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Perimenopause Has anyone covered these points with you yet? If we stick to symptoms and put aside hormone measurements in the blood, it's not all that difficult to recognize a case of perimenopause. Hot flashes may be enough for some, but perimenopause may also involve heavy and prolonged periods, breast tenderness, increased fibrocystic changes, growth of uterine fibroids, flare-ups or progression of endometriosis, endometrial thickening and osteoporosis. One patient of mine also reported anxiety, depression, sugar cravings, fatigue and lethargy. O.K, so what do we do about this? These are not easy things to live with. Most women head off to the conventional medical doctor and come home with enough hormones to choke a horse. Metaphor intended, because usually these hormones come from a horse. In my opinion, these hormones should remain with the horse and not be used by humans. The main hormone is usually some form of estradiol but probably not one that looks identical to the one women produce themselves, even though this is available. So what have we got with this perimenopausal patient now that she's taking the estrogens from a horse? According to the news in almost all media in late July this year estrogen therapy no longer provides any decrease in risk of heart disease. We do, however, have a marked increase in the risk of cancer, especially breast cancer. But to the patient's relief the hot flashes are gone. Isn't there a way to combat the symptoms without risking so much? It is surprising, and contrary to popular belief, that low estrogen status is NOT usually the case in perimenopause.(1) Your adrenal glands and fat cells adequately pick up the slack after the ovaries decrease their production of estrogen. But if that is so, why does estrogen replacement therapy work so well to eliminate the hot flashes? The answer appears to be that it is irregular spikes in hormonal production by the perimenopausal body that produce the hot flashes, not the low estrogen. And swallowing the estrogen pills keeps the hormone level so sky high that all spikes in the hormonal flow are eliminated, and the hot flashes with them.(2) One hormone that does appear to be reduced in perimenopause is progesterone.(3) Where estrogen is responsible for increasing cell growth, for example breast tissue and endometrium, progesterone is responsible for signaling cell death, thus starting the process that ends with the elimination of the endometrium. In other words, the menstrual flow. Progesterone also appears to play more of a role in bone mineralization than estrogen.(4) The perimenopausal symptoms of heavy periods, endometrial thickening, flare-ups of endometriosis, fibroid growth and osteoporosis become more logical once we know that progesterone is reduced in perimenopause. If one is forced to consider hormone replacement therapy, progesterone is probably the one to focus on, not estrogen. Because progesterone initiates cell death it has a rather significant anti-cancer effect as well. This is a much more attractive approach than the pro-cancerous effect of estrogen. May I go back to my patient I mentioned earlier? Her diet included all of the most common food allergens I continually harp on about. I asked her to replace these with other foods, swallow a potent multi-vitamin-mineral supplement and an extract from the plant Cimicifuga racemosa (black cohosh). In three weeks none of her symptoms were left, including the sugar craving. Nutritional and botanical supplements usually take at least one or two cycles to improve a hormone dysregulation. In this case her incredible normalization appeared almost entirely due to dietary changes. If you do have to turn to hormones as one of the last resorts, bear in mind the following: ..1.
You can have tests to determine your deficiencies and References 1.
Santoro, N., Characterization of Reproductive Hormonal Dynamics
in the Perimenopause. Journal Clinical Endocrinology and Metabolism
1996; 81 (4): 1495-1501. Copyright:
Bruce Lofting, N.D. August, 2001
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