Re: Elaine and hormone creams

[Guest guest]

Basically what I saw was with whatever cream was being used -- levels for

that hormone were off the charts. For instance the upper cut-off point on

the lab best for outside of normal would be 200 points and that person's

level came back at 2000. That specific range was for a man whose wife used

progesterone cream and it was rubbing off on his skin. What happens is

people feel great for a while then start to once again exhibit symptoms of

deficiency in the hormone they're applying. They have become resistant to

that hormone. Also, this doc showed lab tests with crazy levels of

particular hormones that women had used extensively, but 6 months to three

years ago. The hormone stores in the fat.

The point that was made to me was that, if possible, treat the cause of the

imbalance first. If you must use creams, do it with *good* medical guidance

and frequent testing of *free* hormones (most serum tests bound). Someone

also sent me a study linking progesterone creams (natural) to increased risk

in cancer. This doc's opinion was that the progesterone cream is overused.

Just spent the weekend at another neurotransmitter seminar. Docs having

excellent results using targeted amino acid therapy to replete deficient

neurotransmitters, thereby balancing hormones. A pretty involved topic. By

what I am learning, avoid Neurosciences labs and products. Look instead for

DBS lab testing and Neuroreplete products, developed by Dr. Marty Hinz.

Google them and find a number to call for a doc in your area. I am doing

this program for weight loss and this is powerful therapy. It fixes so many

other things you don't care about the weight anymore! I am writing a story

on it due out early summer so will share more then.

Elaine

>>

>> Yes, especially natural hormones. I was at a seminar all weekend

>> looking at

>> lab panels of pre-menopausal women who had been on natural hormone

>> creams in

>> the past. Not the final word, just a heads up for something to look

>> into. I

>> read Brownstein's book on natural hormones just before going to

>> this seminar

>> so it was quite something to have these two philosophies collide. The

>> seminar speaker said hormone creams seem like a miracle at first,

>> but you

>> have to look at what happens six months or more later. Safer to

>> address the

>> underlying causes of the imbalance (adrenals!).

>> Elaine

>> --

>

[Guest guest]

Yes, especially natural hormones. I was at a seminar all weekend looking at

lab panels of pre-menopausal women who had been on natural hormone creams in

the past. Not the final word, just a heads up for something to look into. I

read Brownstein's book on natural hormones just before going to this seminar

so it was quite something to have these two philosophies collide. The

seminar speaker said hormone creams seem like a miracle at first, but you

have to look at what happens six months or more later. Safer to address the

underlying causes of the imbalance (adrenals!).

Elaine

Adrenal problems cause menopause?

When you say "premenopause" what age woman do you mean?

I am 50 not yet menopausal, so I consider myself premenopausal.

My hormones are declining because of the natural aging process, not

adrenal dysfunction.

I have been on NHRT close to six months now and would like to

know what changes I should be looking for in my blood panels.

Who was the speaker? Was he affiliated with a pharm company in any way?

Are you sure?

As far as hormone creams for younger women still cycling, hormone imbalance

has multiple causes. Xenoestrogens, insulin, birth control pills, adrenal dysfunction, hypothyroid, etc. I almost forgot to mention possibly iodine!

Thanks for the food for thought-

[Guest guest]

In a message dated 4/2/2006 3:58:20 AM Eastern Daylight Time, itchyink@... writes:

Basically what I saw was with whatever cream was being used -- levels for

that hormone were off the charts. For instance the upper cut-off point on

the lab best for outside of normal would be 200 points and that person's

level came back at 2000. That specific range was for a man whose wife used

progesterone cream and it was rubbing off on his skin. What happens is

people feel great for a while then start to once again exhibit symptoms of

deficiency in the hormone they're applying. They have become resistant to

that hormone. Also, this doc showed lab tests with crazy levels of

particular hormones that women had used extensively, but 6 months to three

years ago. The hormone stores in the fat.

Makes perfect sense to me and may even be mirroring my experience with P and now possibly E.

The point that was made to me was that, if possible, treat the cause of the

imbalance first. If you must use creams, do it with *good* medical guidance

and frequent testing of *free* hormones (most serum tests bound). Someone

also sent me a study linking progesterone creams (natural) to increased risk

in cancer. This doc's opinion was that the progesterone cream is overused.

*good* medical guidance-ha. Therein lies the problem!

[Guest guest]

<<Someone also sent me a study linking progesterone creams (natural) to increased riskin cancer>>

Please post a reference for this. It is irresponsible to post "blind items" on a group as serious as this one.

"Some doctor said" or "A study showed" are not respectful to the diligence of our moderator and our colleagues.

No apologies for being the bad guy here. This had to be said.

Lynne

[Guest guest]

I'm with them on treating the cause, but......perhaps in some of us,

the lowered progesterone causing the estrogen dominance is just our

particular way of going through peri-meno! I certainly had a

particular way of having my periods--let me tell ya.

In Dec. of 2004, my progesterone cratered. A normal first beginning

to peri--the fall of progesterone. And my estrogen came down, too,

but no where near enough to prevent severe estrogen dominance I also

got. I started compounded Progesterone gel in late Jan. 2005, and by

March a year ago, it did the trick to abate the several symptoms I

had of estrogen dominance. I slowly decreased the progesterone by

fall, and stayed on a small amount.....which led me to severe

estrogen dominance once again this past January 2006. So up with

progesterone again........and now I'm looking into iodine, which I

started a week ago, now using one drop per breast.

Janie

>

> Basically what I saw was with whatever cream was being used --

levels for

> that hormone were off the charts. For instance the upper cut-off

point on

> the lab best for outside of normal would be 200 points and that

person's

> level came back at 2000. That specific range was for a man whose

wife used

> progesterone cream and it was rubbing off on his skin. What

happens is

> people feel great for a while then start to once again exhibit

symptoms of

> deficiency in the hormone they're applying. They have become

resistant to

> that hormone. Also, this doc showed lab tests with crazy levels of

> particular hormones that women had used extensively, but 6 months

to three

> years ago. The hormone stores in the fat.

>

> The point that was made to me was that, if possible, treat the

cause of the

> imbalance first. If you must use creams, do it with *good* medical

guidance

> and frequent testing of *free* hormones (most serum tests bound).

Someone

> also sent me a study linking progesterone creams (natural) to

increased risk

> in cancer. This doc's opinion was that the progesterone cream is

overused.

>

> Just spent the weekend at another neurotransmitter seminar. Docs

having

> excellent results using targeted amino acid therapy to replete

deficient

> neurotransmitters, thereby balancing hormones. A pretty involved

topic. By

> what I am learning, avoid Neurosciences labs and products. Look

instead for

> DBS lab testing and Neuroreplete products, developed by Dr. Marty

Hinz.

> Google them and find a number to call for a doc in your area. I am

doing

> this program for weight loss and this is powerful therapy. It

fixes so many

> other things you don't care about the weight anymore! I am

writing a story

> on it due out early summer so will share more then.

> Elaine

> >>

> >> Yes, especially natural hormones. I was at a seminar all weekend

> >> looking at

> >> lab panels of pre-menopausal women who had been on natural

hormone

> >> creams in

> >> the past. Not the final word, just a heads up for something to

look

> >> into. I

> >> read Brownstein's book on natural hormones just before going to

> >> this seminar

> >> so it was quite something to have these two philosophies

collide. The

> >> seminar speaker said hormone creams seem like a miracle at

first,

> >> but you

> >> have to look at what happens six months or more later. Safer to

> >> address the

> >> underlying causes of the imbalance (adrenals!).

> >> Elaine

> >> --

> >

>

[Guest guest]

>>>>Treat the cause of the imbalance? ACCCCHHHHH gimme a break. I have several deficiencies in the H-P-A axis- why?, I have no idea. At this point, age 58, I want to have a bit of a life I never had. I could not do it without hormones, plus Armour, cortef, iodine and HGH. My hormone levels are always "off the charts" but I feel so much better on them than off. So I am suspicious of the testing, not the hormones.<<<

=======================================

I am with you Gracia. My imbalance could have been fixed if it weren't for idiot doctors who ripped my thyroid out and hit me with RAI 3 times. I think I will probably need supplemental hormones for the rest of my life. My adrenals are trashed and my ovaries are struggling.

Buist

[Guest guest]

Hi all,

I am with Lynne, Gracia and ,

I have found sometimes on patients on dessiccated thyroid (Armour

etc.) a high T3 " off the chart " but the patient was doing very well.

I am interested in patient's well being, not in a " right number " from the lab.

------------------------

Vergini, MD

Italy

------------------------

At 19.35 02/04/2006, you wrote:

> >>>>Treat the cause of the imbalance? ACCCCHHHHH gimme a

> break. I have several deficiencies in the H-P-A axis- why?, I

> have no idea. At this point, age 58, I want to have a bit of a

> life I never had. I could not do it without hormones, plus

> Armour, cortef, iodine and HGH. My hormone levels are always " off

> the charts " but I feel so much better on them than off. So I am

> suspicious of the testing, not the hormones.<<<

>=======================================

>I am with you Gracia. My imbalance could have been fixed if it

>weren't for idiot doctors who ripped my thyroid out and hit me with

>RAI 3 times. I think I will probably need supplemental hormones for

>the rest of my life. My adrenals are trashed and my ovaries are struggling.

>

> Buist

[Guest guest]

Hi all,I am with Lynne, Gracia and ,I have found sometimes on patients on dessiccated thyroid (Armour etc.) a high T3 "off the chart" but the patient was doing very well. I am interested in patient's well being, not in a "right number" from the lab.------------------------ Vergini, MDItaly------------------------===============================================

Thank you for not carbon copying all your patients. We are all uniquely created by God.

Steph

[Guest guest]

well I can give you some of the reasons actually.

I can go back 4 generations of untreated hypothyroidism/low adrenals from Buffalo NY (low iodine) manifesting in addiction, mental illness etc. My mother never experienced a normal day in her life, my sisters are ALL very ill. I had a partial thyroidectomy and no meds for 30 years which put enormous stress on my endocrine system. (I have been hypo all my life). In order to survive I moved to the country, farmed organically, lived a perfect lifestyle but was always ill. No one was more shocked than me when I hit menopause and was at death's door. I am sure I would be dead right now if not for hormones. My organs were shutting down.

I have been struggling with these issues my whole life and at one point believed what you believe.

So please, add to this list and enloighten me if you can.

graciaHey Gracia, I am truly glad that your feeling better and that your treatmentis working for *you!* But other people do really, genuinely get betterwithout hormone creams. Please understand that not everyone is going to getbetter on *your* treatment protocol. Hey, at 58, you're right, it's probablytime to pull out the big guns so you can enjoy life.

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[Guest guest]

> Adrenal problems cause menopause?

Yes! When you go into menopause your ovaries end their responsibility for

progesterone and estrogen and your adrenals take over that function, just as

they did before puberty. Problem is by the time most people reach menopause

in our society their adrenals are fried! I have been told that if you ask

really old women what menopause was like for them they don't remember it

being a big deal. Same with women in non-Western countries who are eating

more native diets and not living a western lifestyle.

> When you say " premenopause " what age woman do you mean?

> I am 50 not yet menopausal, so I consider myself premenopausal.

> My hormones are declining because of the natural aging process, not

> adrenal dysfunction.

In a way adrenal dysfunction can cause hormones to decline. If you're under

constant stress from lifestyle, starchy diet, allergens, toxicity, etc.,

your body can put production of sex hormones on hold to devote more energy

to keeping up with demands for stress hormone needs. That and various other

things can happen leading to imbalance.

>

> I have been on NHRT close to six months now and would like to

> know what changes I should be looking for in my blood panels.

> Who was the speaker? Was he affiliated with a pharm company in any way?

> Are you sure?

He is not with a pharm company! He is not even licensed to prescribe drugs,

LOL. People keep asking me this. He works in southern california where aging

clinics are very big and NHRT is being abused. He deals with a lot of fall

out. His name is Dr. Datis Kharrazian. He's done a lot of research and has

developed a line of supplements for Apex Energetics (which, by the way,

makes natural hormones!), so he does have that bias as he works with his own

products and other companies, all natural.

>

> As far as hormone creams for younger women still cycling, hormone imbalance

> has multiple causes. Xenoestrogens, insulin, birth control pills, adrenal

> dysfunction, hypothyroid, etc. I almost forgot to mention possibly iodine!

Yes, birth controls are a bigger disrupter than people thought, contributing

to long-term problems. My understanding is just keep getting tested for

*free* hormones, not bound and make sure you're not getting too out of

whack. Sublingual hormones do not accumulate in the fat. Monitor how you

feel. If possible, make the lifestyle and diet changes you may need to

make.

Elaine

>

> Thanks for the food for thought-

>

[Guest guest]

>

> *good* medical guidance-ha. Therein lies the problem!

>

I hear you on that one!!!

Elaine

[Guest guest]

>>>>That is heartbreaking . I'm sorry this passes as medicine. Justlearned my friend's husband was having major abdominal stress so the doctorstook out his large intestine. I will never understand this method oftreatment.Elaine<<<

It is barbaric and insane. My question was always "Why did I get cancer in the first place?" As I have learned more I now know that it comes from my body needing something it didn't have. I think the stress of my career and the lack of care for nutritional requirements clobbered me. Then I got pregnant and that sucked the remaining life out of my body. I was dx'd 6 weeks after my son was born. My last round of RAI didn't get my Tg down my endo started talking external beam radiation. I stopped that dead in its tracks. I don't want more radiation. That's not what I am dying of. That is why Dr. Brownstein is a God send to me. He is looking at what is off balance in my body and I believe Iodine is a key issue for me. Each time I had to go for RAI they put me on a low iodine diet. No one ever discusses the need to put it back. They make it seem like it is only used by the thyroid and since that was gone I didn't worry. Now my breasts have developed fibromas and my ovaries have cysts. Hmmm..... do you think I need iodine? I am eager to see if these things go away.

B

[Guest guest]

Hey Gracia, I am truly glad that your feeling better and that your treatment

is working for *you!* But other people do really, genuinely get better

without hormone creams. Please understand that not everyone is going to get

better on *your* treatment protocol. Hey, at 58, you're right, it's probably

time to pull out the big guns so you can enjoy life. I am 39 and am feeling

LOADS, LOADS, LOADS better by going the diet and lifestyle route. I am

genuinely happy and energetic. It's harder work and it takes longer but I am

truly healing and I feel deeply good about that and my accomplishments. I do

not want to slide into menopause in poor health because then it will get

really bad. It's WORK to change how you eat and live. Most Americans can't

be bothered. But it's worth it because I can see I am becoming a better mom

and can pass on my healthy lifestyle to my kids (who are also discovered to

be allergic to gluten and dairy -- how lucky they are to not have to deal

with all the health problems those allergens caused me over the years!!!) I

could give you a long list of reasons why you have deficiencies in the HPA

axis, but I believe like you that sometimes you just have to get a person

functioning. If you want to carry on doing whatever brought about that

imbalance, then more power to you! Just don't kid yourself that these things

fall out of the sky and onto your head.

Elaine

--

"

> Treat the cause of the imbalance? ACCCCHHHHH gimme a break. I have

> several deficiencies in the H-P-A axis- why?, I have no idea. At this

> point, age 58, I want to have a bit of a life I never had. I could not do it

> without hormones, plus Armour, cortef, iodine and HGH. My hormone levels are

> always " off the charts " but I feel so much better on them than off. So I am

> suspicious of the testing, not the hormones.

>

[Guest guest]

well I will try to lighten up, I am not trying to blow you off or even gnaw on your hand! I find that most peeps on these lists have struggled like I did for years, pushing a marble uphill, TRYING to do the "right things".

I took my mother the one who has been sick her whole life (thank goD she never raised me, wolves did) to a famous clinic Women to Women and were horribly expensive and just continued her misery after testing ad infinitum. They wouldn't give her progesterone cream b/c it "causes cancer" OMG They told her to take DHEA which I already had her on. She is a zombie on Ativan and Risperdal and busbar and she's had a hysterectomy.

Gracia> I have been struggling with these issues my whole life and at one point> believed what you believe.> So please, add to this list and enloighten me if you can.> graciaI don't think we have an argument here. If it works for you then I supportit. What I take issue with is that you blow off the whole approach oftreating the foundation of health based on your sole experience, becauseit's actually working for a lot of people. (although I agree finding a gooddoc is next to impossible) I am not opposed to pharmaceuticals either if itwill save someone's life, and it sounds like you were indeed 'at death'sdoor.' I just get offended when someone scoffs at my input for what seems tome like an unjust reason. I simply wanted to throw out a different opinionon hormone creams, but I got my hand chewed off, LOL.Elaine

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[Guest guest]

I understand. It is time constraints on my part. The study on progesterone

and cancer is an attachment so I don't think will let me forward that.

I will take the time to upload it to the links section. I am going to a lot

of seminars, reading a lot of books, talking with a lot of practitioners,

but I am not willing to take the time comb through all my stuff and source

everything I say. I also homeschool two children, feed a family of four by

cooking from scratch and keep the house orderly, drive to this class and

that and so on. I felt obligated to raise a flag about hormone creams based

on how much I'm hearing because I hate to see people blindly do something

that may harm them. I will from now on keep my mouth shut, I promise,

except to say this -- educate yourself!!! Because you don't know if your

doctor has!!! Even Dr. Brownstein.

Elaine

>

> Please post a reference for this. It is irresponsible to post " blind items "

> on a group as serious as this one.

>

> " Some doctor said " or " A study showed " are not respectful to the diligence

> of our moderator and our colleagues.

>

> No apologies for being the bad guy here. This had to be said.

[Guest guest]

> I am with you Gracia. My imbalance could have been fixed if it weren't for

> idiot doctors who ripped my thyroid out and hit me with RAI 3 times. I think

> I will probably need supplemental hormones for the rest of my life. My

> adrenals are trashed and my ovaries are struggling.

>

> Buist

That is heartbreaking . I'm sorry this passes as medicine. Just

learned my friend's husband was having major abdominal stress so the doctors

took out his large intestine. I will never understand this method of

treatment.

Elaine

[Guest guest]

> I have been struggling with these issues my whole life and at one point

> believed what you believe.

> So please, add to this list and enloighten me if you can.

> gracia

I don't think we have an argument here. If it works for you then I support

it. What I take issue with is that you blow off the whole approach of

treating the foundation of health based on your sole experience, because

it's actually working for a lot of people. (although I agree finding a good

doc is next to impossible) I am not opposed to pharmaceuticals either if it

will save someone's life, and it sounds like you were indeed 'at death's

door.' I just get offended when someone scoffs at my input for what seems to

me like an unjust reason. I simply wanted to throw out a different opinion

on hormone creams, but I got my hand chewed off, LOL.

Elaine

[Guest guest]

> My hormones are declining because of the natural aging process, not

> adrenal dysfunction.

That appears to my case, too. But I've always had a WACKY reaction to

my female hormones. I had symptoms similar to the FLU every single

time I had a period, for more than 20 years--extreme fatigue,

achiness, and feeling quite hot. Janie

[Guest guest]

Elaine, can you send a link?? Janie

>

> I understand. It is time constraints on my part. The study on

progesterone

> and cancer is an attachment so I don't think will let me

forward that.

[Guest guest]

On Apr 1, 2006, at 11:57 PM, Elaine wrote: Basically what I saw was with whatever cream was being used -- levels for that hormone were off the charts. For instance the upper cut-off point on the lab best for outside of normal would be 200 points and that person's level came back at 2000. Was this blood or saliva testing. The salivary measurements of hormones, particularly for progesterone, is unreliable and inconsistent. I have done extensive research on hormones -- and one of my main concerns about P cream is with its use it to protect an estrogen stimulated endometrium as part of HRT -- the evidence thus far in (at the doses used) suggest that it is not sufficiently absorbed into the blood stream to protect the uterus. Only about 10% of what is applied is actually absorbed according to best estimates -- the fate of the rest of it is unknown -- although it does show up in the saliva big time.That specific range was for a man whose wife used progesterone cream and it was rubbing off on his skin. What happens is people feel great for a while then start to once again exhibit symptoms of deficiency in the hormone they're applying. They have become resistant to that hormone. Also, this doc showed lab tests with crazy levels of particular hormones that women had used extensively, but 6 months to three years ago. The hormone stores in the fat.How do the hormones store in the fat -- any speculation on the physiology?? Adipose tissue definitely has receptors for estrogen and probably for P as well (there is some controversy). And from what I've seen so far in the literature -- Dr. Lee and all the others that quote him -- have it wrong. E is more likely to induce lipolysis and P appears to be lipogenic. P does have a thermogenic effects however so one burns more calories when it's high -- and in young women at least, the calorie deficit is generally made up -- by eating more protein.Dr. Issacs comments in his book, "Hormonal Balance" that in his clinical practice the use of P has led often to weight gain. There are so many variables -- where it's applied probably makes a difference. The point that was made to me was that, if possible, treat the cause of the imbalance first. If you must use creams, do it with *good* medical guidance and frequent testing of *free* hormones (most serum tests bound).The incredible fact is that while blood levels of estradiol fall big time after menopause, many of the tissue levels remain the same as young women's levels. Also, not only do we 'hopefully' still have adrenal production, but other areas of the body including the brain continue to make E and P for their own needs. An exciting area of discussion in hormones now is the emerging data that indicates that menopause is not due to ovarian failure -- that's at the end of perimenopause -- but it appears that the hypothalamus decreases its reception for estradiol. Peri-menopause is actually a time of higher than youthful levels of estrogen -- as if the body is trying to get the hypothalamus to pick up the signal. Someone also sent me a study linking progesterone creams (natural) to increased risk in cancer. Could you send me that study. Just spent the weekend at another neurotransmitter seminar. Docs having excellent results using targeted amino acid therapy to replete deficient neurotransmitters, thereby balancing hormones. A pretty involved topic. By what I am learning, avoid Neurosciences labs and products. Look instead for DBS lab testing and Neuroreplete products, developed by Dr. Marty Hinz. Google them and find a number to call for a doc in your area. I am doing this program for weight loss and this is powerful therapy. It fixes so many other  things you don't care about the weight anymore! I am writing a story on it due out early summer so will share more then.Wow - - tell us more. If it's not appropriate for this forum -- email me privately.Liz

[Guest guest]

> Was this blood or saliva testing. The salivary measurements of

> hormones, particularly for progesterone, is unreliable and

> inconsistent.

These were based on saliva panels and boy is this a controversial topic!

This particular doc said he's done extensive clinical work and research and

found he gets the best results with saliva, so he bases his ideas on that.

But yeah, if it turns out he's wrong about saliva, then that would put all

his ideas in question.

> How do the hormones store in the fat -- any speculation on the

> physiology??

Sorry, I don't know the exact physiology even though I've had it explained

to me at least twice now, LOL! At another seminar the speaker said excess

belly fat basically functions as an estrogen gland and you'll never get your

hormones in balance while you've got too much fat on your belly. I've also

read similar stuff in the new leptin research. So perhaps it goes beyond

estrogen receptors in the fat. It's new info for me so I don't have a grasp

on it yet and am still learning.

> young women's levels. Also, not only do we 'hopefully' still have

> adrenal production, but other areas of the body including the brain

> continue to make E and P for their own needs.

Yes, but I thought production in the brain was rather insignificant.

> An exciting area of discussion in hormones now is the emerging data

> that indicates that menopause is not due to ovarian failure -- that's

> at the end of perimenopause -- but it appears that the hypothalamus

> decreases its reception for estradiol. Peri-menopause is actually a

> time of higher than youthful levels of estrogen -- as if the body is

> trying to get the hypothalamus to pick up the signal.

But do you think that's normal and healthy? Or is it just happening to a

bunch of Americans of sub-standard health? My understanding (which is shaky

at best!) is that those feedback loops 'should' keep working -- that various

health factors nip at that function over time.

>> Just spent the weekend at another neurotransmitter seminar. Docs

>> having

>> excellent results using targeted amino acid therapy to replete

>> deficient

>> neurotransmitters, thereby balancing hormones.

> Wow - - tell us more. If it's not appropriate for this forum -- email

> me privately.

>

I wish I understood exactly how the neurotransmitter therapy balances

hormones. It's a top-down approach, the brain being at the top. Different

transmitters regulate different bodily functions. I would imagine those

feedback loops are being remedied big time too. All I know is it is working!

Working with PMS, menopause and so forth. One speaker on this topic said he

felt iodine supplementation for those deficient was also essential for

estrogen balancing.

So little time, so much to learn!

Elaine

[Guest guest]

> Peri-menopause is actually a time of higher than youthful levels

> of estrogen -- as if the body is trying to get the hypothalamus to

> pick up the signal.

That seems to parallel my experience right now. My estrogen has been

HIGH with peri-meno! Janie

[Guest guest]

On Apr 2, 2006, at 9:17 PM, Elaine wrote:Yes, but I thought production in the brain was rather insignificant.It seems to produce what it needs.    Check out the following abstract:Abstract In premenopausal women, the ovaries are the principle source of estradiol, which functions as a circulating hormone to act on distal target tissues. However, in postmenopausal women when the ovaries cease to produce estrogen, and in men, this is no longer the case, because estradiol is no longer solely an endocrine factor. Instead, it is produced in a number of extragonadal sites and acts locally at these sites as a paracrine or even intracrine factor. These sites include the mesenchymal cells of adipose tissue including that of the breast, osteoblasts and chondrocytes of bone, the vascular endothelium and aortic smooth muscle cells, and numerous sites in the brain. Thus, circulating levels of estrogens in postmenopausal women and in men are not the drivers of estrogen action, they are reactive rather than proactive. This is because in these cases circulating estrogen originates in the extragonadal sites where it acts locally, and if it escapes local metabolism then it enters the circulation. Therefore, circulating levels reflect rather than direct estrogen action in postmenopausal women and in men. Tissue-specific regulation of CYP19 expression is achieved through the use of distinct promoters, each of which is regulated by different hormonal factors and second messenger signaling pathways. Thus, in the ovary, CYP19 expression is regulated by FSH which acts through cyclic AMP via the proximal promoter II, whereas in placenta the distal promoter I.1 regulates CYP19 expression in response to retinoids. In adipose tissue and bone by contrast, another distal promoter—promoter I.4—drives CYP19 expression under the control of glucocorticoids, class 1 cytokines and TNF. The importance of this unique aspect of the tissue-specific regulation of aromatase expression lies in the fact that the low circulating levels of estrogens which are observed in postmenopausal women have little bearing on the concentrations of estrogen in, for example, a breast tumor, which can reach levels at least one order of magnitude greater than those present in the circulation, due to local synthesis within the breast. Thus, the estrogen which is responsible for breast cancer development, for the maintenance of bone mineralization and for the maintenance of cognitive function is not circulating estrogen but rather that which is produced locally at these specific sites within the breast, bone and brain. In breast adipose of breast cancer patients, aromatase activity and CYP19 expression are elevated. This occurs in response to tumor-derived factors such as prostaglandin E2 produced by breast tumor fibroblasts and epithelium as well as infiltrating macrophages. This increased CYP19 expression is associated with a switch in promoter usage from the normal adipose-specific promoter I.4 to the cyclic AMP responsive promoter, promoter II. Since these two promoters are regulated by different cohorts of transcription factors and coactivators, it follows that the differential regulation of CYP19 expression via alternative promoters in disease-free and cancerous breast adipose tissue may permit the development of selective aromatase modulators (SAMs) that target the aberrant overexpression of aromatase in cancerous breast, whilst sparing estrogen synthesis in other sites such as normal adipose tissue, bone and brain.                                                                                                               > An exciting area of discussion in hormones now is the emerging data> that indicates that menopause is not due to ovarian failure -- that's> at the end of perimenopause -- but it appears that the hypothalamus> decreases its reception for estradiol. Peri-menopause is actually a> time of higher than youthful levels of estrogen -- as if the body is> trying to get the hypothalamus to pick up the signal.But do you think that's normal and healthy? Or is it just happening to abunch of Americans of sub-standard health? My understanding (which is shakyat best!) is that those feedback loops 'should' keep working -- that varioushealth factors nip at that function over time.     It appears to be totally normal. It is the brain that signals the onset of the menses and it looks like it's the brain that decides when to shut reproduction down when the  ovaries still have eggs and still making plenty of  estradiol. There are researchers who believe that this evolved to spare us anymore exposure to large levels of estrogen. There is another new way at looking at menopause as a withdrawal syndrome rather than as a deficiency disease per se. There are real deficiency diseases (s, etc.) but they don't suffer 'menopausal symptoms.'  Menopausal symptoms resemble other hormone or drug withdrawal syndromes a lot. In fact, one view of PMS right before the period is as a withdrawal from P.I think it's plausible that adrenal health would be critical to a well functioning menopause in that it is a major source of estrogen. In fact, when women use large amounts of estrogen it appears to shut down their own endogenous production and paradoxically women might take in a huge amount but end up with relatively low blood levels. Salivary testing of hormones is OK but not after P cream -- it is wildly inconsistent and unreliable -- and doesn't correlate with target tissue amounts. After all, it is blood that transports P to its target tissues -- and for HRT, the most critical tissue for P is the uterus. BTW, there are blood tests for free E and P.Liz

[Guest guest]

> Salivary testing of hormones is OK but not after P cream -- it is

> wildly inconsistent and unreliable -- and doesn't correlate with

> target tissue amounts. After all, it is blood that transports P to

> its target tissues -- and for HRT, the most critical tissue for P is

> the uterus. BTW, there are blood tests for free E and P.

Interesting stuff, thanks for sharing your knowledge! This particular doc

who uses saliva tests did talk some about free hormone serum tests and liked

them, he just said they are too expensive too use extensively in a clinical

practice. I think for post-cream use he talked about other factors that

would show up on the test indicating cream abuse, ie, not necessarily the

level of that hormone itself but something else wildly askew because of

excess exogenous hormone (fried feedback loop, other hormone imbalance). He

gave a few examples and of when to ask the patient if creams had been used

in the past. But that is getting over my head a little at this point.

Elaine

[Guest guest]

The

> seminar speaker said hormone creams seem like a miracle at first, but

you

> have to look at what happens six months or more later.

I assume you are primarily talking about progesterone! It stores in

fat and accumulates over time. One needs less progesterone over time

because of that. This is not true for transdermal estrogen.

Madeleen