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September 23, 2007

War and Peace

A delicate balance exists among the hormones of the body in order to have optimal health. A recent request for Yaz (ethinyl estradiol-drosirenone, a birth control pill) by a patient with PMS, irritability, weight gain and poor sex drive reminded me of the important balance between our “warrior” hormone testosterone and our “world peace” hormone progesterone. A woman with PMS can be described as having an imbalance between these two hormones. Her aggitation and irritability may make her seem more ready to start a war than to relax in peace and acceptance of this beautiful world. So drugs like Yaz try to stomp down these testosterone-related symptoms of irritability. But testosterone does more than make a woman assertive and strong, it also contributes to a her sex drive and strength. And progesterone does more than improve her tolerance of others’ imperfections. Progesterone also makes her to want to cuddle and helps regulate her body’s warmth. So optimal and balanced levels of these hormones add better quality to life than depleting either of them. What many women don’t realize is that the drug Yaz helps decrease the testosterone signals in their bodies. This is a reasonable choice for a woman who truly has testosterone excess and a relative, but not true, progesterone deficiency. If the woman is low in both progesterone and testosterone, but has enough tetsosterone to create a relative testosterone deficiency, then use of this medication may produce a worsening of her low testosterone condition, even though she’ll have less irritability. These unwanted symptoms of testosterone deficiency include muscle loss, fat weight gain, fatigue, thinning hair, dry skin, weakness, and depression. This is why I advise women with PMS to test their serum hormone levels during their worst PMS days to see what their true hormone conditions are before starting any hormonal therapy, whether it’s bio-identical or synthetic. Because the truly desired outcome is more than just war or peace before menses, but rather strength, harmony, health and patience.

Dr Natalie Kather, MD

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