Health Services

Hormone Replacement


What is Hormone Replacement Therapy (HRT)?
HRT is a treatment used to augment the body's natural hormone levels, either in the form of estrogen-alone therapy (ET), for women who have had a hysterectomy (or surgical menopause) or as estrogen with progesterone therapy (EPT), for women who experience menopause naturally at midlife.
Why Replace Hormones?
In addition to thickening the lining of the uterus to prepare it for egg implantation, estrogen — in tandem with progesterone — serves many functions. It helps the body to process calcium (important for the strengthening of bone), aids in maintaining healthy cholesterol levels, and keeps the vagina healthy. With the onset of menopause, however, the amount of natural estrogen and progesterone the ovaries produce drops sharply. That, in turn, can lead to such symptoms as hot flashes, night sweats, vaginal dryness, painful intercourse, mood changes, and sleep problems.
Hormone Testing, and Hormone Replacement
The Proof is in the Saliva Steroid hormones, like estrogen and progesterone, are fat soluble. This means that they dissolve in fat, or oil and not water. Therefore, hormones are attached to a protein when in the blood stream, so that it can travel to the appropriate organ. More than 99% of the attached hormone is inactive or has no effect on the body. Measuring blood levels do not reflect the amount of free (active) hormone affecting your body. This is due to that fact that the active hormone is actually found in fat tissue, the uterus, the brain, and saliva. Salivary testing reflects the amount of active hormone in the body and can determine the symptoms of perimenopause and menopause. The amount of information that is gained from this form of testing is enormous! In hormone replacement therapy, better and safer results can be achieved by saliva testing. It allows physicians to monitor bio-identical hormone treatment and to make adjustments to customize a unique treatment plan for each patient.
Estrogen and Progesterone: Knowing Your Hormones
A woman’s life is greatly influenced by the fluctuations of two hormones, estrogen and progesterone. These hormones are the key composers of organ development and function, bone resorption and growth, and a major influence on brain function as well. When these hormones are in a normal balance, life is great. However, when the hormones are out of balance, problems can develop.
Genetic Testing on Obesity
Genetic factors play a key role in obesity and regulating energy balance. Genetic Testing for Weight Control looks at five genes that are known to have a significant impact on the metabolism of fats and carbohydrates and responsiveness to exercise. The genes in the Weight Control panel were selected following a very thorough and current review of research literature related to genes, exercise, obesity and nutrition. Testing is performed on the DNA collected from on cheek cells, which are obtained by brushing the three swabs on the inside of the mouth.

The genes (SNPs) tested are:

FTO, Regulation of metabolism and satiety

MC4R, Regulation of satiety and meal frequency

ADRB2-E27Q, Sensitivity to carbohydrates and stress impact

FABP2-T55A, Fat absorption and insulin regulation of sugar

SH2B1, Regulation of insulin and leptin systems
Cinque Terre

Dr. David Cohen

My interest in Bio-identical hormone replacement started when my wife needed a total hysterectomy and had a surgical menopause. She was treated with the standard therapy after surgery, which only made her worse and caused side-effects. When she failed to improve and actually got worse I knew something needed to be done.

A compounding pharmacist recommended books by John Lee, M.D. I read them all and signed up for a course taught by the John Lee Institute. I have since taken close to 100 hours of training in Hormone replacement for men and women.

I reviewed the medical literature and read many studies, all of which presented a new way to view the issues of low or unbalanced hormones. It made sense to measure these hormones first to see which hormone(s) are deficient and then replace it with a hormone identical to the one the body makes. I have also learned the importance of Neuro-transmitters which can be the final piece of the puzzle.

Since a heart attack in July of 2012 I have limited my practice to Hormone replacement and Acupuncture for many reasons. First I truly love practicing in these unique areas, it has taken me many years of training and practice to become competent, and it gives me an opportunity to really listen to my patient and to treat each patient as a totally unique individual.

Perimenopause: Understanding the Transition
Perimenopause occurs in a woman’s life around the age of 35 and menopause begins around ages 48-52. There are many changes that occur in a woman’s body during these transitions. The menstrual cycle affects all aspects of a woman’s physical, mental, and emotional health. During perimenopause, ovulation, becomes erratic and thus causes the menstrual cycle to become erratic as well. An irregular cycle can cause a wide range effects. Pregnancy becomes more difficult, birth defects occur more frequently, bone loss begins, a higher risk of breast cancer, increase in weight, and many other problems that can make coping with normal, everyday life a hard task. By adding hormone therapy, we can get you feeling better in a short amount of time.
Perimenopause: The Beginning of Estrogen Excess and Progesterone Deficiency
The balance of estrogen and progesterone is crucial to normal functionality in the female body. The amount of estrogen and progesterone produced individually is not as important as their ratio to each other. Recent studies have shown that progesterone decrease and estrogen excess define perimenopause. Any irregularities in the ratio of estrogen to progesterone can result in many of the symptoms that manifest in perimenopause. Estrogen levels are increased by failure to ovulate, consumption of external estrogen found in animal fat, pesticides, and pollutants. The hormone is also produced by body fat and can increase due to obesity. A low fiber, high fat, high sugar carbohydrate diet increases estrogen levels.
Menopause is More Than Hot Flashes
Many women never experience a single hot flash, but still undergo changes that ravage hormone balance. You can have all or just some of the following issues: sleep problems, moodiness, aging skin, hair loss, anxiety, depression, foggy thinking, weight gain, hot flashes, night sweats, just to name a few of the more common problems we see. Why suffer? We can help you get your life back simply, and help you feel normal again.
Misdiagnosis and Mistreatment of Perimenopause
Treating symptoms of perimenopause without an understanding of the cause can lead to more problems than solutions. Perimenopause may be improperly diagnosed if a physician only focuses on a few symptoms in isolation. Treatment for a diagnosis may alleviate one symptom, but cause many other symptoms to worsen. It is vital to take into account everything that occurs during perimenopause.