Hormones & Balance

So, you're starting a new journey. Maybe you arrived a while ago. This strange place you've read about, heard a few rumors,whispered about it with your friends...
Welcome to Menopause!
Like any other trip you take to new places, you should be prepared. Read. Ask questions of those who have been there before you. Find a guide. That's where I come in.
I have been consulting women on menopause and hormone therapy for over 10 years. There are a lucky few that seem to breeze through this time of their lives with barely a blink, and others suffer for years. Most of us land somewhere in the middle. I am often asked "What is the best treatment for me?" Sorry, Ladies, I cannot make that decision for you. Only you can know what feels right for your body, lifestyle, mindset. But I can give you some information, some tools- a "foundation" if you will- upon which you can build your knowledge until you are comfortable making the decision that is right for YOU.
Hormones can be complex and complicated. Each hormone has hundreds of functions in our bodies, and this post is by no means meant to be a complete list. We're going to touch on the highlights and most common issues experienced by my patients. I hope you would like to learn more One of my favorite books is "What You Must Know About Women's Hormones" by Pamela Wartian Smith, MD ( find it easily in our Amazon Store). For the hormone story as told by one the the earliest researchers, read "What Your Doctor May Not tell You About Menopause" by Dr. John R.Lee.
There are some basic definition on the Menopause page HERE that you may want to review before diving into hormone specifics.
**Remember: we are talking about the hormones that are made in your body and Bio-Identical hormones. Please do not confuse these with synthetic hormones which act differently in your body.
Let's get some of the tools and information you'll need for your journey!
 We usually say "estrogen" like it is one hormone, but there are actually many different estrogens of which the three most abundant are : estriol, estradiol, and estrone. They are similar in function, but some are stronger than others. Most estrogen is produced by the ovaries, and there are receptor sites for estrogen everywhere: uterus, breasts, heart, brain, lungs, blood vessels, muscles and bone, among others.
Estrogen has over 400 functions in our bodies! Some are:
  •  helps regulate body temperature,
  • helps maintain strong muscles and bones,
  • helps keep your skin hydrated, and can
  • help with memory and concentration.
As we get older estrogen levels drop. Estrogen deficiency can lead to:
  • depression , anxiety
  • dry skin, hair and nails (some ladies even get dry eyes)
  • osteoporosis
Most women with estrogen issues actually have too much estrogen. This is called "estrogen dominance" . This occurs when there is too much estrogen, or not enough progesterone. Symptoms of estrogen dominance can include:
  • mood swings and irritability
  • bloating and water retention
  • weight gain (especially lower belly!)
Hey, where are "hot flashes and night sweats"? Actually , these very common symptoms can be caused by too much or too little estrogen and/or progesterone. It's a "balance" thing. Tricky , huh?
Progesterone is made in your ovaries until menopause, and then your adrenal glands. Like estrogen there are receptors for progesterone in tissues all over your body and it has many functions, among them:
  • balance estrogen (more later)
  • natural calming effect and helps you sleep
  • necessary for the thyroid hormones to work properly
  • necessary for glucose to work properly
  • is a natural antidepressant
  • is a natural diuretic (like a water pill)
  • lowers the "bad" cholesterol
  • stimulates the production of new bone
Because progesterone is used by many tissues and systems in your body even women who have had a complete hysterectomy (uterus removed) still need progesterone.
A progesterone deficiency can lead to :
  • insomnia
  • migraine headaches
  • depression and anxiety
  • osteoporosis
  • pain and inflammation
  • weight gain
Dr. Lee's book "What Your Doctor May Not Tell You About Menopause" explores progesterone in detail.

Balance & the Estrogen/Progesterone Relationship
The key word in hormone therapy is "balance". You've probably seen it in books, leaflets, websites, even on TV commercials. So what is this "Balance" thing all about? When we talk about hormone balance, we are primarily talking about the balance between estrogen and progesterone. Estrogen and progesterone work together in your body. Too much of one or the other causes some of the most commons symptoms and problems of menopause and perimenopause.
Let's look at one example of the balance between these two hormones (disclaimer-- this is a VERY simplistic example, but it may help you understand the relationship between these 2 important hormones):
Estrogen is a hormone that likes for things to grow . When you are still having periods, it is the hormone that directs the lining of the uterus to re-grown and thicken every month.
Progesterone is a hormone in charge of development. (The name can tip you off: "pro" and "gesterone" from "gestation". In pregnancy, it helps with fetal development.) For the rest of us, proper levels of progesterone can keep the growth directed by estrogen in check. For this example, it stops the lining of the uterus from getting too thick, and makes sure it is properly developed, healthy tissue.
Without enough progesterone, the uterine lining can get very thick , which can lead to heavy periods or break-through bleeding.
The issues usually start around our mid-30's (yep, that early). As we get older the amount of hormones naturally slows and the levels begin to drop. The problem is, progesterone production drops at a much faster rate than estrogen, creating a wider and wider gap in the levels in your body. Estrogen-directed tissue growth can occur with nothing to slow or stop it; this uncontrolled, unregulated growth can cause problems like fibroids and cysts, and even cancer. This "imbalance" can also cause:
  • fatigue
  • depression
  • lack of libido
  • increased risk of breast cancer and uterine cancer
  • increased cholesterol
  • weight gain
  • hot flashes and night sweats
Hormone levels can be measured using saliva, blood or urine testing. Which one you use will depend on your doctor or other hormone consultant ,like your ARNP, or pharmacist. Measurement is necessary to determine what your levels are, so your practitioner knows which ones may need to be supplemented. Prescribing any type of hormone replacement therapy without testing your hormone levels is like prescribing blood pressure medication without taking your blood pressure! How else can we determine what and how much to prescribe?

The rest of the story
Every woman is different, and so is her journey through menopause. An easy cruise through, or an arduous trek ; a minor annoyance or a life-changing event. Maybe for you the pendulum swings back and forth. These short summaries on estrogen, progesterone and hormone balance are only the beginning of your hormone education. Major players in the menopause game also include testosterone, DHEA and cortisol, and we can't discount the role that nutrition, fitness, genetics, and about a million other factors play.
I hope this short conversation has encouraged you to learn more. There is information anyone can access that was unavailable to our mothers (our grandmothers dared not even talk about it) .
Have a good journey! Buon viaggio! Bon voyage!




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