In the years leading up to menopause, also known as perimenopause, menstrual cycles that may once have been like clockwork start to become erratic. Bleeding may be heavier or lighter than usual – although we are not officially in menopause until we have had 12 consecutive months without a period. Erratic cycles are a sign of erratic ovulation, leading to highs and lows in estrogen and progesterone, an effect many  describe as an emotional roller coaster. Don’t let anyone tell you it’s all in your head. When the ovaries begin to sputter, hormone production sputters and so do we: forgetfulness and foggy thinking, mental confusion and mood swings are hallmark symptoms for many women; as are hot flashes and night sweats, tearfulness, unwanted weight gain, thyroid problems and declining interest in sex, no matter how much we love our partner.

Of course, not all  experience these symptoms – as individuals, we each have our very own biochemistry – but it is common to experience some degree of discomfort during the menopausal years. The degree to which we experience discomfort is likely to be associated with the degree to which our hormones are out of balance.  If you are a  experiencing menopausal symptoms, you will want to test at least two hormones: estradiol and progesterone. If you would like a more comprehensive picture, our five panel test measures estradiol, progesterone, testosterone, DHEA-S and morning cortisol.

Now let's go on a journey through Menopause, together. Adrenal imbalances, you're up.

Many people experience high levels of mental and emotional stress on a regular basis, which puts a significant strain on adrenal function. When stress is not well managed, the ability of the adrenal glands to do their job becomes compromised.

The adrenals normally secrete cortisol in response to stress, with exercise and excitement, and in reaction to low blood sugar. The body normally secretes the highest amount of cortisol in the morning to get us going, with levels decreasing throughout the day. People with adrenal imbalance will often have normal cortisol levels in the morning with below normal levels at other times during the day. If stress remains too high for a prolonged period, the adrenals can’t keep up with demand and total cortisol output plummets, leading to adrenal exhaustion.

The hallmark symptoms of adrenal imbalance are stress and fatigue which is not alleviated with sleep – that “tired all the time” feeling. Other common symptoms include sleep disturbances, anxiety, depression, increased susceptibility to infections, reduced tolerance for stress, craving for sweets, allergies, chemical sensitivities and a tendency to feel cold.

Saliva testing charts the extent to which cortisol levels are out of balance and can be used as part of a strategy that looks at the whole person and his or her lifestyle. It's helpful to work with a doctor who can design a complete program of hormone balance and then monitor your progress.

You can begin to support adrenal function on your own by avoiding hydrogenated fats, excess caffeine, refined carbohydrates, alcohol and sugar. Get plenty of quality protein and eat regular meals of high nutritional value. The key to success is to discover and practice stress management in whatever form works for you personally.  

Take time out, evaluate the stressors in your life, and most importantly, get enough sleep.

Next up, we'll be covering low sex drive during menopause. 

xox, Dr. G