Hello everyone and welcome to our series on menopause and perimenopause. In our first article we talked about symptoms of perimenopause and what is happening physiologically. In our 2nd article we talked about the important functions of your hormones after menopause and how your adrenal glands take over as your back up hormone factory. In articles 4 and 5 we will be talking about inflammation and the brain in preventing typical symptoms such as fatigue, brain fog, brittle hair, hot flashes, and other symptoms common (though not normal) with a women entering menopause.
What Goes Wrong?
This article is dedicated to one of the most common questions I get through emails and phone calls. The email is something usually like this:
“Hello Dr. Warren. I am a 52 y/o female and I my health has really plummeted since I began perimenopause. I feel like I can’t think, I’ve gained weight, my hair and nails looks horrible, and the hot flashes are unbearable. I was wondering if you think I need some hormones? Susanne Somers books say bio-identicals are a must and that I probably need progesterone. A friend of mine took estrogen and it helped her feel better but she gained weight. Do you use bio-identical progesterone?”
I get this question so often, I’m posting about it on the blog, so I can link the article to people who email me about it. I will answer the question in simple terms, (because I hate it when people avoid the question) but please realize this is a very difficult question.
The short answer is I prefer bio-identical hormones when available and yes, I do use some of these hormones in my office including progesterone.
The more complete answer is that I rarely use hormones directly with most of my patients and here is why. I practice what is called “functional medicine.” You can look up the Institute for Functional Medicine, but the basic premise is I want to restore the function of your body. This means in theory (especially in the long-term) I do not want to give your body a hormone (like progesterone), but rather I want your body to make it! I find most of my patients are able to raise and balance their hormone levels with-out taking synthetic or bio-identical hormones! Please see my other articles in this serious about adrenal function, inflammation, and brain neurotransmitters for details in getting your body’s hormone back online.
We mention this in our blog post on inflammation, but it is so vital I will post it here also. Taking hormone replacement (bio-identical or synthetic) does not reduce the inflammation that happened when the hormones suddenly dropped, so if you rebalanced your endocrine system by taking hormones you still must do something for the inflammation. With that said, let me at least provide you with some common pitfalls of people who take hormones.
Common Pitfalls of Taking Hormones
1. If you are taking a hormone cream it is extremely easy to overdose, and even if it is bio-identical overdosing can cause huge problems. To ensure you are not overdosing you need to check free hormone levels. I find most doctors doing hormone creams are not checking free hormone levels and when people come into my office they are off the chart high! High hormones give the same symptoms as low hormones because of receptor shut down, so these women think they are deficient and they keep increasing their dose which perpetuates the problem.
2. Other people run into problems because of conversion. Let’s say they are a female taking an estrogen cream. The doctor runs only estrogen blood tests to check on the hormone levels. This is a huge mistake! Hormones can interconvert, which means I can give you estrogen and your body can switch it into other hormones. When you are taking a hormone, you need to monitor with tests of the whole sex hormone family to make sure you aren’t interconverting inappropriately. I find many women on estrogen creams they are converting into high testosterone and wondering why they are getting facial hair. I also find many men on testosterone but they are converting it into estrogen and developing male breasts. If you are taking any hormone, it is vitally important to test the entire family, to make sure you are not over converting.
In closing, it is important to know your hormone levels before taking bio-identical or synthetic hormones so treatment can be efficient and effective.