Healthy ageing is all about achieving and maintaining balance. Hormones do the vital job of balancing the chemical processes of the body. In fact, the whole idea of finding out how to fix hormone imbalance as we age can be key to healthy ageing. With ageing there is a substantial decline in the signals that normally keep things in balance. This results in decreased levels of hormones or their inadequate regulation.
How you look and feel is powerfully influenced by your hormones as they affect virtually every function in the body. If hormones are not functioning properly, or are unbalanced it may cause fatigue, depression, weight gain, loss of libido or premenstrual symptoms. It also results in significant changes in the skin. There are many and varied hormones that impact the skin including the sex hormones, growth hormone, and melatonin, our sleep hormone.
There are many health implications to the natural decline in hormone levels that comes with age. These include illnesses associated with the ageing process, or with menopause in women. Menopause is often the time we start to notice accelerated changes. These changes are why finding out how to fix hormone imbalance early is so critical to health. As it draws nearer we begin to experience drier skin, increased facial hair, skin sagging with declining elasticity, thinning of the epidermis, higher susceptibility to sun damage, and hyperpigmentation or age spots. Hormone modulation can help enormously and is worth investigating for a strategic advantage in healthy ageing.
How to Fix Hormone Imbalance with Hormone Modulation
The science of optimising hormones that are no longer being sufficiently produced by the body is called hormone modulation. Nature’s master plan in the form of genetic programming, as amazing as it is, only takes us to the age of reproductive functioning. After this there appears to be little use for us. And it is at this point we begin to fail. In fact, much of ageing really is a spectrum of deficiencies in the various substances that our body once produced abundantly. The best opportunity for a continued healthy and vigorous life is to regain and maintain physiological, metabolic, and endocrine (hormone) functions at the upper end of the normal blood range for our age group.
Conventional medicine has taken a rather narrow attitude to the replacement of hormones that decline with age. While oestrogen replacement is offered to women, other hormones like DHEA, growth hormone or progesterone are disregarded. Anti-ageing medicine however, takes a more holistic view, levels of many different hormones, including DHEA, the sex hormones (oestrogen, progesterone, and testosterone), thyroid and growth hormone, are tested and balanced. Hormones do not exist in the body in isolation. It is also essential to assess levels of certain other blood components and nutrients that can impact on hormone levels as well your health generally.
The Sex Hormones
Menopause and Changing Oestrogen Levels
A natural transition in the way the sex hormones, oestrogen and progesterone, are produced and released occurs in women from around their mid to late forties. Over the course of five to ten years (known as peri-menopause), hormone production slows, becomes erratic, and eventually shuts down altogether due to the exhaustion of oestrogen-producing reserves in the ovaries. During the latter part of this transition, cycle lengths become irregular and menstruation ultimately stops (known as the menopause).
The declining operation of the ovaries involves not only reproductive performance, but also alterations in almost every aspect of a woman’s body and life. Significant changes are evident in the skin – including thinning, dryness and roughness, easy bruising, wrinkling, and skin that is slow to heal. For women suffering terrible menopausal symptoms, hormone replacement therapy (HRT) can provide much needed relief on many fronts. Additionally, there are now studies showing that HRT can result in improvement in the skin. The term HRT encompasses both synthetic hormone and bio-identical hormone use. Synthetic hormones, though similar to human hormones, are not naturally occurring in the body. By contrast a bio-identical hormone is biochemically identical to the human hormone, and this type of therapy gives superior results. Hormone levels are very individual and a generic formula cannot be applied. Hormone levels must be assessed with blood and/or saliva testing and then balanced using only bio-identical (or natural) hormones, along with certain nutrients, diet and lifestyle
HRT can be delivered by oral, transdermal (topical cream), or vaginal routes. It is often best started in the peri-menopause. This can be taken on a cyclical basis (like the contraceptive pill) or on a continuous daily schedule. For the remainder of this article the term HRT (or BHRT) refers only to the natural bio-identical hormones in their different forms.
The three oestrogens
There are three main forms of the ‘oestrogen’ hormone. It is important to know what these are and their roles, this can assist with deciding the one(s) to include when planning HRT.
Oestradiol (E2) is the primary oestrogen produced by the ovaries and is the most potent form. It is the ‘active’ oestrogen, that creates the broadest spectrum of oestrogenic effects, as it is the one that plugs into the oestrogen receptors in many tissues. Besides being generated by the ovaries, it can also result from conversion of several precursors in the adrenal glands. It is broken down into specific metabolites (end products), dependent on precise levels of particular nutrients being correctly metabolised, and the existence of certain other factors. Some of these metabolites can be harmless and excreted easily by the body, but unfortunately some metabolites are strong oestrogens themselves. They can affect DNA and increase cancer risk as well as affecting insulin resistance resulting in weight gain. If this is occurring, a simple nutritional supplement called diindolylmethane (DIM) can turn things around. This is an important hormone for retaining bone density as well as controlling hot flushes.
Oestrone (E1) is regarded as a weaker form of oestrogen. It is the main oestrogenic form in menopausal women not taking HRT, and is usually produced by distinct fat cells in the belly. Unlike oestradiol it is not ready for action, but first needs to be converted to oestradiol before it can work. For this reason, it is debated by biochemists to be more accurately described as an oestradiol precursor. However, conversion can occur in both directions, oestrone could also be an end product or even a storage form of oestrogen. Due to its weaker quality, it is often presumed to be ‘safer’ than oestradiol, but in reality larger quantities are necessary to obtain the same outcomes as a smaller quantity of oestradiol. Further, since it needs conversion to oestradiol in order to be effective, some feel its safety is no different than oestradiol. There is some evidence that oestrone at high levels may contribute to breast cancer risk. We do not supplement with oestrone at Shine Clinic.
Oestriol is a waste product of oestradiol metabolism with a restricted scope of action on oestrogen receptors. It is produced in the liver, is 8% as potent as oestradiol and 14% as potent as oestrone. When oestriol binds to an oestrogen receptor it essentially blocks the stronger oestradiol. Therefore it is considered to be both oestrogenic and anti-oestrogenic. Some studies indicate that since it blocks the stronger oestradiol, oestriol could be viewed as having ‘anti-cancer’ action. But, the risk then parallels oestradiol, as increased quantities are required to create equivalent effects to oestradiol. Oestriol is a very safe hormone to take. It cannot convert into any of the stronger oestrogens. Higher levels of oestriol can have a breast cancer protective effect. Topical oestriol applied to the vagina directly gives significant improvements in symptoms of vaginal atrophy.
Which oestrogens to supplement for healthy ageing?
There is much discussion on this subject by a wide range of medical professionals. It is agreed though that no ‘one correct choice’ applies to everyone. Menopause varies significantly between women and treatment needs to be individually tailored.
Some are of the opinion that the ratio of the three oestrogens should be restored to what existed during our fertile life, or to an average of what is typical in a broad population of menopausal women. However, this approach is not appropriate on an individual basis. Women originate from a variety of genetic backgrounds, with an array of life events that have impacted their physical health and hormone exposure. Thus it is critical to weigh individual needs when embarking on oestrogen therapy.
Further, there is a major issue with the idea that all oestrogens must be supplemented. This is because in nature the body depends on converting one form to another according to need and timing. A situation of vacant receptors can be handled with a bit of oestrone, a biochemical reaction leading to completely active oestradiol and things are under control. The opposite can take place when there is more oestradiol in circulation than required, it can be degraded to oestrone and remain in the body without harm. Once oestrogens have fulfilled their purpose, they are metabolised into waste products like oestriol, and they slowly are disposed of by the body.
This system for managing oestrogens doesn’t change with menopause, but the amount of available oestrogen does. The ovaries are no longer secreting oestradiol instead the body is in post-fertile maintenance mode with just a trickle of oestrogen. The bulk of the oestradiol is working to plug receptors, and so is not reflected with testing. What is captured is likely only free oestrone. Regardless of whether oestradiol or oestrone is supplemented, it will be converted as per need.
So oestriol by itself does not suffice for oestradiol needs, it is a breakdown product exiting the body. As it has some action though, it can expand the limited oestradiol still being made. But it is not effective as HRT by itself. And it will result anyway from metabolism of oestradiol.
Balancing various oestrogen forms
The reason why some women do best on just one while others fare well on a blend is not too clear. It appears to be subtly connected with the manner with which their bodies handle these forms. The conversion to oestrone may not be difficult but, the conversion back to oestradiol may be problematic. Or perhaps they can handle more oestradiol and need it available much of the time. Conversely, others may experience sensitivity to an abundance of oestradiol, but the weaker oestrone is not an issue, they seem adept at making as much as needed. Apparently the adjustment to menopause, particularly the sudden surgical menopause, can disturb their hormone handling mechanisms. An adaptation period is needed to ease back into doing conversions easily. In this case, starting with oestradiol may be the best route.
Therefore, there is no ‘right’ solution to which oestrogen(s) is needed. The objective is to meet your body’s needs and achieve optimal menopausal wellness. Figuring this out can take awhile especially as there is a plethora of changes occurring, the formulation may need tweaking in the long term.
The use of topical oestrogens as part of bio-identical HRT has become widespread. They provide an answer to the question of how to fix hormonal imbalance later in life, while also preserving the skin’s appearance. Topical oestrogens certainly are absorbed by the skin, and can modestly impact matrix synthesis and thus the skin’s appearance. This includes reductions in wrinkle depth, largely by stimulating matrix regrowth and increasing the skin’s water content. The risks of cancer and heart disease are diminished with this type of HRT. At Shine Clinic in Brisbane the topical route of administration is the one most often used.
The Function of Progesterone
Progesterone has a vibrant relationship with oestrogen to control the menstrual cycle and health of the reproductive organs. As women enter their thirties and forties the balance moves more strongly towards oestrogen. This abundance of oestrogen is termed ‘oestrogen dominance’. It is often implicated in difficult symptoms experienced by women in this age group, such as premenstrual syndrome (PMS), night sweats, and depression.
Besides helping with PMS symptoms, progesterone offers critical benefits for breast and bone health too. It assists with maintenance of bone density in all women by promoting new bone formation through stimulus of bone-building cells. There is evidence of its cancer protective effects, through impeding undue proliferation of both normal and cancerous breast cells. Breast cancer risk is lower in women with elevated progesterone levels. Studies indicate that the long-term survival rate is much increased in breast cancer surgery patients with higher progesterone levels.
It has also been shown that progesterone is very important for brain cells to operate optimally. This is a function of fostering energy production, and safeguarding against cell damage and brain ageing. It has been demonstrated that progesterone therapy can treat depression in women.
Undoubtedly progesterone therapy has many applications for women’s health, both pre- and post-menopause. Unfortunately, many of these beneficial effects are often ignored by traditional medicine. The majority of gynaecologists rarely use progesterone and instead use the synthetic progestins to assist with protecting against endometrial cancer in women on oestrogen supplementation either as HRT or birth control. The common belief is that after a hysterectomy progesterone is no longer useful, overlooking the many positive effects it facilitates. Progesterone receptors are located on every cell of the body. This hormone is needed in the right balance.
Synthetic progestins are used in conventional birth control formulations and HRT, but not the natural progesterone. However, progestins and progesterone are very different chemically, progestins do not provide the same benefits as natural progesterone. In fact, there are considerable risks associated with progestin use such as birth defects, breast cancer, blood clots, fluid retention, acne, rashes, weight gain, and depression.
Natural progesterone can be sourced from soy and wild yam. The extracted plant hormones are chemically altered into a product identical to human progesterone. After conversion, the progesterone can be incorporated into a cream for transdermal application. An advantage of this delivery mode is that it side-steps the liver, avoiding the degradation of the hormone before its arrival at the intended tissue, Natural progesterone creams are very safe, toxicity or overdose is rare. Creams are favoured due to their excellent ability to pass through the skin , but oral micronised forms (broken into tiny particles) in oil suspensions are more potent and exact, permitting slow, regular absorption however, they do require a much higher dose. In situations where the results of the cream are too weak, the oral form can offer more measured outcomes. Careful checking of blood levels is advised to make sure levels are optimised and the balance with oestrogen is managed.
Andropause and Declining Testosterone Levels
Blood levels of the major male hormones (called androgens) also decline by about one percent each year from the mid-thirties. This is termed the ‘andropause’ and occurs in both men and women. It is far more gradual than, and not as absolute as what takes place with female hormones in the menopause. It is a little known fact that the ovaries and adrenal glands of women produce testosterone (about one-tenth as much as men). Women in their forties have approximately half the testosterone level they had in their twenties.
Powerful anti-ageing effects have been attributed to sustaining youthful testosterone levels in males as evidenced by many studies. Declining testosterone in men is associated with ‘middle-aged spread’ and reduced muscle mass, as well as diminished sexual interest and functioning. Heart attack, diabetes, Alzheimer’s disease, osteoporosis and depression have also been linked to low testosterone.
Despite the understanding that women also produce testosterone, mainstream medicine has been very slow to recognise its significance. The ‘female’ hormones progesterone and oestrogen were the only ones considered to impact a woman’s health. However, in the last two decades increasing evidence reveals how vital testosterone is for women on many fronts, including fitness, muscle tone, abdominal obesity, sex drive and arousal, cardiovascular health and breast cancer risk. Testosterone deficiency is believed a key predictor for heart disease in ageing women or women who have had hysterectomies and/or oophorectomies (removal of ovaries). Marginally raising testosterone levels in ageing women enhances mood, energy, sleep, skin, overall health, and quality of life. This is also true for women of all ages.
Importance for Women’s Sexuality
It is now widely accepted that testosterone replacement in women who have had hysterectomies and/or oophorectomies improves mood and well being, but the concept of it being helpful to those with an intact uterus and ovaries is still discounted.
Research investigating whether testosterone supplementation can benefit women regardless if they have had these surgeries is slowly gaining ground. Testosterone replacement therapy is being studied in both pre- and post-menopausal women. Careful testosterone therapy in post-menopausal women who have had oophorectomies has resulted in continued increase in sex drive and arousal. Treatment of young women in their twenties and thirties with testosterone for low libido is contentious, but further examination is warranted. It is postulated that supplementation in young women with low testosterone dealing with sexual dysfunction could be valuable.
Oral contraceptives are known to reduce testosterone levels, young women on birth control pills have experienced fatigue, low libido, and reduced concentration. It has been suggested that prudent testosterone replacement in such pre-menopausal women could alleviate many of these symptoms. More studies of pre-menopausal women are needed, evidence shows vast improvement in sex drive of post-menopausal women treated with testosterone, who have undergone hysterectomies and/or oophorectomies.
Breast Cancer Protective Effects of Testosterone
Breast cancer is the most prevalent cancer in women despite extensive research into its causes and treatment. It is widely accepted that elevated oestrogen levels are a significant risk factor for developing breast cancer. Some findings implicate high testosterone levels also playing a role. Others postulate that the connection between high testosterone levels and breast cancer is due to testosterone and oestrogen levels being strongly related. Testosterone can be a precursor for oestrogen. Studies have shown that it may protect against breast cancer. Breast cells demonstrate rapid cancer-like proliferation in the presence of oestrogen, but when testosterone is included it appears to inhibit multiplication.
Normal levels of testosterone in both men and women are therefore important for many reasons, including muscle preservation, bone density, energy maintenance, mood, pelvic tissue health and libido. Modulation of testosterone levels is key to keeping health in balance and for general well-being. Care however is needed with testosterone supplementation to avoid unwelcome side effects including acne, increased facial hair, weight gain, breast enlargement and mood changes (including increased aggression at high doses). When used appropriately, supplementing testosterone can
- restore libido
- improve sleep
- enhance energy
- elevate mood
- increase concentration
- boost overall health.
By far, the most effective way to supplement with bio-identical testosterone is with a transdermal cream or gel.
Dehydroepiandrosterone (DHEA) is a hormone manufactured by the adrenal glands, and is the most abundant hormone. It is sometimes referred to as the ‘parent’ or ‘master’ hormone, as it is the source of all the key adrenal hormones, including oestrogen, progesterone, testosterone, and the stress hormone cortisol. DHEA production reaches its peak around age 20, and then declines steadily, and by the age of 40 output has plummeted to 50 percent. In our eighties we are at less than 5 percent of what is optimal.
DHEA has a broad impact on the body, and its decline is felt in every system, organ and tissue. Plummeting DHEA synthesis leaves the immune system open to attack by viruses, bacteria, free radicals, and the plethora of degenerative diseases that result. Low DHEA levels in the elderly are linked with osteoporosis, heart disease, high cholesterol, memory loss, Alzheimer’s disease, and breast cancer, though the connection doesn’t necessarily imply that DHEA is responsible. However, there is growing scientific evidence supporting its role in prevention or reversal of age-related diseases such as atherosclerosis (hardening of the arteries), cancer, diabetes, and reduced immunity. Unquestionably DHEA levels are critically predictive for age-related illnesses. Studies show that diminished DHEA more accurately predicts heart attack than elevated cholesterol.
Whether the hormone can actually extend human life span remains to be proven, but it shows potential to safeguard against the degenerative diseases of ageing. DHEA is being investigated as a possible treatment for chronic fatigue syndrome, adrenal insufficiency, depression, Epstein-Barr virus, herpes, lupus and other autoimmune diseases, menopausal symptoms, osteoporosis, and even AIDS. Reports from healthy individuals on DHEA therapy indicate
- increased energy
- better stress tolerance
- heightened clarity
- lower cholesterol
- enhanced resistance to colds and flu
- improved libido in ageing women
- overall improved well-being.
Research shows that DHEA supplementation may also be helpful for infertility, schizophrenia, cocaine withdrawal, anorexia nervosa, and dementia, but further study is needed.
Menopausal Relief with DHEA Therapy
There is controversy about DHEA supplementation in healthy pre- and post-menopausal women, though it has become popular for those seeking relief from menopausal symptoms, including reduced sex drive, poor skin tone, and vaginal dryness. Proponents claim that it relieves menopausal symptoms without heightening the risk of breast cancer or endometrial (lining of the uterus) cancer – unlike synthetic hormone replacement therapy. However, definitive proof of this does not exist.
Early research shows DHEA therapy can increase levels of some hormones in post-menopausal women. The safety and efficacy of DHEA supplementation requires further study. Medical supervision is important when undertaking such therapy, especially for those with a history of or who are at high risk for cancer. Since DHEA can be transformed into either oestrogen or testosterone it may be unsafe for anyone susceptible to hormone related cancers, such as breast or prostate cancer. Women with breast cancer typically have low levels of DHEA, there is debate about whether taking DHEA may contribute to increased cancer cell proliferation or actually control growth.
DHEA supplements are manufactured from diosgenin, an extract of the Mexican wild yam. High quality DHEA supplements are important, those with just unconverted diosgenin are ineffective. It is best to purchase DHEA through a healthcare professional. DHEA is available in capsules, troches and topical creams. Side effects may include oilier-than-normal hair and skin, acne, hair loss, and increased facial hair due to increased testosterone production, also lowered HDL ‘good’ cholesterol.
Other Hormones for Healthy Ageing
Growth hormone is produced by the pituitary gland, known as the ‘master gland’. Its production is influenced by a complex set of hormones produced in the hypothalamus, the pancreas, and the intestinal tract. Key among these is insulin-like growth factor. Output of growth hormone is in bursts, in response to exercise, trauma, and sleep. Usually more of the hormone is produced at night than during the day.
A key component in the regulation of growth and repair in the human body, growth hormone acts to build and maintain structures in all parts, including the skin. It is responsible for stimulating the growth of bone and cartilage in children, and its production rises during childhood and adolescence, peaking during puberty. In the general population, the hormone boosts protein production, promotes fat metabolism, disrupts insulin action, and elevates blood sugar levels.
With the onset of middle-age, physical growth slows and eventually halts. Consequently, levels of growth hormone also drop every year from puberty. This is known as the ‘somatopause’. By the age of 70, growth hormone levels have fallen to about one-fifth of what they were at age 30. Of all the hormonal changes in the human body, declining growth hormone levels are the most closely correlated with ageing. In fact, some people who have reduced ability to make this hormone (through genetics, disease, or injury) also manifest many of the signs of premature ageing, including heart disease, bone thinning, expanding waistlines, cognitive decline, and characteristic skin changes.
Therapeutic use of growth hormone
Children deficient in growth hormone and others with very short stature are prescribed the hormone. It is also used for treating adult deficiency, though this is rare and is almost always associated with major dysfunction of the hypothalamus, and/or the pituitary gland. Diagnosing adult deficiency requires special tests which stimulate production of the hormone. As the level of hormone rises and falls throughout the day, simple blood tests are not reliable. The chance of a false positive result is higher than the likelihood that the disease is real. It is critical that testing be done by a qualified clinician.
Adults suffering from growth hormone deficiency benefit from injections of the hormone. This provides fracture protection, improved muscle mass, increased exercise capacity, improved cognition and lower risk of heart disease. Such treatment is also sanctioned for adults with short bowel syndrome or AIDS- or HIV-related muscle wasting. However, there are some potential side effects. Relatively common side effects include fluid retention, joint and muscle pain, carpel tunnel syndrome and occasionally an elevation of blood sugar levels in susceptible individuals. Although blood sugar levels may increase slightly initially, this will be more than corrected with weight loss, increased muscle mass and improved exercise habits in the longer term. The side effects relating to fluid retention are avoided or minimised by starting the growth hormone at low doses and increasing slowly.
The Magic Elixir for Ageing
Growth hormone has been much touted as the ‘anti-ageing miracle’. It has become enormously popular among those keen to enhance and preserve physical appearance. Most attractive in its spectrum of biological effects, are improved muscle mass and promotion of fat metabolism. The natural decline has fueled interest in replacement therapy to avert some of the changes that come with age, such as reduced muscle mass and skeletal integrity.
Athletes all over the world have experimented with it to promote muscle mass, but this has not translated into improved performance or endurance. The use of the hormone has been banned by the World Anti-Doping Agency due to safety concerns.
Caution is advised when considering supplementation with growth hormone as anti-ageing therapy. Research into healthy adults taking the hormone is ongoing and more studies are needed. The hazards and advantages of long-term use of the hormone in healthy people remain to be fully elucidated. However, clinical studies to date show that supplementing the hormone of growth and repair to the optimal range, can have significant benefits with respect to healthy ageing. Best results are seen in people with very low levels to begin with. When these individuals attain levels in the optimal range, they feel and function much better.
Effects on longevity are also still in question. The connections between growth hormone, insulin-like growth factor, life expectancy, and chronic illnesses are very complex. Some studies indicate low hormone levels may even protect the elderly from age-related diseases. A recent study found that cancer survival was enhanced in those with lower insulin-like growth factor. These participants also had low blood sugar levels, which appears contra-indicated based on earlier studies, but may help explain their longevity.
Melatonin is the hormone released according to the body’s natural clock, with the highest levels seen at night, and the lowest levels around the middle of the day. This cycling of melatonin is critical for regulating sleep and supporting other parts of the circadian rhythms. Melatonin also has important influences on daytime health and ageing, including effects on stress, the immune system, and inflammation. It also impacts the functions of the skin, including augmenting hair growth and reducing sun damage. Regrettably, melatonin production declines with age. As a result, elderly people often display just minor nocturnal increase in melatonin production. Obviously, this makes falling asleep a problem, and it may also have an impact on skin. Supplementing with melatonin is a relatively simple and safe way of restoring the circadian rhythm, as well as improving the immune system.
How to Fix Hormone Imbalance
Hormone supplementation is key to optimising tissue levels and achieving balance suited to our age group. This will contribute to enhanced functioning and renewed vigour at all levels. Some doctors such as Dr Kathy Gallagher have a specific interest in the area of hormone balance and healthy ageing.
Bio-identical (or Natural) Hormones
A bio-identical hormone is a hormone that is biochemically and molecularly identical to the human hormone. It is derived originally from a plant and converted by biochemists into one of the various human hormones, eg oestrogen, progesterone, testosterone and DHEA.
Synthetic hormones by contrast do not occur naturally in the body. They are in some ways similar to human hormones but in other ways very different. Side effects are more likely with the use of synthetic, artificial hormones. Synthetic forms of HRT are still very commonly used despite widespread knowledge of the increased risks of breast cancer and heart disease. Bio-identical hormones facilitate a much safer path to follow.
Every person is unique, needing different hormones and different dosing regimens to improve symptoms and achieve hormone levels in the optimal range. Monitoring is done through blood and saliva testing. Therapy is individually customised and carefully checked with ongoing assessment and testing. Dietary and lifestyle advice, as well as nutritional supplements if needed are provided. Consult with a doctor who has a particular interest in hormone balancing for healthy ageing. Dr Kathy Gallagher of Shine Clinic in Brisbane has many years of experience in healthy ageing and continue to read widely and engage with the research community for evidence-based best practice.
The Benefits of Hormone Balancing
Because hormones have effects in virtually every part of the body, the benefits of knowing how to fix hormone imbalance with hormone balancing can be widespread. These benefits include:
- Increased energy and physical endurance
- Improved weight management
- Improved memory
- Improved mood and libido
- Treatment of hot flushes and night sweats
- Improved bone density
- Improved menstrual cycle
- Improved skin elasticity and texture
- Improved immune system.