Menopause is defined as the ceasing of menstruation. But, ask any menopausal woman and she can confirm that menopause is much more than that. Menopause is often accompanied by uncomfortable symptoms such as hot flashes, night sweats, dryness (hair, skin, eyes, vagina), mood swings, insomnia, anxiety, and many more. Many women will also experience more significant consequences such as bone loss and cardiovascular disease. So, why do we experience so many symptoms from “the ceasing of menstruation”? Because the ceasing of menstruation is just one result of low estrogen production, a normal aging process.
Estrogen receptors are located all over the body, not just the female organs. The loss of estrogen affects many body symptoms. This is a well-accepted fact, and many women are offered estrogen replacement to make them more comfortable. Is estrogen the only hormone affected during menopause?
Progesterone is well known for its effects on the uterus – maintaining a secretory endometrium and preventing estrogen dominance. Conventional thought is that after menopause or hysterectomy, progesterone is no longer needed since estrogen levels are significantly lower and/or there uterus is no longer present. But just like estrogen, progesterone also has receptors all over the body.
Progesterone levels begin to decline in some women as early as the mid 30’s, long before estrogen. This decline in progesterone creates an environment of estrogen dominance, which can cause many uncomfortable symptoms such as worsening PMS, insomnia, anxiety / depression, shortened menstrual cycles, night sweats, weight gain, fibroids, and headaches or migraines. More seriously, estrogen dominance can contribute to endometriosis, PCOS, and breast disease including cancer. With estrogen only replacement, many women will continue to have uncomfortable symptoms, due to estrogen dominance. The most common response is to increase estrogen dose, which often perpetuates the problem.
Progesterone replacement is just as important as estrogen replacement for menopausal women, with or without a uterus, for more complete symptom relief, but more importantly, to prevent estrogen dominance and offer cancer protection. But, not all progesterone is created equal. Progesterone, as well as all hormone replacement, should be bio-identical. This means the chemical structure is a duplicate of the progesterone created by the body. With the exception of its direct action on the uterus, synthetic progestins (medroxyprogesterone, birth control pills) have the opposite affect of bio-identical progesterone on the body, increasing cancer risk and causing many symptoms associated with low progesterone. Bio-identical progesterone is available commercially as an oral capsule, and also available from compounding pharmacies in a variety of dosage forms.
Progesterone isn’t just for menopause. Progesterone deficiency often occurs long before menopause, causing significant symptoms in younger patients, especially PMS. Many younger patients respond to phytoprogestins (Vitex) supplemented during the luteal phase (days 15-28), but some patients will need bio-identical progesterone to relieve symptoms. The transition to menopause (referred to as peri-menopause) can be as long as 10 years! So, don’t wait until menopause to get relief.
If you think you are suffering from symptoms of hormone imbalance, testing is best! Our hormone test kits can be taken in the comfort of your own home. You can then schedule a consultation with our pharmacist to go over the results and develop a plan to balance your hormones and feel better. We are available by M-F, 9am-6pm. Call us 334-478-3522, email firstname.lastname@example.org, or stop by for more information.