Penny's Story: Total Hysterectomy:Total Hormone Imbalance

This is the story of my patient Penny. When she first came to see me she was 52 years old and had been experiencing “Menopause” symptoms since age 34. That is when she had a Total Hysterectomy, in which her Gynecologist removed her uterus and both ovaries due to severe Endometriosis. Too bad she didn’t come to see me 18 years ago.
When Penny came to my office she was suffering from hot flashes, sleeplessness, anxiety, depression, total loss of libido, vaginal dryness, painful intercourse, weight gain and joint pains. She was miserable and I was her last hope. These symptoms are more than mere nuisances; they are indicators for increased risk of female cancers.

Penny’s Endometriosis had gotten so bad that it covered her ovaries and her bladder like a web. (Endometriosis is due to too much Estradiol, bad estrogen, and too little Progesterone). Unfortunately, all that her gynecologist knew to do was to cut everything out.
After her hysterectomy, Penny became depressed and gained gained weight. Before she realized what had happened she was 10 years older and 35lbs heavier. She lost some of the weight for a time then it gradually all came back.
Penny suffered from hot flashes and night sweats 2-3 times per night that made it impossible to get a good night’s sleep and she was tired all the time. A lack of Estrogen for so many years had caused thinning of her skin,  bones and vaginal membranes. Her sex drive had become very low and she had very little interest or sensitivity, which was perhaps a good thing because it had all become too painful. 
Here’s her symptom list at the first visit:

When I meet with a new patient I go over their entire history and do a thorough review of all of they body systems and ask details about all of their symptoms so that I can get all of the clues the body can give to help determine the weakness of the various organ and glands that lead to the key hormonal imbalances, as well as the vitamin and mineral deficiencies, which are causing the body to age and preventing it from healing. Above, I have listed the hormone imbalances that I noted in Penny’s file as I elicited her symptoms.

Once I have obtained the history and review of symptoms, I perform a physical exam to look for additional clues of hormonal and system deficiencies so that I know what tests to perform. Here are the results of Penny’s initial and 1st follow-up lab tests.

As you can see in the above labs, Penny had a very high level of Estradiol at the initial visit. She had been taking a prescription estrogen tablet known as Estrace, containing 1mg of synthetic 17-beta-estradiol. Here is the WARNING that comes with this estrogen:

How does Penny Feel Now that her hormones are getting into balance?

Penny is now feeling great! She says that she feels like a different person. No more night sweats keeping her awak so she has a lot more energy. She said her hot flashes stopped within the first few days of starting Estriol. Other improvements that she learned were due to the Estriol include softer thicker skin and healing of the vaginal lining, which resolved the dryness and painful  intercourse.

Boosting her Testosterone level boosted her mood and her energy as well as her libido and stopped her joint pains. When I asked if her sex drive was better she said, “Oh yes! I have more interest and greater sensitivity. Sex no longer hurts at all and I have lots of lubrication.”

Mentally, she said she feels more balanced and calm. She is no longer anxious or tearful and is more motivated and less apathetic. She said that even the body aches and joint stiffness that used to plague her every morning are gone. Testosterone and Progesterone are mainly responsible for these changes.

Balance Your Hormones / Balance Your Life!

Here’s the bottom line, all of these hormones are essential for life. Women who have had their uterus and ovaries removed are essentially castrated and can no longer produce adequate amounts of Estrone, Estradiol or Estriol, Testosterone or Progesterone. They of course are going to require a small amount of one or all of these hormones to correct the imbalance.
Too little estrogen will cause thinning of the bones, vaginal atrophy, thinning of the skin, easy bruising, wrinkles, hot flashes, sleeplessness, depression and droopy breasts.
Too much estrogen, especially too much Estrone and Estradiol, causes irritability, proliferation of the uterine lining, uterine cancer, breast tenderness, breast cancer, blood clots, dementia and strokes.
The ovaries produce three different Estrogens: Estrone (E1), Estradiol (E2) and Estriol (E3). The two most concentrated and most potent estrogens are Estrone (E1) and Estradiol (E2). They are the hormones that stimulate cell growth of the uterine lining and breast tissue associated with preparation for pregnancy. Because they stimulate cell growth they can also stimulate cancer cell growth. Both Estrone and Estradiol are now classified as carcinogens.
Estriol(E3) is the “safe estrogen.” It is the key to estrogen balance and breast cancer prevention. Estriol selectively binds to estrogen receptor-beta (ER-beta), which inhibits breast cell proliferation and prevents breast cancer development. (Source: Postgraduate medicine, Vol 121, Issue 1, January 2009Endocrinology. 2006 Sep;147(9):4132-50. Epub 2006 May 25.)
Estradiol (E2), on the other hand, activates the cancer activating protein known as bcl-2, which promotes cancer cell growth and decreases Tumor Suppressor Protein (known as p53), which is one of the body’s primary cancer prevention mechanisms. (Source: Ann Clin Lab Sci. 1998 Nov-Dec;28(6):360-9Int J Cancer. 2003 Jul 10;105(5):607-12)
Estriol (E3) produces a 30% reduced risk of breast cancer; Estradiol (E2) causes a 10% increased risk of breast cancer. (Source: Fournier et al, “Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort,” Int J Cancer 2005 Apr 10;114(3):448-54.)
What’s more, synthetic estrogens and progestins cause even more damage because they amplify the adverse hormonal imbalance. In February, 2009, a study published in the New England Journal of Medicine, found that women who take synthetic estrogen-progestin combination hormone therapy for more than five years suffer a doubling of their risk of getting breast cancer and the risk doubles again every additional twelve months they continue to take the drugs. (N Engl J Med. 2009 Feb 5;360(6):573-87)
Natural Progesterone is essential in order to offset the potential risks that would otherwise be caused by Estradiol. It counteracts Estradiol to restore the balance doing the exact opposite: Progesterone decreases bcl-2 and increases Tumor Suppressor Protein (p53), which activates DNA repair and initiates programmed cell death (apoptosis) when DNA damage is irreparable. Progesterone also activates GABA, one of the principal calming neurohormones. I think of it as the brakes on the race car. After rushing around all day you need a good set of brakes to slow things down and bring everything to a stop. Progesterone helps you calm down and get a deep restful sleep.
Testosterone is key to balancing one’s mood, energy, interests and physical strength. It strengthens the nerves, muscles and bones. It lowers total cholesterol, raises the good HDL cholesterol and prevents plaque from building up in the arteries.
Restore Your Hormones: Restore Your Strength, Vitality and Longevity
Optimal levels of hormones provide a veritable fountain of youth. Nature designed hormones to work synergisticly to keep your body strong, active and beautiful. The major cause of deficient hormone levels is the aging of the endocrine glands that occurs due to the increasing stress and toxic load of our modern lifestyle. Without help your glands will simply wear out and wither away. They will become overwhelmed with toxic waste and oxidative damage and no longer be able to keep up with the stress of life. The cells of the glands will die faster than they can be repaired. The good news is that you can change the course of your own aging process. You can test your hormones, find out which hormones are deficient and replenish or replace them. You can take natural supplements to repair and rebuild your glands and restore the hormone levels back to level of a health 30-35 year old. The fountain of youth is within you.
Testing Your Hormones
Where do you start to figure out what’s causing what? Here’s what I recommend. Start by examining your symptoms. By taking a comprehensive assessment of your symptoms you can narrow in on the cause of your problems. Once you know which hormones are most likely to be causing your symptoms, then you can test them specifically to determine where you stand compared to the optimal range.


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Dr Hansen, Hansen Clinic of Natural Medicine

About the Author

Dr. Clark H. Hansen is a licensed Naturopathic Medical Doctor (N.M.D.) who has been in private practice in Scottsdale, Arizona, since 1986. He is the President and Medical Director of the Hansen Clinic of Natural Medicine, Aesthetics and Mesotherapy. Dr. Hansen is one of the most well respected Naturopathic Physicians in the country and a Diplomat of the World Society of Anti-Aging Medicine.

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