Lauderdale By The Sea Center For Integrative Medicine

Aging in Lauderdale By The Sea is difficult enough for women without having to deal with declining hormones. Women in Lauderdale By The Sea often complain of a diminished sense of well being, chronic fatigue, and a loss of libido just to mention a few symptoms of hormone imbalance.

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For many women there is a tremendous void in treatment of menopausal symptoms. Hot flashes, mood swings and low or no sex drive are just the tip of the iceberg. Some earlier hormone imbalance symptoms of estrogen deficiency are frequent waking at night. Many others are present, including “mental fogginess.” A woman’s short-term memory retention may be dwindling and her concentration and focus isn’t as good as it used to be. Frequently, women may experience some loss of energy to the point that they actually slide into symptoms of chronic fatigue. In addition, women may experience some mood swings and irritability, and at the extreme may actually develop feelings of depression. With the loss of energy and chronic fatigue, females find themselves unable to exercise as much as in the past, or to recover as quickly when exercising. Women often find themselves increasing weight gain in spite of attempts at exercising. One hormone imbalance symptom that is not frequently discussed is the loss of sex drive and diminished libido. Not only is energy level and sense of well being diminished, but anticipation and enjoyment of sexual activity is waning as well.

How Bio-Identical Hormone Replacement Therapy Is Used To Treat Menopause

It might be tempting to get a quick fix for hot flashes, but consider a different perimenopause treatment besides hormone replacement therapy (HRT). HRT may be inexpensive and easy, but its long-term risks outweigh the benefits - not to mention that it will likely further aggravate the symptoms of menopause! This outcome occurs because HRT causes estrogen dominance, a condition where there is far more estrogen than progesterone in the body. On the other hand, products that are natural for menopause-related symptoms will provide relief from your symptoms without causing estrogen dominance.

How is estrogen dominance related to traditional perimenopause treatments?
Estrogen dominance was a term coined by Dr. John Lee, the first doctor who published shocking findings on the dangers of HRT. His research was premised on the fact that a woman can experience serious health problems if she has normal or excessive estrogen, but little or no progesterone to balance out estrogen's effects on the body. Progesterone inhibits estrogen's effects on the body, e.g. when estrogen increases fat accumulation and weight gain, progesterone burns fat for energy. For these reasons, Dr. Lee suggested that giving progesterone supplements would benefit menopausal women more than estrogen-only HRT. However, his work was shunned by the medical community despite mounting evidence against HRT and the damage it causes. It's easy to see why - when Dr. Lee's research first came out in the 1980s, everyone was still caught up in the hype of estrogen HRT pushed by pharmaceutical companies.

Despite what you might be led to believe, HRT promotes unopposed estrogen. Women these days are very susceptible to becoming estrogen dominant, even when they are menopausal. The beauty products and cosmetics we use are laden with xenoestrogenic preservatives - manmade chemicals that behave like estrogen when they enter the body. Cows and chickens are also fed estrogen so they can grow and fatten up faster. On the other hand, we aren't exposed to the same levels of progesterone. Taking HRT will only skew the balance of estrogen and progesterone, causing estrogen dominance and increasing the risks of various health problems.

Risks of estrogen dominance caused by medications for perimenopause
Below are just some of the risks faced by menopausal women when they take HRT.

Increased menopause symptoms
While restoring your estrogen levels might reduce hot flashes initially, it may also cause increased weight gain, poor sleep patterns, headache, anxiety, and depression if left unopposed.

Fibrocystic breasts and breast cancer
Researchers from Harvard University discovered that the longer your exposure to estrogens, the greater your risk of fibrocystic breasts (breast cysts) and breast cancer. In their Nurses' Health Study, a study that tracked the health of 70,000 women for almost 20 years, they discovered that menopausal women who used estrogen had a 30% increased risk for breast cancer than women who didn't take HRT. The risk for breast cancer was 40% more among women who took estrogen and progestin (a manmade progesterone). Those who were taking HRT for over five years had an elevated risk that increased with their age. The Nurses' Health Study supports early evidence that HRT plays a significant role in the onset of breast cancer, even if progestin is added to balance out the estrogen.

Blood clots
Studies show that an increased risk of blood clots among menopausal women is triggered by two things: cigarette smoking and the use of synthetic estrogens.

Gallstones and liver problems
If you have a liver disorder, then you should definitely avoid HRT; estrogen affects the function of the liver enzymes. Research shows that women taking HRT have twice the risk of developing gallstones that require surgical removal.

Uterine cancer
Four to eight out of every one thousand menopausal women will develop uterine cancer because of HRT. Although the risk of uterine cancer is decreased when progestin is added, research shows that progestin will place you at risk for breast cancer. Other risk factors like cigarette smoking, a family history of uterine cancer, and abnormal uterine bleeding will also increase the likelihood of HRT-related uterine cancer despite the presence of progestin.
Unlike the symptoms of menopause, which are temporary, the side effects of HRT may last a lifetime. Avoid these risks and consider making lifestyle changes or using natural progesterone or phytoestrogens (plant estrogens) for perimenopause and menopause relief.

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Hormone Imbalance in Women

Theoretically,  menopause is not a disease.  Therefore, there is no cure.  Many women opt to forgo any treatment at all, and simply tolerate many of the symptoms associated with this normal transition.  However, for those women whose symptoms are so severe as to interfere with their quality of life, there are many options at their disposal.

Remedies may be implemented by the woman herself for the conditions associated with menopause.  For example,

Hot flashes: Several nonprescription treatments are available, and lifestyle choices can help.

  • Many women feel that regular aerobic exercise can help reduce hot flashes
  • Foods that may trigger hot flashes, such as spicy foods, caffeine, and alcohol, should be avoided.
Heart disease: A low-fat, low-cholesterol diet helps to reduce the risk of heart disease.

Weight gain: Regular exercise is helpful in controlling weight.

Osteoporosis: Adequate calcium intake and weight-bearing exercise are important. Strength training (lifting weights or using exercise bands in resistance training) can strengthen bones.

Certain medications are beneficial in reducing many of the signs and symptoms of menopause.

Hormone Replacement Therapy

  • estrogen or a combination of estrogen and progestin
  • treats hot flashes
  • reduce fracture risk by building bone mass
  • improve cholesterol levels
  • decrease vaginal dryness
  • estrogen and progestin combination associated with increased risk of heart attack, stroke, and breast cancer
  • estrogen alone associated with increased risk of endometrial cancer
  • increased risk of gallstones and blood clots
Selective Serotonin Reuptake Inhibitors (SSRIs)
  • normally used for depression and anxiety
  • effective in reducing hot flashes
Clonidine (Catapres)
  • used to lower blood pressure
  • effective in reducing hot flashes
Gabapentin (Neurontin)
  • primarily used for treating seizures
  • used to treat hot flashes
Megestrol (Megace)
  • short-term relief of hot flashes
  • not recommended as first-line drug
Medroxyprogesterone (Depo-Provera)
  • injectable
  • sometimes effective in treating hot flashes
  • may cause weight gain and bone loss
Several medication options are available for the treatment of osteoporosis during menopause.  They include:
  • Aldenodrate (Fosamax)
  • Raloxifene (Evista)
  • Calcitonin (Calcimar or Miacalcin)
There are natural remedies on the market which report to reduce hot flashes.  However, for many, the clinical studies are conflicting and inconclusive.  These include:

Black Cohosh

  • herbal supplement
  • German studies recommend limiting its use to six months or less
  • not regulated by the Food and Drug Administration
  • side effects include nausea, vomiting,  dizziness, visual problems, slow heart beat, and excessive sweating
Plant Estrogens (Phytoestrogens)
  • soy is an example
  • safety of soy in women with breast cancer not established
Other Herbal Preparations - avoid or take under supervision of health care provider
  • dong quai
  • red clover
  • chaste-berry
  • yam cream
  • Chinese medicinal herbs
  • evening primrose oil
There are several treatment options available to help alleviate the symptoms of menopause.  These treatments should be individualized for each patient.  As many of these methods are not without risk, they should be implemented and monitored under the guidance of a physician.

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