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. I'll be covering everything from hot flashes, adrenal imbalances, low sex drive, and everything in between. If you are just starting Menopause, or have already been through Menopause, my hope is that these articles, and an open dialogue on the topic can help to support all of you, wherever you are in your wellness journey.
Let's get into it, shall we?
Is it hot in here or is it just me? – is a common refrain among the estimated 50 to 75 percent of women in the U.S. who experience hot flashes during menopause. Hot flashes can be very mild, or bad enough to have you opening every window in the house, even in the dead of winter. Also known as “vasomotor flushing,” the hot flash occurs when the blood vessels in the skin of the head and neck open more widely than usual, allowing more blood to shift into the area, creating the heat and redness. Perspiration is also common to the phenomenon and in some, the hot flash takes the form of a night sweat, followed by a chill that has one groping for the covers kicked to the floor just minutes earlier. It’s usually over in seconds, and there’s no telling when it will recur – maybe minutes, maybe hours – but it will be back.
Triggered by falling estrogen and rising levels of follicle stimulating hormone (FSH), hot flashes arrive unannounced, and usually at a most inconvenient time– in the middle of a job interview, in the middle of an important speech, in the middle of the night. Besides hormonal changes, anxiety and tension magnify hot flashes and many women find that hot drinks and wine do the same.
Saliva testing identifies the degree to which the specific hormones linked to hot flashes are out-of-whack. Using test results as a guideline, natural hormone supplements can be prescribed to restore balance and cool the hot flashes. Many women also use Phyto- (plant) estrogens, such as Dong Quai and Black Cohosh; optimal nutrition and relaxation exercises for added relief. In most cases, hot flashes usually go away a year or two after actual menopause and the cessation of menses.
Next up, we'll be covering adrenal imbalances. Let me know of any questions you have in the meantime!
xox, Dr. G