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Menopause & Hormone Testing

Hormone Testing and Treatment

Our office is happy to provide hormone testing and treatment to correct imbalances that may be causing you symptoms. Do you feel like you can’t lose weight? Do you feel more tired than in the past? Do you have trouble sleeping? Is your sex drive less that it used to be? Are you dealing with adult acne? Do you feel you have PMS or your PMS is getting worse? Do you have fibroids? Do you have fibrocystic breasts or breast pain? Do you have endometriosis?

Women have been saying for years that their hormones are out of whack, and they probably are. In the female body, balance is key. Women need a balance of estrogen, progesterone, testosterone, thyroid hormones and cortisol. When this balance is not in place, women can feel symptoms such as hot flashes, night sweats, forgetfulness, foggy thinking, unwanted weight gain, declining interest in sex, PMS, sleep disturbance….The list is endless.

Do you have any of these symptoms? Take our hormone quizzes for assistance in determining what your symptoms could be trying to tell you.

Don’t let anyone tell you it’s all in your head or it is just a part of aging. Let us help you on your journey to feeling better.

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Test – Don’t Guess

For the past 5 years over 300 medical studies have used saliva as a way to measure free hormone levels. The free hormone level is the key here. Ninety to 99% of hormones are bound to proteins, making them unavailable for accurate testing in the blood. For years women have been asking to have their hormones tested, and we will provide that testing. Normally we use a combination of blood and saliva testing, we can assess your female hormones and thyroid hormones to determine if there is an imbalance present. To use an analogy from Dr Eldred B. Taylor’s book, Are Your Hormones Making You Sick, “A woman has a hundred pieces of her favorite chocolate candy in a bag and decides to eat two pieces of candy. She unwraps two pieces of candy and enjoys it. If she is driving a car, she may decide to unwrap a few pieces and leave them in the bag to make them easily accessible. There are a hundred pieces of candy in a bag but only two to three pieces are unwrapped and accessible. Measuring estrogen and progesterone in the blood reveals how much hormone is in the blood but not how much is accessible to the tissue. Blood measurements reflect the total hormone (candy) present but not how much hormone (candy) is free or unwrapped and accessible. The saliva is an excellent medium to measure the amount of free hormone available to the breast, uterus, brain or other tissues that are sensitive to these hormones. This method of testing was discovered in 1959 and is now widely available and many insurance companies cover the cost. However, this form of testing is still new to most doctors”.

Saliva testing can accurately measure your free and available hormone levels, eliminating the guessing from your treatment. If we discover a deficiency or imbalance we can monitor your hormone levels after starting bio-identical hormone treatment, which allows us to individualize your hormone therapy. If you are experiencing symptoms, you will want to test at least two hormones, estradiol and progesterone. If you would like a more comprehensive picture, we can perform a five panel test measuring estradiol, progesterone, testosterone, DHEAS and morning cortisol.

Saliva testing is easy to do in the comfort of your own home. We will provide you with a test kit in our office, and you collect the specimen at your home, and mail your specimen to ZRT labs in the pre-paid envelope. It’s that easy! We will receive your results about one week later, and we will meet withl you to discuss your results and your treatment options.

Estrogen, Progesterone, Testosterone

These three female are mainly secreted by the ovaries, and have pivotal functions in fertility, menstrual cycles, and basic female well being. In general, estrogen levels drop off around age 51, but progesterone and testosterone decline as early as the thirties, or even twenties for some women. The estrogen and progesterone levels need to be properly balanced to each other, like a see saw, for women to feel their best. When the progesterone levels fall in the thirties, then there is a functional excess of estrogen. The levels of estrogen may be in the normal range, but without progesterone for balance, women can have multiple symptoms of progesterone deficiency, or estrogen dominance. (The see saw is not equal). With testing and treatment, this situation is usually easily resolved, and women are spared multiple symptoms during these peri-menopause years.

Make sure to take our hormone quizzes to help you identify your symptoms.


Another hormone shared by both men and women is the thyroid hormone. The thyroid is a small gland, shaped like a butterfly, located in the lower part of your neck. The function of a gland is to secrete hormones. The main hormones released by the thyroid are triiodothyronine, abbreviated as T3, and thyroxine, abbreviated as T4. These thyroid hormones deliver energy to cells of the body. When the thyroid gland is underactive, improperly formed at birth, surgically removed all or in part, or becomes incapable of producing enough thyroid hormone, a person is said to be hypothyroid (too little=hypothyroid). A hypothyroid patient will have a high level of TSH, thyroid stimulating hormone, as it is attempting to stimulate the thyroid gland, but it is not responding. This lack of response makes the body make more TSH, hence the rising TSH when the gland is NOT working. One of the most common causes of hypothyroidism is the autoimmune disease called Hashimoto’s disease, in which antibodies gradually target the thyroid and destroy its ability to produce thyroid hormone.

Symptoms of hypothyroidism usually go along with a slowdown in metabolism, and can include fatigue, weight gain, constipation, dry skin, depression, hair loss, irregular periods, sleep disturbance, infertility, hoarse voice, light sensitivity… among others.

When the thyroid gland becomes overactive and produces too much thyroid hormone, a person is said to be hyperthyroid (too much=hyperthyroid). The most common cause of hyperthyroidism is the autoimmune condition known as Graves’ disease, where antibodies target the gland and cause it to speed up hormone production.

Symptoms of hyperthyroidism usually go along with a speed up in metabolism, and can include rapid heartbeat, weight loss, diarrhea, moist skin, and anxiety/nervousness… among others.

To test your thyroid, we can perform simple blood tests to measure your TSH (thyroid stimulating hormone), Free T3, Free T4 and thyroid antibodies to evaluate for Hashimoto’s hypothyroid. The TSH level is evaluating the stimulation to the thyroid gland. If they thyroid gland does not respond to the stimulating hormone (TSH), the body responds by making more TSH, if the thyroid still does not wake up, still more TSH is made, therefore HIGH TSH levels mean LOW functioning thyroid (hypothyroid). The current TSH range used by most labs is .5 to 5.5, although most people do not feel good unless their TSH levels are around 1-2.

Looking at the whole picture – TSH, Free T3, Free T4, thyroid antibodies, cortisol, hormone levels, plus your symptoms, will help us determine if you need thyroid replacement.

Some patients can have functional hypothyroid, meaning the blood tests appear to show normal function of the thyroid, but the patients have all the classic symptoms of hypothyroid. Sometimes, adding the vitamins that are crucial for thyroid function, such as iron, iodine, selenium, zinc, copper, manganese, vitamin C and B vitamins, will help the thyroid function better. And sometimes these patients will respond to low dose thyroid hormone replacement.

Good supplements that can help your thyroid perform are iodine, iron, selenium, zinc, copper, manganese, vitamin C and B vitamins. It is important to know your cortisol function when determining if you have suffered hypothyroidism for a long time and not been treated. The cortisol response becomes tired over time, trying to compensate for a poor functioning thyroid, and even when your thyroid condition is treated, if you adrenals are still tired, you may not feel better. (Read above Stress section for more information on adrenals and cortisol)

Replacing thyroid hormone is relatively easy and inexpensive. It can just take time to find out which dose of thyroid hormone will alleviate your symptoms. We can replace thyroid hormone by giving you synthetic T4, in such preparations as Synthroid or Levoxyl, or by using Armour thyroid, which has a ratio of T4 and T3 in it. In the body, T4 must be converted to T3, and some patients lack this conversion response, therefore some patients respond better to a combination of T4/T3 than T4 alone. No matter which combination of medications we use, when using thyroid hormone we “start low and go slow” in order to decrease side effects form adjusting your medications too quickly. It just takes time for your thyroid to respond to our newly added medications.

Make sure you take our hormone quizzes to help identify your symptoms.

Diet and Lifestyle

The presence of estrogen and progesterone in proper ratio creates balance in the body. Modifying diet and lifestyle choices can control many of the risk factors for hormone imbalance. A diet high in fiber and low in fat is shown to decrease PMS symptoms and pain associated with your period. Exercise decreases weight, stress, and insulin levels, all which affect your hormone balance. Supplements can assist in relieving symptoms and restore depleted vitamins and minerals. Adequate sleep will assist in all aspects of your well being.

Limit your exposure to toxins. Buy organic meat, dairy and produce. If you can’t buy organic produce, buy a bottle of veggie/fruit wash and try to remove as many pesticides from your foods as you can. Limit your use of the microwave, but if you use the microwave, cook your food in glass. Store foods in glass or ceramic and not plastic, avoid use of plastic wrap. Drink your water from stainless steel containers, not plastic bottles.

Weight and Nutrition

Women make 200 subconscious food decisions in one single day! It is not surprising that a majority of women feel they need to lose weight. We have always known there were health implications associated with being overweight, but what about our hormones? Overweight women have a large amount of available estrogen due to it’s storage in body fat. They are more likely to have irregular bleeding because they have more available estrogen than progesterone. They also have an increased risk of breast cancer, and uterine cancer, two cancers that are very sensitive to estrogen. Approximately 50% of the American population is 20% over their ideal body weight. Therefore it is likely that a majority of women have increased free estrogen instead of decreased levels of free estrogen. Most of these women are given estrogen replacement therapy in menopause or perimenopause, but if tested using saliva testing, would show high levels of free estrogen, and low levels of progesterone. Most of these women don’t need estrogen at all!!! They may benefit from a little progesterone if the tests indicated, and progesterone supplementation may be all that is needed to bring balance to the hormones. Once in hormonal balance, women are more able to lose weight and feel better.

Make the commitment to lose weight, your health and future depends on it.

Read the Eat Clean Diet book. It is awesome at explaining nutrition and helping with weight loss. (www.eatcleandiet.com). Author Tosca Reno states weight loss is an 80-10-10 split. 80% nutrition, 10% exercise, and 10% genetics. So, how are you eating? We have been struggling with how to each patients nutrition, and we have found it. This book teaches you everything you need to know on how to change your nutrition habits, from shopping, cooking and ordering out healthy, delicious meals that will help you feel great and lose weight.

Check out Dr. Oz’s website, www.realage.com. They have volumes of information concerning total health, from obesity to high blood pressure to weight loss. Their book, You on a Diet, and You the Owner’s Manual are must read’s too.

Check out Dr. C.W. Randoph’s website www.hormonewell.com. He has two good books, “From Hormone Hell to Hormone Well”, and “From Belly Fat to Belly Flat”. They are must read’s for women. He touches on hormones, diet, stress reduction, and vitamins.

Check out www.lowglycemicdiet.com to make good choices about your foods. Choosing foods with a low glycemic index will allow you to store less fat, and lose weight instead of gaining. Also, rethink your food pyramid. Check out www.oldwayspt.org and look at the Mediterranean food pyramid.

Remember that weight loss begins at the grocery store! All the books above have tips on how to be a better shopper. Only have the foods at home that you should eat. The whole family will benefit if you are a better shopper.


One test we recommend is a cortisol level. This can be measured just one time, in the morning, with your hormone levels, or up to 4 times in that one collection day to give us an accurate picture of your cortisol pattern. Cortisol is produced by your adrenal glands, small glands situated on the top of your kidneys. Your adrenal glands are involved in energy production, fluid and electrolyte balance, fat storage, sex hormone production. DHEAs is made almost exclusively in the adrenals, and after menopause are the major sources of estrogen and progesterone. When you are under stress, whether emotional, physical or medical, cortisol production rises, which affects every major process in your body – energy production, fluid and electrolyte balance, fat storage and sex hormone production. Over time, if the stress doesn’t go away, your adrenals get tired and eventually will get in crisis mode. This means weight gain (especially abdominal fat), diabetes, insulin resistance, hormone imbalance symptoms, high cholesterol, high blood pressure…Wow, stress never looked so serious. You have to make some changes when you are under stress. Stop refined carbohydrates or high glycemic foods, stop caffeine, stop eating excess calories, start exercising, start taking supplements, and commit to performing stress management techniques. First begin by eating real food, not packaged food. Fresh is best, but frozen is the next alternative, with canned being the last choice. We recommend going organic, especially with dairy and meat and certain fruits and vegetables. Adopt a Mediterranean diet, (www.oldwayspt.org), with nutritious foods, lots of vegetables, fruit, fish, beans, olive oil, with low glycemic foods. Eat in moderation, avoid overeating and take time for your meals. The Italians have it right here! Eat protein at every meal and snack, eliminate caffeine, white flour foods, and artificial sweeteners. Reduce white sugar but eliminate high fructose corn syrup or any -ose ingredient. Exercise 30-40 minutes a day, varying your exercise between aerobic (walking, light jogging, sports), anaerobic (weight lifting) and flexibility (yoga and pilates). Add supplements that are depleted when you are under stress, like Vitamin C, B Vitamins, Vitamin E, Alpha Lipoic Acid, CoQ10, Omega Fatty Acids, Magnesium and Calcium.


Don’t forget to take your supplements. Nutrition, which includes both the foods you eat and the supplements you take, are an integral factor in you feeling well. Above we list supplements that are good for particular stress or thyroid needs. Daily we recommend Vitamin C, Vitamin B, Calcium/Magnesium, Essential Fatty Acids, Co Q 10, and antioxidants.

We carry a line of pharmaceutical grade vitamins. We are very impressed with their purity, effective and cost. They are available in the office or online, but we support your use of high quality name brand over the counter vitamins as well.

Vitamin Testing

We are happy to offer vitamin testing in our office. Spectracell Laboratories, based in Texas, patented FIA analysis measures levels of selected vitamins, minerals, antioxidants, and other essential micronutrients within your white blood cells. Testing can reveal nutrient deficiencies often missed by traditional blood testing. Such deficiencies could impair your health by contributing to the development or progression of chronic diseases.

Your blood is collected in the morning prior to noon, but no fasting required, and we will receive a report on 31 nutrients. Covered by most PPO insurance plans, and require an $105 copay payable to Spectracell Laboratories on the date of collection.

Food Allergy Testing

What is the significance of food allergy testing? It is important to remember that most autoimmune diseases and chronic conditions that we all suffer from are caused by responses in the digestive track due to delayed food allergies.

Sage Medical Laboratory developed a new patent-pending Elisa test to pin point delayed food allergies causing many autoimmune diseases and chronic illnesses. It is a unique multi-pathway test. A comprehensive picture of the allergic foods can be identified quickly and more accurately than any present Elisa test on the market. Eliminating all allergic foods from the diet can immediately alleviate symptoms and improve the health of the patient. The Sage ELISA Test has proven to be clinically effective over 80 percent of the time. This high incidence of success and the outstanding consistency of this test will continue to set the standard for delayed food allergy testing.

We have kits available for testing for delayed food allergies. It is a simple blood draw, non fasting, then the blood is sent to Sage Medical Laboratory. When testing is completed you receive a comprehensive report on all foods, food additives and dyes that are positive for delayed food allergies. Information from the Sage Chef on elimination of these foods from your diet is provided as well.

Please visit Sage Medical Laboratory’s website for more information on testing and insurance coverage, or call them at 800-491-9511 begin_of_the_skype_highlighting 800-491-9511 end_of_the_skype_highlighting.

Come In For Your Evaluation

Make an appointment today with Dr. Cowen or Barbara Buckley, NP to discuss your symptoms and get you on the journey to feeling better. Appointments last approximately 30-60 minutes, depending on each individuals concerns. With a detailed and comprehensive history, a physical exam and measurements, and saliva testing, we can help you start your journey to a healthier lifestyle.


Estrogens – a family of hormones (estradiol, estrone, estriol) secreted by the female ovaries. They are necessary for maintaining the health of the reproductive tissues, breasts, bones, skin, and the brain.

Progesterone – an essential female sex hormone produced by the ovaries after ovulation and in lesser amounts by the adrenal glands which promotes healthy functioning of the female reproductive system. It has many vital functions, from maintaining pregnancy to regulating menstrual cycles; has calming and diuretic properties, and enhances the beneficial effects of estrogens while preventing problems linked to estrogen excess. Progesterone facilitates balance of other steroid hormones. (Not the same as progestins, a synthetic form of progesterone found in birth control pills and Provera)

Progestins – synthetic hormones that act partially like progesterone in some ways but are structurally different; suppress normal ovarian production of progesterone and many have negative side effects.

Testosterone – one of a group of hormones known as androgens produced in both males and females. It builds and maintains bone and muscle mass, skin elasticity, sex drive and cardiovascular health in both sexes.

DHEA – (dehydroeplandrosterone) hormone made by the adrenal glands, it converts to androgens, like testosterone and estrogens. Its actions influence energy, stamina, mental outlook and immune function. – a family of hormones (estradiol, estrone, estriol) secreted by the female ovaries. They are necessary for maintaining the health of the reproductive tissues, breasts, bones, skin, and the brain.

Cortisol – produced by the adrenal glands; it regulates the stress response, glucose metabolism, and immune function. Cortisol has a catabolic (breaking down) action on tissue when levels are too high or out of balance.

Adrenal imbalance – This occurs when the adrenals no longer produce enough hormone to meet bodily demands and is a result of prolonged stress (emotional, viral, physicl). Adrenal support includes adequate rest, exercise, nutrition, and supplementation.

Estrogen dominance – an excess of estrogen in teh absence of adequate levels of progesterone. It can result from estrogen replacement therapy, hysterectomy, birth control pills, and/or decline in ovarian progesterone production. The symptoms range from breast tenderness and bloating, to mood swings and depression.

Bioidentical – hormones that have the exact structure and function of hormones produced naturally within the body.

Thyroid – gland that produces hormones that regulates metabolism; imbalances lead to weight gain, cold body temperature, depression, hair loss, etc…

TSH – Thyroid stimulating hormone, pituitary hormone, signals the thyroid to produce T4 (Thyroxine) which converts to active T3 (Triiodothyronine).

Phytoestrogens – plant compounds (e.g. soy, black cohosh) with mild estrogen-like activity; are used as natural alternatives to relieve menopausal symptoms.

Insulin resistance – a term used to describe the failure of the tissues to respond (resistance)

Cholesterol – a waxy, fatlike substance in your blood, necessary for hormone production

LDL – (low density lipoprotein) cholesterol – the “bad” cholesterol that builds up in your arteries

HDL – (high density lipoprotein) cholesterol – the “good” cholesterol that helps carry away LDL cholesterol to prevent buildup

Triglycerides – another blood fat that increases your risk of heart disease if levels are high

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