MANY of us are familiar with those small, but indispensable biological molecules called hormones.
They are essential to the ongoing functioning of our bodies, affecting processes that range from stimulating growth to regulating our metabolism, and even preparing our bodies for reproduction.
They do this by acting as molecular messengers between our central nervous system and the various organs in the body to stimulate or inhibit various physiological processes.
The number of hormones circulating in our body hits their peak around our teens and 20s.
Subsequently, as we age, they begin decreasing. This naturally affects the functioning of our bodies, resulting in conditions like menopause in women and andropause in men.
For many women, this has resulted in doctors prescribing hormone replacement therapy (HRT) during the peri-menopausal stage. This is the stage before menopause, when the level of female sex hormones start fluctuating, resulting in symptoms like hot flashes, night sweats, vaginal dryness and mood swings.
HRT is also commonly prescribed for women experiencing surgical or medical menopause.
This is menopause brought on by a surgical or medical procedure the woman had to undergo. Examples would be surgical removal of the ovaries due to cancer, and chemotherapy.
However, with the growing trend in anti-aging and wellness therapy, some doctors have also taken to prescribing HRT to both men and women in an effort to reduce age-related changes in the body.
Topping up hormones
Using HRT in such manner is a common practice at the Preventive Medicine Clinic of Beverly Hills, California, US.
Shirley Elzinga, one of the practitioners at the clinic, gave a talk to a small invited group on the topic recently in Kuala Lumpur.
Elzinga, who is a registered nurse, qualified chiropractor and licensed acupuncturist, is a strong proponent of bio-identical HRT as a way of improving a patient's quality of life.
As she explains it: "Bio-identical HRT is using bio-identical hormones and placing them back into, or supplementing your levels back to an optimal blood level."
This "optimal blood level", she says, is the amount of hormones we have in our 20s and early 30s.
The idea behind using bio-identical HRT as an anti-aging tool is that we need not undergo the effects of naturally declining hormonal levels within our body as a consequence of growing older.
By boosting the amount of certain hormones in the body back to youthful levels, Elzinga says that patients will benefit in a variety of ways.
She claims that the hormones would help decrease cholesterol, help protect against heart disease, increase metabolism, help maintain bone density and improve skin elasticity, among others.
Adding on testosterone to the more traditional oestrogen and progesterone of HRT also helps to improve the libido (for both men and women), as well as mood in general.
"Many a time as we age, we have a decreased libido, although this varies a lot among people.
"Women will start experiencing vaginal dryness and start losing interest in intercourse.
"And men are starting to look for prescriptions for Viagra, etc,
"By taking testosterone, it increases your interest, performance and response (in sex)," says Elzinga.
As for mood changes, she shares that as women age, they tend to become more irritable and grumpy, particularly those aged 40 and above.
"Men get grumpy too," she says. "And very, very lazy - they are happy to just stay at home on the couch every day."
However, she shares: "As soon as you start replacing oestrogen in women, they perk up, their mood changes (for the better), they like their husbands again...
"And when you put the hormones back into the guys, they start to want to go out again in the evenings, have a nice dinner with their wives, and generally get going again."
An important factor in the use of HRT as an wellness therapy, Elzinga stresses, is the type of hormones used. She and her colleagues prescribe bio-identical hormones.
The distinction between bio-identical HRT and conventional HRT is that bio-identical hormones are supposed to be molecularly identical to the hormones produced by our own bodies, and are derived from natural products like yam and soy.
In contrast, most conventional HRT preparations are synthetic compounds that have similar chemical effects as the body's hormones, but are not completely similar in their molecular make-up.
Because of these differences, Elzinga claims that bio-identical HRT does not cause the slightly increased risk of cardiac disease and breast cancer associated with conventional HRT (from the 2002 Women's Health Initiative study).
The only side effects come if the patient takes too much or too little of the hormones, she says.
However, while practitioners like Elzinga believe that taking bio-identical hormones is beneficial - and she herself has been taking bio-identical HRT for her own levels of oestrogen, progesterone, testosterone, and even DHEA and human growth hormone for the past 14 years - no large-scale research has been done in this area.
According to the United States Food and Drug Administration (FDA), no large, long-term studies have been done to determine the adverse effects of bio-identical HRT.
Similarly, it has not been scientifically proven that bio-identical HRT has less side effects or is safer than conventional HRT.
Another aspect of bio-identical HRT is that each patient receives an individualised prescription of hormones according to their blood tests.
This has to be done through a compounding pharmacy, which makes up each preparation based on the health practitioner's prescription for the patient.
The preparations can be made in the form most convenient for the patient, for example, as a gel, cream or pill.
Because the prescriptions are not standardised, they cannot be regulated by authorities such as the FDA for safety and quality.
As such, it is up to patients themselves to ensure that the pharmacy, and pharmacist, making up their prescription are properly licensed and monitored in terms of quality.
Elzinga was in town at the invitation of Imperial Medical Centre and Accent Wellness compounding pharmacy in Kuala Lumpur, which have recently introduced bio-identical HRT as part of their services.