Weight loss hormone therapy

With the warmer months here, you may be thinking about weight loss. In addition to proper diet and exercise, hormones play a vital role in our body weight and composition. When we are experiencing a hormone imbalance, we can also experience weight gain due to lowered energy levels and increased fatty deposits. On the flip side of this, overweight individuals may experience hormone fluctuations related to a metabolic syndrome.

Bioidentical Hormone Replacement Therapy (BHRT) can help both men and women manage their weight. Testosterone is associated with higher energy levels and helping the body convert food into energy and lean muscle mass. Estrogen enables the leptin in our bodies to help us feel full so we eat less and increase our metabolism.

When we have low testosterone levels, we tend to become more sedentary, and more of our food becomes fatty deposits rather than lean muscle. During perimenopause and menopause, women who use BHRT typically experience fewer problems with weight gain and the distribution of fat.

BHRT pellets can help individuals with hormone imbalances lose weight by replenishing hormones with those that are naturally occurring. Pellet therapy can release hormones within the body throughout the day as needed.

Contact us today at 201-225-2525 to schedule your free consultation. Let’s get you feeling your best for the summer!

The ZRT Laboratory Blog

Hormone Health Educator Candace Burch hosted an informational webinar explaining how hormones affect our weight – specifically, how they inhibit our ability to lose weight and keep the pounds off. During the webinar, we received many great questions from the audience and Candace has answered them below.

I’ve reduced my stress and eat well, but still have high cortisol levels. What else can I do?

It sounds like you are making progress in reducing your stress and eating well, but as someone once said – “it’s not always what you’re eating, but what’s eating you that is the real problem.” You may need to dig a little deeper to tackle some of the thornier issues that may still remain unresolved in your life – particularly unresolved anger or frustration. Nothing keeps those cortisol fires burning better than a sense of feeling overwhelmed by life – that your stress is controlling you – rather than you controlling your stress.

Keep in mind there is good stress (weddings, Christmas, newborns) and bad stress (injury, accident, riots in the streets). Stress comes in many forms: the physical stress of an injury or chronic pain; the mental stress of job strain or performance anxiety; or the emotional stress of an abusive relationship or unmet personal needs. Extremes of anything – relentless bodybuilding, junk food diets, or an overbooked lifestyle wreak havoc on cortisol levels. Eventually, the adrenal glands become fatigued and fail to keep pace with demand. The bottom line: whether we’re talking about a divorce or doughnuts, once you determine where the constant demand for stress hormones is coming from, you can develop strategies to cut it off at the source.

I’m on BHRT (bioidentical hormone therapy) but am still gaining weight. What more can I do?

Bioidentical hormones are an excellent way to get healthy again, due to their capacity to duplicate the body’s natural physiology with few side effects if used appropriately. However, hormones are potent substances. Even very small amounts can be very powerful. Too much of a good thing, even a hormone derived from plants and made to mimic Mother Nature, can pose a problem. Anyone supplementing with hormones needs to periodically monitor their impact – just as those taking thyroid or insulin hormones routinely test their levels. With BHRT, or any type of hormone therapy, re-testing within three months of beginning a regimen is suggested to track progress and determine the need to make adjustments to the dose. You and your provider always want to make sure you are using hormones in the correct, so-called “Goldilocks” amounts – not too much, not too little, but just right!

How long will it be before I see results after I start hormone therapy?

The short answer is that it depends on how long you have been suffering from a hormone imbalance. Re-balancing is doable and life changing. But just as each of us are unique in hormone levels and body chemistry, our individual response to hormone therapy will differ. Some people feel better overnight or within days; for others it takes longer. The results depend on pursuing a lifestyle that supports your program therapy; reducing unnecessary stress, practicing optimal “hormone-free” nutrition, getting regular exercise and enough sleep, reducing toxic chemicals that disrupt hormone function (xenoestrogens) and cultivating a satisfactory work / life balance. If you have been burning the candle at both ends for a prolonged period of time, it may take a while for hormone therapy to kick in. But stay the course, be consistent, and allow treatment to take effect. Hormones are potent substances and when used in the proper amounts at the proper times, and monitored accordingly, they can be our greatest secret weapon against chronic symptoms, rapid aging, and disease.

Can you help me find a doctor to test my levels?

Your doctor can work with our doctors on staff to review and discuss test results and considerations for natural treatments. To find a provider in your area who is knowledgeable about hormone testing and natural hormone therapy, please .

To watch the complete webinar on hormones and weight gain, click below.

  • Blog: How Hormones Lead to Obesity
  • Blog: The Hidden Truth About Weight Gain
  • Blog: Menopause – Is it all in Your Head?

Gain Insight on How Hormone Replacement Therapy Can Help You Lose Weight

Weight loss becomes much more difficult as you get older. No matter how much you diet and exercise, the scale refuses to budge. This can be extremely frustrating, but it’s important to know that it’s not your fault. Your hormones are to blame. More specifically, a hormone imbalance has affected the way that your body regulates your weight. But you don’t have to bear this heavy burden once you realize that losing weight begins by gaining hormones.

How Hormones Affect Weight Loss and Retention

Hormones are chemicals within the body that are produced by the endocrine system’s glands.
These hormones travel throughout the body to the proper organs, systems, and tissues to deliver messages telling systems within the body what to do and when. 1

Research has shown that as we age, there are changes in hormones that occur naturally; for example, an endocrine tissue may produce less of its hormone than it did at a younger age, or it may produce the same amount at a slower rate.2 This is followed by a drop in progesterone, DHEA, parathyroid hormone, and calcitonin. Without the right balance of hormones, your body loses the ability to regulate the processes that lead to weight loss. This results in a slower metabolism, an increase in abdominal fat, and less energy for exercise.

Hormone Replacement Therapy for Weight Loss

There is good news, you can reverse your hormone imbalance and restore your ability to lose weight by simply replenishing the hormones you’ve lost. Many patients seek hormone replacement therapy to help with weight loss, replenishing lost hormones to help promote increased energy and metabolism.

But not all hormones are created equal, so medical experts recommend selecting a hormone replacement therapy that uses bioidentical hormones rather than synthetic ones. Bioidentical hormones are preferred because they’re tailored to have the same molecular structure and biological effect as the hormones produced by your body. Research shows that bioidentical hormones may be safer and rarely cause side effects.

What Hormones Make You Lose Weight?

Once you realize how various bioidentical hormones affect the way your body regulates your weight, you can understand why hormone replacement therapy may help with weight loss. When added to a healthy diet and proper exercise, these hormones can help you take off the weight. Hormones that help with weight loss include:

  • Testosterone: This sex hormone produced by both men and women inhibits fat storage, especially in the abdomen. Low levels cause sugar cravings and may lead to insulin resistance.
  • Estrone: This form of estrogen helps women control their appetite and sugar cravings.
  • Progesterone: This sex hormone facilitates the conversion of stored body fat to energy. It is often used in HRT for women since an imbalance of progesterone causes women to overeat.
  • DHEA: A hormone that promotes weight loss by increasing the body’s metabolism, preventing fat storage, and decreasing the appetite for dietary fats.
  • Human Growth Hormone (HGH): Naturally produced in the pituitary gland, this hormone is needed to convert body fat into muscle mass. It also inhibits the production of body fat and decreases the visceral and subcutaneous fats.
  • Insulin: In addition to regulating fat metabolism, this hormone causes glucose absorption in the liver, muscles, and fat tissues.
  • Incretin: This hormone helps ensure an appropriate insulin response after eating by preventing elevated glucagon levels, producing a sense of fullness, curbing food intake, and slowing the rate of gastric emptying.
  • Pregnenolone: A powerful hormone that appears to regulate other hormones to prevent the abdominal fat storage and stress caused by cortisol, keep metabolism high, improve brain function and memory, and provide rejuvenating effects.

By replenishing your ideal amounts of these hormones through bioidentical hormone replacement therapy, you can get your hormones back in balance and your weight loss back on track.


  1. Medical News Today – What to Know about Hormone Imbalances

Medline Plus – Aging changes in hormone production

Can Hormone Therapy for Menopause Prevent Weight Gain?

Menopause brings with it what’s known as the “menopot,” or middle-aged spread. Hormonal shifts, including a decline in estrogen, cause belly fat to pack on; women also experience muscle loss.

RELATED: The Best and Worst Diet Plans for Weight Loss

But weight gain may not have to be your fate: Menopausal hormonal therapy may help prevent this increase in visceral (belly) fat, BMI, and body fat in general, according to new research published online today in the March 2018 issue of The Journal of Clinical Endocrinology & Metabolism.

Findings Suggest Well-Timed Hormone Therapy Helps Prevent Belly Fat

The study analyzed data from a sampling of 1,053 women in the OsteoLaus cohort (which takes its sampling from Lausanne, Switzerland) ages 50 to 80 years old who had their body compositions analyzed through DXA bone density screening. After adjusting for age, those who were currently undergoing hormonal therapy had significantly less visceral fat than women who were never on hormonal therapy. Compared with women who had taken it in the past, current users were found to be nearly one point lower on the BMI scale and have nearly 3 pounds (lb) less of fat mass. Even better: Over the course of 10 years, hormonal therapy prevented this weight gain, which often naturally occurs with age.

RELATED: BMI May Not Detect Obesity in All Postmenopausal Women, a Study Says

Hormone Therapy May Help Fight Insulin Resistance, Metabolic Syndrome, and Other Risks

The finding of this study adds to growing knowledge of how hormonal therapy may avert certain health risks. “Preclinical data has shown that either surgical menopause or declines in estrogen accelerates fat accumulation, primarily visceral, or abdominal, fat. This increase in abdominal fat has been shown to be associated with insulin resistance and higher prevalence of metabolic syndrome, both of which increase the risk of atherosclerotic cardiovascular disease,” says JoAnn Pinkerton, MD, executive director of the North American Menopause Society (NAMS). (She was not involved in the research.) Previously, in the Women’s Health Initiative, “hormone therapy has been shown to reduce the risk of abdominal fat and new onset diabetes with fewer heart events for women who started hormone therapy between 50 to 59 years of age,” she continues.

Hormonal therapy is used to treat vasomotor symptoms like hot flashes and night sweats, plus vaginal dryness, problems with sexual function, and urinary symptoms, as well as preventing bone loss and fractures, the NAMS spokesperson points out.

RELATED: How Much Exercise Is Enough?

Exercise and Diet Are Still Important for Midlife Health

But before you run to your doctor to ask for hormonal therapy, the authors note that the effect on weight loss is pretty small, so it’s not a replacement for other lifestyle changes, like exercise. In fact, to reap the benefits of a lower BMI, women had to be currently on hormone therapy. After stopping, the women instead rebounded by gaining fat, the study found.

Beware Rebound Weight Gain That Can Occur When Hormone Therapy Stops

There is something of a catch. The benefit may last only as long as the therapy. Ultimately, if you’re stopping hormone therapy, also talk to your doctor about the risk of increasing belly fat, as well as what you can do in terms of diet and exercise to prevent this weight rebound, says Pinkerton.

RELATED: Eat Less, Feel Full: Does the Volumetrics Diet Plan Work for Weight Loss?

Weight Loss Helps Reduce Frequency of Hot Flashes, Night Sweats

That doesn’t have to be downer news, however. Past research has shown that women who lost at least 10 lb through a healthier diet (lots of fruit and vegetables, whole grains) over the course of a year were significantly more likely to see hot flashes and night sweats disappear compared with those who didn’t lose weight. That small weight loss can also decrease your heart disease risk, Dr. Pinkerton notes.

To determine if this hormone therapy is right for you, Pinkerton notes that the treatment is safe for women who start it at menopause, especially for women under 60 or who are within 10 years of menopause. (Starting after age 60 or 70 is not recommended, as these women have a higher risk of heart disease, stroke, blood clots, and dementia.)

RELATED: 14 Diet and Weight-Loss Mistakes — and How to Avoid Them

What’s more, if women are over 65 and already using hormone therapy for symptoms, Pinkerton says there’s no evidence to suggest they stop. Certainly, any of these situations warrant a conversation with your doctor to assess the benefits and risks for you.

RELATED: 10 Things Your Doctor Won’t Tell You About Hysterectomy

Action Points

  • Current menopausal hormone therapy (MHT) is associated with reduced total and visceral adiposity, but the effect is small and disappears when therapy is discontinued, according to a cross-sectional study of about 1,500 postmenopausal women 50 to 80 years of age.
  • Recognize that the benefit of MHT on body composition might rapidly disappear after its withdrawal, and it is important therefore to strongly encourage women to optimize nutrition and increase physical activity when stopping MHT.

Menopausal women undergoing hormone replacement therapy tended to have less body fat, especially visceral fat, although the effect disappeared once therapy was discontinued, researchers reported from a cross-sectional study.

The mean percentage of body fat in women undergoing therapy was 34.6%, compared with 36.2% for women who had therapy in the past and 35.9% for women who never had hormone therapy (P=0.01 for trend), said Georgios Papadakis, MD, of the Lausanne University Hospital in Switzerland, and colleagues.

Mean visceral fat mass, measured as the fat deep in the abdomen around the internal organs, not subcutaneous abdominal fat, was 0.42 kg for women undergoing therapy, compared with 0.48 kg both for women with past therapy and those who never received it (P=0.01 for trend), the team reported online in the Journal of Clinical Endocrinology & Metabolism.

Similarly, the mean body-mass index (BMI) was 24.9 for current users of menopausal hormone therapy, versus 25.6 for past users and 25.8 for never users (P=0.03). All study results were adjusted for potential confounders including age, diet, physical activity, and a diagnosis of depression, Papadakis and colleagues said.

However, the benefits of therapy did not persist once it stopped. Mean visceral fat mass in women who had been off therapy for less than 2 years was 0.53 kg, and this was not significantly different in women who had been off therapy for 2-5 years (0.51 kg) or more than 5 years (0.50 kg; P=0.813). Differences in mean BMI were similarly non-significant among the three groups (P=0.985).

“In conclusion, current MHT use prevents the increase of visceral adiposity,” Papadakis and colleagues said. “This finding may have important cardiovascular, metabolic, and bone implications which should be taken into account when assessing the benefit-risk ratio for MHT prescription. Nevertheless, the effect size on BMI and total fat mass is relatively small and MHT prescription cannot substitute for other interventions such as physical activity.”

“Physicians should be aware that the benefit of MHT on body composition might rapidly disappear after its withdrawal and strongly encourage women to optimize nutrition and increase physical activity when stopping MHT,” the study authors said.

JoAnne Pinkerton, MD, executive director of the North American Menopause Society, agreed with the authors’ recommendation. “Discussions about stopping hormone therapy should include a discussion of increased gain of abdominal fat, the associated health risks, and recommendations to decrease caloric intake and increase regular physical activity to combat the weight gain seen with stopping hormone therapy,” Pinkerton said in an email to MedPage Today.

The best candidates for hormone therapy are symptomatic women younger than 60 or within 10 years of menopause, Pinkerton said. “Having less increase in abdominal fat is an extra benefit beyond relief of hot flashes, night sweats, improved sleep, and less bone loss,” she said.

However, “There is no one-size-fits-all approach when it comes to decisions about hormone therapy,” Pinkerton added. “The risks and benefits vary depending on the woman’s own characteristics as well as the type of hormone therapy, the dose used, the duration of use, type of administration — whether it’s a pill or a patch, for example – and especially age and time from menopause when therapy is initiated.”

The cross-sectional, observational study included 1,053 postmenopausal women age 50-80. They were classified as current hormone therapy users (21%), past users (27%), or never users (52%). The vast majority (98%) were white. Current users had been on therapy an average of 12 years, and past users had been off therapy an average of 8.5 years. Participants were questioned about their diet, physical activity, and psychological health.

Participants underwent dual-energy X-ray absorptiometry (DXA) with body composition assessment. The main outcome was visceral adipose tissue as measured by DXA. Secondary outcomes included BMI, total fat mass, lean mass, and hand grip strength. The study found no significant differences among participants for lean mass or grip strength.

Exactly how hormone replacement therapy affects fat mass is unclear, Papadakis and colleagues said. It could have a direct effect on fat cells, or it could have behavioral effects that influence food intake and physical activity, they said.

Because the vast majority of study participants were white, the results may not be generalizable to other patient populations, they said. In addition, information on the duration of hormone therapy, as well as the type of therapy and route of administration, was self-reported, “preventing us from reliably assessing these factors,” they said.

Click here for the American Association of Clinical Endocrinologists (AACE) Medical Guidelines for Clinical Practice for Diagnosis and Treatment of Menopause.

The study was funded by the Lausanne University Hospital and the Swiss National Science Foundation.

No study authors reported financial relationships. Pinkerton disclosed no financial relationships.

  • Reviewed by Henry A. Solomon, MD, FACP, FACC Clinical Associate Professor, Weill Cornell Medical College


last updated 03.27.2018

  • Primary Source

    Journal of Clinical Endocrinology & Metabolism

    Source Reference: Papadakis GE, et al “Menopausal hormone therapy is associated with reduced total and visceral adiposity, the OsteoLaus cohort” JCEM 2018; DOI: 10.1210/jc.2017-02449.

How Bioidentical Hormone Replacement Therapy Can Improve Your Weight Loss Efforts

Do you find it overwhelming and downright frustrating to lose weight? You’re not alone. So-called “proven” diet trends come and go, all the while making outrageous claims of pounds lost. You give up carbs, nosh like a caveman, count your calories, and, even if you do drop the weight, it seems to come back with a vengeance once you resume a more typical lifestyle.

If you’re eating a healthy diet, watching your portions, and walking past the dessert bar more often than not, the odds are your metabolism is thwarting your weight loss efforts. Age, a sedentary lifestyle, and yo-yo dieting all impact your metabolism, but what’s at the very core of making your body burn away those calories from that spaghetti dinner? And what can be done to turn up your metabolism and boost your weight loss?

The hormone connection

It’s hard to overstate how much control hormones have over what goes on with your body. Your growth and development, fertility, immune system, cardiovascular system, and even your behavior all rely on these chemical messengers to keep things running in good order. Your ability to metabolize food for fuel is directly connected to your hormones.

Two of the primary hormones that regulate things like cravings and metabolism are estrogen and progesterone. When one or both levels fall, you will not only have a difficult time losing weight, but you will see your weight increase, despite your best efforts. Adjusting your hormones to the proper levels is necessary to prevent additional weight gain and improve your ability to lose weight.

Beginning at around age 30, your body curtails how much of certain growth hormones it produces. At about 40, women’s production of estrogen begins to slow down, as does progesterone, and in men, testosterone wanes.

This decrease in hormones interferes significantly with your body’s ability to lose weight. You have less energy, which may cut into motivation when it comes to exercise. Your metabolism slows to a crawl, your fat-burning muscle mass decreases, and you’ll notice an increase in abdominal fat.

Hormonal imbalance can leave you feeling unmotivated

Out-of-whack hormones affect you in so many ways. Aside from a lack of energy and a slowed metabolism, you may also feel depressed and irritable, and experience some serious food cravings. Think about it: If you’re cranky, tired, depressed, and want nothing to eat but chocolate bars and potato chips, you might have a tough time losing weight. And imbalanced hormones are at the core of this struggle.

Hormone replacement therapy can help you balance your teeter-tottering hormones and reclaim control of your life. Bioidentical hormones, which are made from plant sources, offer a safe and natural solution to restore this hormonal balance.

Through bioidentical hormone replacement therapy, you’ll begin to feel as you should: vibrant, energetic, calm and healthy. And you’ll likely begin to see a payoff for all of your weight loss efforts.

The benefits of bioidentical hormone replacement

Managing your hormone imbalance with bioidentical hormone replacement therapy benefits you in so many ways: from restoring your libido, to giving you back that energy you once had, and helping you achieve your weight loss goals.

However, every case is unique and you’ll need a full assessment before we can customize the right formula to restore balance. Many factors can come into play when it comes to trying to lose weight — and if you succeed, to keeping those pounds from coming back.

If you’ve tried a thoughtful, focused approach to lose weight and find that those stubborn pounds just won’t budge, you may be the ideal candidate for bioidentical hormone replacement therapy. Contact Cross Roads Hormonal Health & Wellness today. We’re located in Cross Roads, Texas, and proudly serve the region, including Denton, and Frisco.

Hormones That Take Off the Pounds

The frustration of not losing weight despite eating right and exercising is usually related to hormone imbalances. Last week I wrote about hormones that cause weight gain. Now let’s consider several hormones that can you help lose weight! Some of them increase metabolism, some build muscle, while others lower appetite and cravings plus stimulate the breakdown of fat.

Hormones That Increase Metabolism

Thyroid hormone is our main metabolic hormone, directly increasing the burning of calories. It increases the body temperature and overall energy. Thyroid helps our fuel (food) burn more efficiently and will improve cholesterol metabolism. Thyroid sensitizes other hormone receptors so they operate better. Optimizing thyroid is similar to turning up the furnace or tuning an engine – the body simply operates better

Glucagon, from the pancreas, is the opposite of insulin and works to release fat and glucose from storage to be used as fuel. Protein intake will increase glucagon while high blood sugar and high insulin levels will turn down glucagon production.

Many women are progesterone deficient and have heavy estrogen dominant menstrual cycles coupled with PMS for several weeks when their estrogen is not balanced with enough progesterone. Aside from weight gain caused by estrogen dominance, the low progesterone encourages weight gain as progesterone supports thyroid while increasing body temperature and metabolism.

Hormones That Build Muscle

Androgen hormones such as testosterone and DHEA build muscle and break down fat. They directly turn on DNA to make protein and build structure such as muscle and bone. They also “kick-start” enzymes that break down fat. The fat accumulation around the belly of aging men and women (over 40) is partly due to declining levels of these androgen hormones.

Growth hormone is touted as the “mother of anti-aging” hormones since it has so many benefits that promote health and slow aging. Made by the liver, it too will build muscle and bone while breaking down fat.

These hormones are all “anabolic” which means they build tissue. Unlike the synthetic anabolic hormones abused by sports stars these natural anabolic hormones promote strong healthy bodies. Unfortunately they normally decline with aging such that by age 50-60 most of us are starting to show the signs of their disappearance.

Hormones That Lower Appetite and Cravings

Leptin is a fascinating hormone that was only discovered in 1994 and since then has generated much interest in the area of weight loss. Leptin is made by fat cells and will signal the brain to lower our appetite and increase metabolism. Leptin increases with weight gain, which sounds good, but similar to insulin, as we gain weight and make more leptin, we become more and more resistant to its beneficial effects. When I treat someone with insulin resistance I just assume they have leptin resistance as well and treat both.

Several hormones affect our mood, sleep, and appetite. The key players are melatonin (sleep), serotonin (mood), dopamine (pleasure), and GABA (mood). Melatonin is our main nighttime hormone, helping to promote restful sleep and the production of other hormones such as thyroid and growth hormone. Melatonin levels decline by age 45-50 and many people start having sleep disturbances around this age.

Serotonin deficiency is the cause of low mood and certain foods such as sugar and high-glycemic foods will temporarily stimulate serotonin. Dopamine is our pleasure hormone being associated with cravings, appetite and activities such as sex. Stimulant drugs increase dopamine and lead to the “high” associated with them. GABA influences mood by calming the brain, balancing the effects of dopamine and serotonin, thus promoting restful sleep and a calm controlled mood. Proper support of this family of hormones will support controlled appetite and cravings.

Putting It All Together

Restful sleep has so many benefits on natural hormone production that perhaps it is our most important strategy to successful weight loss! During deep sleep we make more anabolic hormones and more leptin. Melatonin is part of the normal sleep cycle and is promoted by absolute darkness, quiet, and cooler temperatures.

Regular exercise is another way to increase anabolic hormone production and improve insulin and leptin sensitivity so that each works properly. A combination of aerobic (walking, etc) and anaerobic (strength training) is ideal. Peak intensity training, also called interval or burst training, to threshold will maximize growth hormone output.

Diet plays a major role in more than just the amount of calories consumed. The proper balance of proteins and carbohydrates is essential. The protein stimulates glucagon production and provides the amino acids necessary to make serotonin, dopamine and GABA. Protein is also necessary for good muscle development. Including anti-inflammatory fats (omega-3) is also important as fats do not stimulate insulin and help provide a long lasting energy source. Eliminating sugar and limiting high-glycemic foods and inflammatory fats (saturated, red meat) will help. Avoid high-fructose energy drinks.

We recommend many natural supplements to help with hormone production. 5-HTP will help serotonin, tyrosine will increase dopamine, and GABA supplements can be taken directly. Irvingia (from life extension) is derived from the African Bush Mango and is a great product that helps increase leptin sensitivity. These are just a few of the dozens of natural supplements that can help manage weight.

Thyroid and progesterone imbalances are often cured by recognizing the underlying cause of the deficiency and treating the root cause. Medical conditions such as leaky gut or gut dysbiosis, autoimmune disease, polycystic ovarian syndrome and others need be identified and fixed. At some point direct hormone replacement is indicated for the normal age related decline in the anabolic hormones.

Our weight loss program addresses all these issues and many others. Simply telling patients to “watch what you eat and exercise more” is not good enough! Addressing hormone imbalances is a necessary part of successful weight loss.


Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.

Can progesterone help relieve menopause symptoms?

I am 60. I had a partial hysterectomy at age 29. I suffered from migraines from age 18 to 50. They stopped when I began topical progesterone. Later, I was given topical estrogen cream, but it didn’t help the hot flashes at all. You don’t recommend progesterone, but what if the saliva tests show I am low in it?

1. Do I go by saliva tests or not?
2. How can I stop these hot flashes and night sweats?

Thank you,

Dr. Fox:

Good questions, Bobbie. Progesterone is not needed except to prepare the uterus for pregnancy. It is absent in menopause and in the first two weeks of every cycle during the reproductive years. If it was necessary women would really be in trouble. If I measure progesterone in any menopausal patient it will be extremely low. That is normal…..not abnormal and does not require replacement. Progesterone does cover up symptoms such as headaches, hot flashes, night sweats etc, so women “feel better” when they are on it and think that they are healthier. Without needed estrogen, the hormone that truly treats the problem, deterioration can continue despite the progesterone “cover-up.”

Saliva testing for progesterone and estrogen has been shown to be very inconsistent and vastly less accurate than blood testing.

Estrogen topical cream is inconsistent in delivering adequate and consistent serum levels of estradiol. Many creams are mostly estriol and estrone which are 1000X and 100X respectively, LESS effective than estradiol in controlling symptoms. You need estrogen delivered in a consistent way with blood monitoring of the estradiol levels (make sure estradiol). The appropriate range is 60-200 or so depending on age.

Can’t lose weight in ketosis

Please help me. I lost just over 100 lbs (45 kg) on the low carb South Beach diet in my late 20s, so I know the low carb lifestyle works. I gained back approximately 30 pounds (14 kg) after being hospitalized for 8 days due to severe asthma and treated with high dose steroids for a couple months. I kept the rest of the weight off, and it’s been over 15 years.

The SB diet didn’t work for me to take off the steroid weight, and I also have PCOS, so I tried the LCHF/keto. I have been in ketosis with readings between 1.1-1.9 consistently on blood tests, and the urine sticks always turn medium to dark purple. I never go over on carbs, rarely go over on protein (if I do it’s by a gram or two) and have a calorie deficit every day. By all indicators, I should be losing weight, but I’m not. When I did the SB diet the weight dropped off so fast I couldn’t keep up with getting clothes that fit.

Now it’s been 7 weeks of being in moderate ketosis and exercising regularly, and I have lost nothing, zero, zip, nada. My measurements haven’t changed, the amount of flab hasn’t changed, I’m no better toned, and it’s almost two months. My doctor says my thyroid is fine, and naturally tells me that no wonder I’m not losing weight eating butter and bacon and coconut oil and that I need to start eating whole grains and low-fat snacks. Conventional medicine (I’m a critical care/ER nurse myself) just cannot accept the keto concept, but I know for a fact that if I eat brown rice and whole-wheat pasta I’ll gain 5 lbs (2 kg) in a week. Please help me. I’m so discouraged and desperate. What is the point of staying keto if I’m going to be exactly the same size and shape as when I was eating lasagna and baked potatoes?


Dr. Fox:

Don’t be discouraged! I would definitely stay the course. You may feel ebtter with a TSH Will the keto diet help with neurodegenerative conditions?

I have been told that the keto diet will help prevent neurodegenerative conditions getting worse, however most of what is on this site is information for weight loss. I’m wondering will this website help me in the neurodegenerative condition area and if so is it the same approach to the recipes?


Dr. Fox:

Yes, the brain is very sensitive and responsive to ketosis. In certain situations, the recovery may be slow.

More questions and answers

Questions and answers about low carb

Read all earlier questions and answers to Dr. Fox – and ask your own! – here:

Ask Dr. Fox about nutrition, low carb and fertility – for members (free trial available)

Other Options to Relieve Most Common Symptoms of Menopause

When deciding whether to quit, think about why you started taking hormones. Maybe hot flashes drove you to it. Hot flashes can pass after a few years. If they don’t, they usually get less intense over time. The following may be enough to bring relief:

  • A low dose of an antidepressant such as Celexa, Effexor, or Prozac
  • Gabapentin, an anti-seizure medicine
  • Dressing in layers, drinking cool drinks, avoiding spicy food and alcohol, and exercising daily

There are three options for vaginal dryness, pain, itching, and burning:

  • Low-dose, prescription vaginal estrogen works best. You apply it as a cream, tablet, or ring into the vagina. Only a tiny bit is absorbed into the bloodstream, so the chance of health problems is much lower than with estrogen pills.
  • Water- or silicone-based vaginal lubricants are put in the vagina or on the penis just before sex to reduce discomfort. You can buy them over the counter.
  • Vaginal moisturizers, also available over the counter, keep tissues moist. You apply them three times a week, but not before sex.

For mood swings and depression:

  • Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), can help mood.
  • Daily exercise, plenty of sleep, and stress control techniques like yoga, deep breathing, or relaxation exercises can also help.

Menopause Does Not Result In Weight Gain – It Increases Belly Fat

Menopause does not result in weight gain among women, however, hormonal adjustments are linked to a difference in fat distribution, which increases belly fat, according to a recent study that has been released by the International Menopause Society in light of the upcoming World Menopause Day on October 18th.
The new trial, published in Climacteric, is a comprehensive, scientifically based report on weight gain when a woman reaches the menopause.
Many women are bothered by the thought of gaining weight, and during middle-age years they begin to gain around 0.5kg or 1lb every year. Weight gain is of concern not only because women do not like to look overweight; it is associated with a several chronic diseases and conditions, such as hypertension (high blood pressure), depression, cardiovascular disease, diabetes and other medical conditions.
Approximately 1.5 billion adults are overweight worldwide – 300 million of them are obese females. Since 1980, obesity rates have increased two-fold, mostly in industrialized nations. Experts say the obesity epidemic is caused by lifestyle changes, physical inactivity, and eating habits. A higher percentage of females are obese than males; probably because women are more susceptible to hormonal imbalances.
Experts examined findings regarding weight gain during menopause and discovered that surprisingly, increase in weight is due to non-hormonal factors, rather than the actual menopause.
The researchers found that the way fat is deposited during the menopause changes significantly; this is the main reason for rising obesity rates among women in this age group. Regardless of whether women gain weight when they hit middle-age years, they do undergo a change in the way fat accumulates in their bellies.
Lead author of the study, professor Susan Davis from the Monash University in Melbourne, Australia, said:
“It is a myth that the menopause causes a woman to gain weight. It’s really just a consequence of environmental factors and aging which cause that. But there is no doubt that the new spare tire many women complain of after menopause is real, not not a consequence of any changes they have made. Rather, this is the body’s response to the fall in estrogen at menopause: a shift of fat storage from the hops to the waist.”
The report explains that when fat in the abdomen is increased, for post-menopausal women, the chances of developing a metabolic disease are increased as well, including the risk of heart disease and diabetes.
Although it is believed that estrogen therapy (HRT) is a cause of weight gain for women, the researchers say that is not the case, and HRT can help women lose the unwanted belly fat that appears post-menopause.
The IMS is stressing the important of awareness of health problems linked to weight gain among women going through menopause, and are encouraging them to take the initiatives crucial to preventing weight gain. A 2009 study confirmed the benefits of hormone therapy and physical activity in reducing weight gain after menopause.
Davis said:
“What this translates to in real terms is that women going through the menopause should begin to try to control their weight before it becomes a problem, so if you have not been looking after yourself before the menopause, you should certainly start to do so when it arrives. This means, for all women, being thoughtful about what you eat and for many, being more active every day. Estrogen therapy (HRT) can also help. But each woman is different, so at the menopause, it is important to discuss your health with your doctor.”
President of IMS, Tobie de Villiers, concluded: “Weight gain is a major risk factor for a variety of diseases, including diabetes and cardiovascualr disease. Heart disease is by far the number one killer of postmenopausal women, and this risk is increased by excess weight. Women need to be aware of this, especially at the menopause when estrogen levels drop. A woman may need to adjust her lifestyle to ensure a healthier life after the menopause. In fact, I would say that a woman should consider using the menopause as a marker, a reason to review her overall health, with her doctor, so that she can take her own decisions on how her life moves forward.”

Written by Christine Kearney




The most commonly reported adverse reaction to Estraderm (estradiol transdermal) in clinical trials was redness and irritation at the application site. This occurred in about 17% of the women treated and caused approximately 2% to discontinue therapy. Reports of rash have been rare. There have also been rare reports of severe systemic allergic reactions.

The following additional adverse reactions have been reported with estrogens:

  1. Genitourinary system. Changes in vaginal bleeding pattern and abnormal withdrawal bleeding or flow; breakthrough bleeding; spotting; dysmenorrheal, increase in size of uterine leiomyomata; vaginitis, including vaginal candidiasis; change in amount of cervical secretion; changes in cervical ectropion; ovarian cancer; endometrial hyperplasia; endometrial cancer.
  2. Breasts. Tenderness, enlargement, pain, nipple discharge, galactorrhea; fibrocystic breast changes; breast cancer.
  3. Cardiovascular. Deep and superficial venous thrombosis; pulmonary embolism; thrombophlebitis; myocardial infarction; stroke; increase in blood pressure.
  4. Gastrointestinal. Nausea, vomiting; abdominal cramps, bloating; cholestatic jaundice; increased incidence of gall bladder disease; pancreatitis, enlargement of hepatic hemangiomas.
  5. Skin. Chloasma or melasma, which may persist when drug is discontinued; erythema multiforme; erythema nodosum; hemorrhagic eruption; loss of scalp hair; hirsutism; pruritus, rash.
  6. Eyes. Retinal vascular thrombosis; intolerance to contact lenses.
  7. Central nervous system. Headache; migraine; dizziness; mental depression; chorea; nervousness; mood disturbances; irritability; exacerbation of epilepsy, dementia.
  8. Miscellaneous. Increase or decrease in weight; reduced carbohydrate tolerance; aggravation of porphyria; edema; arthralgias; leg cramps; changes in libido; anaphylactoid/anaphylactic reactions including urticaria and angioedema; hypocalcemia; exacerbation of asthma; increased triglycerides.

Read the entire FDA prescribing information for Estraderm (Estradiol Transdermal)

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