MENOPAUSE & YOUR HORMONES

Menopause is a super individual journey. To optimize your skin, it really helps me plan your care when you are holistically stable in the hormone/adrenal aspect, your skin is a refection of your inner health.

Understanding your options is the first step to enjoying the transition from child bearing to not. We get into a more emotionally stable place where its really its nice not being cycled up and down a hormonal roller-coaster.

I want to highlight some facts and give you an idea of what’s available to ease the transition so you can keep on being you. Some people cruise through menopause with no symptoms… if that you don’t waste you time here. But if you are not feeling like yourself then read on.

Perimenopause usually begins in our mid to late 30’s when the ovaries start to slow down and hormone levels begin to drop. They continue to drop until periods become more spaced out and irregular. Menopause is defined once a woman has had 12 full months without a period and it marks the end of your reproductive years. Afterwards, you are considered post-menopausal.

During the years of perimenopause and into post menopause women can get fluctuating symptoms with these hormonal changes. These include:

● Hot flashes, night sweats, mood swings, and Insomnia

● Irritability, depression, and brain fog

● Vaginal dryness and worsening of thyroid or autoimmune disorders. Low progesterone can shift the body’s immune system and cause a flair of Hashimoto’s during this hormonal transition time. Even if you are not having a period anymore, you can still check your hormone levels. You can test any day and the panel is the same for cycling women- estradiol, progesterone, free testosterone, total testosterone, SHBG, DHEA-S, complete thyroid panel and cortisol A DUTCH complete test is a great idea during this phase of life because it will show the estrogen metabolites that are present. You can work with your doctor to improve your estrogen profile to prevent breast cancer and other hormonally linked cancers. It will also provide you information about adrenal function and melatonin production.

HORMONE REPLACEMENT THERAPY: Typically, the hormone replacement therapy women are prescribed includes estrogen as either estradiol or estriol, or a combination of both, progesterone, testosterone, and DHEA.

Synthetic Hormones VS Bioidentical Hormones

Synthetic hormones are sometimes called “natural” because they are sourced from plants or animals. { Sneaky pharmaceutical companies} For instance, premarin is a synthetic estrogen that is derived from a female horse’s urine, which is a natural substance. In order for our body’s to use it, the pharmaceutical company needs to attach a side chain to it so the chemical works in our bodies. Progestin is the synthetic form of progesterone. These synthetic hormones are what most of the research on hormone replacement therapy has been on. Which is why there were bad outcomes and women were scared away.

Bioidentical hormones are hormones that are identical in molecular structure to the hormones we make in our bodies. They match the chemical structure exactly so your body can’t differentiate between your own sex hormone and the ones you are taking.

● A review of the literature in 2009 stated that physiological and clinical data have indicated that progesterone is associated with a diminished risk for breast cancer, compared with the increased risk associated with synthetic progestins. Synthetic progestin is also associated with negative cardiovascular effects that may be avoided with bioidentical progesterone.

● A recent study in the New England Journal of Medicine followed 1.8 million women, aged 15 to 49, and found that progestins, found in birth control, may increase the risk of breast cancer.

● One study found an increased risk for breast cancer in women who used synthetic progestin in combination with estrogen. However when bioidentical progesterone was used with estrogen, the risk was abolished and there was actually a protective effect of this combination,

lowering the risk for breast cancer.

● A 2017 review in the Journal of the North American Menopause Society stated that estriol, bioidentical estrogen also called E3, offers considerable benefits for postmenopausal women with reduced risks that are normally associated with traditional hormone therapies.

There are a lot of researched benefits from hormone replacement therapy -

● Relieves hot flashes, insomnia and mood changes

● Estrogen replacement has been used for over 30 years to prevent osteoporosis, memory decline and cardiovascular disease that are all associated with decreased estrogen levels.

● Women have a lower risk for cardiovascular disease up until menopause. After menopause, the risk for cardiovascular disease becomes more similar to men. This suggests that hormonal changes and reduction in estrogen may be one of the contributing factors. In addition, we know that estrogen and progesterone are neuroprotective, that is they support brain health, and neuroplasticity, our ability to learn new things.

Putting a perimenopausal woman on the pill is a bad idea. The risk for blood clots is increased on the pill. Not to mention, there are better ways to manage perimenopause symptoms naturally, or with BHRT, that don’t pose all of the harmful side effects of the pill. Some natural therapies to reduce the symptoms of perimenopause and post menopause include black cohosh, vitex, magnesium, exercise and stress reduction, and adrenal support.

HOW IS BHRT ADMINISTERED?

Progesterone can be used as a cream or orally. It is usually taken at bedtime because progesterone is calming to the brain and can also help with sleep. If women are experiencing insomnia and anxiety, the oral form offers more relief.

Estrogen is typically a cream. There are oral versions of bioidentical estrogen, but the issue is that estradiol in a pill is converted to estrone by the liver. Estrone is the form of estrogen that may increase your risk of breast cancer when compared to estradiol or estrone. In addition, oral estrogen is associated with increased cardiovascular risk. If you use an estrogen cream, it bypasses the liver and the estradiol that you apply stays in its original form, it isn’t converted to estrone. Estriol is often used for vaginal dryness and because it is less potent. If you have symptoms of vaginal dryness, DHEA or estrogen might be helpful when they are applied directly to the vagina topically. This needs to be under the supervision of your doctor.

Bioidentical hormone replacement is not for everyone though. If you have a history of certain cancers, or if it has been too long since you had your last period, then BHRT might not be the best option for you.