By physicians who have been trained in
the most comprehensive medical education on earth,
whose goal is to restore and maintain health,
and whose highest professional allegiance
is to our patients.
The attainment of value over time
© by Cheryl Hamilton, NMD
Menopause is not a diagnosis or a time to be dreaded. Menopause is a wonderful passage from the childbearing years to the attainment of value over time. This value is equivalent to our capacity to learn from our experiences.
When we truly learn from experience, our perspective on life deepens and broadens. This allows our hearts, having known both suffering and forgiveness, to open in compassion for all of life.
Menopause is defined by the complete cessation of menses for 12 consecutive months. The average age of menopause is 52, but symptoms can start months or even several years before your period ends. Perimenopause, literally meaning “around menopause”, is the period of time when the ovaries start to wind down their egg production. It can start in the early 40’s and is usually noted with irregular menses. During this time, women may begin to re-examine their place in life and how they feel about their interpretation of their presence and the world around them. This passage of life provides an extraordinary awakening of being and allows for profound growth and enlightenment.
While mild symptoms are a normal part of the decrease in estrogen coming from the ovaries, many women experience more severe symptoms during this passage because they have had an imbalance of hormones and brain neurotransmitters in the years leading up to menopause. This can be due to environmental exposure to estrogens; high levels of stress; nutritional imbalances due to impaired liver function, malabsorption due to food allergies and/or dysbiosis of gut flora; adrenal fatigue and/or thyroid malfunction.
Symptoms that can occur while a woman is going though peri-menopause and menopause include:
Hot flashes and/or night sweats
Cravings for sweets or carbohydrates
Diminished sexual desire, vaginal dryness and tissue thinning
Anxiety, irritability, depression, and/or mood swings
Restless sleep and/or insomnia
Fuzzy thinking (difficulty concentrating, memory problems)
Weight gain, especially around the abdomen
Stiffness and joint issues
Other menopause symptoms include heart palpitations, headaches, thinning hair, dry skin and eyes, increased facial hair, digestive problems, pain during intercourse and urinary dysfunction.
Why do we have these symptoms? Because changes in hormones affect every cell in the body. For example even though the exact mechanism behind the alteration of the thermoregulation area of the hypothalamus of the brain has never been determined, it is known that loss of estrogen is the key factor in hot flashes. Estrogen elevates serotonin, a neurotransmitter that lowers body temperature. This is why antidepressants, known as selective serotonin reuptake inhibitors (SSKI’s) can help relieve hot flashes. Other symptoms, such as vaginal atrophy are directly related to the loss of estrogen’s proliferative properties.
Why do we lose estrogen? Follicles, developing in the ovaries, are the primary producers of estrogen. As follicles stop developing, estrogen production sharply declines so that the only estrogen source is from the minute amount produced in the adrenal glands and the conversion of testosterone to estrogen via an aromatase enzyme, found primarily in abdominal fat. For many women, cessation of follicular development doesn’t occur instantaneously. Instead it takes a number of months or years. Since the hormone production from the developing follicles becomes disrupted, the follicles may mature sporadically so that women experience periods closer together, further apart, or even one right after another for several weeks or months. Extreme fluctuations in hormones that contribute to moodiness can also accompany this process.
Progesterone production depends on the corpus luteum – that part of the follicle left over after luteinizing hormone stimulates the release of the ovum (matured follicle). If no egg is released, less progesterone is produced (some progesterone is produced in the adrenal glands). With less progesterone on board, the blood isn’t held in the endometrial tissue of the uterus and spotting can occur. Insomnia, mood swings and depression are also related to low progesterone levels.
Many women choose to use hormone therapy to reduce or eliminate symptoms. Since our personal environment, biochemistry and physiology influence hormones, each woman has a unique need for and supply of hormones – there is no one size fits all. Using bio-identical hormones from a compounding pharmacy allows one to individualize treatment. Bio-identical hormones are molecularly identical to the hormones of the human body and can be delivered via capsules, creams, sublingual troches and injectable pellets to provide symptomatic relief of peri-menopause, menopause and andropause (yes, men can use hormone therapy, too).
The bio-identical hormones are thought to be safer with no known increased breast cancer risk for the first 3-5 years of use, and only slightly increased risk for longer use (statistics vary with types of hormones utilized). One also has to understand the limits of research because it is extremely difficult to obtain definitive numbers due to the fact that it takes years for breast cancer tumors to develop and many factors, including age, genetic predisposition, environmental toxin exposure, adipose tissue and lack of exercise affect tumor occurrence and growth rates.
If you have a family or personal history of breast, ovarian or uterine cancer, there are plenty of non-hormonal options. Many women try over the counter herbs and have little or no success. This can be due to the quality of herb used as well as the dosage. It’s important to work with a health care provider who is highly trained in herbal therapy so the correct dosage and combination of herbs are utilized to achieve maximum symptom relief. The quality of herbal supplements is imperative, so make sure you get what you pay for by asking the manufacturer for a third party certificate of analysis or purchase from a reputable retailer. Herbal therapy, along with optimum diet and lifestyle are highly effective in helping women feel like themselves, again.
There are also pharmaceuticals, such as anti-depressants that are used to address uncomfortable symptoms associated with menopause. It’s important that you choose a doctor who will take the time to explain hormone replacement (both pharmaceutical and bio-identical hormones from compounding pharmacies), pharmaceutical drug, herbal and nutriceutical therapies, along with their benefits and risks, so you can decide what is best for you. Regardless of the therapy you choose, it is imperative that your health care provider takes the time to explain diet and lifestyle modifications in order to minimize the risks from hormone therapy and/or improve the effectiveness of other therapies.
The menopausal stage of womanhood is a wonderful time that does not have to be encumbered with uncomfortable physical and mental symptoms if you take measures to invest in your health and wellbeing. A naturopathic medical doctor who is highly trained in women’s medicine can be a valuable ally in your journey toward the years of wisdom!
Cheryl Hamilton, NMD, began her career in healthcare 32 years ago.
She earned a B.S. degree in Nutrition, worked in the health and fitness industry, and raised four children before attending the Southwest College of Naturopathic Medicine to become a Naturopathic Medical Doctor. Her office, the Women’s Health and Healing Center, is located at 1237 N. Rhinestone Dr., Prescott, AZ. For more information, call 928-515-2363, or go to www.womenshealthandhealingcenter.com.