Recommended, 2024

Editor'S Choice

Natural hormones help to stay healthy

Privatdozent med. Alexander Römmler
Photo: djd

Expert Interview

The WUNDERWEIB expert on hormones: med. Alexander Römmler

Privatdozent med. Alexander Römmler is a gynecologist, andrologist, and president of the German Society of Anti-Aging Medicine (Praxisklinik und Hormonzentrum) in Munich.

He is also a member of several other scientific societies and has a capacity in the field of anti-aging and hormone medicine.

In the large WUNDERWEIB interview, the expert talks about how natural hormones help people stay healthy, about the hormone dose they need individually, and how they can offer helpful tips on hormone replacement therapy.

What is the current state of knowledge on hormone replacement therapy during menopause?

Dr. Römmler : In conventional hormone replacement therapy, patients have been given estrogens in tablet form in combination with synthetic, non-body progestogen. The combination of hormones in this administration unnecessarily increases the risk of liver damage, stroke, thrombosis and breast cancer. With hormone replacement therapy to the current state of knowledge, these risks can be avoided because natural estrogen and progestin are used. Here, estrogen is supplied via the skin, for example in the form of gel and progestogen, preferably natural progesterone, as a capsule.

What are the benefits of getting hormones through the skin compared to a therapy with tablets? Are the benefits the same for all women?

Dr. Römmler : The administration of hormones through the skin can not be considered as a whole. Rather, the right question is which dosage form is right for which hormone. With the hormone estrogen, the intake of tablets is associated with higher risks for all women. This is because estrogen is transported first through the intestine and then through the liver. This can lead to side effects such as changes in the liver, but also increase the risk of thrombosis, arteriosclerosis and high blood pressure. When progestin, which is only for oral use, natural progesterone is preferable.

Are there any risk groups of women who have special rules for hormone therapy?

Dr. Römmler : Women who already have advanced illnesses are at particular risk. This applies, for example, to patients with genetic coagulation disorders or women who are overweight. High levels of alcohol and nicotine consumption as well as stress increase the risks associated with hormone use. Especially with these risk groups, estrogen application via the skin is important and its positive effects are obvious. Compared to patients outside of the risk groups, the risk of side effects hardly increases. To give one example: If obese patients with a BMI index of over 30 take the hormone estrogen through the skin, for example in the form of gynokadin dosing gel, the risk of thrombosis does not increase any further. When taking hormone in the form of tablets, the risk of thrombosis in these patients increases 20-fold.

Do you have to expect side effects or risks with hormone replacement therapy?

Dr. Römmler : The use of hormones in menopausal complaints should usually be associated with no side effects, since only natural conditions are restored. So the body only gets the hormones in the missing amount it needs.

Does the timing of when hormone therapy begin impact on success?

Dr. Römmler : A hormone deficiency should be compensated as quickly as possible with natural hormones. If this immediate balance does not take place, the hormone deficiency will inevitably lead to physical discomfort and disease over time. The further such developments have progressed, the more difficult it will be to reverse them with natural hormones. In addition, late-onset hormone replacement therapy is more likely to have side effects, as the affected tissue is often no longer naturally responsive.

How is the individually required hormone dose determined in a woman? When and how often should this happen?

Dr. Römmler : Everybody is different, so everyone takes a certain hormone dose differently. As a result, we doctors always prefer a personalized dose that is determined by hormone status. The first dose can already be estimated from the initial medical values ​​as well as the height and weight. After two to three weeks and then once or twice a year, it should be checked whether the selected dose is correct or needs to be adjusted. This is particularly important for women in the early menopause, where hormone fluctuations are due to not yet fully depleted ovarian production.

So what do you have to pay attention to today when it comes to hormone replacement therapy?

Dr. Römmler : In addition to the aforementioned controls and the recommended regular check-ups, the following basic rule remains valid: Just as the body needs food and oxygen every day, so does it need its natural hormones to stay healthy and prevent old-age diseases. We physicians therefore advise an early, individual and low-dose hormone replacement.

Popular Categories

Top