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Menopause

MENOPAUSE


Menopause and its related conditions are not actually disease states, but are processes a woman goes through during the time she is ceasing to have menstrual periods. Let’s define what menopause and its related states actually mean. 

Premenopausal Symptoms involve the milder symptoms occurring up to 15 years before actual menopause when a woman has some of the symptoms such as irregular cycles and is a time-frame during which estrogen dominates. Weight gain, mood changes and other symptoms can appear. 


Perimenopause is the time around 2-3 years before actual menopause where the menstrual cycle can become further disordered, resulting in skipped periods. Hot flashes can also occur during this time. 

Menopause happens when a woman stops having periods altogether for a period of one year. She can continue to have hot flashes and mood swings; these symptoms can last longer than a year and can occur up to 8 years after the cessation of menstrual periods. 

What happens to the hormones in menopause?
Many people, including healthcare providers, are under the mistaken impression that the ovaries completely shut down after menopause. In fact, ovaries continue to make enough female hormones in the body their entire life. Other body areas, such as the adrenal glands, skin, fatty tissue and the brain make hormones as well. 

Progesterone, thought to be made inside the corpus luteum exclusively, actually is made in the absence of regular ovulatory cycles. Progesterone is also made from the adrenal glands. It is imperative that you have your adrenal glands tested, especially if you are fatigued and under stress. By keeping the adrenal glands healthy, you will have a natural transition in to menopause. 

How does menopause happen?
There are three ways in which a woman can arrive at the menopausal state. She can do this naturally through the gradual alteration in hormones that occurs between the ages of 45 and 55. Some women can go through menopause even later than that. The entire process happens over a 5-10 year period of time and includes the lowering of the absolute estrogen and progesterone in the body. The FSH and LH rise and stay elevated for the rest of a woman’s life. The rise, however, isn’t steady and can fluctuate during the perimenopausal state. In addition, a woman may experience subtle changes in her brain function as both male and female hormones have a direct effect on brain function.

A woman can experience premature menopause. This occurs as early as the early to mid-thirties or in the early 40s. It can be a hereditary issue or can occur as a result of autoimmune disease, nutritional problems, illness, adrenal stress, emotional stress or through the use of either oral or injectable contraceptives.

Artificial menopause occurs suddenly as a result of an abrupt loss of ovarian function. Some factors behind artificial menopause include having the ovaries removed during surgery, loss of blood supply following a hysterectomy, chemotherapy, radiation, tubal ligation or when taking certain drugs, such as Lupron-Depot. These drugs will generally only temporarily cause a loss in ovarian function.


Recommended testing: 

Who Can Benefit From Menopause Panels
Non-cycling women with intact ovaries who have had no menstrual flow or spotting for two consecutive years· 
Non-cycling women with total hysterectomy·

Cycling women currently on birth control pills.

Non-cycling  women with intact ovaries who have had no menstrual flow or spotting for 6 months to two years·

Non-cycling women with hysterectomy where one or both ovaries are intact·

Perimenopausal women: irregularly cycling women with less than 8 cycles per year

Traditional Medical Approach:
This type of treatment will vary depending on your doctor’s view. I can tell you this much; I have seen clinically that a lot of patients are put on HRT without proper hormone testing. This is not a wise thing to do. Some doctors will prescribe HRT based upon symptoms alone. What happens if your symptoms decrease but you still have elevated
estrogen levels in your body? Your body becomes a prime candidate for estrogen dominance.  This sets you up for all the conditions, including breast and uterine cancer because your hormones were not properly tested. 

Do not rely on your symptoms alone. This is only one piece of the puzzle. I see a lot of patients taking compounds made by pharmacies without having had any tests run to obtain their baseline hormone levels. I have seen patients go to so-called anti-aging doctors who prescribe Progestereone, Estrogen DHEA, and Testosterone. This is insane. If you understand the hormone pathways, you can balance them out without being on all of the above hormones and precursors to hormones. Their follow up blood tests are showing levels way above the normal reference ranges. These patients then come to me and are hormonally out of whack and very emotional. Some even had their hair fall out. If a doctor wants to put you on all of these compounds at once, I would question his reasoning. This can be over-kill on your system because each of these hormones can affect other hormones in the pathway. In other words DHEA can go in to testosterone and estrogen. So, if you test and have high estrogen you may not want to go on DHEA unless you test to see which pathway it is going down. One other word of caution: your hormone levels should not exceed the normal reference ranges on a blood test. There are practitioners out there who are causing major problems with people’s chemistry and emotions by keeping these hormones at an elevated level. Proper testing and follow up testing is a must. 

Functional Medical Approaches: 

First of all, hormone testing is recommended along with an adrenal stress index test. The adrenal glands are responsible for producing progesterone as you go into menopause. Remember, the adrenal glands are our stress glands. If we have a blood sugar problem such as insulin resistance or diabetes or, if we have tissue inflammation or are sensitive to certain foods, or if we have mental and emotional stressors from within or outside are body, this will create stress on our adrenal glands and they will not be able to produce enough progesterone as you go into menopause or once you are in menopause. Addressing the adrenal glands is a must for perimenopausal or menopausal women. The underlying factors need to be found through testing and balancing the chemistry is the key for optimal health.

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