Hormone Balance in Perimenopause/Menopause

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Hormone Balance

It's not all in your mind

 

The Anatomy of a Hot Flash

 

Fatigue, Stress & Hormone Imbalance

 

Libido and Hormone Imbalance

 

Hormone Imbalance and PMS

All About Natural Hormones

 

Progesterone, What and Why?

 

Hormone Balance and Osteoporosis

 

Estrogen Dominance & Low Thyroid

 

Depression and Mood Swings

http://www.springboard4health.com/notebook/health_hormone_bal.html

 

 

 

In the years leading up to menopause (perimenopause) menstrual

cycles that may once have been like clockwork begin to become

erratic. Bleeding may be heavier or lighter than usual – although we

are not officially in menopause until we have had 12 consecutive

months without a period. Erratic cycles are a sign of erratic

ovulations leading to highs and lows in estrogen and progesterone,

an effect many women describe as an " emotional roller coaster. "

 

And don't let anyone tell you " it's all in your head " !

 

When the ovaries begin to sputter, hormone production sputters and

so do we…forgetfulness and foggy thinking, mental confusion and mood

swings are hallmark symptoms for many women; as are hot flashes and

night sweats, tearfulness, unwanted weight gain, thyroid problems

and declining interest in sex, no matter how much we love our

partner. Of course, not all women experience all these symptoms – as

individuals we each have our very own biochemistry – but it is

common to experience some degree of discomfort during the menopausal

years. And the degree to which we experience discomfort is likely to

be associated with the degree to which our hormones are out of

balance.

 

If you are a woman experiencing menopausal symptoms you will want to

test at least two hormones: Estradiol and Progesterone. If you would

like a more comprehensive picture, ZRT Laboratories five panel test

measures: estradiol, progesterone, testosterone, DHEAs and morning

cortisol.

 

The Anatomy of a Hot Flash

 

Is it hot in here or is it just me? It's a common refrain among the

estimated 50 to 75 percent of women in the U.S. who experience hot

flashes during menopause. Hot flashes can be very mild, or bad

enough to have you opening every window in the house, even in the

dead of winter. Also known as " vasomotor flushing, " the hot flash

occurs when the blood vessels in the skin of the head and neck open

more widely than usual, allowing more blood to shift into the area,

creating the heat and redness. Perspiration is also common to the

phenomena and in some women the hot flash takes the form of a night

sweat, followed by a chill that has one groping for the covers

kicked to the floor just minutes earlier. It's usually over in

seconds, and there's no telling when it will recur – maybe minutes,

maybe hours – but it will be back. Triggered by falling estrogen and

rising levels of follicle stimulating hormone, hot flashes arrive

unannounced, and usually at a most inconvenient time – in the middle

of a job interview, in the middle of an important speech, in the

middle of the night. Besides hormonal changes, anxiety and tension

magnify hot flashes and many women find that hot drinks and wine do

the same.

 

Saliva testing identifies the degree to which the specific hormones

linked to hot flashes are out-of-whack. Using test results as a

guideline, natural hormone supplements can be suggested to restore

balance and cool the hot flashes. Many women also use phyto (plant)

estrogens, such as Dong Quai and Black Cohosh; optimal nutrition and

relaxation exercises for added relief. In most cases, hot flashes

usually go away a year or two after actual menopause and the

cessation of menses.

 

" Tired but Wired " – Fatigue, Stress and Hormone Imbalance

 

Many people experience high levels of mental and emotional stress on

a regular basis, which put a significant strain on adrenal function.

When stress is not well-managed the ability of the adrenal glands to

do their job becomes compromised. The adrenals normally secrete

cortisol in response to stress, with exercise and excitement, and in

reaction to low blood sugar. The body normally secretes the highest

amount of cortisol in the morning to get us going, with levels

decreasing throughout the day. People with adrenal imbalance will

often have normal cortisol levels in the morning with below normal

levels at other times during the day. If stress remains too high for

prolonged period, the adrenals cannot keep up with the demand and

total cortisol plummets, leading to adrenal exhaustion.

 

The hallmark symptoms of adrenal imbalance are stress and fatigue

that is not alleviated with sleep – that tired-all-the-time feeling.

Other common symptoms include sleep disturbances, anxiety,

depression, increased susceptibility to infections, reduced

tolerance for stress, craving for sweets, allergies, chemical

sensitivities and a tendency to feel cold.

 

Saliva testing charts the extent to which cortical levels are out of

balance and can be used as part of a strategy that looks at the

whole person and his or her life style. It is helpful to work with a

doctor who can design a complete program of hormone balance and then

monitor your progress.

 

You can begin to support adrenal function on your own by avoiding

hydrogenated fats, excess caffeine, refined carbohydrates, alcohol,

and sugar. Eat plenty of quality protein and regular meals of high

nutritional value. Key to success is to discover and practice stress

management in whatever form works for you personally. Take time out

to evaluate the stressors in your life and find ways of expressing

yourself creatively. Get enough rest and sleep. And last but no

least, keep a sense of humor!

 

Low Sex Drive (Libido) and Hormone Imbalance

 

Estrogen, progesterone and testosterone are key players in the

maintenance of circulation, nerve transmission and cell division, so

an imbalance of these hormones can easily lead to changes in sexual

response. Declining estrogen levels common to the menopausal years

can dampen nerve impulses during sex, making us less sensitive to

vibration and touch. And since estrogens increase blood flow to

sexually sensitive areas, decreased levels can slow or diminish the

arousal response. Imbalances of estrogen and testosterone can cause

dryness and thinning vaginal tissue making intercourse uncomfortable

or downright painful – an effect that does absolutely nothing for

libido.

 

Key to a normal sex drive is the right balance of estrogen to

progesterone. An excess blocks thyroid function which inhibits

libido. A balance stabilizes mood and supports thyroid function

which enhances libido. Significantly, progesterone is also a

precursor to estrogen and testosterone so we need it in steady

supply for optimal sexual pleasure.

 

Testosterone and DHEA also have a major impact on sex drive. Levels

gradually decline in the years leading to menopause and can drop

dramatically with hysterectomy, chemotherapy, surgery and radiation.

If you have a low libido and have lost interest in sex, saliva

testing to measure levels of estradiol, progesterone, testosterone

and DHEAs can establish probably cause and a rationale for

correcting the imbalance.

 

Hormone Imbalance and PMS

 

PMS differs from all other disorders because the diagnosis does not

depend on the type of symptoms you suffer from, but on the time when

your symptoms appear and disappear. Dr. Katharina Dalton of the

U.K., a leading specialist who first used the term " premenstrual

syndrome " defines it as the presence of recurrent symptoms before

menstruation with the complete absence of symptoms after

menstruation. Doctors have identified at least 150 symptoms that

occur in PMS, but fortunately, because all of us are different, no

one has all of them! Among the most common are bloating, headache,

backaches, severe grouchiness, depression, breast tenderness, loss

of libido and fatigue.

 

Do these symptoms sound familiar? They are also the symptoms off

estrogen dominance!

 

Katherine Dalton knew this back in the late 1950's when she

pioneered the use of natural progesterone to balance estrogen in PMS

patients, with great success. Over the years she and physicians like

Dr. John Lee in this country have treated thousands of women in this

way. The great majority of patients report remarkable improvement in

their PMS symptoms including the elimination of premenstrual water

retention and weight gain. Dr. Joel T. Hargrove of Vanderbilt

University Medical Center published results indicating a 90 percent

success rate in treating PMS with oral doses of natural

progesterone. We know too, that topical progesterone creams are

equally effective. This has to do with progesterones potent

balancing effect upon estrogen. Saliva testing can determine if your

PMS is associated with estrogen dominance. Measure you saliva levels

of estradiol and progesterone during days 19-21 of your cycle. A low

progesterone/estradiol ratio on your test report indicates estrogen

dominance and the likelihood of PMS symptoms. If this is the case,

it is worthwhile to talk to your doctor about supplementing with

natural progesterone to keep estrogen levels in check. To learn more

read: PMS: The Essential Guide to Treatment Options by Dr. Katharina

Dalton, and What Your Doctor May Not Tell You About Menopause, by

Dr. John Lee.

 

All About Natural (Bio-identical) Hormones

 

Natural or " bio-identical " hormones (BHRT) are synthesized from

natural plant substances to be identical in structure and function

to those our bodies produced naturally before menopause. When

hormone production starts to drop below normal levels in the years

leading up to menopause, natural hormones are the best and safest

way for women to supplement. They are available through your doctor

on prescription and tailor made to meet individual need by a

compounding pharmacist. Some natural hormones are available over-the-

counter, but it is always wise to do research first. Consult Dr.

John Lee's books on premenopause and menopause for an approved list

of creams.

 

Note: Progesterone – not " progestin " – is the natural bio-identical

form of the hormone as opposed to progestin, the synthetic version

(the " pro " in Prempro). Natural progesterone is just like the

progesterone your ovaries make, and it is available in a topical

form over-the-counter, and by prescription when compounded with

natural estrogens and other hormones by compounding pharmacists.

 

When hormone balance is restored and maintained using natural,

bioidentical hormones, there are far fewer side effects, symptoms

and cancers than observed with synthetic HRT. Following natural

physiology as closely as possible makes sense, because in a sense

natural hormones have undergone safety trials as long as humans have

walked the earth.

 

What is Progesterone and Why Do We Need It?

 

Progesterone can be thought of as a hormonal balancer, particularly

when it comes to the estrogens. Progesterone is a steroid hormone

made by the corpus luteum of the ovary at ovulation, and in smaller

amounts by the adrenal glands. It is the precursor, or substance

from which most of the other steroid hormones are derived, including

cortisol, androstenedione, the estrogens and testosterone.

Progesterone has a remarkable repertoire of important jobs from

normalizing blood sugar levels and facilitating thyroid hormone

action to regulating menstrual cycles and maintaining a healthy

pregnancy. The survival of the embryo in the womb absolutely depends

on this vital hormone. Progesterone also has natural calming and

diuretic properties, and it enhances the positive effects of

estrogen while preventing the problems associated with estrogen

dominance.

 

Unopposed estrogen can build to unsafe tissue levels that can lead

to a strong risk for breast cancer and reproductive cancers. While

estrogen levels drop only 40-60% at menopause, progesterone levels

may drop to near zero in some women, resulting in estrogen dominance

and the array of symptoms that go with it. Supplementation of

natural, bioidentical progesterone has been shown to restore

hormonal balance, especially during perimenopause and menopause.

 

Hormone Balance and Osteoporosis

 

Saliva testing can easily test for imbalances in each of the major

hormones that have an impact upon bone health – particularly,

testosterone, DHEA, cortical, estrogen and progesterone. Bone is a

hormonally sensitive tissue that is affected by age-related decline

in production of these hormones. Many studies show that as they age,

both men and women begin to lose bone as the androgens –

testosterone and DHEAs in particular – start to fall off. And when

these hormones are low and cortical is high, bone loss increases at

an even more rapid pace. We know that too much stress raises

cortical output, interfering with calcium absorption and bone-

building activity, while at the same time stepping up the activity

of bone destroying cells. We also know that cigarette smoking,

alcohol intake and a lack of physical activity are associated with

bone loss. In a typical case study from our files a 63 year-old

woman who had never taken hormones since her menopause at age 51 had

a bone density scan which revealed osteoporosis in her hip and

spine. Saliva testing identified an imbalance of androgens as well

as low estrogen and progesterone levels. Supplementing with natural

hormones brought noticeable improvement, but to gain full relief, a

program of stress reduction, optimal nutrition and weight-bearing

exercise was also introduced.

 

Estrogen Dominance and Low Thyroid: Weight Gain and Depression

 

More than 10 million Americans have been diagnosed with thyroid

disease, but interestingly, women are at greatest risk, developing

thyroid problems seven times more often than men. Thyroid hormone

regulates metabolic rate, so low levels tend to cause unwanted

weight gain, depression, low energy and cold intolerance. Excess

thyroid causes higher energy levels, a feeling of being too warm all

the time and weight loss. But it is hypothyroidism or low thyroid

that is most common in women during the perimenopausal and

postmenopausal years; in fact some 26 percent of women in or near

menopause are diagnosed with hypothyroidism. In his book, What Your

Doctor May Not Tell You About Menopause, Dr. John Lee discusses how,

as he learned more about the condition of estrogen dominance, it

became apparent that the taking of thyroid supplements among his

women patients was especially common in those with estrogen

dominance. This is because when estrogen is not counterbalanced with

progesterone, the estrogen buildup blocks thyroid hormone creating

hypothyroidism. Saliva hormone tests show that women who are

estrogen dominant often have menopausal symptoms intertwined with

low thyroid symptoms. The most common are weight gain or being

unable to lose weight and depression. Cold intolerance, thinning

hair, sleep disturbance, fatigue, mood swings and low sex drive are

also associated with low thyroid. If you are suffering from these

symptoms, estrogen dominance may be a factor that can be identified

through saliva testing.

 

Depression and Mood Swings

 

Many women experience mood swings and depression as their hormones

begin to fluctuate erratically in the perimenopausal years and the

decline to ever lower levels at menopause. Unfortunately, far too

many women are put on anti-depressants when, in fact, natural

hormone supplementation to smooth out the roller coaster of waxing

and waning hormones during these years may be all they need. All of

the sex hormones, especially progesterone, estrogens and androgens,

have a potent effect upon state of mind, mood, and memory. So when

they are out of balance – too high, too low, or up and down – as is

not uncommon in mid-life, the effects can range from less than

desirable to devastating.

 

Estrogen, the hormone that surges to highest levels in the first

half of the menstrual cycle, has been shown to increase mood-

enhancing beta-endorphins in menopausal women as well as in women

who are still cycling. It is also known to boost serotonin and

acetylcholine – the neurohormones associated with positive mood and

memory. So a lack of estrogen can bring on tearfulness and anxiety.

But an excess can also affect our mental state by holding sway over

progesterone in the waning reproductive years. That's because as we

age we ovulate less frequently and when we do not ovulate, we do not

product progesterone. In this way we lose the inherent calming and

mood-stabilizing effects of progesterone. We also lose its balancing

power upon estrogen which then builds up, blocks thyroid action

leading to low thyroid, and with it, depression.

 

The androgens, testosterone and DHEA also play an important role in

mental outlook and vitality. So it's not surprising that many women

find they are in much better spirits once they are put on natural

hormone therapy. Hormone balancing is vital after a hysterectomy,

because the removal of the ovaries shuts down all hormone

production, forcing a woman into menopause literally, overnight. One

of the immediate consequences of the surgery is depression, which

can be more safely alleviated by restoring hormone balance than by

taking Prozac. Saliva testing to identify hormone imbalances linked

to depression can serve as a basis for restoring balance and with

it, a positive outlook.

 

Reprinted with the permission of Candace Burch