The idea of accepting that the decline in hormones is normal with aging and that you have to live with it is concerning.
Perimenopause
This phase of a woman’s life can be frustrating as her hormones are fluctuating and changing. Cycles can become heavier, irregular, infrequent or more frequent as a woman transitions into menopause. Usually, this stage lasts 10-15 years. It can start as early as 30-35 years old.
Changing hormones create symptoms of anxiety, depression, irregular cycles, sleep issues, fatigue, weight gain, low libido, thyroid/adrenal challenges, feeling crazy and hot flashes.
Menopause
Menopause officially starts when menstruation stops for one full year. Even after women have transitioned into full menopause, they can still have symptoms of hormone imbalance at any time in their lives. Some common symptoms of menopause include hot flashes, night sweats, fatigue, low libido, vaginal dryness, problems with urinary health, cognition problems, osteoporosis, cancer, cardiovascular risk and dysfunctional uterine bleeding.
Effect of Low Hormones on the Aging Woman
Decreased androgens in women result in decreased libido, decreased muscle strength, lowered genital arousal and orgasm, decreased vaginal lubrication and lower energy levels.
Low estrogen levels are associated with increased cognitive decline and osteoporosis.
Estrogen with testosterone increases bone density.
Low DHEA results in accumulation of abdominal visceral fat and increases insulin resistance.
Loss of estrogen reduces the quality of life, increases vaginal dryness, stress incontinence and urogenital discomfort. It also increases the risk of life-threatening illnesses, such as cardiovascular disease, dementia and osteoporosis.
There is also an increased risk for Alzheimer’s disease. The number of people with Alzheimer’s disease is projected to triple by 2060.
Low progesterone levels are associated with increased risk of breast and endometrial cancer.
Are You Considering Bio-Identical HRT?
The idea of accepting that the decline in hormones is normal with aging and that you have to live with it is concerning. The traditional method of telling patients that their blood serum levels are “normal” is just not acceptable, especially if they are experiencing symptoms of low hormone function. The body has an amazing ability to adapt to its new normal of low hormone function. But with that gradual hormone decline comes an increased risk of diabetes, cardiovascular disease, cancer, decrease in bone health and cognitive decline. Often these diseases can be prevented and treated with hormone optimization.
The Women’s Health Initiative study confirms synthetic hormones can cause cancer and increase the risk of stroke, heart attacks and blood clots. Bio-identical hormones used in hormone replacement therapy for testosterone and progesterone protect breast tissue and can prevent cancer as well as provide many more health benefits. Testosterone pellets have been shown to protect the breast against cancer and are used in breast cancer survivors. Visit hormonebalance.org or patients.worldlinkmedical.com/category/hormones for more up-to-date research.
Potential Side Effects of Bio-Identical Hormone Replacement Therapy
The most common potential side effect when starting bio-identical hormone replacement therapy (HRT) in menopausal women is vaginal bleeding. Although bleeding is not common in menopause, it can happen when using bio-identical HRT. Bleeding always needs to be investigated with an endometrial biopsy, transvaginal ultrasound and making sure the patient is taking progesterone correctly. When starting hormones in menopause, you go from having little to no hormone levels to optimal hormones. That shift can trigger spotting or bleeding usually caused by estrogen or not enough progesterone. If a woman has a history of fibroids or polyps, they are often triggered by hormones that can cause bleeding. We always need to investigate the cause.
Other side effects may include:
Hair growth: Testosterone optimization can cause increased fine hair growth on the face and body.
Hypersexuality: Testosterone can increase the desire and improve the quality of sex by the effects of testosterone on increasing the size and sensitivity of the clitoris. It also helps to reduce vaginal dryness.
Breast tenderness or swelling: Usually when starting progesterone or estrogen, women can get swollen breasts. The breast tenderness decreases over time as the body adjusts to the shift in hormones.
Erythrocytosis: An increased red blood cell count, hemoglobin and hematocrit on a blood test may occur. This often gets confused by medical providers as a blood disorder like polycythemia vera. Testosterone does not cause increased risk for stroke, blood clots or thickening of the blood. The increase in red blood cells, erythrocytosis, happens when patients live at high elevation, like in Flagstaff. If it worries the patient, they might consider donating blood regularly. Donating not only helps build the blood bank, it also decreases the high concentration of blood cells.
Many women desire to feel their best; while bio-identical hormones are safer than the synthetic forms, we do not have a crystal ball to predict whether a patient will get cancer or not. There are many factors that may cause breast, uterine or ovarian cancers. That is why it is important to get regular pap smears, mammograms, thermal scans and blood testing/ monitoring when using bio-identical HRT and for women with a personal or family history of cancer. Women in perimenopause and menopause will need to review the risks and benefits and decide with a hormone specialist provider what types of hormones will best suit them and reduce the risk of age-related disease that naturally occurs. FBN
By Christina Kovalik
Dr. Christina Kovalik NMD, LAc, The Vitality Doctor, is a naturopathic physician and acupuncturist specializing in hormone optimization, optimal health and vitality. She is a new Flagstaff resident, practicing since 2004, and opened her second location in Doney Park in 2020. For more information, visit thevitalitydoctor.com or call 928-863-6086.
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