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Menopause. Just when you think your life is finally sorted out all of a sudden your ovaries stop producing eggs and oestrogen. The symptoms and reality of menopause are well-known, and the efficacy of at least short term hormonal treatment to reduce the symptoms of this sudden hormone deficiency (even if "normal") are undisputed.
Is oestrogen the only hormone that we fail to continue to produce in abundant quantities as we age? No. Levels of production of DHEA, progesterone, testosterone, growth hormone and others also fall.
Does it matter that they fall? Yes. For optimal cellular function at all ages there needs to be adequate levels of all hormones available.
Is it a natural part of ageing that they fall? Yes, but so what? Menopause is natural too, but we still treat it.
Why is the age-related decline in oestrogen that we call menopause the only one that gets treated by most doctors? Because it happens suddenly enough to be distinguishable from the other processes of ageing, and because it is heralded by a cessation of menstruation. Other age-related hormonal failures occur too slowly to have been so identified.
Is it ethical for a doctor to prescribe hormones just to improve quality of life? Ask any doctor who prescribes the oral contraceptive pill. In this instance two hormones are being prescribed at higher-than-supplementation levels, with risks of weight gain, hypertension, clotting, migraine, liver problems, breast disease, heart disease, gall bladder disease, etc, and for perhaps 20 or more years, to young otherwise healthy women, in whom there is therefore a long lead time to allow late side effects to develop as they age.
We fully support the use of the oral contraceptive pill and Dr Mahony has prescribed it on countless occasions, but point out that the Pill is prescribed for a lifestyle indication. We believe that hormonal therapy in middle and older age, in physiological doses, can bring more medical benefit with less risk than the oral contraceptive pill can in youth.
Will hormonal treatment make me live longer? There's currently no evidence to support this as a general contention. Specific individuals may reduce specific risks by hormonal supplementation.
Will hormonal treatment "turn back the clock"? Nothing turns back a clock, but if individuals have low hormone levels and specific symptoms consistent with those low hormone levels and no other identifiable causes for those symptoms, then hormonal treatment is worth trying and thus may help someone look younger and feel younger.
A full treatise on natural hormone replacement therapy in middle and older age lies outside the intended scope of this website, but if the topic is of interest make an appointment to see Dr Mahony.
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