?

Dr. Wilson: Look for someone who is certified in bioidentical hormone therapy. Or look up a good compounding pharmacy and ask for a referral.

What else should we know about this therapy?

Dr. Wilson: People should keep an open mind. Doctors in this country are not trained in the use of alternative approaches, but integrative medicines are becoming more widely accepted. People should explore all of their options, rather than going with the traditional treatments. We rank fairly low among developed countries in disease prevention and health optimization. We are much more reactive than proactive. If we could get people to follow healthier lifestyles and optimize their health, we could save somewhere in the range of $10 trillion in health-care costs.

Think of it this way: We need to change the oil in our car. Do we think A) it’s more important to get the oil changed as recommended, or B) wait until the car breaks down and then change the oil? Obviously we think B is pretty silly, but that’s what we do with our bodies.

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