GUIDE TO HORMONES
At Omniya Clinic in London
Hormone balance is essential for age management – for your memory and concentration, cardiovascular health and strong bones, as well as supporting the body’s ability to maintain health, energy and happiness. Hormone Therapy is the overarching treatment of hormones.
Hormone deficiency may be associated with significant changes in body composition, bone density, lipid/cholesterol metabolism, cardiovascular function, skin, physical and mental wellbeing. With decreased hormone levels, sleep patterns and immune system function may also be affected.
The aim of hormonal therapy is to cause an actual physiological change to your body by improving cardiovascular, neurological and bone health, as well as improving your symptoms and quality of life.
As we age, there is a naturally occurring decline in hormones, such as oestrogen, progesterone and testosterone. Balancing these hormones can have a wide-range of significant health benefits
Within this page, we cover a variety of hormones, including:
For more information on both male and female hormone replacement therapy treatments (HRT and TRT) please see the links:
Hormone Therapy Incorporates The Following
Memory
Concentration
Cardiovascular Health
Strong Bones
Energy
General Sense Of Happiness
Genetics
Gut Health
Tesosterone
Oestrogen
Progesterone
DHEA
Cortisol
Insulin
Telomeres
Thyroid
Melatonin
Hormone Therapy Treatment Overview
Hormone Treatment Performed By
General Practitioner
MRCGP, Dip Study of Integrative Medicine, Cert BioIdentical
Hormone Therapy, Dip Reproductive and Sexual Health
Hormone Therapy at Omniya Clinic London.
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Information On Hormones
What Exactly Are Hormones And What Do They Do?
Hormones are special chemical messengers in the body that are made in the endocrine system via various glands. These messengers control most of our bodily functions, from needs like hunger to more complicated systems like reproduction, and even our emotions and mood. Understanding the major hormone functions will help you take control of your health.
BHRT Bio-Identical Hormone Replacement Therapy
Bio-identical hormone replacement therapy (BHRT), also known as bio-identical hormone therapy, or body identical hormone therapy, is a term referring to the use of hormones that are chemically the same structure as the hormones in our body.
In both men and women, key hormones begin to decrease with age which can lead to health issues and unpleasant symptoms, so BHRT is used to help balance out the natural decline of our hormone production or address general hormonal imbalances at any age. BHRT can be used for many types of health issues, for example infertility, thyroid disease, menopause, erectile dysfunction, sexual dysfunction, fibroid, endometriosis, polycystic ovarian syndrome and adrenal fatigue.
BHRT comes in cream, lozenges, gels and tablet form and sometimes injections. Depending on your diagnosis and type of hormonal issue, a specific format will be chosen for treatment, as different formats will absorb into the body at different rates.
Patients who are prescribed BHRT are monitored very closely.
Doses are adjusted according to a patient’s symptoms and natural hormone levels, with the goal of keeping the dose to the minimum required to help address the hormonal issues.
Age Management
Hormone deficiency may be associated with significant changes in:
- Body composition
- Bone density
- Lipid/cholesterol metabolism
- Cardiovascular function
- Skin
- Physical and mental wellbeing
- With decreased hormone levels, sleep patterns and immune system function may also be affected.
The aim of hormonal therapy is to cause an actual physiological change to your body by improving cardiovascular, neurological and bone health, as well as improving your symptoms and quality of life.
As we age, there is a naturally occurring decline in hormones, such as oestrogen, progesterone and testosterone. Balancing these hormones can have a wide-range of significant health benefits, as will be discussed.
Other Tests
Other tests that can help us to assess health and ageing are:
Telomeres
Telomeres are the caps on the end of our chromosomes that protect them, a bit like the plastic tip on a shoelace.
Our DNA is located on our chromosomes which means that telomeres protect our genetic material.
Telomere length is a good predictor of longevity. For example in 2007, a study showed that in elderly twins, the twin with shorter telomeres is three times more likely to die first.
Having your telomeres tested will give you a measure of your biological age. Based on this, Dr Roked can then see what lifestyle changes and supplements are needed, as well as what other testing that may be need.
Vitamin and mineral analysis
A lot of people follow a good diet and lead a healthy lifestyle but still do not feel optimum. It can be of benefit to have your individual vitamin, minerals, amino acids, fatty acids and other nutritional markers looked at in depth to guide what supplements your body needs and make improvements in nutrition.
Gut health testing
Making sure our gut health is optimum is important as it can affect our immune system, mood, weight, energy and digestive health.
If your gut isn’t working well, you won’t be able to metabolise what you eat and it will also affect your ability to process hormones. Some symptoms of gut dysfunction are:
- bloating
- abdominal pains
- loose stools
- constipation
- feeling sluggish
- low mood
- low energy
- increased weight
Dr Sohere Roked’s Protocol in managing gut health issues involves:
- eliminating offending agents such as pathogens or foods causing irritability
- testing for parasites
- treating and repairing increased gut permeability
- adding in supplements if needed such as probiotics and enzymes
- looking at other imbalances that can affect your gut
DNA/Genetic testing
A simple cheek swab test can hold the key to your health. This enables analysis of over 100 of the best researched genetic markers that can be impacted by diet and lifestyle.
Your genes are not your destiny, but understanding them can be the first step to preventative health.
Key areas addressed are:
- DNA Diet – what to eat for your genetic type
- DNA Sport – what sort of exercise should you be doing and how much do you need to stay healthy
- Methylation – one of the most important processes in the body. If this isn’t optimum it can affect your hormone metabolism, mood, sleep, energy and heart health.
- Detoxification – how is the liver functioning and is your body able to detoxify.
- Hormonal Balance – is your body able to process hormones and detoxify them. This can be for your own hormones or any hormone replacement therapy.
- Allergies and Histamine Balance – are your genetic pathways not functioning well and causing you to have increased allergies?
For more information about these tests and if they could benefit you, ask Dr Sohere Roked.
Oestrogen
Problems like mood swings, unexplained weight gain, and even difficulty getting to sleep can be caused by an oestrogen imbalance.
Your ovaries start releasing oestrogen at puberty as part of your menstrual cycle and levels increase and decrease depending on what time of the month it is. Oestrogen plays a huge role in our bodies, especially in our brains where it controls and regulates our emotions. Oestrogen increases levels of serotonin and even changes the effects of endorphins. So, you can see when levels are disturbed and why it affects our emotions so much.
Oestrogen is also key in providing protection to our hearts and bones and is also involved in keeping our reproductive organs healthy.
As we age our bodies naturally experience a drop in our testosterone and progesterone levels, which can leave us with excessive oestrogen levels.
You can also experience low libido, hot flashes, heart palpitations, night sweats, dry skin, urinary symptoms such as increased frequency or cystitis or incontinence, vaginal dryness, joint aches and pains.
Low levels of oestrogen are common in the lead up to menopause, a time when hormone fluctuations are common place, and for some this can go on for years before you are considered to have passed through menopause.
The typical approach to address oestrogen imbalance is to balance the other hormones or if menopause related then HRT – hormone replacement therapy. The Dr Roked approach is to use a combination of bio-identical hormones but also lifestyle changes such as nutrition, supplements and movement.
To support balancing out your oestrogen, give your digestion a helping hand with good bacteria (from probiotics and a varied range of fruit and vegetables) and lots of fibre from fruit, vegetables and wholegrains. Also include cruciferous vegetables (for example broccoli, kale and cabbage), which help the liver process oestrogen.
In men, some oestrogen is a good thing as it protects the heart. Testosterone can convert to oestrogen in the body. Too much oestrogen in a man can cause weight gain and mood swings. Dr Roked can help with medications to reduce this.
Signs of oestrogen dominance include premenstrual syndrome, fat around the hips and struggling to lose weight. It also affects our thyroid, blood sugar levels and is even linked to some hormone related cancers.
Low oestrogen can result in disturbed sleep, poor concentration, and a general feeling of not being yourself.
Progesterone
Progesterone, sometimes known as the pregnancy hormone, helps the endometrium prepare for pregnancy as it helps thicken the lining of the womb for a fertilised egg. It also helps prepare the breasts for milk production.
There can be various reasons to use progesterone supplementation, for example before pregnancy, progesterone prepares the uterus for pregnancy and during pregnancy helps nurture the foetus.
Women who have low levels of progesterone can have abnormal menstrual cycles and may well struggle to conceive because the progesterone does not activate the right environment for a fertilised egg to grow.
Women who have low progesterone and are successful in getting pregnant are at a much higher risk of miscarriage or premature delivery, because progesterone helps maintain the pregnancy. Low levels of progesterone can also cause problems like irregular, heavy or missed periods, spotting, bloating, acne, hair loss, fluid retention, and abdominal pain during pregnancy and recurrent miscarriages.
In addition, low progesterone levels can cause excessive levels of oestrogen, which can decrease libido and increase weight gain.
Bio-identical progesterone helps with more than just fertility and regulating menstrual cycles. Taking progesterone also helps with sleep, mood, fluid retention, hair and skin.
Testosterone
Testosterone is often mistakenly referred to as the ‘male hormone’. Whilst typically associated with men and masculine behaviour, it does a far more specific job in both male and female bodies.
In women, testosterone is produced in the ovaries, in the testes in men, and in the adrenal glands in both genders.
It is an androgen hormone, which means it primarily influences the growth of the male reproductive system. While men have higher amounts than women, both genders need testosterone in varied levels to function correctly.
For both men and women, it signals to the body to produce new blood cells, so our muscles and bones stay strong during and after puberty.
It also enhances libido for both genders. Testosterone controls the secretion of LH (Luteinising Hormone in women helps regulate menstruation and in men helps produce testosterone) and FSH (Follicle-Stimulating Hormone in women helps egg production and in men helps sperm production).
Women need good levels of testosterone for energy, concentration, memory, mood, motivation, muscle strength, to prevent osteoporosis and to boost libido.
Low levels of testosterone in adult males can cause loss of body hair and wrinkling and ageing of the skin.
It can also cause increased body fat, poor sexual performance, lower focus, lower sex drive, mood swings and increased irritability.
Men hardly have many physical struggles if they have too much testosterone. After the age of 40, the levels can gradually decline, which is also known as andropause.
However high testosterone in women can cause acne, body and facial hair, increased muscle gain, and balding or hair loss.
It can also indicate PCOS (Polycystic Ovary Syndrome, when a woman’s hormones are out of balance which can affect fertility.
DHEA
DHEA (Dehydroepiandrosterone) is produced by the adrenal glands and it functions as a precursor to male and female sex hormones.
In this context, DHEA being a precursor means the body converts it into hormones, namely testosterone and oestrogen.
DHEA levels peak in our mid to late 20’s then gradually start to decline, and as it is converted to testosterone and oestrogen, it can be used in a supplementary manner to help the body produce these hormones.
It can be taken for a variety of reasons by both men and women, such as boosting the immune system and giving the body energy. It is also thought to contribute to mood improvement, bone and muscle strength and even helps with memory and coping with stress.
Vitamin D
Vitamin D is a hormone the kidneys produce that helps the body absorb calcium and phosphorus.
The body makes vitamin D in a chemical reaction that occurs when sunlight hits the skin, producing cholecalciferol, which the liver converts to calcidiol. This is then converted into calcitriol by the kidneys, which is the active form of the hormone in the body.
Vitamin D helps the body absorb calcium, ensuring that the blood calcium levels are at an optimum level. This helps enable the process of mineralisation that is essential for strong, healthy bones and preventing osteoporosis.
Vitamin D deficiency has been linked to a variety of health concerns, which shows its use in many of our bodily functions.
A deficiency in Vitamin D can be caused by – limited exposure to sunlight, your kidneys not being able to convert it into the active form in your body or your digestive tract is not absorbing it.
It can cause many problems for your health, for example poor functioning of the immune system, cardiovascular disease, and muscle and bone weakness and can affect mood and energy.
Vitamin D also has an apoptotic effect, which means it can destroy diseased and cancerous cells in the body.
Cortisol
Cortisol is often referred to as the “stress hormone” because of its association to stress, however its function is much more than just a hormone released during stress.
Most cells in our body have cortisol receptors so it affects many of our bodies functions. Cortisol can help in controlling blood sugar levels, regulate our metabolism, help reduce inflammation and even help control blood pressure.
In women, cortisol aids the developing foetus during pregnancy. These functions make cortisol a crucial hormone to help protect our overall health and general wellbeing in both men and women.
In addition, high cortisol levels can cause changes to occur in menstrual cycle and affect our libido, energy, mood and cause weight gain.
Anxiety and depression have also been linked to having high cortisol levels. Cortisol levels can be measured to see if yours are irregular.
We can have subtle imbalances in levels of cortisol which can be regulated through certain supplements and lifestyle changes and stress management.
There are diseases that involve cortisol and the adrenal glands, such as Cushing’s Disease or Addison’s Disease. If your doctor is suspicious of this, you would be referred to an appropriate specialist.
Insulin
Insulin regulates many metabolic processes that provide our cells with the energy they need to function. Behind our stomach is an organ called the pancreas, this produces insulin.
The production of insulin is regulated dependent on blood sugar levels and other hormones in the body. In a healthy person, insulin production and its subsequent release into our bodies is a highly-regulated process.
Specifically, insulin lets the cells in our muscles, fat and liver to absorb glucose from our blood. The glucose in turn makes energy, or can also be converted into fat when required.
The most common health issue associated with insulin is diabetes. Diabetes occurs when the body either doesn’t secrete enough insulin or it can happen when the body no longer uses the insulin it has created effectively.
Diabetes has two categories:
Type 1 diabetes happens when the pancreas cannot produce enough insulin needed. Some symptoms of type 1 diabetes include tiredness, increased urination and thirst, and problems with vision. This often happens at a young age.
Type 2 diabetes is generally more associated with adults and lifestyle choices. Someone with type 2 diabetes will produce insulin, but it’s often not enough for their body’s requirements.
They might also struggle to use the insulin they produce successfully.
Insulin resistance or pre-diabetes happens when our blood sugar is normal, but we need to produce a lot of insulin to keep the sugar stable. Insulin is an inflammatory hormone and can make many conditions in the body worse. If this isn’t treated it will lead to diabetes in the future. Diet, supplement, exercise, lifestyle habits and certain medications can help to reverse this.
When the body does not produce enough insulin, or use the insulin it has produced properly, the blood sugar levels build up. Our cells do not get the energy they need from our glucose, so you might experience fatigue. When the body turns it to other tissue, like fat or muscle for energy, weight loss can occur.
Thyroid
The thyroid gland is an important part of our endocrine system, secreting several hormones, one of those hormones being thyroxine, also known as T4, and T3 which is the more active thyroid hormone.
Thyroxine is created in the thyroid gland, and the gland then secretes it into our bloodstream. A lot of thyroxine is converted by enzymes in the body to T3.
Thyroxine and T3 also play a vital role in our heart and digestive functions, brain development, bone health and metabolism. It affects almost all the body’s systems, which means correct thyroxine levels are crucial for health.
If your body releases too many thyroid hormones, this causes a condition called thyrotoxicosis.
The main cause of thyrotoxicosis is hyperthyroidism, which is an over activity of the thyroid gland, causing it to produce excessive levels of thyroid hormones. This can also cause swelling in the thyroid gland.
Thyrotoxicosis can also cause menstrual abnormalities, effect fertility, increase bowel movements, weight loss, inability to regulate your temperature, fatigue and irritability.
When the body does not make enough thyroxine and T3, this is known as hypothyroidism.
In adults, a thyroxine deficiency will reduce the metabolic functions, causing weight gain, memory problems, infertility, fatigue and muscle stiffness.
This can be treated with various medications, nutrition and supplements that boost the thyroid function. Other hormonal imbalances can also reduce thyroid function so it is important to look at the thyroid in conjunction with other hormones.
Melatonin
Melatonin is created by the pineal gland in our brain. In a healthy individual, melatonin is released in a rhythmic cycle, with more melatonin produced at night when the light entering the eyes is significantly lower.
It travels through our blood stream where receptors pick it up to signal the need for sleep.
Melatonin is essential to signalling our relaxation and lower body temperature that help with a resftul night’s sleep.
Levels of melatonin are higher at night, signalling the body that it is time to rest.
Melatonin is often called the “sleep hormone” due to its association to sleeping, however it is not necessary for sleep, as people can sleep with insufficient levels of melatonin in the body.
That said, the secretion of melatonin does contribute to a better night’s sleep and allows the body to rest and carry out important repair processes. We make most of our melatonin between 10pm and 2am.
Good levels of melatonin are needed for deep sleep and recovery. New research in to melatonin is linking it to treatment of certain neurological conditions and dementia.
Melatonin can be taken as a supplement, but there are changes you can make in your lifestyle to improve your levels.
Hormones FAQ’s
For men: your bloods can be tested on any day, however we advise that you have them taken at approximately 9am. If you are currently taking hormone therapy, you should have your blood tested 4-6 hours after taking your dose, or if you are having an injection, halfway before your next one.
Typically, you do not need to be fasting for your blood tests, unless you are having fasting insulin tested.
For women: if you are having a regular period (every 28- 32 days), please do blood tests 21 days after the first day of your last period. If you are having irregular periods, please do the blood tests at least 16 days after your last period, otherwise you can have your bloods tested at any time.
If you are using a contraceptive pill, please stop taking the medication, wait for 6 weeks and then do your blood test. Also, if you have a coil or are currently taking hormone replacement therapy, you can have your bloods tested without stopping the therapy or removing the coil.
If you are currently taking hormone replacement therapy, you should have your blood tested 4-6 hours after taking your morning dose of hormones.
Typically, you do not need to be fasting for your blood tests, unless you are having fasting insulin tested.
There is no right or wrong answer for this. Some women have very mild symptoms and can manage them by making changes to their diet, lifestyle and taking certain supplements. Dr Roked can also advise you on this if this is the route you are interested in as she is trained in this ‘integrative approach’ to dealing with menopause, not only hormonal therapy.
Taking hormone therapy to deal with symptoms of the menopause should not be seen as a ‘failure’.
Women today are working well into their 60s, and life is far busier than that of women generations ago, plus life expectancy is going up. If there is a solution that helps women feel great, function better and improves their rate of ageing, it may be worth considering.
As mentioned in the BHRT section, a small proportion of patients may experience some negative effects. This is usually due to the dosage not being quite right, and a simple adjustment can be enough to stop the unwanted effects.
Your doctor will advise you on how to deal with this should it occur. The normal procedure would be to stop the treatment completely until the symptoms settle, then restart at a lower dose.
Other side effects can occur and some patients can be more sensitive to hormones than others, but by communicating effectively with your doctor we can resolve this and make adjustments to help the symptoms and get you feeling optimum quickly.
Dr Roked recommends a blood test to check your hormone levels at least every 12 months, but every 6 months would be optimum.
This is to make sure the levels in your system are adequate to improve your symptoms but also to cause a physiological improvement in your cardiovascular, neurological and bone health.
A mammogram or alternative breast screening, bone density scan and pelvic ultrasound scan to check the lining of the uterus and ovaries would also be recommended every 1-2 years. This can be arranged via the clinic if this is more convenient.
Dr Roked also likes her patients to check how their body is metabolising oestrogen every 1-2 years. A DNA test to see how you genetically metabolise hormones is also recommended and can be arranged by Dr Roked.
Other tests such as saliva or stool can also be arranged by the doctor if needed.
If you are having your regular blood tests, pelvic ultrasound scan, mammogram and bone density scan and other recommended testing from Dr Roked and the results are favourable, there is no reason why you cannot continue with this therapy long term.
The evidence has shown a small increased risk in breast, ovarian and uterine cancers with synthetic hormones that do not have the same chemical structure as the hormones made by your body.
There has not been a link shown between the hormones that do share the same chemical structure as your own hormones.
It is important to discuss these concerns with your doctor, especially if there is a strong link to female cancers in your family. Your doctor can then advice you on the best route of treatment and the best form of hormones to take for you.
It is however important to know that although taking the hormones may not cause cancer, any hormones can cause cancer cells that are already in the body to grow, which is why regular screening is important.
In men, the highest risk of stimulating the prostate is in the first few months of treatment.
However, we regularly monitor testosterone and PSA (Prostate Specific Antigen) levels from 3 months of treatment and throughout to monitor health for any changes.
Yes absolutely, the doctor will review what you are currently taking and at what dose then create a plan to transition on to bio-identical hormones.
Yes, you can request them from your GP. Please note they may not be able to offer all the testing required.
If you do have any tests done with your GP or other doctors, please bring the results with you to your appointment.
Balancing hormones can be quite complicated. Dr Roked has been fascinated by hormones for some time and has spent years learning about the intricacies of hormone balance and prescribing. On top of this she’s also seen thousands of patients so has the clinical experience as well as the knowledge.
Your GP has to know about so many medical conditions which doesn’t allow them the time to learn about hormones in depth. The GP can also be restricted by what he or she can prescribe by NHS and local guidelines.
Not at all. Dr Roked will always emphasise the importance of lifestyle, nutrition, stress management, even quality of sleep on your health and hormones.
There are also supplements that can be taken to help boost hormones. This is why Dr Roked provides ‘Holistic Hormone Therapy’ as she finds the combination of both hormones with lifestyle intervention works the best.
However if you didn’t want to take hormones, Dr Roked will work with you to create a lifestyle and supplement plan to ease your symptoms.
At Omniya Clinic London, our focus is to help you feel better, both inside and out. It is for this reason we offer a variety of treatments, including Botox London, Lip Fillers London, dermal fillers london and many more! Speak to our friendly team for more information.
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