Hormone Health, the environment and HRT – a frank discussion

Hormones are Nature’s molecular messengers. We literally cannot survive as a species without them. I care for my patients with menstrual and menopausal abnormalities with nonhormonal oxygen therapies. I do so because I get far superior long-term clinical results with this approach.

To save the human species from extinction, Nature created a rather simple design: It prepares the uterus for pregnancy each month during the entire reproductive life of the women. Oestrogen peaks during the first half of each menstrual cycle to prepare the soil of the uterus for conception. If conception occurs, oestrogen peaks further, and oestrogen overload is balanced with a progesterone peak to protect the beginning of life for the baby from an unbalanced oestrogen overdrive. As the fertilised egg develops into an embryo and beyond, there is an outpouring of oestrogens from the placenta that also increase its output of progesterone, again to keep the oestrogens under control.

Times have changed. There are simply enough of us on the planet now. Women do not need to stay pregnant all the time. The way we live our lives has changed rapidly, but evolution does not work that fast. The result: A fundamental chemical conflict between the needs of 21st century women and their hormonal clocks. When an oestrogen peak goes unbalanced by progesterone, endometriosis – the growth outside the uterus of misplaced cells that normally line the uterine cavity (a disabling disorder that may lead to infertility) – may occur along with other menopausal disorders such as: severe menstrual syndrome, too much flow, scant flow with clots, anovulatory state, polycystic ovarian syndrome, and what may be designated as ‘pseudomenopause’ — a state of presumed menopause in which menstruation resumes with robust non-hormonal integrative management plans and remains regular for years to come.


In biologic molecular pathways, molecules compete for ‘receptor-mates’ as aggressively as animals do in the animal kingdom. Such competition among molecules is based upon their structural similarities. This, however, does not always hold, and many synthetic chemicals not belonging to the family of human hormones actively compete for their receptors. This natural phenomenon is well illustrated by the example of competition for receptors among oestrogens and xenoestrogens (oestrogen mimics). Following is an incomplete list of xeno-estrogens:

  • Pesticides such as DDT and heptachlor
  • Plastic (polycarbonates) breakdown products
  • PAHs (polycyclic aromatic hydrocarbons)
  • Petroleum by-products
  • Polystyrene
  • Marijuana compounds such as tetradyfrocaanabinol
  • Plant oestrogens such as coumestrol, equol and zearalenone
  • Combustion by-products
  • Electromagnetic fields that boost the concentration of oestrogens in blood.

Hormone receptors are proteins with complex and malleable structures. Nature conferred remarkable malleability and resilience on hormone receptors — that resilience, however, is not enough to withstand the onslaught of chemicals currently soaking human habitats. Among the consequences of that global chemicalisation is the age of hormone receptor burn-out, which has brought forth epidemics of the menstrual and menopausal disorders discussed earlier.

There is an enormous number of environmental pollutants causing reproductive dysfunctions in humans and animals on an unprecedented scale. The discussion of the roles of genes and environments in hormonal health are frivolous, since gene-environment interactions are dynamic and ever-changing. Otherwise we humans would have been microbes — at some level, it seems to me, we still are.

Endometriosis rarely occurs, if ever, in tribal cultures removed from the rush of modern life.


For nearly three decades, I have not found it necessary to prescribe synthetic oestrogens and synthetic progesterones for teenagers and young women with menstrual problems. During these years, I also did not find it necessary to prescribe Premarin (a synthetic oestrogen) and Provers (a synthetic progesterone) for women who needed hormone therapies for peri-menopausal or menopausal symptoms. As for switching from synthetic hormone replacement therapy (HRT) to naturally-derived hormones, I was unable to do so in three cases (less than one percent).

To my great surprise, in early 2014, the Food and Drug Administration (FDA) approved Paxil by another name (Brisdelle, a brand of paroxetine) for treating hot flushes associated with menopause. What did not surprise me about this was that this approval was strongly opposed by FDA’s own advisory committee (Reproductive Health Drugs Advisory Committee), specifically, the Committee had concluded, by a vote of 10 to four, that the overall benefit-risk profile of the drug did not justify its approval.

The Drugs Advisory Committee duly pointed out that the drug (Brisdelle) had taken teenagers’ lives by inducing suicides.

Over the decades of my clinical work, I have had my share of patients whose lives were made miserable by menopausal hot flushes. Never once did I find it necessary to consider any antidepressant drugs for controlling this problem.


Severe menopausal hot flushes are heightened vascular (vaso-motor) responses to hormonal disruptions rooted in disturbances in the bowel-blood-liver axis. How do I know this? Severe hot flushes of my patients were controlled only after I addressed these problems along with a programme of hormonal normalisation with naturally derived hormones, guided by blood hormone tests.


About eight to 10 million American women are prescribed HRT by their physicians. Of these, about half discontinue hormones due to untoward effects of hormones or for fear of developing breast, uterus and other cancers. This means about five million women in the US are taking oestrogens and progesterone regularly.

If HRT is all that risky, why do some women agree to take this?

This question has interested me for some time. On the surface, it negates my theory about the oestrogen overdrive described above. The answer is that they are not made aware of healthful, natural alternatives to synthetic hormones. I make three points here.

  1. A vast majority of menopausal symptoms can be controlled with sound nutritional therapies, exercise, and self-regulation, and without oestrogen. Indeed, many of the symptoms attributed to inadequate oestrogen are in reality symptoms of sugar-insulin-adrenaline-roller coasters that respond well to natural non-drug measures.
  2. For some of my patients who need further relief, I frequently prescribe natural plant-derived progesterone creams. Indeed, it is uncommon for me to have to use oestrogen for symptoms that are difficult to control otherwise.
  3. How do I explain the occurrence of hot flushes, fluid retention and related symptoms that seem to respond well to oestrogen therapy? An insight into a possible explanation of this phenomenon came to me some time ago as I listened to a patient describe her difficulty with sugar craving and sugar roller coasters. It occurred to me that the need of some women for extra oestrogen for hot flushes is similar to the need for sugar in someone craving sugar, or for cocaine in a cocaine addict.

No one recommends that we solve the problem of sugar craving with sugar, or that we treat cocaine addiction by giving the addict regular doses of cocaine. Why do we do so for oestrogen?

Melatonin and oestrogenic overdrive

Melatonin is the primary hormone of the pineal gland located in the centre of the brain. It is mainly produced during night-time darkness. Light and electromagnetic fields suppress melatonin production.

Melatonin is a powerful antioxidant. Among its other important roles is reduction of oestrogen production in the body, and probably reduction in the number of oestrogen receptors.

Studies have shown that the protective, oestrogen-reducing effects of melatonin are significantly reduced by excessive exposure to light (including late night TV viewing), electromagnetic fields, chemical pollutants such as pesticides and fungicides, and many commonly prescribed drugs, such as betablockers for heart disease, high blood pressure and headaches.


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Hormone Health, the environment and HRT – a frank discussion

Professor Majid Ali
About The Author
- He is a surgeon, pathologist, immunologist, allergist, and teacher in self-regulation. He has written many books as well as articles for medical journals. He is deeply committed to ‘an emerging new possibility of a molecular medicine’, a medicine that seeks to reverse chronic disease and preserve health using non-pharmacological molecular protocols of nutrition, allergy and chemical sensitivity, self-regulation and fitness. He is the author of The Principles and Practice of Integrative Medicine.