‘Menopause education is mixed messages – it should be evidence-based’

Lifeforce’s Dr Vinita Tandon on why measuring and correcting hormone levels is a key part of a longevity protocol – especially for women.

Everyone’s heard of hormones, chemical messenger molecules that coordinate biological functions in the body. These busy molecules have their fingers in many pies, including metabolism, sex and reproduction, growth, development, sleep and mood, and they are numerous, with more than 50 hormones identified in the human body so far. This can mean that keeping them in balance is tricky, so what can we do to help achieve a healthy, optimal hormone balance? This question is especially relevant for women, who undergo a hormone cataclysm as they move into and through perimenopause and menopause, stages in life that can have serious implications for their healthspan and longevity.

Longevity.Technology: The numbers are stark – 47% of American women aged between 30 and 60 report having experienced the symptoms of a hormonal imbalance, but a whopping 72% said they did not realize until later in life [1]. Given that even the slightest imbalance can cause fatigue, reduced sex drive, difficulty in losing weight and more, companies are looking at therapeutics that can start to redress this. 

Lifeforce, a company that provides personalized plans that combine biomarker testing, functional medicine doctors, certified health coaches and advanced nutraceuticals, also offers bespoke hormone optimization for women. We sat down with its Medical Director, Vinita Tandon, MD, who is Board Certified in Endocrinology and Metabolism, to find out more.

The issue of education runs through our conversation with Dr Tandon – women cannot make choices about how they tackle their hormones because they aren’t given pertinent information. But the problem runs deeper than that, as Tandon explains.

“Even though women make up half the population and menopause is as inevitable as taxes, no one teaches us how to manage menopause in medical school, throughout residency, or beyond,” she says. “When the women’s health initiative came out over 20 years ago, the media made damning announcements about the risks of taking hormone therapy that were subsequently refuted by the study’s own investigators. However, the media continued to irresponsibly push that message, resulting in fear and confusion amongst women and their providers, that to this day, more than 20 years later, we are still feeling the effects of such misreporting.”

Dr Tandon explains that when clinicians wish to learn the true ins and outs of menopause management, they often have to pay for additional courses to learn the data and research behind menopausal hormone therapy (MHT). 

“Unless clinicians really have the motivation to go the extra mile to attend these courses, lack of expertise and knowledge persists and women don’t get the care they deserve,” Tandon says, adding that, as might be expected, the situation is even worse among the lower socioeconomic populations.

Hoping to correct this lack of agency, Lifeforce’s decision to add women’s hormone optimization to its offerings was, says Tandon, “very intentional.” 

“We really wanted to do right by women and give them a place they could trust and receive gold standard care within the context of evidence-based medicine. We are one of the few places that actually monitor hormone levels not just for safety, but also efficacy.”

Hormones are innately bound up with both lifespan and healthspan, so menopause directly affects women’s ability to age well. Dr Tandon says that it is not a coincidence that once a woman enters menopause, her risk for developing chronic conditions increases – these conditions include heart disease, osteoporosis, dementia and metabolic dysfunction, the biggest killers for American women. 

“One of the key reasons for this increased risk is the sudden drop in hormone levels,” Tandon explains. “Numerous studies now confirm that if a woman begins menopausal hormone therapy right at the onset of menopause before she’s had time to develop atherosclerosis and plaque, she can prevent or slow down the progression of heart disease and stroke risk. Similarly with osteoporosis, hormone therapy is the only osteoporosis treatment that not only reduces the risk of bone loss, but also has myriad other health benefits – and improves quality of life!” 

As well as HRT, there are other steps women can take to help alleviate some menopausal symptoms. Dr Tandon recommends Rhapontic Rhubarb which is a non hormonal supplement that helps ease vasomotor symptoms such as hot flashes and night sweats, as well as improve mood and sleep. 

The other supplements she recommends are vitamin D, DHEA, melatonin and magnesium, which while not aimed at ‘hormone balance’ specifically, may target other deficiencies that often occur in menopause.

“Once a woman’s hormones decline, she may experience an increased risk for osteoporosis, insomnia, loss of libido, anxiety, and a decline in lean muscle mass. Vitamin D and DHEA improve bone density and DHEA also improves libido and lean muscle mass. It may have a modest effect on hot flashes, night sweats, and vaginal dryness as well. Both melatonin and magnesium improve sleep and stress mitigation. At Lifeforce, we have unique formulations which contain therapeutic amounts of the active ingredients and are highly bioavailable.”  

Longevity therapeutics are becoming highly personalized, and hormone therapy is no different. Dr Tandon explains that hormone therapy needs to be individualized because if a woman gets too little or too much hormone, this can have detrimental effects – not only in regards to how they feel, but can increase their risk for developing adverse events like vaginal bleeding or endometrial hyperplasia. 

“Depending on a woman’s medical history and how sensitive she might be to hormones, we want to dose to just the right amount to alleviate symptoms and mitigate risk of developing chronic conditions while also minimizing side effects,” Tandon says, explaining that this requires regular monitoring of symptoms and lab work to ensure levels are where Lifeforce wants them to be. 

It’s not a one-size-fits-all by any means, as Tandon explains.

“For example, if a woman has a history of uterine fibroids, we know that we want to start with more conservative dosing so that her fibroids are not adversely affected. Or, conversely, if a woman has used hormonal birth control in the past and knows that she needs higher doses to function optimally, we can adjust hormone dosing appropriately.”

When it comes to tackling hormone imbalance, the education issue comes up again. Dr Tandon is acutely aware that women are at a loss of where to turn to for advice and are receiving a great deal of mixed messages that are not based on evidence. 

“Women also tend to receive hormone replacement from non-experts, either in physical practices or online, with unsafe or ineffective dosing regimens,” she adds, explaining that there is little follow up, no monitoring of labs or symptoms, and definitely no education. 

Changing that up is, she feels, what really sets Lifeforce apart. 

“At Lifeforce, we prescribe gold standard regimens that are both therapeutic and safe, as well as have close follow up on both laboratory data and clinical response,” explains Dr Tandon. “Additionally, we love to educate our members on the evidence regarding MHT so that they are better informed and armed with knowledge when discussing it with their other providers who may not be as informed. 

“At Lifeforce, we take a detailed medical and family history and the hormone regimen is very individualized. Because we do quarterly lab testing, we’re able to track levels as well as make sure we’re achieving efficacious levels that are safe.”

[1] https://drannacabeca.com/blogs/keto-alkaline-diet/hormones-health-what-many-women-don-t-know