Menopause is the natural stage of a woman’s life when the menstrual cycle permanently ends. Menopause marks the end of the childbearing years and is often called “the change of life”.  Specifically, Menopause is defined as 12 consecutive months without a menstrual period. By age 55, virtually all women have experienced complete Menopause.

What Causes Menopause?

When a baby girl is born, her ovaries already contain all the eggs that she will produce in her lifetime. Her ovaries will also produce estrogen and progesterone, being the two hormones which regulate menstruation and ovulation. These two hormones also cause Menopause to occur.  Production of estrogen in the ovaries slows down during Perimenopause. By the time we experience Menopause, estrogen production has decreased by 60-80% and ovulation no longer occurs. Ovulation triggers the production of progesterone; as ovulation ceases, progesterone levels become nil. 

Premature Menopause

When Menopause occurs after the age of 40 it is considered natural and is the normal part of aging. But some women experience Menopause earlier. Genetics play a significant role in determining when a woman starts Menopause. Cigarette smoking will cause Menopause to start early while the heavier the smoker, the higher the risk of early Menopause.

Surgical procedures such as hysterectomy or damage to the ovaries from chemotherapy or radiation can cause Menopause to occur before 40.  When Menopause occurs before the age of 40, regardless of cause, it is called Premature Menopause.

Perimenopause vs. PMS

Perimenopause begins several years before menopause when the ovaries start to produce less estrogen creating a hormone imbalance. Symptoms of  Perimenopause are often mistaken for those of premenstrual syndrome (PMS). Both PMS and Perimenopausal symptoms are a result of an imbalance between estrogen and progesterone. If your menstrual cycle has changed (if your periods are lasting longer or shorter than they used too, or if they become irregular) then there is a good chance you are experiencing Perimenopause. Your physician can recommend a blood test called Follicle Stimulating Hormone (FSH) to determine your hormone level. The levels of FSH can verify if you are in Perimenopause.  FSH levels increase as estrogen levels decrease.

Menopause Symptoms

The fluctuations in your hormone levels cause Menopause symptoms. Some women have very mild symptoms while others have symptoms that are severe enough to disrupt their daily lives. Menopause is a natural part of growing older and you don’t have to be tested or treated unless the symptoms are disturbing you. Common symptoms include:

-         Irregular periods;

-         Hot flashes;

-         Trouble sleeping;

-         Night sweats;

-         Emotional changes;

-         Headaches;

-         Fuzzy thinking;

-         Vaginal dryness.

Western women generally experience far more symptoms of Menopause than do Japanese women. The Lancet, which is a British medical journal, reported that Japanese women consume far more phytoestrogens (plant estrogens) than Western women. These phytoestrogens, when consumed, act like estrogens produced by the body. They are found in foods such as soybeans, tofu, miso, flaxeeds, pomegranates and dates.

For those women who are suffering from minor symptoms, lifestyle changes may be all that is needed. Moderate, regular exercise may reduce mood swings while yoga or other forms of stress release may also help. Increase consumption of phytoestrogens in your diet. Avoid foods that aggravate symptoms such as coffee, spicy foods, refined foods and sugary treats.

If lifestyle changes are not sufficient to suppress your symptoms you may need to add an herbal supplement that will help regulate hormonal balance during Menopause while reducing hot flashes, mild mood swings and occasional sleepiness.  There are a number of teas, tinctures or capsule formulations that help with these symptoms.

When these are still not enough to deal with your symptoms, then the way to go is bioidentical hormones. You will need to get a prescription from your doctor and make sure he prescribes bioidentical hormones. These have the same chemical composition as your hormones, therefore, they are much safer to use. Many physicians are reluctant to prescribe bioidentical hormones because they have been using HRT (Hormone Replacement Therapy) for years.  HRT has many serious side effects.

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Menopause is more than just hormonal changes. Understanding your body’s changes during this phase is very important. By making the proper lifestyle changes you can ease your transition, as well as safeguard your health, to what can be the best years of your life. Most women will live 25 to 30 years, after menopause. This translates to about one third of your life. By paying close attention to Menopause therapy you will enjoy what could be the most productive and satisfying years of your life.

In our bodies, estrogen is made from cholesterol primarily in the ovaries. A small amount is also produced in the adrenal glands or it may be converted from testosterone. Estrogens are predominantly female hormones that are important for maintaining the health of your reproductive organs, breasts, skin and bones. During menopause, when your ovaries no longer produce estrogens, the lower levels of estrogens in your body can lead to symptoms such as hot flashes, insomnia and mood swings.

More importantly, estrogen protects our bones and cardiovascular system while helping to control blood glucose levels. For some women the symptoms associated with menopause are intolerable and Menopause therapy must be considered. Consider the lifestyle changes discussed in the following articles:

- Weight loss during menopause;
- Vitamins for menopause

If you’ve tried the suggestions in these articles and they have proved to be insufficient to overcome your symptoms then the next step in menopause therapy is to consider hormone replacement therapy.

I recommend the use of bioidentical hormones. Bioidentical hormones, being estrogens, progesterones and testosterone, are substances that have the same chemical structure as the hormones in our bodies. They are made from botanical plants such as soy and yams. Our bodies cannot convert the plant hormones into human hormones; therefore, these plant hormones are pharmaceutically processed to match our own hormones.
Much confusion exists for both women and health professionals over the latest buzzwords “Bioidentical or synthetic” hormones. What is the difference?

Synthetic hormones indicate hormones created in the laboratory that do not chemically match the hormones made by our bodies whereas bioidentical hormones match our hormones precisely. Both bioidentical and synthetic hormones are created in pharmaceutical laboratories using chemical means. Also both come from natural sources ( yams, soy…), and then are manipulated in the laboratory to create either identical or synthetic hormones.

In relation to menopause therapy, the effects from bioidentical and synthetic hormones are very different. Since bioidentical hormones have a molecular structure identical to our own, their effects are more consistent with our own hormones. Women respond quicker at finding relief from hot flashes, insomnia and vaginal dryness. Also, bioidentical hormones are not mass produced, as they are compounded in pharmacies, and can be tailored to your specific needs.

If you are interested in using bioidentical hormones you must first see your doctor and if he thinks you need hormones he will have to write a prescription. Bioidentical hormones are available at any compounding pharmacy. The pharmacist individualizes your Menopause therapy at the request of your physician and you. Usually, these hormones are compounded into creams to be applied on the skin (transdermal) or vaginally ( transmucomal). They can also be made into lozenges. Be aware that the lozenge form will require a higher dose of hormones since they will pass through the liver to be metabolized which can lead to unwanted side effects.

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