On, November 14, 2023, Sir Frederick Banting, a Canadian physician and medical scientist was awarded the Nobel Prize for using insulin to treat diabetes in humans.
As the Hormone Pharmacist, my emphasis is on hormones for menopause, especially estrogens and progesterone. But insulin is a hormone with a colorful history that parallels the history of menopause hormones.
Insulin Was Originally Extracted From Animal Sources
Before the use of insulin was developed, diabetes had always been an incurable disease that destroyed organs by allowing blood sugar levels to get dangerously high. Diabetes is the 7th leading cause of death in this country. About 9% of the population has this disease. Over 1.25 million people in the U.S. have Type I diabetes, the type which can be treated with insulin. Over time, the high blood sugar of diabetes causes numbness and loss of blood flow in your feet, loss of vision, and kidney damage, among many other problems.
Dr. Banting started using insulin from dogs and eventually settled on insulin from cows and pigs to treat patients with diabetes. The insulin from animals has save of millions of people who would have died from diabetes related complications.
We don’t use much animal insulin any more, mainly because of allergy issues and risks associated with them. Instead, doctors prescribe “human insulin,” which is chemically identical to the insulin made by non-diabetic people. In the late 20th Century, “human insulin” made by genetically engineered bacteria became available and is still used by millions of diabetics today.
Menopause Hormones
Just like insulin, which was derived from dogs and pigs, hormones for menopause were originally isolated from animal sources. Doctors used estrogen from pregnant mares’ urine, starting in the 1940s, to treat menopause symptoms. The estrogen derived from horse pee was crude, dirty, and full of contaminants, but it worked. Horse estrogen made a huge difference in the lives of millions of menopausal women for 75 years. Surprisingly, Premarin®, the brand name of horse urine estrogen, is still prescribed for menopause, although not as frequently as in the past.
In the early 1940s, Russell Marker, a chemist at at Penn State, figured out how to synthesize bioidentical hormones from a derivative of Mexican wild yams. The process Marker developed is still used today to create estradiol and progesterone, hormones which are exactly the same as those your body once made, before you went into menopause. More studies are published every year showing that these hormones, often called “bioidentical hormones” are way better than animal-derived or non-bioidentical hormones for treating menopause.
Bioidentical estradiol is a clean, safe, and effective treatment for hot flashes and many other symptoms of menopause. Estradiol does not have all the contaminants found in estrogens from pregnant mares’ urine. Estradiol makes sense as the best way to replace estrogen in menopause.
Not only is estradiol a clean and effective estrogen for menopause, it’s also available in a generic that costs as little as $5 a month at some big pharmacies. My 2 Minute Hormone Guide, gives a brief overview on pricing for basic bioidentical hormone combinations of estradiol and progesterone.
Bioidentical progesterone has been shown to be protective against cancers, especially endometrial cancer but also against breast cancer. Bioidentical progesterone given for menopause has been shown to reduce the risk of breast cancer, especially when compared to medroxyprogesterone, a powerful non-bioidentical “progestin.” Progesterone also helps with anxiety and sleep issues in menopause and may even reduce hot flashes.
Diabetes Risks
Insulin is important in treating diabetes because it takes away the symptoms of the disease. Diabetes causes people to have unquenchable thirst, frequent urination, nausea, vomiting, and severe weight loss. In certain types of diabetes, insulin will eliminate those symptoms, almost immediately. But the real problem in diabetes is not the symptoms, it’s the risks. Long term, high levels of sugar in your blood lead to very serious risks like clogged blood vessels, nerve damage, kidney damage, loss of vision, and ultimately, early death.
Treating diabetes with insulin greatly reduces the risks of the disease and can lengthen a patient’s life. As important, insulin can completely enhance the quality of life for diabetic patients.
Menopause Is NOT A Disease
It’s very clear that menopause, unlike diabetes, is not a disease. Menopause is something that happens to every woman who reaches the age of 51, on average. It’s the genetically programmed drop off in hormone levels that coincides with the end of menstruation and the ability to get pregnant. Even though menopause is not a disease, it does cause many symptoms for a lot of women, symptoms you are probably very familiar with. Menopause, and the lack of estrogen and progesterone that goes with it, creates some serious health risks.
Even though menopause is a natural condition and not a disease, it does have an impact on your health and your risks for other health problems. In the same way that insulin helps reduce the risks of diabetes, if a menopausal woman replaces missing hormones, her risks of several menopause complications will be greatly reduced. These risks include:
- “metabolic syndrome” – a set of issues that start with weight gain around your waist
- heart disease
- high blood pressure
- osteoporosis
- colon cancer
- age-related dementia
All these risks can be reduced by replacing the estradiol and progesterone your body once made with bioidentical hormones. Whether hormones should be replaced in order to reduce these risks has been a matter of debate.
Like Insulin – Menopause Hormones Are Not For Everyone
Insulin was a major breakthrough in the treatment of diabetes, It has saved millions of lives. But insulin is not the right treatment for every person with diabetes. There cases of diabetes where insulin would not be effective or necessary and might even cause damage.
In a similar way, hormone replacement is not the best option for every menopausal woman. There are women who, for various reasons, can’t take estradiol and progesterone. Most women will benefit from hormone replacement and I believe the number of women who shouldn’t take hormones is actually a very small minority.
Only you and your physician can ultimately tell whether hormone replacement is the right option for you. Your physician needs to evaluate your symptoms, their severity, your medical and family history, your risk factors, and the potential for benefit and risk from hormone replacement in your specific situation.
If you’re struggling with menopause symptoms or if you’re concerned about the risks of not replacing your hormones after menopause, join my email list to get clear, simple hormone information. I’m working to create accessible information to help you decide, along with your doctor, whether hormone replacement is right for your menopause.