Perimenopause and Menopause

The perimenopause to menopausal transition can be marked by chaotic hormonal changes that can impact women in many ways. For some, the transition begins as early as the late 30’s, or as late as the 50’s, while others experience no symptoms at all.

Common symptoms of female hormone imbalance include:

Hot flashes
Night Sweats
Insomnia (difficulty sleeping)
Weight gain, especially around the waist
Mood Changes (such as mood swings and anxiety)
Irritability
Brain fog
Headaches
Inability to concentrate
Loss of Libido
Skin tone loss
Vaginal Dryness
Bone Loss
Bladder Problems

Perimenopause may affect many physical and psychological factors, causing burdensome interruptions in a woman's daily life, such as frequent cycles, heavy bleeding, and menstrual pain. Changes to the menstrual cycle often begin due to fluctuations of the sex hormones progesterone and estrogens, while fluctuations in testosterone often impact libido. A woman might experience changes to the frequency of periods - either more often or less often, and at times fluctuation between the two. Changes in character and the amount of bleeding include spotting, cycles that seem to shorten, space out, or become heavier and longer.

A woman is affected by menopause on average at the age of 51. It is estimated that 6,000 women in the United States reach menopause every day, resulting in over 2 million women per year.

Since you may live in a state of menopause longer than in your reproductive years, the identification of risk factors for common diseases such as osteoporosis, cardiovascular disease, and cancer must be evaluated and discussed between you and your health care provider.

Sex hormones are linked to countless different body changes.

Estrogen receptors are everywhere in the body- skin, blood vessels, brain, bones, bladder, joints, fatty tissue, and vaginal tissue.

Estrogen drops directly influence temperature regulation.
There are various effects on the brain and the nervous system. Neurotransmitters such as serotonin and dopamine are under the direct influence of estrogen, impacting mood and resulting in anxiety, mood swings, and irritability. Lower blood flow may cause brain fog and difficulty finding words. Sleep patterns can change, potentially leading to insomnia.
Collagen production, which keeps our skin youthful, dramatically drops.
The greatest bone loss occurs during the first 5 years after menopause, as estrogen influences bone remodeling. Joints become achy, and tendon problems increase, including the risk of frozen shoulder.
Mitochondrial cell health is impacted. Estrogen affects how our cells make ATP (energy). Lower estrogen is thus linked to increased fatigue and slower exercise recovery.
Estrogen has positive vascular health. Replacing estrogen within the first 10 years after menopause has been shown to prevent fibrosis, stiffening, and even six years of menopause effects calcification of the arteries. Additionally, research supports lipid metabolism, as it lowers LDL and Lp(a), raises HDL, and reduces inflammation.
Metabolic changes occur in blood sugar regulation and fat storage. Estrogen impacts insulin and works as an anti-diabetic. Deficiency has been linked to new-onset DM. Women often experience weight gain around the middle.
Estrogen and thyroid function are directly related, as estrogen increases thyroid-binding globulin, which carries T3 and T4 in the bloodstream. Elevations in thyroid antibodies have been linked to estrogen dominance.
Urogenital changes are also associated with low estrogen levels. Perimenopausal changes are seen in increasing urinary tract infections, dryness in the vagina, pain with sex, as well as urgency and frequency of urination.

The Estrobolome: The Estrogen Gut Microbiome Connection

The Estrobolome is the collection of bacteria in the GUT biome involved with estrogen metabolism. A healthy gut is imperative for balanced sex hormones. Lipopolysaccharides (LPS) from gram-negative bacteria directly influence sex hormones. These bacteria cross the gut border and increase systemic inflammation. Constipation leads to hormone recirculation, termed enterohepatic recirculation, and is often one of the root causes of imbalanced sex hormones.

Treatments for Menopause Symptoms

Various treatments exist to treat perimenopause and menopause. Forms of treatment include:

Complementary and Alternative Medications: Black Cohosh, Red Clover, Don Quai, Evening Primrose, and other natural supplements.
Lifestyle changes: dietary changes, increased exercise, smoking cessation, and stress reduction
Conventional prescription medications: synthetic hormones and antidepressants are available for the treatment of menopausal symptoms.

At Innovative Health, we utilize Bioidentical Hormone Replacement Therapy (BHRT). Bioidentical Hormones are hormones made to be structurally the same as your body's own natural hormones.

BHRT uses only natural hormones and can be administered in a variety of ways:

Orally through pills, capsules
Troche (slow dissolving lozenge that travels to the lymph system) or sub-lingual pearls
Injection therapy
Pellet therapy
Topical Creams
Topical Gels

Types of Menopause

Natural Menopause

Also called spontaneous menopause, natural menopause is defined as the cessation of menses. Before this event, many physiological changes occur. In the U.S., the average age at the beginning of menopause is 51 years. Symptoms of menopause can occur for 4-8 years before your menstrual cycle stops.

Premature Menopause

Premature menopause is defined as menopause occurring before the age of 40. This can be due to certain medical conditions, such as autoimmune, thyroid, ovarian, and metabolic conditions.

Induced Menopause

This menopausal state may be temporary or permanent. Temporary menopause is short-term and may occur as a consequence of cancer therapies such as radiation or chemotherapy. Permanent menopause results from the removal of the ovaries, which frequently occurs simultaneously with a hysterectomy.

Natural aging, stress, nutrition, medications, weight gain, environmental exposures, as well as various disease processes can cause hormone imbalance.