Right now there are tens of thousands of women in the United States who are experiencing the symptoms and signs of menopause and struggling to figure out why they feel the way they do. The start to have irregular periods (either more frequent, heavier bleeding, skipped periods), start gaining more weight, are more irritable, have difficulty sleeping, experience low libido (decreased sex drive), have memory issues, loss of lean muscle and increase in belly fat. They also have the more commonly associated symptoms of hot flashes, night sweats and vaginal dryness. These symptoms are very disruptive to their overall quality of life and can be easily treated if they go to the right doctor.
1. What should I do if I start having any of the signs of menopause?
The first thing you should do if you are experiencing any of these symptoms is have your blood levels checked (not saliva). The standard panel that I do for all my perimenopause and menopausal women is: FSH, LH, TSH, free T3, free T4, 8AM cortisol, total and free testosterone, DHEA-S, IGF-1, Vitamin D, Complete Blood Count, Complete Chemistry Panel, Fasting Insulin and HgBA1C. In addition I do a markers to predict stroke and heart attack as 90% of women will die of heart disease. Lipoprotein a, NMR lipoprofile, Lp-PLA2, CRP, Apolipoprotein B and microalbumin to creatinine ratio. In addition, if you are experiencing any irregular bleeding you MUST have you OB-Gyn doctor do an exam to include a transvaginal ultrasound of the uterus to make sure the bleeding is not secondary to cancer.
2. What is the best treatment for the signs of menopause?
Unfortunately women are like snowflakes and no two women will respond exactly the same way to hormones. Here is a general guideline to treating women in both perimenopause and also menopause. In both perimenopausal and menopausal women we make sure their thyroid, testosterone, growth hormone, cortsiol and DHEA levels are optimal. That is many of these women will get prescriptions for testosterone, DHEA and thyroid.
In perimenopause, women are still bleeding monthly so we never give them estradiol. Doing so would result in what we call estrogen dominance (heavy bleeding, breast tenderness, irritability, bloating and acne). In these women generally prescribe daily bio-identical progesterone at night. Progesterone is generally enough to help regulate their menstrual cycles and eliminate some of the hot flashes and night sweats they are getting.
In women who are menopausal we give them all of the above (progesterone, DHEA, thyroid (if needed)) but we also add estradiol. Estradiol is the hormone in women which protects their heart, bone and brain. It protects against cancer, keeps the vaginal mucosa moist, the memory sharp, the skin thick and eliminates the hot flashes and night sweats. It also helps prevent them from gaining weight in their abdomen which happens to women in their 40’s as they approach menopause. Here is a great link to Dr. Rouzier treating women with hormones: https://www.youtube.com/watch?v=YUptH9GGnkQ
3. When am I technically in menopause?
The definition of menopause is when you have not had any periods for 12 months and your FSH (follicle stimulating hormone) level is >50. Once you meet both those criteria you are technically in menopause. Interestingly, women can have up to 6 additional menstrual cycles in the first two years in menopause which give many women concern.
Prior to meeting both those criteria you are considered what is called perimenopause. In perimenopause anything that happens is normal and anything can happen. I have seen women start menopause as early as 30 and as late as 59 but the average age is 50-52. Here is a great link to understanding bio-identical hormones in women: http://www.lifeextension.com/Protocols/Female-Reproductive/Female-Hormone-Restoration/Page-01
The signs of menopause and are difficulty losing weight, fatigue, irritability, insomnia, irregular bleeding, hot flashes, night sweats, low libido, vaginal dryness and changes in mood can happen in women starting at age 30.
The first thing you need to do is have your blood levels checked by doctors who specialize in anti-aging medicine with a special emphasis on bio-identical hormone replacement.
To have your levels checked and evaluate by Dr. Sean Breen simply call us at 877-721-0047 or visit us on the web at www.DoctorBreen.com