REBALANCING YOUR LIFE IN MENOPAUSE
How Menopause affects women
Many women feel suddenly hit by the symptoms of menopause and are struggling to adjust to lack of sleep and lower levels of physical and mental energy.
However, there are women who are only experiencing very gradual effects and don’t have major complaints about their menopausal state. They would just notice some weight gain and a rise in their blood sugar, blood pressure, or cholesterol levels.
Throughout the years, taking care of women with hormonal changes, I have seen patients with debilitating menopausal symptoms and some who had no symptoms at all.
Symptoms of Menopause
The most significant physical and mental changes usually happen in the Peri-Menopausal period, when the menstrual cycle becomes irregular .
The most commonly reported menopausal symptoms are:
- Hot Flashes
- Memory Fog
- Decreased libido
- Weight changes
- Hair Loss, Dry Skin
- Joint pain
Menopause usually starts around the age of 50, when ovary size and hormone production start declining.
Although we can relate the age of menopause to a genetic pattern, and see women getting their first symptoms around the same age as their others or sisters, menopause can occur earlier for different reasons.
Stress and Menopause
We underestimate how much stress is affecting us both physically and mentally. High stress levels can throw a woman into early menopause, and symptoms are usually more pronounced.
The reason why they would have more hot flashes and depressive symptoms with stress-induced menopause is that it affects the Adrenal Glands. Cortisol fluctuations in the adrenals are “stealing” hormones away, causing more severe hot flashes, often night sweats that interfere with sleep.
Anxiety and depression are also more pronounced when Cortisol is imbalanced.
The decline in Estrogen levels is responsible for many of the menopausal symptoms, especially hot flashes and brain fog. As soon as we replace Estrogen, hot flashes go away completely, and symptoms of memory fog and depression are alleviated.
We also have to be aware of the consequences of lack of estrogen on our general health, and how it hastens the aging process.
Women have estrogen receptors on most of the cells in their bodies, meaning that they need estrogen to function well. In the same way, men have Testosterone receptors in most cells of their bodies.
As a result, when we become estrogen-deficient in menopause, all the systems in our body can be affected. We know most about the cardiovascular system and the increase risks of heart disease in menopausal women, but this is also true for the immune, endocrine, and nervous systems.
Progesterone levels start declining much earlier, around the age of 35, and the effects often go unnoticed.
Progesterone is acting as the calming GABA neurotransmitter in the brain. So lack of Progesterone can cause anxiety or sleep disturbances. I often see young women having panic attacks because of Progesterone deficiency. They are usually prescribed anti-depressant or anti-anxiety meds when all they need is Progesterone.
I am very cautious in the way I prescribe hormones to my patients. I am in favor of giving the lowest dose possible to rebalance the body so you can feel good, sleep well, and regain energy and mental clarity.
Also, before we jump to hormone replacement, we have to think of all the other substances that help make and release hormones. For instance, the chemistry of hormone production is regulated by enzymes and nutrients. In functional medicine, we look at deficiencies or borderline low nutrient and enzyme values in the labs that may affect the production of hormones.
Testosterone Therapy for Women
A recent trend of focusing on Testosterone replacement with injection for women is raising a lot of questions in my practice.
Testosterone replacement gives great results for men going through andropause, just like estrogens for women in menopause.
The way I prescribed hormone replacement therapy is aimed to create balance and lasting health and longevity, rather than the picks and valleys caused by excessive amounts of hormones.
I only prescribe low doses of Testosterone when needed. Usually, Estrogen, Progesterone, and DHEA replacement are sufficient to take care of menopausal symptoms. The body converts DHEA into testosterone, which is a much better-tolerated hormone for women, with fewer side effects than testosterone.
Testing for Menopause
The two blood test markers that use in conventional medicine to diagnose menopause are FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone). When they are elevated beyond the normal range, this means that ovarian function is low, and estrogen and progesterone are not released in sufficient amounts anymore.
However, you can experience menopausal symptoms with normal levels of LH and FSH while you are in the peri-menopause period.
We all have different ways of processing hormone changes, and we can see that from the time we start our menstrual cycles. Some young women would have regular periods and experience no PMS (Pre-Menstrual Syndrome), others would have irregular cycles and experience very painful cramps and extreme emotional changes.
Women were talked out of hormone therapy for years after a large study made in the late 1990s, the Women’s Health Initiative (WHI), showed an increase in cancer and blood clots. The women in this study were given high doses of oral estrogens that were not safe. Fortunately, the Menopause Society revisited this study and concluded that estrogen therapy given topically (through the skin) is safe and beneficial.
Rather than the high doses of synthetic hormones that were used in the study, we use minimal doses of topical bioidentical hormones, which are derived from natural products. Their chemical structure is also much more similar to the one that our body produces.
Monitoring Hormone Replacement Therapy
Once you start hormones, it’s important to check your levels every 3 to 6 months.
I prescribe a urine test to check how estrogens are metabolized in the body to make sure that they are eliminated properly. This is an important cancer preventive measure.
I also ask my patients to keep up with their Gynecologist to assess any changes in the uterus. This indicates if the balance between estrogens and progesterone is appropriate.
Bio-Identical Hormone Replacement is a great way to overcome the symptoms of menopause and slow down the aging process. However, be aware that, like with any medical treatment, it has potential sides effects and needs to be done under skilled medical supervision.
Also keep in mind that stress can make you less responsive to hormone therapy. Use meditation and breathing to optimize your hormones!
In Vibrant Health,
EVELYNE LEONE, DO, FAARM, ABBARM