Ontario Regenerative Medicine
HRT and Neurodegenerative Disease (Case Study)
Association between menopausal hormone therapy and risk of neurodegenerative diseases: Implications for precision hormone therapy...
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Hormone Health
Over the years, our bodies experience significant changes in hormone production and hormones levels. Hormones can have an incredible impact on our physical health, behavior, moods, and energy levels. When hormone levels decrease with age, these lower levels are associated with many significant symptoms and health concerns. Hormone Replacement Therapy can help individuals achieve optimal hormone wellness from the inside out and reduce or reverse most of the health and physiological issues related to the drop in hormone levels.
See below for the Hormone Health treatment options available at
Ontario Regenerative Medicine.
Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT) is the assessment and optimization of a patients’ hormonal health, and the prescribing / administration of bioidentical hormones to correct any detected imbalances. Bioidentical hormones are structurally similar to the hormones naturally produced in the body, and while they are not made by the body, the body responds to them as it would to a person's naturally occurring hormones. With advancing age there is a depletion of the usual hormone levels which results in undesirable symptoms and health issues. Our bodies recognize bioidentical hormones and respond to them in the same manner they would to their own hormones due to their identical molecular structure.
Why do some individuals require HRT?
Over the years, our bodies experience significant changes in hormone production and hormones levels. Hormones are the chemical messengers within the body that act on a multitude of body organs and tissues due to specific receptors to these hormones. When hormone levels decrease with age, these lower levels are associated with many significant symptoms and health concerns. Hormones are vital chemical messengers within our body that regulate many critical physiological pathways that affect our overall health, energy level, body rejuvenation and also impact our mental health. While there are a multitude of signs and symptoms that present as a result of our hormone imbalance, they are not always easy to spot without a comprehensive medical evaluation.
Signs of a Hormone Disorder
Hormones can have an incredible impact on our physical health, behavior, moods, and energy levels. One of the most notable periods of hormone change in a woman's life is menopause. This transitional period where a women stops menstruating, takes place over several years. During this time, women experience a reduction in testosterone, estrogen and progesterone levels. Men experience a similar, yet typically less acknowledged change during this life phase. This is known as andropause. During andropause, research indicates that testosterone levels decrease anywhere from 0.8% to 2% each year after a man reaches middle age. (1)
Both men and women experience many of the same symptoms when it comes to entering middle age, including: reduced energy levels, insomnia, mood swings, cognitive issues (ex. memory loss), lowered or minimal libido (sex drive), weight gain, hair loss, loss of muscle mass, or loss of bone density.
Symptoms specific to women include hot flashes, reduction of vaginal lubrication, loss of breast volume, and weight gain in the abdomen. Symptoms specific to men include weight gain in the midsection, weight gain in the chest, or development of erectile dysfunction.
How can HRT help?
Although these symptoms and signs are common, you don't need to simply endure them. HRT can help individuals achieve optimal hormone wellness from the inside out and reduce or reverse most of the health and physiological issues related to the drop in hormone levels. If you suspect that your symptoms are related to a hormone deficiency or disorder, HRT may be the solution you're looking for.
Ideal Candidates for HRT
Individuals with symptoms and health issues related to their reduction in their hormone levels may benefit greatly from a customized HRT treatment pln. To create an individualized, patient specific treatment plan, our team will facilitate a comprehensive series of blood tests and complete a medical assessment. Individuals with a medical history of andropause or menopause symptoms may appreciate a dramatic improvement in their quality of life after initiating HRT.
Consultation and Assessment
Our approach to HRT is customized to meet each patient's unique needs. By undergoing an in-depth consultation and by conducting a thorough laboratory evaluation of your hormone levels and other blood tests, we are able to design a treatment plan that addresses your specific concerns. HRT uses bioidentical hormones which are identical in molecular structure to the hormones naturally produced by your body. These bioidentical hormones have been shown to effectively alleviate symptoms and restore hormonal balance with minimal or no side effects.
Bioidentical Hormones
What are bioidentical hormones?
Bioidentical hormones are composed of naturally derived ingredients and are structurally identical to hormones produced by the body.
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Most commonly refers to:
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Estradiol (E2)—most biologically-active estrogen
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Estriol and estrone also present in body
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Progesterone (NOT progestin)
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Testosterone (T)
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HRT For Women
As women age there is a reduced production of estrogen, progesterone and testosterone. In designing a HRT program each woman’s hormone levels for estrogen, progesterone and testosterone will be optimized with bioidentical hormones to reverse the negative impacts experienced with the reduction of functional / therapeutic levels of hormones in their bodies. Estrogen has been shown to help prevent bone loss as well as the onset of coronary heart disease in postmenopausal women. (2) Recent studies support the use of combining estrogen and progesterone to treat many of the symptoms of menopause including hot flashes. (3) Estrogen can be administered in various forms, including gel, cream, or an implanted pellet. Progesterone is often provided in a pill form and taken at bedtime. Testosterone replacement is usually done as an implanted pellet.
How does an HRT pellet work?
An HRT pellet is a subcutaneous implant that measures only fraction of an inch, approximately the size of a grain of rice. To insert the pellet, one of our registered medical experts will use a small amount of local anaesthetic to place the minute pellet into the buttock or waist. This process takes only a few minutes and is done every 3 to 4 months. Patients can return to most activities immediately. Once the pellet has been inserted, only steri-strips are applied. There is no need for sutures following insertion. Some individuals may experience minimal swelling at the insertion site that subsides within a couple of days. Pellets contain a patient specific dose that your body will utilize over the course of 3 to 4 months.
Testosterone Replacement Therapy (TRT)
While there is the belief that testosterone replacement therapy benefits men only, this is a common misconception. When properly implemented, testosterone replacement therapy can assist both men and women in gaining lean muscle mass, improve neurologic and mental health, improve energy levels, improve sexual function and enjoyment, prevent dementia and increase bone density. (1) TRT can be administered as an injection, cream, or pellet.
To learn more about TRT for men, click HERE.
To learn more about TRT for women, click HERE.
Benefits of HRT
After determining the best dosage to treat your hormonal imbalance, you can expect a variety of positive changes, including:
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Improved fitness levels
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Increased feelings of well-being and vitality
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Decreased perimenopausal and menopausal symptoms
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Improvements to cognitive functions
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Increased bone density
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Decreased body fat
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Increased sex drive and increased sexual enjoyment
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Higher quality sleep
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Improved skin quality
Cost of Hormone Replacement Therapy
The cost of HRT will vary depending on each patient's customized treatment plan and is dependent on the type of therapy recommended, the duration of treatment, and any additional services required. During your consultation and evaluation, we will provide an accurate quote. Patients are enrolled in an annual HRT / TRT program which includes the consultation, assessment, administration of medications, repeat testing and adjustment of their bioidentical hormones during the year to optimize their outcome, health and well being.
FAQ About Hormone Replacement Therapy
Is the HRT pellet implant comfortable?
The administration of a local anaesthetic prior to the insertion of the pellet ensures the process is extremely comfortable. Once inserted, you will not feel the pellet under your skin.
Does the HRT pellet need to be removed?
There is no procedure to remove the HRT pellet. Pellets provide your body with the prescribed hormones over the course of 3 to 4 months, and completely dissolve prior to the insertion of replacement pellets.
Can anyone receive HRT?
Individuals who have a diagnosable hormonal disorder or deficiency can receive HRT. Individuals who have a history of symptoms related to andropause or menopause may also benefit from HRT, but their symptoms must be confirmed by a blood test.
What is the difference between HRT and non-prescription hormone supplements?
HRT uses bioidentical hormones that have the same molecular structure as naturally occurring hormones. Over the counter “hormones” are not regulated, and often contain various herbal ingredients and compounds that have not been proven to support hormonal health.
Complementary Procedures
Platelet-rich Plasma (PRP)
Treatment using the injection of platelet-rich plasma (PRP)is a form of regenerative medicine. PRP is a concentrate of platelets and plasma derived from your own blood and is used to deliver high levels of platelet-associated growth factors and bioactive molecules in the treatment of hair loss, skin rejuvenation and joint pain.
To learn more about PRP, click HERE.
Semaglutide
Semaglutide is a GLP-1 agonist, a type of medication that imitates the GLP hormone, which is the substance that regulates insulin levels in the bloodstream. Semaglutide functions as both a weight loss medication and a supplementary treatment for individuals with type 2 diabetes who struggle to produce insulin. Insulin plays a significant role in metabolism by breaking down glucose, or sugar, in food, and also greatly impacts appetite. The increased levels of insulin caused by treatment with semaglutide can effectively reduce cravings, making it easier and more viable to lose excess weight. Treatment with semaglutide can be particularly impactful for individuals who have gained weight as a result of menopause or andropause.
To learn more about Semaglutide, click HERE.
References:
Yeap BB, Almeida OP, HydeZ, et al. In men older than 70 years, total testosterone remains stable while free testosterone declines with age. The Health in Men Study. European Journal of Endocrinology. 2007;156(5):585-594. doi:https://doi.org/10.1530/eje-06-0714
Delgado BJ, Lopez-Ojeda W. Estrogen. PubMed. Published 2023. Accessed October 19, 2023. https://www.ncbi.nlm.nih.gov/books/NBK538260/#:~:text=Mechanism%20of%20Action
Hipolito Rodrigues MA, Gompel A. Micronized progesterone, progestins, and menopause hormone therapy. Women & Health. 2020;61(1):3-14. doi:https://doi.org/10.1080/03630242.2020.1824956
HRT and Alzheimer's Disease
Dementia Overview
The following statements provide a general overview of dementia:
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General term for loss of memory, language, problem-solving, and other thinking-abilities enough to interfere with daily life.
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AD is the most common cause of Dementia.
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Begins with mild cognitive impairment (MCI).
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Some brain changes seen in autopsies of those with MCI are:
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Clumps of beta-amyloid protein, called plaques, and tangles of tau proteins are seen in Alzheimer's disease.
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Microscopic clumps of Lewy bodies. They are associated with Parkinson's disease, dementia with Lewy bodies and some cases of AD.
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Small strokes or reduced blood flow through brain blood vessels
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May be accelerated by hormonal and neurotransmitter imbalances
References:
Effect of Hormones on Alzheimer’s Disease and Dementia
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Estrogen and Testosterone are neuroprotective
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Both are known to help decrease apoptosis
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Both are known to help decrease ß-amyloid deposition
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Women are more likely to develop AD than men
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Estrogen therapy is shown to have beneficial effects against neurodegenerative diseases (such as AD and Parkinson’s disease)
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The thyroid also is known to decrease ß-amyloid
References:
Song, Yu-jia and Li, Shu-ran and Li, Xiao-wan and Chen, Xi and Wei, Ze-xu and Liu, “The Effect of Estrogen Replacement Therapy on Alzheimer's Disease and Parkinson's Disease in Postmenopausal Women: A Meta-Analysis” Frontiers in Neuroscience, Volume 14, 2020, https://www.frontiersin.org/articles/10.3389/fnins.2020.00157
Medical Case Studies
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