Postmenopausal women suffering from hot flashes, may hesitate to take estrogen because they’ve heard it can cause weight gain. Who needs any extra help to gain weight? Is there any truth to all this?
What are Bioidentical Hormones?
When you’re replacing deficient estrogen, it’s important to respect the wisdom of the body. No drug we give can approach the amazing complexity of the endocrine system. However, you can start by giving a hormone that is identical to the hormone that’s missing. We call these bioidentical hormones.
Another important factor is the route of administration. Estrogen is most commonly given as a pill that’s taken orally. It’s convenient and easy to pop a pill. But easy isn’t always the best. If we’re wanting to mimic the body, how does the ovary deliver estrogen to your tissues? I assure you the ovary doesn’t dump a big load of estrogen in your stomach once a day!! A more natural way to take estrogen is by applying it to the skin as a patch or cream. Estrogen taken in a pill form overloads your liver with excessive amounts of estrogen that increase harmful proteins, clotting factors and proinflammatory substances leading to various problems. Let me explain how oral estrogen leads to weight gain.
Weight Gain & Oral Estrogen
Weight gain from oral estrogen causes visceral obesity, the medical term for increased fat around your middle from fat that gets deposited in vital organs like the heart, kidneys and liver. This increased fat mass leads to increases in leptin produced by the fat cells. Topical, but not oral, estradiol prevents this increase in body fat and leptin. An interesting fact about visceral obesity is that women who take NO estrogen can also get weight gain around their middle because they develop insulin resistance. This is a frequent complaint from older women who are not on estrogen!
Oral, but not topical, estrogen increases the production of thyroxine-binding globulin (TBG) the carrier for thyroid hormone. Higher levels of TBG lower the amount of available thyroid hormone thereby lowering your metabolism. Oral, but not topical, estrogen also suppresses IGF-1, a marker for growth hormone. Growth hormone is needed to build muscle and burn fat. All this explains a common complaint I hear from women who’ve been on oral estrogen. “After starting oral estrogen, I gained 15 pounds in the first month and I didn’t increase my calories or lower my exercise. Now I’m eating less and exercising more and I just keep gaining!” Estrogen from injections or pellets can also lead to weight gain because the blood levels produced are much too high.
Weight gain from oral or injectable estrogen occurs because these preparations violate the natural physiology of the body. The ovary is amazing…it releases tiny bits of estradiol throughout the day directly into the blood stream. Even topical estradiol preparations can’t reproduce this same elegant effect, but it’s the closest delivery system we have. That’s why your chances of maintaining a healthy metabolism and weight are best when you choose topical estradiol preparations.
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