ePainBook: Hormone Replacement Therapy - Presented by Arizona Pain Specialists

Pain medicine, pain management, fibromyalgia, Arizona pain, back pain, pain treatment, discography, back pain, neck pain, migraine., headaches, sciatica, muscle pain, Arizona pain center, acupuncture, arthritis, Arizona, Scottsdale,

Estrogen

Estrogen is an excitatory hormone produced by ovaries and adipose (fat) cells. Estrogen causes an increase in blood
flow and oxygen metabolism. It also can increase several neurotransmitters or brain hormones.

Norepinephrine, Serotonin, and Dopamine are the neurotransmitters responsible for many of the emotions you
experience. Estrogen improves your mood by increasing Serotonin levels. Low Serotonin levels are thought to cause
depression and anti-depressants like Prozac increase Serotonin. Norepinephrine has a stimulating effect by increasing
alertness, and having a role in the production of long-term memory. Ideal levels of Norepinephrine can produce a calm
state in stressful situation, however too much Norepinephrine can produce anxiety. It is important to have a balanced
level of neurotransmitters to maintain homeostasis or normal body functioning.

Progesterone

Progesterone acts as a relaxing hormone produced by the ovaries, instead of a stimulant. It works with a different
neurotransmitter in the brain, but can cause a calming effect. Progesterone allows for feelings of well-being. Just like
Estrogen, when Progesterone levels are offset depression and anxiety may ensue.

Thyroid Hormone

Hyperthyroidism (increased thyroid hormone) and Hypothyroidism (decreased thyroid hormone) are very common
diseases. Patients who suffer from Hyperthyroidism are often extremely anxious, have an increased metabolism, feel hot,
lose weight, have a rapid heart rate and may have panic attacks caused by increased levels of Thyroid hormone. On the
contrary, patients with Hypothyroidism often suffer from weight gain, slow thinking, cold sensation, and depression. If you
suffer from Thyroid Hormone deficiencies or excess you may benefit from regulation of these hormones.

Cortisol

Cortisol is a hormone produced by your adrenal glands and is necessary for survival. It is responsible for energy
metabolism and is critical in the management of stress. Increased levels of Cortisol are seen in stress; however, when
pathologic it is called Cushing’s syndrome. Cortisol levels can be affected by many conditions, such as physical or
emotional stress, strenuous activity, trauma, and infection. Chronically high levels of Cortisol can produce face and trunk
weight gain, excessive sweating, hypertension, easy bruising, thinning of the skin, stretch marks, hump-back fat deposits,
insomnia, mood disorders including depression and anxiety. “Chronic elevation of Cortisol may also lead to
Dopaminergic, Noradrenergic and Thyroid dysfunction.” (Duval 2006 ). When Cortisol levels are too low a person is said
to have Addison ’s disease. The most common symptoms experienced are fatigue, muscle pain, muscle weakness, joint
pain, weight loss, hypotension, vomiting, diarrhea, and mood changes.

Depression

Depression is a mental illness that can be severe and affects many people of all different ages. Depression is thought to
result from a chemical imbalance of Serotonin within the brain. Serotonin is the chemical in the brain that controls a
person’s mood and is usually decreased in patients suffering from depression. Therefore, many of the therapies for
depression (Prozac, Zoloft, Celexa…) raise Serotonin levels.

“Major depressive disorder has been associated with changes in the hypothalamus-pituitary-thyroid (HPT) axis and with
hypercortisolism. In a large controlled clinical study. When compared with matched control subjects, outpatients with
major depression had slightly higher serum TSH (Thyroid Stimulating Hormone), while urinary cortisol levels were similar.
Also observed was lower serum cortisol in atypical depression than in non-atypical depression” (Brouwer 2005). A large
body of evidence suggests a potential role for the Norepinephrine function as a possible biological factor in the control of
suicidal behavior (Pitchot 2003).

Some clinical research has shown that estrogen, progesterone, and testosterone replacement may be helpful in people
with deficiencies. A thorough work must be done to determine what hormone replacement you may benefit from. A
customized hormone replacement therapy program may help alleviate your depressive symptoms.

Menopause

During menopause the levels of estrogen, progesterone, and testosterone all decrease in a woman's body. The drop in
these hormones can cause many bothersome symptoms including hot flashes, weight gain, vaginal dryness, mood
fluctuations, and sleep disturbance.

Hormone replacement therapy, also known as HRT, reduces many of these complaints in women. The HRT typically
consists of estrogen and progesterone. Estrogen replacement has been helpful reducing hot flashes, night sweats,
vaginal dryness, and urinary tract problems. Low-dose estrogen along with low dose progesterone may especially benefit
women who complain of disturbed sleep (Gambacciani 2005).

HRT is also recommended by many physicians to decrease the risk of post menopausal women from developing
osteoporosis and heart disease. While clinical trials have continued to demonstrate HRT's effectiveness in preventing
osteoporosis, women must weigh the risk of the therapy with the benefits. The trials also showed that HRT actually
increased rather than decreased risk of heart disease and many women are not given HRT routinely.

Progesterone is included in HRT because it reduces the risk of uterine cancer (higher when taking Estrogen only).
Women can also add testosterone to their regimen, as this helps with vaginal dryness.

Many other symptoms and conditions including chronic pain, may be improved by a customized hormone therapy regimen.

Journal Articles

Thyroid and adrenal axis in major depression: a controlled study in outpatients. Brouwer JP, Appelhof BC, Hoogendijk
WJ, Huyser J, Endert E, Zuketto C, Schene AH, Tijssen JG, Van Dyck R, Wiersinga WM, Fliers E. Eur J Endocrinol. 2005
Feb;152(2):185-91 PMID: 15745924

Cortisol hypersecretion in unipolar major depression with melancholic and psychotic features: dopaminergic,
noradrenergic and thyroid correlates. Duval F, Mokrani MC, Monreal-Ortiz JA, Fattah S, Champeval C, Schulz P, Macher
JP. Psychoneuroendocrinology. 2006 Aug;31(7):876-88. Epub 2006 Jun 12.

Catecholamine and HPA axis dysfunction in depression: relationship with suicidal behavior. Pitchot W, Reggers J, Pinto E,
Hansenne M, Ansseau M. Neuropsychobiology. 2003;47(3):152-7.

Effects of low-dose, continuous combined hormone replacement therapy on sleep in symptomatic postmenopausal
women. Gambacciani M, Ciaponi M, Cappagli B, Monteleone P, Benussi C, Bevilacqua G, Vacca F, Genazzani AR.
Maturitas. 2005 Feb 14;50(2):91-7

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Hormone replacement therapy
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D

Your body produces many hormones that allow for normal daily
functioning. A disruption in the production of certain hormones
or the balance of hormones can affect you emotionally and
physically. At Arizona Pain Specialists we understand the
importance of holistic therapy, including a proper balance of
essential hormones. We are happy to offer these services to
Scottsdale and the Phoenix metro area.

Hormone replacement therapy, depression, anxiety, Pain medicine, pain management, fibromyalgia, Arizona pain, back pain, pain treatment, discography, back pain, neck pain, migraine., headaches, sciatica, muscle pain, Arizona pain center, acupuncture, arthritis, Arizona, Scottsdale,

Book I - Pain Syndromes

Chapter 1     Low Back Pain
Chapter 2     Neck Pain
Chapter 3     Cancer Pain
Chapter 4     Headaches
Chapter 5     Spinal Stenosis
Chapter 6     Sciatica
Chapter 7     Arthritis
Chapter 8     Fibromyalgia
Chapter 9     Motor Vehicle Injuries
Chapter 10   Complex Regional Pain
Syndrome
Chapter 11   Vertebral Body
Fractures
Chapter 12   Hip and Leg Pain
Chapter 13   Diabetic Peripheral
Neuropathy

Book II - Interventional Procedures

Chapter 14   Epidural Steroid
Injection
Chapter 15   Facet Injections/Medial
Branch Blocks
Chapter 16   Radiofrequency Ablation
Chapter 17   Spinal Cord Stimulator
Implants
Chapter 18   IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20   Discography
Chapter 21   Percutaneous
Discectomy
Chapter 22   Occipital Nerve Block
Chapter 23   Sympathetic Block
Chapter 24   Stellate Ganglion Block
Chapter 25   Intrathecal Pump
Implants
Chapter 26   Caudal Steroid Injection
Chapter 27   Adhesiolysis
Chapter 28   Cervical Steroid
Injection
Chapter 29   Sacroiliac Joint
Injections
Chapter 30   Celiac Plexus Block
Chapter 31   Head and Neck
Procedures
Chapter 32   Joint Injections
Chapter 33   Continuous Catheter
Nerve Blocks
Chapter 34   Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35   Disc Denervation

Book III   Other Treatments

Chapter 36   Medication Management
Chapter 37   Acupuncture
Chapter 38   Prolotherapy
Chapter 39   Botox
Chapter 40   Massage
Chapter 41   Alternative and
Complementary Medicines
Chapter 42   Exercise and Nutrition
Counseling
Chapter 43   Prayer
Chapter 44   Cognitive Behavioral
Therapy
Chapter 45   Group Therapy
Chapter 46   Biofeedback
Chapter 47   Chiropractic
Manipulations
Chapter 48   Vitamin Supplements
Chapter 49   Customized
Pharmaceutical Formulations
Chapter 50   Hormone Therapy

Frequently Asked Questions