The average age of a woman entering natural menopause is 51 years. Menopause is typically confirmed when a woman has missed her periods for 12 consecutive months. Measuring blood hormone levels can also be used to help make the diagnosis of menopause. Persistently elevated follicle stimulating hormone (FSH) and luteinizing hormone (LH) is suggestive of menopause.
There is a 30% drop in estrogen by age 50, with a sharp decline after menopause. There is 75% loss of progesterone between 35-50, and progesterone is almost nonexistent after menopause. Menopausal symptoms often start prior to this because of fluctuating levels of estrogen. Persistent symptoms of estrogen deficiency is a sign of menopause.
The most common symptoms of estrogen deficiency are hot flashes, night sweat, vaginal dryness, mood swings, memory loss and sleeping difficulties. In early menopause, estrogen fluctuations are still occurring, leading to more menopausal symptoms. Later in menopause, the symptoms can disappear.
The severity of symptoms associated with menopause varies from woman to woman. Some women experience troublesome symptoms, while others make the transition with few symptoms at all. If your menopausal symptoms are moderate to severe, you will benefit greatly from bioidentical hormone replacement therapy.
Perimenopause is the period right before menopause and usually starts in the mid forties and lasts until menopause. Perimenopause is characterized by a decrease in the number of functional ovarian follicles and significant fluctuations in hormone levels. Estrogen levels fluctuate dramatically throughout the day and vary greatly between cycles. Women may have no signs of estrogen deficiency one day and then be symptomatic the next day. Symptoms of estrogen deficiency include hot flashes, night sweat, sleeping difficulties, and vaginal dryness, just like in menopause. Therefore, supplementation with bioidentical estrogen is warranted.
Another important feature of perimenopause is so called estrogen dominance. This means there is not enough progesterone to counterbalance the estrogen, though estrogen levels are relatively low. Progesterone deficiency can result in mood disorders like depression, irritability, anxiety and nervousness in perimenopausal women. These symptoms closely resemble symptoms of PMS.
The first line of treatment is to replace the missing progesterone with bioidentical progesterone. Not only can this regulate the menstrual cycle, but many of the perimenopausal symptoms are alleviated as well. It is important to take only natural progesterone, and not synthetic progestins. Synthetic hormones will not help alleviate the symptoms of perimenopause, and often will make these symptoms worse.
Estradiol and progesterone should be checked via blood levels. It is important to work with an experienced physician to interpret these levels appropriately because the reference range is typically too wide and estrogen and progesterone levels fluctuate through the cycle. Sometimes, patients can still have perimenopausal symptoms after hormone replacement, though their hormone levels are normal. It is essential to treat patients and their symptoms, not lab values.
Our metabolism is controlled thyroid hormones, thyroxine (T4) and triiodothyronine (T3). The thyroid hormones also regulate body temperature and energy levels. T3 and T4 are produced by the thyroid gland near the trachea. A deficiency in thyroid hormones is called hypothyroidism. The most common cause of hypothyroidism is Hashimoto's thyroiditis. It is an autoimmune disease where auto-antibodies (i.e. produced by our own bodies) destroy the thyroid gland. Approximately 10% of women have an undiagnosed thyroid condition. The basal metabolic rate drops 5% every decade of life, which is why hypothyroidism is very common in women over the age of sixty. This is also partly explains the weight gain with aging.
The most common symptoms of hypothyroidism are weight gain, fatigue, constipation, hair thinning, and intolerance to cold. There is good evidence that hypothyroidism is responsible for causing atherosclerosis, leading to heart disease. Women are more likely than men to develop a thyroid disorder.
Hypothyroidism needs to be diagnosed based on laboratory testing and good clinical history. The most common test is to measure thyroid stimulating hormone (TSH), and it is used as a screening procedure. Since there are often inaccuracies with this test alone, the whole panel test: TFT (thyroid function test) is often needed. Many women who have hypothyroidism have normal TSH levels. Measuring TFT and good clinical evaluation are essential in the accurate diagnose of thyroid disorders.
The underlying disorder of hypothyroidism needs to treated with thyroid hormone. The most prescribed thyroid hormone is levothyroxine (Synthroid). Synthroid is synthetic thyroxine (T4). T4 is the most predominant hormone in our body, while T3 is the most active thyroid hormone. T4 needs to be converted to T3. However, some people are not able to convert T4 to T3 (known as Wilson's syndrome). This is the problem with using synthroid alone. Our physician prefers Armour thyroid. Armour thyroid is derived from pig and cow thyroid tissue and contains both T3 and T4. Armour thyroid is completely natural and also contains other trace amount thyroid hormones, which might be vital to our metabolism. Armour thyroid can be compounded at your local pharmacies as well.
Andropause is also known as male menopause and is caused by decline in testosterone (Low T levels). Starting at about age 30, testosterone levels drop by about 1% per year. Common symptoms of andropause include the following:
Decreased energy and decreased desire for physical activity.
Low sex drive.
Emotional, psychological and behavioral changes (such as depression and irritability).
Decreased mental quickness.
Decreased muscle mass and muscle weakness.
Increased upper and central body fat
Night sweats and trouble sleeping.
Apart from the symptoms, andropause has long-term impact on your quality of life: increased cardiovascular risk and osteoporosis (or weaker bones). Low bone density puts you at risk of frequent fractures, associated pain, and in many cases, loss of independence. Wrists, hips, spine and ribs are most commonly affected.
Testosterone deficiency can be treated with bioidentical hormones given by gel, cream, patch or injections. Testosterone patch is frequently associated with local skin irritation, thus less popular. Gels are available commercially. Cream can be compounded (more concentrated, only need to use a small amount) at your local pharmacy. The gel/cream can be applied to your arm, chest and belly. Intramuscular injection is administered to your buttock every 1 to 2 weeks. Gel/cream and injections bypass the necessity for liver detoxification and therefore show better results.
Bioidentical hormone can be used to treat a variety of hormonal disorders for both women and men.
Women suffering from menopause: the common symptoms are hot flashes, night sweats, memory loss, mood swings, weight gain, and low libido;
Men experiencing andropause (male menopause): the common symptonms are weight gain, low/lost of libido, fatigue, lost of energy and muscle mass, and accumulating body fat;
Women suffering from peri-menopausal symptoms, PMS (premenstrual syndrome), premenstrual migraines, endometriosis, PCOS (polycystic ovarian syndrome), uterine fibroids, breast fibrocysts, post-partum depression and fibromyalgia;
Men and women with obesity, metabolic disorder, insulin resistance and hypothyroidism;
Following links will provide additional information on andropause, menopause, perimenopause, , PMS (premenstrual syndrome), PCOS (polycystic ovarian syndrome), post-partum depression, hypothyroidism and Sun Wellness weight management program, of which bioidentical hormone therapy is the cornerstone.