Hormone Replacement: How to Balance Your Hormones Naturally. Dr. Cabot Sandra

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       heavy and/or painful menstrual bleeding

       growth of fibroids and uterine polyps

       growth of endometriosis

       irregular menstrual cycles

       premenstrual depression and mood disorders

       premenstrual headaches

       fluid retention

       abdominal bloating

       breast tenderness and lumpiness

       hair loss

      The Peri-menopause

      This phase of a woman’s life is defined as the several years before and after the menopause. Hormonal imbalances are common during the peri-menopausal years.

      The menopause is said to have occurred when menstrual bleeding has been absent for 12 consecutive months. Because the age of the menopause varies considerably, the time of onset of the peri-menopause also varies. The majority of women will go through the menopause between the ages of 45 and 55.

      The years following the menopause are called the post-menopause. During the post-menopause, the production of sex hormones from the ovaries continues to decline, and may eventually become non-existent.

      What Causes the Menopause?

      The human female is the only creature known to live much longer than her sex glands and reproductive capacity. We could ask ‘Why us and not men?’ or ‘Did Mother Nature have a design fault?’

      These questions are valid, however the fact remains that our ovaries simply run out of follicles (eggs). It is the follicles that produce the vast majority of the female sex hormones, and thus we are no longer able to produce these hormones in adequate quantities. The age at which the supply of ovarian follicles becomes exhausted varies between women; this is why we see such a large variation in the age at which the menopause occurs.

      IS THERE A TEST FOR THE MENOPAUSE?

      The menopausal ovary being devoid of follicles is unable to manufacture significant amounts of the female sex hormones. If a blood test is done to measure the levels of oestrogen and progesterone, they will be found to be at very low levels. In menopausal and post-menopausal women, blood oestrogen levels (which are measured in the form of oestradiol) are generally less than 160pmol/L. The term pmol/L means picomoles per litre, and is a standard laboratory measurement.

       Typical Results of the Hormone Levels in Menopausal and Post-menopausal Women

	HORMONE	BLOOD LEVEL
	FSH	greater than 30U/L
	Oestradiol	less than 160pmol/L
	Progesterone	less than 3nmol/L

      Oestradiol is the most potent form of oestrogen produced by the ovary. Other types of oestrogen produced by the ovary and the fat tissue are weaker, and consist of oestrone and oestriol.

      The function of the ovaries is under the control of the pituitary gland, which is situated at the base of the brain and acts as a master-controller for the most of the hormonal glands in the body. The glands which produce hormones are known as endocrine glands, and the medical speciality of hormones is called endocrinology.

      The pituitary gland is very sensitive to the hormonal output of the ovaries, and it begins to react when the ovaries fail to pump oestrogen and progesterone into the bloodstream. Indeed, the pituitary gland is not at all ‘happy’ with the failure of the menopausal woman’s ovaries. The pituitary gland quickly responds by pumping out large amounts of a hormonal messenger called Follicle Stimulating Hormone (FSH).

      FSH travels from the pituitary gland, via the bloodstream, to the failing ovaries to try to stimulate them back into action.

      Alas, this does not work; the ovaries have ‘closed up shop’ forever, and despite the hormonal pleas and wooing from the pituitary gland the ovaries remain inactive. Meanwhile, the pituitary gland cannot comprehend that the ovaries are unable to respond to its advances, and in a futile attempt to reawaken them it continues to pump ever-increasing amounts of FSH into the bloodstream. This achieves nothing as far as the ovaries are concerned, but it does provide a useful diagnostic test for your doctor to determine if you are menopausal. Typically the blood FSH levels are quite high if you are menopausal, and will be greater than 30 U/L, and may reach up to 300 U/L. In other words, you will have continually elevated levels of FSH, and this is the most accurate test for the menopause. Obviously all women who are wondering if they are menopausal will want to know what their FSH level is, because if they are truly menopausal they no longer have to worry about contraception. They will also know if it is the failure of their ovaries that could be responsible for any unpleasant symptoms that they may be suffering with.

      If you are on the oral contraceptive pill, you will need to stop taking it for several months before having a blood test; otherwise your blood tests for the menopause will be inaccurate. The oral contraceptive pill makes the results of blood tests for hormone levels totally meaningless. Women on the Pill will always show very low levels of both FSH and their own naturally-produced hormones, because the Pill suppresses the production of hormones from the pituitary gland and the ovaries. I am often amazed that women are sent for testing of their hormonal levels while they are still taking the Pill!

      Symptoms of the Menopause

      Some women will not experience any menopausal symptoms and may get a shock to discover that their blood tests show menopausal levels of hormones!

      Other women may experience unpleasant symptoms, ranging from mild to severe, such as:

       Hot flushes

       Aches and pains – sometimes called fibromyalgia

       Vaginal dryness and discomfort

       Vaginal shrinkage

       Painful sexual intercourse

       Bladder problems such as urgency and incontinence

       Loss of sex drive

       Shrinkage of the breasts

       Mood changes, which may be severe enough to result in a clinical depression

       Low self esteem

       Anxiety and panic attacks

       Memory problems

       Poor concentration

       Dry and ageing skin

       Hair loss

       Sleep disorders

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