A FAQ From Steven Hotze, M.D.
and the Hotze Health and Wellness Center:

What causes aging and isn't aging natural?

Sure aging is natural, if you live long enough! Death is natural too, so are wrinkles! But, who doesn’t fight the inevitable? Aging is caused by the slow and steady decline of our bodies’ natural hormones. Our hormones were at their peak when we were young healthy adults. The thyroid hormones, sex hormones and adrenal hormones all decline with age. This decline is associated with the onset of degenerative problems, such as, heart disease, hypertension, strokes, adult onset diabetes, arthritis, Alzheimer’s, and cancer. Numerous symptoms occur with hormonal decline as we age including: loss of energy, weight gain, decreased mental sharpness, depression, anxiety, irritability, joint and muscle pains, headaches, sluggish bowel function, hair loss, cold sensitivities, numbness and tingling in the extremities, insomnia, restless sleep, tiredness after sleep, afternoon fatigue, loss of stamina and endurance, decreased libido, loss of sexual potency, irregular menstrual cycles, fibrocystic breast disease, uterine fibroids, weight gain, and loss of resistance to infections.

These symptoms are so very common that they are considered normal by individuals and physicians alike. But they are not normal, rather they are a sign of a decline in biologically identical hormones that accompany aging. These symptoms are an indication that our bodies are transitioning from health and wellness to sickness and tiredness.

Since aging is caused by a decline in our natural hormones, it can be easily corrected by biologically identical hormone replacement. Think of hormonal decline as a drought. If your grass and plants are withering during the summer months due to a heat wave and lack of rain, then you can accept this as natural and normal, or you can water your yard to ensure that your grass and plants live. So too, when your hormones decline, as they inevitably will, you can replenish them with the same natural, biologically identical hormones, restoring your health, or you can suffer the drought of hormones with all the associated problems. It is your choice.

How did women who lived one hundred years ago survive?

The average woman who lived 100 years ago did not survive very well. Her life expectancy was approximately 40 years.

What are hormones?

Hormones are biologically identical chemical messengers made by the hormone producing glands in the body, known as the endocrine glands. The term hormone is derived from the Greek root hormaein which means to arouse to action or to excite. Hormones are secreted through glandular tissue into the blood stream which carries them to different areas of the body where they exert their effect. The endocrine system allows the body to respond to both internal and external conditions in order to maintain the body’s internal equilibrium and balance. Ultimately the brain controls the hormonal production by sending messengers, called neurotransmitters, to the endocrine glands signaling them to action. The hormones are produced in minute amounts and are measured in picograms, parts per billion, yet they are very powerful. The influence of the various hormones on the functions of our body is profound. They regulate our growth, sex characteristics, reproductive capabilities and the energy production or metabolism which enables the cells of our body to perform their functions.

You have probably heard of the several of the glands that produce hormones, such as the thyroid gland, the ovaries, the testes and the adrenal glands. The hormones produced by these glands work together synergistically, enhancing one another’s function when they are properly balanced.

What does estrogen dominance mean?

Estrogen dominance refers to a time during a woman’s menstrual life when the primary influencing hormones are the estrogen hormones. This condition is caused by progesterone deficiency and is the cause of female hormone imbalance.

A woman’s ovaries generally function best between a few years after puberty until around age 30. As a woman ages so do her ovaries. By the time a woman reaches 35 years of age she is over halfway through her menstrual life and her ovarian function begins to falter. The progesterone hormone production falls most dramatically over the last half of her menstrual life, between the ages of 35 and 50. This decline in progesterone occurs for two reasons. Firstly, the ovaries are aging and functioning less effectively than they did earlier in life. Secondly, as a woman ages she begins to have menstrual cycles during which her ovaries do not ovulate, that is, they do not give off an egg. This is called an anovulatory cycle. When a woman does not ovulate during a menstrual cycle, her ovaries will produce no progesterone. These are the causes of what is termed “progesterone deficiency”. In these cases the hormones that have the greatest influence in a woman’s body are the estrogen hormones. When this occurs a woman will experience estrogen dominance, meaning her female hormones are imbalanced in favor of the estrogen hormones. Many women have experienced estrogen dominance since puberty. In most women this condition develops as they move through their menstrual lives.

The estrogen hormones and progesterone decline as a woman ages. But progesterone declines much more rapidly than do the estrogen hormones. As a woman approaches and enters the change of life, menopause, she may begin to experience the symptoms of declining estrogen hormones manifested by hot flashes and vaginal dryness. By this time progesterone is no longer being produced by the ovaries. Even as she has symptoms of declining estrogen a woman still has estrogen dominance because there is no progesterone to balance the lower levels of estrogen. When a woman enters menopause her ovaries no longer function. Yet she still makes estrogen hormones, primarily estrone, in her fat cells at approximately 50% of what she made premenstrually.

The estrogen hormones affect every cell in a woman’s body. Depending on the degree of the progesterone deficiency, estrogen dominance may manifest itself with one. See the section, What are the Symptoms of Estrogen Dominance?

In menstruating females bioidentical Progesterone can be used on days 15 through 28 of the menstrual cycle. The dose of bioidentical Progesterone will vary depending a woman’s age, size, symptoms and weight. Very few physicians, including Ob-Gyn doctors, have been trained or have the experience to properly dose the biologically identical human hormones correctly. Most physicians, who prescribe these hormones, use much too high of a dose. This can cause adverse symptoms and make you think that you cannot take these biologically identical hormones. It is important to seek the care of a physician who is experienced and who has been successful in evaluating and treating female hormonal imbalances with biologically identical hormones.

After a hysterectomy, if the ovaries are removed, the Ob-Gyn will prescribe counterfeit estrogen hormones or horse estrogen, such as Premarin, Ogen or Cenestin. This maintains the condition of estrogen dominance and progesterone deficiency which caused her problems in the first place. The symptoms of estrogen dominance will persist and worsen on the counterfeit estrogen hormones.

After a hysterectomy, in which the ovaries were removed, a woman still needs progesterone. Many Ob-Gyn doctors tell women that they do not need progesterone after a hysterectomy because they no longer have a uterus. This would be true if it was only the uterus that had receptors for progesterone. But every cell in the body has receptors for progesterone, most importantly the brain cells. Progesterone balances estrogen and opposes the stimulating effect of estrogen on the cells of the body. Progesterone is also the hormone which stimulates new bone formation and is needed to prevent further bone loss.

Menopausal women should take both Bi-Est, a combination of the biologically identical human estrogens, estriol and estradiol, and Progesterone. Additionally, bioidentical Testosterone may be helpful in restoring a normal sex drive. Again, it is crucial that you be evaluated and treated by a physician who is experienced and who has been successful in treating female hormone imbalances with biologically identical biologically identical hormones.

What role does birth control pills play in estrogen dominance? Many young girls and older women are prescribed birth control pills to control their menstrual irregularities. Premenstrual fluid retention and weight gain, and other menstrual irregularities are caused by female hormonal imbalance. Birth control pills are counterfeit hormones which turn off the production of a woman’s biologically identical hormones by the ovaries. Counterfeit hormones are made by drug companies and do not occur naturally. Counterfeit hormones are not biologically identical to naturally occurring human hormones. They do produce effects similar to the biologically identical hormones in a woman’s body but are also associated with numerous side effects, many of which are serious.

What are the side effects of birth control pills?

Birth control pills create a state of estrogen dominance and progesterone deficiency. Common side effects of birth control pills are headaches, including migraines, breast tenderness, mood swings, fluid retention, weight gain, and loss of libido. They are also associated with an increased incidence of breast cancer, strokes and blood clots to the lungs. Birth control pills prevent the production of women’s biologically identical female hormones and pheromones making them less attractive to men. There is no reason for any woman to poison her body every day with the counterfeit hormones in birth control pills in order to control premenstrual symptoms and menstrual irregularities when bioidentical Progesterone is available. Menstrual cycles can be easily regulated using bioidentical Progesterone on days 15 through 28 of the menstrual cycle.

What are the symptoms of estrogen dominance?

Estrogen dominance refers to a time during a woman’s menstrual life when the primary influencing hormones are the estrogen hormones. This condition is caused by progesterone deficiency and is the cause of female hormone imbalance. The estrogen hormones affect every cell in a woman’s body. Depending on the degree of the progesterone deficiency, estrogen dominance may manifest itself with one, some, or are all of the following symptoms:

• Premenstrual breast tenderness
• Premenstrual mood swings, irritability, depression
• Premenstrual fluid retention and weight gain
• Premenstrual headaches, including migraines
• Heavier periods often associated with clotting
• Irregular menstrual cycles
• Menstrual cramping
• Fibrocystic breast disease
• Uterine fibroids
• Loss of sexual desires
• Anxiety and panic attacks
• Infertility
• Insomnia and restless sleep
• Bone loss, osteopenia and osteoporosis
• Adrenal gland fatigue
• Autoimmune disorders
• Triggering of allergies associated with more frequent respiratory illnesses
• Urinary frequency
• Easy loss of urine when coughing, laughing or sneezing
• Frequent headaches, including migraines, throughout the month
• Dry eyes
• Increase in body fat
• Sagging skin and wrinkles
• Decreased mental sharpness
• Gall Bladder Disease
• Polycystic Ovaries
• Elevated cholesterol
• Elevated blood pressure
• Breast cancer
• Cancer of the uterus
• Hypothyroidism

Many of these symptoms and conditions commonly occur in women of all ages. They may be common but they are not normal. These symptoms are an indication of declining ovarian function which leads to an inevitable deterioration in health as women age. In order for women to obtain and maintain health and wellness as they age, it is essential that they preserve female hormonal balance as soon the symptoms of its presence occur.

What is progesterone?

Progesterone is the hormone secreted by the ovaries after a woman produces an egg during the middle of her menstrual cycle. Progesterone is the dominant female hormone for the last half of the menstrual cycle.

Female hormonal balance between the estrogen hormones and progesterone is essential in order for women to obtain and maintain health and wellness. The three human estrogen hormones have numerous effects on the body which require the balance of progesterone to prevent the hyper effects of estrogen dominance which can lead to a host of health problems. (See What are the Benefits of Progesterone?) Good health occurs when the hormones in the body are produced in adequate amounts and are in balance. Think of this as hormonal harmony, as if the hormones are a symphony orchestra. If one section of the orchestra, say the brass section, is too loud, then this will drown out the other sections of the orchestra and ruin the symphony.

What effects do the three human estrogen hormones, estrone, estradiol and estriol, have in the body?

• stimulate growth of the lining of the womb or uterus,
• cause breast tissue to develop and grow,
• promote fat storage and weight gain,
• promote fluid retention,
• cause thickening of the blood,
• decrease bone loss, but do not stimulate new bone growth
• increase emotional sensitivity,
• activate progesterone receptors,
• inhibit the sex drive, and
• stimulate the production of thyroid binding globulin by the liver, inhibiting the action of the thyroid hormones.
• causes feminization

What are the benefits of Progesterone?

Progesterone has the following effects which counterbalance the estrogen hormones:

• matures the uterine lining preventing excess buildup of tissue,
• inhibits breast tissue overgrowth, preventing fibrocystic breast disease,
• has a diuretic effect which mobilizes fluid, decreasing swelling,
• enhances the action of thyroid hormones, increasing metabolism,
• stimulates the production of new bone, protecting against osteoporosis,
• increases the sex drive,
• protects against breast cancer and uterine cancer,
• thins the blood, preventing blood clots,
• supports the function of the adrenal glands,
• elevates mood, and
• promotes pregnancy.

What is the difference between biologically identical hormones and counterfeit hormones?

When our bodies no longer produce our hormones in adequate amounts to maintain good health, we should restore our faltering hormone levels with the same biologically identical hormones that our bodies currently make. The term biologically identical does not refer to the source from which they are derived. Because the supplemented biologically identical hormone molecules are exactly the same as those which we produce, then they are identical in action. The cells of the human body benefit from the supplemented biologically identical hormones in identically the same way they benefit from the hormones which the human body produces. The cells of our body have receptors for each of our biologically identical hormones. When we supplement with biologically identical biologically identical hormones supplementation, then we are replenishing the body with the same identical hormone molecules that our body has always made. Because these hormones are biologically identical they bind quickly to the receptors and cause the appropriate effect. Our body has enzymes which breakdown the biologically identical hormones quickly and metabolize them so that they can be excreted from our system.

Biologically identical hormones are derived from diosgenin, a plant molecule found in soybeans and wild yams. Diosgenin is extracted from these plants and converted into progesterone in the laboratory. Progesterone can then be converted into the three human estrogen hormones, estrone, estradiol, and estriol, and also converted into human estosterone, cortisol, dihydroepiandrosterone (DHEA), and pregnenolone.

Counterfeit hormones produced by drug companies have different molecular structures than the biologically identical hormones. They bind to the receptors in our cells in such a way that they are not easily broken down and removed by a woman’s body. It may take several months for the counterfeit hormones to be cleared from the body. This can cause an exaggerated hormonal effect, which can lead to a host of side effects.

Counterfeit hormones, including birth control pills, are produced by pharmaceutical companies and do not occur naturally in the human body. The counterfeit hormones are synthetically produced by making chemical changes to the biologically identical human hormones. The drug company counterfeit hormones are not biologically identical to naturally occurring human hormones. The counterfeit hormones include those hormones commonly used by mainstream medicine for hormone replacement therapy and for birth control. They do produce some effects similar to the biologically identical hormones in a woman’s body but are also associated with numerous side effects, many of which are serious. The counterfeit hormones create a state of estrogen dominance and progesterone deficiency. Common side effects of the counterfeit hormones are headaches, including migraines, breast tenderness, mood swings, fluid retention, weight gain, and loss of libido. They are also associated with an increased incidence of breast cancer, heart disease, strokes and blood clots to the lungs. The numerous and severe side effects of counterfeit hormones are listed in the Physician’s Desk Reference. The counterfeit hormones also prevent the production of women’s own natural female hormones and pheromones making them less attractive to men. There is no reason for any woman to poison her body every day with counterfeit hormones when safe and effective biologically identical hormones are available.

If biologically identical hormones are superior to drug company hormones, then why doesn’t my doctor recommend them?

The use of natural, biologically identical human hormones is not taught in medical schools. You are probably wondering, "Why not?" It is because medical schools have adopted the belief, propagated by the drug companies, that the medical problems of aging can be treated with drugs or surgery. Medical schools do not teach future physicians how to help people get well and stay well. Rather, they teach budding physicians how to intervene when people get sick. The mainstream medical establishment does not view illness as caused by a decline or imbalance of our own naturally occurring hormones. Illness is seen as an opportunity to prescribe drugs. If you do not think that this is the case, then take a look in your medicine cabinet.

What is the difference between wild yam creams, phytohormones and biologically identical Hormones?

Many health food stores carry wild yam creams which contain diosgenin. Diosgenin is termed a phytohormone, which means plant hormone. Often these products are claimed to contain progesterone or progesterone building phytohormones. Diosgenin is not progesterone and cannot be converted by our bodies into progesterone or any other hormone. While some women may experience a partial improvement of their symptoms using wild yam creams, you should not be misled into thinking that this is the same as biologically identical hormone supplementation or replacement. Many different brands of over the counter progesterone cream products are available. The Federal Drug Administration (FDA) limits the maximum amount of progesterone that can be present per ounce of these creams. The FDA only allows these products to be sold as skin care products. In many of these products the amount of progesterone present is not even listed. The purity of the progesterone in these over the counter creams varies greatly from company to company. Contrary to what some authors have written, progesterone is poorly absorbed through the skin.

What are the causes of Hypotestosteronemia (low testosterone)?

The causes of low testosterone are many and varied. Primarily, testosterone declines as men age. Another prevalent reason for the decline in testosterone in males of all ages is the exposure in our environment to petrochemicals. Xenoestrogens are byproducts of the petrochemicals in our environment. Petrochemicals enter our bodies through a variety of mechanisms, including the air we breathe, the water we drink, the foods we eat and the products with which our bodies come into contact, such as lotions and creams. Very simply, when petrochemicals enter the body, they are often converted to Xenoestrogens. Xenoestrogens then disrupt the synthesis and metabolism of the body's hormones. As a result, males produce less and less natural testosterone. In fact, an article published in Baillieres Clinical Obstetrical Gynecology in 1997 entitled Declining Sperm Quality: A Review of Facts and Hypotheses, stated that there has been a 50% decrease in male sperm count since 1960. Environmental physicians attribute this decline to the growing exposure to petrochemical products and the resulting xenoestrogens. Other causes of low levels of testosterone in males include primary testicular dysfunction, also known as Klinefelter Syndrome, pituitary dysfunction and hypothalamic dysfunction.

How do you diagnose Hypotestosteronemia (low testosterone)?

In our medical practice, the diagnosis of hypotestosteronemia is made primarily by taking a thorough clinical history from the patient. Blood tests, including free testosterone levels and less often, luteinizing hormone (LH) and follicular stimulating hormone (FSH) are also helpful in the detection of low testosterone.

What is the best way to treat Hypotestosteronemia (low testosterone)?

In keeping with my philosophy regarding the use of natural products whenever possible to obtain and maintain health and wellness, we treat this condition using natural testosterone in the form of injections of Testosterone Cypionate. Patients are given a physiologic replacement dose. This dose can be adjusted to allow our patients to receive the optimal benefits of testosterone without the side effects of other forms of testosterone. Patients take an herbal supplement, Saw Palmetto, in conjunction with testosterone. Saw Palmetto decreases the conversion of testosterone to DHT, which can cause benign prostatic hyperplasia. We conducted our own in-house study regarding testosterone supplementation in male allergy patients. The results of the study indicated that the vast majority of patients experienced significant improvement of many symptoms, including fatigue, mental sharpness, memory, abstract thinking, mathematical ability, goal setting, initiative, assertiveness, decisiveness, sense of well being, self confidence, depressed moods, anxiety, irritability, muscle strength and romantic inclinations.