Menopause and Peri-Menopause Blog

Question from Radio Show Caller
Caller: I entered menopause or peri-menopause just a few years ago, I found some things that worked for me, and now they are no longer working even though I am on bio-identical hormones. I started having the nights sweats, the fatigue, moodiness and things like that. I have tried several estrogens and several different things. So far, no luck, meaning I am experiencing those symptoms still, and I have occasional periods. What do I do?

Dr. Darrow: You need to get your hormone levels checked. If you have occasional periods then you are still peri-menopausal, which is the most difficult phase, because at that stage your ovaries are erratically putting out different amounts of hormones, it is very tough at that stage to really get someone on track.

Progesterone is probably the most important thing that you can have in your system because it is a relaxant, it modulates the amount of estrogen so you don’t get it too high, like those months that you are flaring with estrogen and probably moody and feeling a little bit out of whack and retaining fluids, etc.

The way I like people to take Progesterone is by pill just before they go to sleep, I give it to men and women. For women, it is the most relaxing of all the hormones, it also helps build bone. I don’t know if you had a bone densitometry taken recently but it is something that is very important, if you need one you can always call our clinic because that tells the tale right there if you have enough estrogen, testosterone and progesterone because those hormones build up the bone structure, it is most important to maintain the bones, because if the bones are demineralizing, there is a risk of fracture.

You need to have your hormone levels checked. You also need to have very adequate levels of testosterone, not the levels that a man has, but the upper levels that a strong young women has and if you are peri-menopausal, I am not sure how old you are.

Caller: I am 54

Dr. Darrow: Then your Testosterone level has probably dropped down to nothing, it does for most women, and that, in it of itself, once supplemented, can bring you back into alignment. It is also good for the libido and quality of life and the ability to accomplish things.

Estrogen

There is a great deal of fear and confusion when it comes to menopause and hormone supplementation. First, the term Hormone Replacement Therapy or HRT can conjure up the image of a cancer, stroke, and heart disease causing cocktail of synthetic hormones.

Next there is the “alternative,” Natural Hormone Replacement Therapy (NHRT). There is no Natural Hormone Replacement Therapy. Hormones for use in humans need to be synthesized from something. While many use the term, it is the sometimes favorite of internet sites selling “hormones,” and thus an easy target for critics who still favor the use of horse hormones and point to the “NHRT” websites as those making unsupported claims and being medically dangerous.

Sometimes, but incorrectly added to the latter group are the aptly and descriptively named “Bio-Identical Hormones.” Bio-identical Hormone Replacement Therapy (BHRT) is not “natural” hormones and should never be referred to as that. Their sources are natural, being derived from plant sources, but, they must be chemically altered to exactly match the hormones produced in the body.

This is where the “natural” confusion comes in. Bio-identical Hormones are engineered to exactly match the natural hormones present in the body, but they themselves are not “natural” but indeed, bio-identical.

I would like to point out here that NOT every woman coming in with peri-menospausal, menopausal or post-menopausal complaints is put on hormone therapy at our clinic and there are no studies that clearly show that bio-identical hormones are any safer than synthetic hormones.

Sometimes the desired results a women wants can be achieved by quitting smoking or drinking, altering a diet to avoid foods that could aggravate symptoms, such as coffee, sugars, and foods loaded with chemicals, getting more exercise, reducing stress, reducing exposure to caustic elements and more.

There are options to Hormone Replacement Therapy and these can and should be discussed with a physician knowledgeable in understanding all the options available to the peri-menospausal and menopausal woman. Just because Grandma went through menopause naturally, doesn’t mean she was the better for it!

Hormone replacement, peri-menopause and menopause
For over four decades doctors freely prescribed synthetic estrogen replacement to women in the throes of menopause to alleviate the myriad of symptoms associated with the “Change of Life.” It was an easy thing to do. A women would come in with “hot flashes,” “mood swings,” and “fatigue,” among other complaints and the doctor would simply give them estrogen. Why not? The women who took estrogen seemed to be more youthful, enjoy life more, and “had control of their bodies.”

The problem became supplying the demand for estrogen. To which “Estrogen Farms,” were set up to capture the urine of pregnant mares (where the name Premarin comes from (Pre=Pregnant, Mar=Mare, In=Urine) to glean the estrogen from it.

Synthetic horse-urine estrogen replacement was now the vogue and over 10,000,000 women were “in style.” Physicians felt comfortable putting women on this estrogen, since many studies proclaimed the vast benefits of estrogen replacement therapy. In fact, once on horse-estrogen, many women refused and still refuse to give it up!

Happy with horse estrogen

After menopause, estrogen levels in a woman’s body declines.

Estrogen Replacement Therapy (ERT) alleviated the familiar symptoms of menopause for many women.
With this decline often comes the familiar symptoms of:
1. Vaginal dryness, painful intercourse
2. Vaginal mucosal atrophy
3. Hot flashes
4. Night sweats
5. Fatigue
6. Mood swings and memory problems
7. Fluid retention
8. Sleep problems
9. Decreased libido
10. Involuntary loss of urine (stress incontinence)
11. More frequent urinary tract infections

It seemed like an idyllic world. Women wanted estrogen, the doctors were eager to comply, and the pharmaceutical industry was happy to produce.

Then on July 12, 2002, the world of synthetic estrogen replacement abruptly collapsed and panic filled women across the world. The Journal of the American Medical Association (JAMA) reported that Hormone Replacement Therapy was too dangerous to research!

Estrogen Segments 1 2 3

Ask A Question?

Hormone Replacement

Hormone Supplementation

What are hormones?
What is hormone supplementation?
How does it enhance vitality even as we age?

Hormones are chemicals within our bodies responsible for many things including the regulation of our metabolism, immune function, blood pressure, sugar levels, body temperature as well as a host of other things including regrowth and repair of damaged tissue. They are produced by our glands, namely the Thyroid (Thyroid), Adrenals (DHEA, Pregnenolone), Pituitary (Human Growth Hormone (HGH)), Ovaries (Estrogen, Progesterone, Testosterone) or Testes (Testosterone), and Pineal (Melatonin). After about the age of 30, our body’s hormone levels start to decline. Many cite this decline with the “normal” aspect of aging and its familiar characteristics of fatigue and loss of energy, problems of memory and mood, lack of ambition, loss of libido, weight gain and muscle loss and much more that add up to a sense of poor health. This hormonal decline continues as we age, and usually becomes problematic in our 40’s and 50’s, although, it can create issues at an even younger age. An example are the statin drugs that can cause a dramatic decrease in testosterone even at a young age. With testosterone decline, we find incidence of erectile dysfunction.

Giving “pause” to thought We have all heard of and embraced the term menopause to describe a decline in the female sex hormones, but there are other “pauses” that are becoming more recognizable as house-hold names. Doctors have coined the terms “andro-pause” to describe the decline of male sex hormones in men, “somatopause” to describe the decrease in human growth hormone, “adrenalpause” to describe a decline in DHEA, and “pinealpause” to describe a decline in melatonin.

In the opinion of many doctors, maintaining optimal hormonal balance is our best opportunity to enhance vitality into “old age” and overcome these “pauses” in life. Some doctors however believe that aging is inevitable and that nothing can be done about it except to accept it gracefully. This is a stigma of modern medicine. On one hand, medicine is proud, and rightfully so, of enormous jumps in life expectancy ages, but on the other hand, they are skeptical about enhancements in quality of life. Therefore some doctors may be reluctant to treat hormonally deficient patients because they see this as a normal result of aging, and something they can’t do anything about.

In other words a 70 year-old man presents himself to the doctor’s office with complaints of loss of sex drive, fatigue, and inability to lose weight. It is likely that his doctor will say, “You are 70 years old, and this is normal for your age!”, rather than take blood tests of hormone levels. If the patient was insistent about getting his hormones checked the doctor may see “normal” results, that are the normal ranges for a man 70 years old and tell the patient that he is normal. But the patient isn’t “normal,” that is why he went to his doctor! He doesn’t want the hormones of a 70 year-old man, he wants the hormones necessary to have sex drive, muscle tone, strength, ambition, joy, and his vitality back. He also wants a good chance to be free of heart disease, diabetes mellitis, and other diseases of aging. Why not check his c-reactive protein, fasting insulin, and homocysteine levels, along with many other markers of hidden disease?

Hormone Supplementation Parts 1 2 3

Testosterone For Men

TESTOSTERONE FOR MEN
The medicinal value of testicles have been documented in the Bible, the writings of the ancient Egyptians and from India. Indeed, nearly every ancient culture believed that the testicles held some form of masculine power.

The use of testosterone as a means of restoring vitality can be traced in the modern era to the work of famed medical researcher Charles Edouard Brown-Séquard (1817-1894). Brown-Séquard had been hailed as a medial pioneer for his ability to treat difficult and previously untreatable disorders of the nervous system. At the age of 72, when he noticed his declining vitality, he injected himself with the extracts of crushed testicles from dogs and guinea pigs and increased his physical strength and intellectual abilities and announced his results to his colleagues.

Brown-Séquard’s work sparked an influx of research and medical use of testicles, however, technology could not, at that time, substantiate his claims.

In 1935 Dutch researchers were able to isolate and create a synthetic form of testosterone. Doctors prescribed it in males with hypogonadism—where levels of testosterone are so low it prevents normal sexual development. Older men suffering from impotence were also treated. A few years later, testosterone supplementation for these disorders became “mainstream.”

What are the potential signs of Testosterone deficiency in men?

1. Diminished Libido
2. Erectile Dysfunction
3. Fatigue
4. Muscle Weakness
5. Bone Density Loss, with increased fracture risk
6. Decrease in Endurance, Stamina
7. Loss of Body Hair
8. Depression
9. Mood Disorders
10. Obesity or increase in fat mass
11. Hypertension
Testosterone Supplementation
Testosterone supplementation has received a fair share of “bad press.” Mostly due to health problems (sterility, coronary artery disease, liver damage, and brain tumors), caused in young men and women who should not be taking testosterone supplementation, but do so at super-physiological doses, to enhance athletic performance. Indeed, testosterone is part of the “Steroid Crisis” affecting amateur and professional sports.

There is very little evidence to support that testosterone supplementation to restore levels lost to aging can cause health problems. Numerous research supports the opposite. Study participants and researchers noted gained muscle, a slowdown in bone loss, increased sexual desire, and better cognitive skills.

Drops in testosterone levels begin in men after the age of 30 and its effects are described as “male menopause” or andropause when problematic.

The recognition that men can suffer from sex hormone deficiency just as women do, and be treated for this deficiency in the same manner as women prescribed hormonal supplementation have lead to an explosion in the demand for testosterone supplementation.

Testosterone Supplementation Risks
It is important to understand that not all men will benefit from Testosterone supplementation. The goals, realities, and risks of Testosterone supplementation should be discussed, at length, with your physician prior to onset of treatment.

Testosterone Supplementation and Prostate Cancer
Men taking testosterone supplementation should have twice yearly PSA tests and once yearly manual examination of their prostate gland. No evidence suggests that testosterone supplementation causes prostate cancer. In fact, studies show a higher incidence of prostate cancer in men with a lower baseline level of testosterone. Have you ever heard of a teen age male (with the highest testosterone levels) having prostate cancer? Studies do suggest that in the presence of existing prostate cancer, testosterone supplementation may accelerate tumor growth. It also appears that there is an association of high estrogen levels and prostate cancer.

Warnings:
Any hormone supplementation can adversely effect other hormone levels.

Testosterone supplementation must be monitored by a physician through blood testing. Very high levels of testosterone can lead to severe and dangerous health problems.

Men who take too much Testosterone may can shut down production of DHEA and other sex hormones.

The result is the frequently seen side effects of:
1. Testicular shrinkage
2. Impotence
3. The development through increased estrogen production of breasts (gynecomastia).
4. Male Pattern Baldness
5. Infertility

Other complications may include:
1. Fluid retention (swelling)
2. Heart Problems through increasing hardening of the arteries.
3. Increase in body hair
4. Acne
5. Liver problems
6. Kidney disease
7. High Blood Pressure
8. Gallstones