Archive for the ‘progesterone’ Tag
It has been just over 5 years since Alice died – I’ve kept this blog and her message boards basically the way she started them. I decided – finally – that life goes on and new discoveries are being made to help women going through menopause.
To that end, I decided to include news items of relevance here and here’s the first…
Officials with the FDA have approved TherapeuticsMD’s Bijuva (estradiol and progesterone) capsules, 1 mg/100 mg, the company announced Monday. According to TherapeuticsMD, Bijuva is the first and only FDA-approved bio-identical hormone therapy combination of estradiol and progesterone in a single, oral capsule for the treatment of moderate to severe vasomotor symptoms due to menopause in women with a uterus.
“The approval of Bijuva represents an important and new opportunity for menopausal women suffering from moderate to severe vasomotor symptoms. Menopausal women and their healthcare providers have been seeking bio-identical combination therapies for many years without an FDA-approved option,” said Dr. Brian Bernick, Co-Founder and Director of TherapeuticsMD, in a prepared statement. “Bijuva is the first and only FDA-approved combination of bio-identical hormones, offering a proven balance of bio-identical estradiol to reduce moderate to severe hot flashes combined with bio-identical progesterone to reduce the risks to the endometrium.”
The approval is based on the Bijuva clinical development program that included the pivotal Phase III Replenish Trial. This trial evaluated the safety and efficacy of Bijuva in generally healthy, postmenopausal women with a uterus for the treatment of moderate to severe hot flashes. Consistent with FDA guidance, the co-primary efficacy endpoints in the Replenish Trial were the change from baseline in the number and severity of hot flashes at weeks 4 and 12, as compared to placebo. The primary safety endpoint was the incidence of endometrial hyperplasia with up to 12 months of treatment.
Bijuva demonstrated a statistically significant reduction from baseline in both the frequency and severity of hot flashes compared to placebo while reducing the risks to the endometrium. The most common adverse reactions (≥3 percent) were breast tenderness, headache, vaginal bleeding, vaginal discharge, and pelvic pain. Additionally, there were no clinically significant changes in lipid, coagulation or glucose parameters as compared to placebo. There were no unexpected safety signals.
“For the first time, we have a combination hormone therapy of bio-identical estradiol with bioidentical progesterone evaluated in a large, well-controlled, randomized clinical trial that has demonstrated both safety and efficacy for the treatment of moderate to severe hot flashes due to menopause,” said Dr. James Liu, M.D., President of the North American Menopause Society and Chairman of the Department of Obstetrics and Gynecology, UH Cleveland Medical Center, in a prepared statement. “The approval of Bijuva represents an important, novel and effective treatment option for women and their healthcare providers to manage the vasomotor symptoms of menopause.”
Bijuva is expected to be available in the United States in 2019.
Reference
TherapeuticsMD Announces FDA Approval of TX-001HR: BIJUVA (Estradiol and Progesterone) Capsules for the Treatment of Moderate to Severe Vasomotor Symptoms Due to Menopause [news release]. Boca Raton, FL; October 29, 2018: TherapeuticsMD.
From https://www.pharmacytimes.com/resource-centers/womens-health/hormone-therapy-combination-granted-fda-approval-for-treating-menopausal-women-
Have you recently experienced a major stress in your life, be it illness, job, death, children, etc? After this stress, have you felt as though you just cannot seem to get yourself together, or at least back to where you used to be? Are you usually tired when you wake up, but still “too wired” to fall asleep at night? Is it hard for you to relax or to get exercise? Do you find that you get sick more often and take a long time to get well? If so, then you, like many other Americans may be experiencing symptoms of Adrenal Fatigue.
Adrenal fatigue is not a new condition. People have been experiencing this condition for years. Although there is increasing physician awareness, many are not familiar with adrenal fatigue as a distinct syndrome. Because of this lack of knowledge, patients suffer because they are not properly diagnosed or treated.
Adrenal fatigue is a condition in which the adrenal glands function at a sub-optimal level when patients are at rest, under stress, or in response to consistent, intermittent, or sporadic demands. The adrenal glands are two small glands that sit over the kidneys and are responsible for secreting over 50 different hormones—including epinephrine, cortisol, progesterone, DHEA, estrogen, and testosterone. Over the past century, adrenal fatigue has been recognized as Non-Addison’s hypoadrenia, subclinical hypoadrenia, neurasthenia, adrenal neurasthenia, and adrenal apathy.
Generally patients who present with adrenal fatigue can often be heard saying, “After______, I was never the same.” The onset of adrenal fatigue often occurs because of financial pressures, infections, emotional stress, smoking, drugs, poor eating habits, sugar and white flour products, unemployment and several other stressors. After experiencing many of these events over a long period of time, the adrenal glands tend to produce less cortisol, the body’s master stress hormone. Cortisol’s main role in the body is to enable us to handle stress and maintain our immune systems. The adrenal gland’s struggle to meet the high demands of cortisol production eventually leads to adrenal fatigue.
Patients with adrenal fatigue have a distinct energy pattern. They are usually very fatigued in the morning, not really waking up until 10 AM, and will not usually feel fully awake until after a noon meal. They experience a diurnal lull in their cortisol (the stress hormone produced by the adrenal gland) and as a result, they feel low during the afternoon, generally around 2-4 PM. Patients generally begin to feel better after 6 PM; however, they are usually tired after 9 and in bed by 11 PM These patients find that they work best late at night or early in the morning.
Some key signs and symptoms of adrenal fatigue include salt cravings, increased blood sugar under stress, increased PMS, perimenopausal, or menopausal symptoms under stress, mild depression, lack of energy, decreased ability to handle stress, muscle weakness, absent mindedness, decreased sex drive, mild constipation alternating with diarrhea, as well as many others.
Although there no specific tests that will provide a true diagnosis of adrenal fatigue there are tests that may contribute to an assessment, such as a postural hypotension test, an AM cortisol test, or an ACTH stimulation test. It is customary for a physician to assess the adrenals together with thyroid tests to rule out insufficiency, which sometimes occurs in long-standing hypothyroidism.
A single determination of plasma cortisol or 24-hour urinary free cortisol excretion is not useful and may be misleading in diagnosing adrenal insufficiency. However, if the patient is severely stressed or in shock, a single depressed plasma cortisol determination is highly suggestive. An elevated plasma ACTH level in association with a low plasma cortisol level is diagnostic.
Treatment for adrenal fatigue is relatively simple. Lifestyle modifications can be initiated to treat this condition. Simple changes such as more laughter (increases the parasympathetic supply to the adrenals), small breaks to lie down, increased relaxation, regular meals, exercise (avoiding any highly competitive events), early bedtimes and sleeping until at least 9 AM whenever possible can all benefit those experiencing adrenal fatigue.
A diet that would be conducive to treating adrenal fatigue includes one that combines unrefined carbohydrates (whole grains) with protein and oils (nuts and seeds) at most meals—olive, walnut, fiber, flax and high-quality fish oil. It is also important for patients to eat regular meals, chew food well, and eat by 10 AM and again for lunch. Patients should look to avoid any hydrogenated fats, caffeine, chocolate, white carbohydrates, and junk foods. Diets should have a heavy emphasis on vegetables. It may be of additional benefit that patients add salt to their diet, especially upon rising and at least a half-hour before their lowest energy point of the day. (Preferably, 1/8 to 1/2 teaspoonful of sea salt, Celtic salt, or sea salt w/kelp powder added to an 8 oz glass of water). In adrenal fatigue, one should not follow the USDA’s Food Guide Pyramid, as these patients tolerate fewer carbohydrates and need more protein.
The addition of nutritional supplements may also offer additional benefits to patients experiencing adrenal fatigue. They should consider the addition of:
- Vitamin C 2,000-4,000 mg/day Sustained Release
- Vitamin E w/mixed tocopherols 800 IU/day
- Vitamin B complex
- Niacin (125-150 mg/day) – as inositol hexaniacinate
- B-6 (150 mg/day)
- Pantothenic acid (1200-1500 mg/day)
- Magnesium citrate (400-1200 mg)
- Liquid trace minerals (zinc, manganese, selenium, chromium, molybdenum, copper, iodine)– calming effect
- If depression is present – Add SAM.e 200 mg bid; DL-Phenylalanine (DLPA) 500 mg bid
Some herbal remedies that have been noted as possible therapies include Licorice, Ashwagandha, Maca, Siberian Ginseng, Korean Ginseng. Note: Licorice can and, if taken over time, does have a propensity to elevate blood pressure. It should not be used in persons with a history of hypertension, renal failure, or who currently use digitalis preparations such as digoxin.
Under the supervision of a physician hormone supplementation with DHEA, Pregnenolone, and Progesterone may also offer some benefits. There are several glandular extracts on the market that contain adrenal, hypothalamus, pituitary, thyroid, and gonadal that are also often recommended.
Sometimes the initiation of hydrocortisone (Cortef®) may be necessary as a replacement hormone when cortisol is not being produced by the adrenals. While the initiation of corticosteroids, such as hydrocortisone may have quick and dramatic results, they can sometimes make the adrenals weaker rather than stronger. As a result, the initiation of hydrocortisone is usually a last resort. It is important to note that patients may have to undergo treatment for 6 months to 2 years.
While a cortisol measurement may be helpful to confirm any thoughts or ideas that a patient may have decreased adrenal function, typically blood cortisol levels would be tested along with blood levels of potassium, and sodium. If the pituitary gland is the cause of adrenal failure electrolyte levels are usually normal. Practitioners usually pay attention to extremely low cortisol levels, which generally diagnoses Addison’s disease—a condition in which the adrenal glands are completely depleted, also considered a medical emergency.
From http://www.power-surge.com/educate/adrenalfatigue.htm
Natural Hormone Replacement Therapy (NHRT): If you are currently on or considering the use of Hormone Replacement Therapy (HRT) and you think individualized, natural HRT makes more sense than a “one-size-fits-all” approach, then you may want to look into naturally compounded, bio identical, plant-derived Hormone Replacement Therapy. Compounding is preparing medicines tailored to patients’ individual needs. Compounding is the preparation, mixing, assembling, packaging, or labeling of a drug as the result of a practitioner’s Prescription Drug Order based on the pharmacist-patient-prescriber relationship. Compounding offers patients their choice of drug, strength, dosage form, excipients, or lack of and can be decided on a case-by-case basis. This process allows for medical treatments that otherwise might not be possible.
With an individualized approach to hormone therapy, you can know exactly what your hormone levels are, compare the benefits vs. risks of all possible therapies, and choose the ideal replacement protocol to bring your hormones back to their proper balance. If your doctor is willing to prescribe conventional HRT, s/he should be more than willing to prescribe naturally compounded HRT.
Estradiol, the principal estrogen found in a woman’s body during the reproductive years, is produced by the ovaries. Estradiol is very effective for the symptomatic relief of hot flashes, genitourinary symptoms, osteoporosis prophylaxis, psychological well-being and reduction of coronary artery disease.
Because it is much more potent than estriol, it can be more effective for symptomatic relief than estriol. When Estradiol is replaced using a parenteral (sublingual, percutaneous, or transdermal) route, it is not subject to first pass metabolism by the liver, and therefore does no produce high levels of estrone. Using these routes of administration a woman can mimic the physiologic release of estradiol from the ovaries, thus receiving natural hormone replacement.
ESTRIOL (E3)
Estriol is the weakest of the three major estrogens. In fact it is 1000 times weaker in its effect on breast tissue. Estriol is the estrogen that is made in large quantities during pregnancy and has potential protective properties against the production of cancerous cells.
An important article in the 1966 Journal of the American Medical Association by H.M. Lemmon, M.D., reported a study showing that higher levels of estriol in the body correlate with remission of breast cancer. Dr. Lemmon demonstrated that women with breast cancer had reduced urinary excretion of estriol. He also observed that women without breast cancer have naturally higher estriol levels, compared with estrone and estradiol levels, than women with breast cancer. Vegetarian and Asian women have high levels of estriol, and these women are at much lower risk of breast cancer than are other women. Estriol’s anticancer effect is probably related to its anti-estrone properties-it blocks the stimulatory effect of estrone by occupying the estrogen receptor sites on the breast cells.
Estriol is the estrogen most beneficial to the vagina, cervix and vulva. In cases of vaginal dryness and atrophy, which predisposes a woman to vaginitis and cystitis, topical estriol is the most effective and safest estrogen to use. Because of this estriol is better than estradiol for the treatment of urinary tract infections.
None of the American drug products contain Estriol, so it is not available in most drug stores, although it has been used widely in Europe for over fifty years. Because estriol cannot be patented it does not hold much interest for the pharmaceutical industry. Its availability through compounding has caused its use to grow rapidly throughout the country.
ESTRONE (E1)
Estrone is the estrogen most commonly found in increased amounts in post menopausal women. The body derives it from the hormones that are stored in body fat. Estrone does the same work that estradiol does, but it is considered weaker in its effects.
BI-EST
Biest is a combination of two estrogens: estriol and estradiol. It is most commonly found in a ratio of 80:20, estriol to estradiol. This combination allows for all of the protection of estriol while providing the cardiovascular and osteoporosis benefits along with the vasomotor symptom relief of estradiol.
TRI-EST
Triest is a combination of three estrogens: estriol, estradiol and estrone. It is most commonly found in a ratio of 80:10:10, estriol, estradiol, and estrone. This combination is very popular and contains all of the three major circulating estrogens. It is slightly weaker in its effect when compared to biest. However, this can be compensated for by increasing the strength or by slightly changing the ratios.
PROGESTERONE
Progesterone is produced by the ovaries and the adrenal glands in women and, in smaller amounts, in the testes and the adrenal glands in men. One of its most important functions is in the female reproductive cycle. Progesterone prepares the lining of the uterus for implantation of a fertilized egg, then helps to maintain it during pregnancy. If pregnancy does not occur it signals the uterus to shed this lining.
Progesterone also plays an important role in brain function and is often called the “feel good hormone” because of its mood enhancing and antidepressant effects. Optimum levels of progesterone can mean feelings of calm and well being, while low levels of progesterone can mean feelings of anxiety, irritability and even anger. Current research shows that progesterone may pay a role in the maintenance of the nervous system, the sense of touch, and motor function.
PREGNENOLONE
Pregnenolone is a superhormone that is key to keeping our brains functioning at peak capacity. Some scientists believe it is the most potent memory enhancer of all time. Perhaps what is even more amazing are the studies that demonstrate pregnenolone enhances our ability to perform on the job while heightening feelings of well-being. In other words, this superhormone appears to make us not only smarter but also happier.
Like the other steroid hormones pregnenolone is synthesized from cholesterol. In a complex series o steps, cholesterol is broken down into different steroid hormones as the body needs them. It is first synthesized into pregnenolone and used by the body in that form. What is not utilized undergoes a chemical change that “repackages” it into DHEA. DHEA in turns used by the body as DHEA and is also broken down into estrogen and testosterone. This chain of hormones is known as the “steroid pathway.” Because pregnenolone gives birth to the other hormones, it is sometimes referred to as the “parent hormone.”
Pregnenolone was studied extensively in the 1940s. It was shown to be beneficial in elevating mood, improving concentration, fighting mental fatigue, improving memory and relieving severe joint pain and fatigue in arthritis. Pregnenolone has vast therapeutic potential and is currently undergoing further studies in these areas.
DHEA
Short for Dehydroepiandrosterone, DHEA is a steroid hormone distinguished from others by its unique chemical structure. DHEA is produced by the adrenal glands (located just above the kidneys) as well as by the brain and the skin, and is the most abundant steroid in the human body.
As newborns, we have an extremely high level of DHEA, but within a few days after birth, our DHEA level drops to nearly zero. Then between the ages of six and eight, we experience the even called “adrenarche” in which our adrenal glands begin to stir and gear up for puberty. At the same time our DHEA level begins to rise steadily and continues to rise until it peaks at around age twenty-five to thirty. From that point on in declines at a rate of about 2 percent a year, and we begin to feel the result of this decline in our mid-forties. By eighty our DHEA level is only fifteen percent of what it was when we were twenty-five. This drop in DHEA levels correlates dramatically with the signs and “symptoms” associated with aging.
DHEA is currently the focus of some of the most exciting medical research of this century. Researchers at distinguished medical centers all over the country are studying the properties and promise of DHEA. It is proving to be a potent protector against cancer. It protects against heart disease by lowering blood cholesterol and preventing blood clots. Studies also demonstrate that DHEA improves memory, strengthens the immune system, prevents bone loss, and may even protect us from diabetes and autoimmune disease. It has been shown to fight fatigue and depression; it enhances feelings of well-being and increases strength. DHEA alleviates symptoms of menopause, reduces body fat, and is even known to enhance libido.
Because DHEA is showing such tremendous promise in so many areas, and because of the limited amount of space provided here, we recommend further reading on the superstar of superhormones. An excellent resource for more information is the book “The Superhormone Promise” by W. Regelson, M.D., and Carol Colman.
TESTOSTERONE
Usually considered a male hormone or androgen, women also produce testosterone although in much smaller amounts than men do. Testosterone works differently in the bodies of men and women, but it plays a very important role in the overall health and well-being of both sexes. Often called the “hormone of desire” because of its powerful effect on libido, testosterone is also important in building strong muscles, bones, and ligaments as well as increasing energy and easing depression. Low levels of testosterone have been known to cause fatigue, irritability, depression, aches and pain in the joints, thin and dry skin, osteoporosis, weight loss, and the loss of muscle development.
As with all of the hormones, testosterone must be dosed properly to be effective without causing unwanted side effects. The dose in women is generally one-tenth that used in men. Because testosterone is not effective when it is taken orally it is usually prescribed as a topical gel, cream or as a sublingual tablet. Although testosterone was discovered more than sixty years ago, only very recently have we begun to fully understand and appreciate the power of testosterone.
HUMAN GROWTH HORMONE – HGH
HGH is one of many endocrine hormones, like estrogen, progesterone, testosterone, melatonin and DHEA, that all decline in production with age. While many of these hormones can be replaced to deter some of the effects of aging, HGH reaches far beyond the scope of any of these hormones. Not only does it prevent biological aging, but it acts to significantly reverse a broad range of the signs and symptoms associated with the aging process.
The decline of growth hormone with age is directly associated with many of the symptoms of aging, including wrinkling, gray hair, hair loss, decreased energy and sexual function, loss of muscle and increased body fat, cardiovascular disease, osteoporosis, and overall lower life expectancy.
The good news is that there is now clinical evidence which demonstrates that by replacing growth hormone we can dramatically reverse all of these symptoms. Although this may appear to be too good to be true, the more closely the scientific evidence is examined the more clear it becomes that everything that we associate with aging may be due totally or in part to the decline of HGH levels in our bodies.
Until recently, the only way to increase HGH levels in the body, was to use injectable HGH. These injections are very effective, although they are costly and difficult to use. Now, there are natural substances that have been well documented to increase growth hormone by stimulating the bodyís own production of HGH. According to researchers, these cutting edge natural secretagogues may have the ability to more closely mimic the bodyís youthful GH secretion patterns.
These natural substances which stimulate the body’s own production of HGH are known as secretagogues. They can be introduced into the body in two ways: orally or transdermally (topically applied to the skin).
The oral secretagogues are very popular and have shown to be very effective. They include such products as Pro-HGH®, Rejuvamin®, Rejuvamax® and Medi-Tropin®. Though effective, all of these except Medi-Tropin® are available without a prescription. Achieving consistent results with the oral products can be difficult due to changes in absorption from the stomach and the necessity for the stomach to be empty for four hours prior to use.
Trans-D Tropin ®
Trans-D Tropin ®, a transdermal product that is now available by prescription only, provides a very efficient delivery system and an ease of administration that leads to better patient compliance and consistent results. Trans-D Tropin ® is a natural complex which mimics growth hormone releasing hormone(GHRH). The transdermal delivery system allows frequent dosing, up to four times daily, which more closely resembles the body’s own natural response. Imitating this natural response results in an effective and superior release of the body’s own growth hormone.
Saliva Test for Hormones
Adequate levels and an appropriate balance of the steroid hormones (estradiol, progesterone, testosterone, DHEA, cortisol) are necessary for maintaining optimal health and well being in both females and males. This family of steroid hormones supports a wide range of essential physiological functions, including blood lipid balance, bone mineral density, fertility, sexuality, a general sense of well being, as well as certain aspects of brain functioning. The saliva test measures levels of specific hormones that are produced in the body, consumed as foods, dietary supplements or medication. Saliva yields a direct measure of “free hormone ” level and is comparable to that measured by blood. Also, timing of the test can be precisely controlled and levels can be determined at optimum times. Saliva testing provides a means to establish whether or not your hormone levels are within the expected normal range and it is simple and non-invasive. It is appropriate to monitor and titrate doses to minimize side effects and risks without compromising the benefits of replacement therapy.
Estradiol
Estriol
Progesterone
Testosterone
DHEA
Cortisol
Melatonin
Total Estrogens
Total Progestins
PyriLinks-D (urine sample)
* must be ordered by a physician
Medical insurance may pay for testing
THE MANY MYTHS OF hypothyroidism
By Kenneth Blanchard, M.D.
Read the transcript of Dr. Kenneth Blanchard (coming soon!)
Thyroid disorders are extremely common and, in my opinion, are often undiagnosed or poorly treated due to a total reliance on laboratory testing and some-long standing but fundamentally flawed principles of treatment. Of the many standard teachings in this area, I believe the most common mistake physicians make in every day practice is to “rule out” hypothyroidism on the basis of laboratory tests .alone, especially use of the TSH (thyroid-stimulating hormone) test. There are few teachings in medicine more sacrosanct than an elevated TSH test as the “gold standard” for a diagnosis of hypothyroidism. I believe that there are millions of patients (mostly women) who would benefit from thyroid hormone but who are not treated because of results from this test.
A common story in popular magazines is “The Diagnosis your Doctor Will Probably Miss”. The story is that many individuals (mostly women) with symptoms like fatigue, depression, muscle aching, constipation, etc., see a physician who orders a T4 test and, on the basis of this, are told that hypothyroidism has been “ruled out”. The “smarter physician” also orders a TSH test because this is more sensitive and often reveals an abnormality even when T4 results are normal. While this scenario can happen, I believe it is far more common to find both T4 and TSH tests registering normal in the face of significant clinical hypothyroidism. In my practice, if the medical history and physical findings are highly suggestive of hypothyroidism, patients are treated with a therapeutic trial of the hormone and the results are overwhelmingly positive. As of early 2001, opinion in this field is still that the TSH test is absolute, although the upper limit of normal has been questioned, which is starting to include more individuals in this diagnosis.
Another common teaching that I believe to be fundamentally wrong is that all treatment should be done with 1OO% T4 hormone L-thyroxine (Synthroid, Levoxyl, etc.). The normal secretion of the thyroid gland contains small amounts of the T3 hormone (triiodothyronine) and I believe that giving some T3 is an important part of effective treatment for most individuals. The standard medical view is the T3 is unnecessary because T4 is converted to T3 in the body. But many patients taking the standard 100% T4 hormone report chronic fatigue, depression, menstrual abnormalities, fibromyalgia, irritable bowel syndrome (IBS), restless legs and other complaints, and these complaints are almost always better when some T3 is added. This particular teaching in medicine has been breached by a paper appearing in the New England Journal of Medicine in 1999 in which patients on standard 100% T4 were given some T3 and all patients felt better mentally and physically. The use of T3 has been standard in my practice since 1990 and I am quite sure it will be routine in the near future, although many physicians at this point still do not use T3 in addition to T4.
Thyroid hormone activity has a variety of complicated interactions with other hormones. For instance, I believe that thyroid hormone treatment is effective in PMS (premenstrual syndrome) despite the fact .that there are major studies in the literature which say this is not true. It is most likely that PMS fundamentally represents a deficiency of progesterone production prior to menstrual flow, but I believe that normalization of thyroid deficiency enables the woman to make more progesterone, thus relieving the symptoms. The woman in her mid-forties who is just starting to have irregular periods and notices some hot flashes, sweats and sleep disturbance at night can often be treated simply by optimal thyroid replacement, specifically including some T3. While such symptoms are commonly regarded as estrogen deficiency and will respond to the use of estrogen, I find that many such women have normalization of symptoms on proper thyroid therapy alone. The fundamental reason for this may well be that normalization of thyroid function enhances estrogen production by the ovaries themselves and by, the increased production of estrogen in fat tissue from adrenal hormone precursors.
If a woman at this age has frequent migraine headaches that are clearly related to the menstrual cycle (essentially premenstrual), these will often respond to balanced T4- T3 treatment, again possibly because of raising and/or stabilizing levels of estradiol. While clinical depression is not an integral part of menopause, there are many issues at this time of life that can cause emotional upset or depressed feelings. Again, use the T3 hormone in a physiologic way can be very helpful. Indeed, much of the current use ofT3 is in the hands of psychiatrists, who. use it as an adjunctive treatment for depression that is not responding well to standard antidepressants. Although this can be extremely effective, psychiatrists tend to use pharmacologic doses rather then physiologic doses. In other words, they exceed the amount needed to reproduce normal hormone balance. For virtually every purpose, a physiologic dose is desirable since excessive doses yield no additional benefits. I also disagree with the use of Armour thyroid by itself for the same reason, that it does not contain a physiologic balance of T4 to T3. The human thyroid produces roughly 95% T4 and 5% T3. Armour thyroid is an animal thyroid that contains 80% T4/20% T3. People who take Armour thyroid usually feel better for a short period of time because they were deficient in T3 but, after a period of time, the Armour thyroid will cause a T4-T3 imbalance at tissue level and a variety of undesired symptoms can then develop over time. One can get a better balance by giving some T4 with the Armour.
Some doctors are reluctant to prescribe (and some women reluctant to take) thyroid hormones in the belief that this will somehow increase the risk of osteoporosis. . I personally do not believe that there is good evidence for this, although my guess would be that excessive thyroid hormone does contribute to bone loss. Since there is no benefit in going above the normal physiologic levels of thyroid hormone, following the TSH result and clinically monitoring the patient will prevent overdose and resultant adverse effects.
Every organ system in the body is affected to some degree by treatment with thyroid hormone. I believe that the proper treatment of hypothyroidism with physiologic amount ofT4 and TI is critical in managing many complex medical problems at mid-life. If treatment is carefully monitored, there are no adverse effects. Management of hypothyroidism with T4 and TI is significantly more complicated than the standard 100% T4 therapy that has been used for the past 30 years or so. TI dosage must be monitored and altered precisely for optimum effect and this must be done by the use of compounded T3 time-release capsules. These are almost always made in units of 1OO capsules for practical reasons. Patients are initially seen every three months in order to adjust the dosage for the next prescription of T3. Another practice that will eventually become standard in this field is the adjustment of thyroid dosage for seasonal change, i.e., higher dosage in the colder weather and reduced dosage in the warmer weather.
Once dosage has been adjusted over 3 to 5 3-month visits and everything appears stable, visits are done at 6-7 month intervals. Patients must be ready to keep their appointments and take the medication exactly as directed. At the present time, there are many patients on a waiting list so that patients who drop out of the treatment plan fall back to the end of the list. Patients who have difficulty with the practices outlined above should stay with their current therapy.
By Power-Surge guest:
Kenneth Blanchard, M.D
Read the transcript of Dr. Kenneth Blanchard (coming soon!)
Read the Power Surge disclaimer
MaryO’Note: Some of these links have been removed.
What is Menopause and Perimenopause?
Menopause is defined as the cessation of menstruation as a result of the normal decline in ovarian function. Technically, you enter menopause following 12 consecutive months without a period. Menopause has become increasingly medicalized, which means it is viewed as something that requires intervention and treatment rather than as a natural life transition that may benefit from support. Menopause signals the end of fertility and the beginning of a new and potentially rewarding time in a woman’s life. Part of the stigma of menopause is its association with aging, but we age no more rapidly in our 50s than in any other decade of life.
When Does Menopause Happen?
For most women, natural menopause occurs between the ages of 45 and 55, with the average age of onset being 51.4 years of age. In rare instances, menopause can occur as early as the 30’s or as late as the 60’s. Menopause is considered premature if it occurs before the age of 40, or artificial if radiation exposure, chemotherapeutic drugs, or surgery induces it. Other factors that may contribute to the early onset of menopause include a history of smoking, poor nutrition, a co-existing medical condition, or even a traumatic experience.
Until a woman is technically considered menopausal (aka postmenopausal), she’s considered to be premenopausal, also referred to as perimenopause. It’s during the perimenopausal phase that most women experience the worst symptoms.
Menopause (or postmenopause) occurs when a woman hasn’t had her period for 12 consecutive months. Once hormones have levelled off, most of the symptoms experienced during perimenopause will disappear — although some women have occasional hot flashes, anxiety, bouts of depression, et al, for a few years after they become postmenopausal.
The Physiology of Menopause
To best understand what occurs at menopause, it is helpful to know about the physiology of menstruation and the hormones that are involved in our monthly cycle. Hormones are substances in our bodies that act like messengers. They travel throughout the body and can bind to specialized areas of cells known as receptor sites, where they then initiate a specific chain of events. The first half of the menstrual cycle is dominated by estrogen, whose role is to build the lining of the uterus in preparation for a potential pregnancy. At approximately day 14 of the cycle, or two weeks prior to menstruation, an egg is released from the ovaries. This is referred to as ovulation.
As a result of ovulation the ovary begins producing progesterone. It is during this second half of the cycle that progesterone is dominant. Progesterone’s role is to change the character of the uterine lining to prepare for pregnancy, and to prevent further buildup of the lining by estrogen. At the end of the cycle, if the egg is not fertilized, estrogen and progesterone levels drop, causing a sloughing of the uterine lining, or menstruation. The body goes through this cycle every month to ensure a fresh uterine lining in preparation for a potential pregnancy.
If a woman fails to ovulate, however, she does not produce progesterone, and this may result in the experience of symptoms of hormonal imbalance. Women are born with a finite number of eggs that eventually runs out. At birth, a woman has close to a million eggs, by puberty a mere 300,000. In the 10 to 15 years prior to menopause, this loss begins to accelerate. Perimenopause is the term used to describe the time of transition between a woman’s reproductive years and when menstruation ceases completely. Typically perimenopause occurs between the ages of 40 and 51 and may last anywhere from six months to ten years. During this time, hormone levels naturally fluctuate and decline, but they do not necessarily do so in an orderly manner. Shifts in hormones are a major contributor to that sense of physical, mental, and emotional imbalance that may characterize a woman’s experience of menopause.
Eventually estrogen levels decrease to the point that the lining of the uterus no longer builds up and menstruation ceases. This is menopause. After menopause, estrogen levels off at approximately 40 to 60% of its premenopausal levels and progesterone falls close to zero. Although there are similarities in what happens hormonally, each woman’s experience can be very different. Genetics may play a role in the timing, but lifestyle can certainly influence a woman’s experience of menopause. Many women find that the right combination of herbs, exercise, nutritional support, and natural hormones helps them to manage most of their symptoms. Others find they may need some medical intervention and pharmaceutical agents. This site will help guide you in making the decisions that best support your individual needs.
How long does perimenopause last?
It varies. Women normally go through menopause between ages 45 and 55. Many women experience menopause around age 51. However, perimenopause can start as early as age 35. It can last a few months to quite a few years. There is no way to tell in advance how long it will last OR how long it will take you to go through it. Every woman is different.
I’ve been depressed in the past. Will this affect when I start going through perimenopause?
It could. Researchers are studying how depression in a woman’s life affects the time she starts perimenopause. If you start perimenopause early, researchers don’t know if you reach menopause faster than other women or if you’re just in perimenopause longer.
What should I expect as I go through perimenopause?
The 34 Signs/Symptoms of Menopause.
Some women have symptoms during this time that can be very difficult. Some of these symptoms include:
- Changes in your menstrual cycle – i.e., longer or shorter periods, heavier or lighter periods, or missed periods
- Hot flashes (power surges — sudden rush of heat from your chest to your head)
- Palpitations, skipped heartbeats
- Internal shaking / tremor-like feelings
- Night sweats
- Vaginal dryness
- Dry skin and skin changes
- Itching
- Formication (feeling like ants are crawling on your body)
- Insomnia and other sleep disturbances
- Mood swings
- Allergies, sinus problems
- Wheezing, respiratory problems, coughing
- Depression
- Anxiety
- Panic attacks
- Crying for no apparent reason
- General irritability and/or anger
- Hair thinning or loss
- Pain during sex
- More urinary infections
- Urinary incontinence
- Decreased or non-existent libido
- Increase in body fat, especially around your waist
- Forgetfulness, brain fog, problems with concentration and memory
Additional Reading: The 34 Signs/Symptoms of Menopause.
There are numerous articles addressing all of these issues and more in Power Surge’s ‘Educate Your Body’ Library.
Excellent suggestions for coping with menopause in Power Surge’s Menopause Survival Tips
I don’t understand why I get hot flashes. Could you tell me what’s going on with my body?
Read What’s A Hot Flash? We don’t know exactly what causes hot flashes.
It could be a drop in estrogen or change in another hormone. This affects the part of your brain that regulates your body temperature. During a hot flash, you feel a sudden rush of heat move from your chest to your head. Your skin may turn red, and you may sweat. Hot flashes are sometimes brought on by things like hot weather, eating hot or spicy foods, or drinking alcohol or caffeine. Try to avoid these things if you find they trigger the hot flashes.
I feel so emotional. Is this due to changes in my hormones?
Your mood changes could be caused by a lot of factors. Some researchers believe that the decrease in estrogen triggers changes in your brain causing depression. Others think that if you’re depressed, irritable, and anxious, it’s influenced by menopausal symptoms you’re having, such as sleep problems, hot flashes, night sweats, and fatigue, and/or by issues you’re dealing with that aren’t strictly related to hormonal changes. It could also be a combination of hormone changes and symptoms. Remember, menopause doesn’t happen in a vacuum. All the issues you came into menopause with are only exacerbated by your changes.
Menopause doesn’t happen in a vacuum. It’s part of the bigger transition of “aging.” Other things that could cause depression and/or anxiety include:
- Having depression during your lifetime
- Feeling negative about menopause and getting older
- Increased stress (look at the world we’re living in)
- Having severe menopause symptoms
- Children growing up and leaving home – empty nest syndrome
- Smoking
- Being sedentary – not being physically active
- Not being happy in your relationship or not being in a relationship
- Not having a job, or being unhappy in your current job
- Continuing working during a difficult menopause
- An unfulfilling marriage / marital problems
- Financial problems
- Low self-esteem (how you feel about yourself)
- Not having the social support you need
- Feeling isolated
- Not having anyone to talk to (Use our message boards)
- Regretful that you can’t have children anymore
What can I do to prevent or relieve symptoms of perimenopause?
- Read the Power Surge Recommendations for treating various menopause symptoms.
- Read Power Surge’s Menopause Survival Tips
- Keep a journal for a few months and write down your symptoms, like hot flashes, night sweats, and mood changes. That can help you figure out the changes you’re going through
- Record your menstrual cycle, noting whether you have a heavy, normal, or light period
- Find a physical activity that you’ll enjoy doing
- If you smoke, try to quit. There are areas, such as A Breath of Fresh Air! for help.
- Keep your body mass index (BMI) at a normal level. Figure out your BMI by going to www.nhlbisupport.com/bmi/bmicalc.htm
- Network with other women who are in perimenopause or menopause. Most likely, they’re going through the same things you are!
- Do something new: start a new hobby, do volunteer work, take a class
- Learn meditation and breathing exercises for relaxation
- Use a vaginal lubricant for dryness and pain during sex Read the article on Midlife Sexuality / Vaginal Dryness for more information.
- Dress in lighter layers (preferably cotton), so if a hot flash comes on, you can peel away the top layer (without getting arrested!)
- Try to figure out (and avoid) those triggers that may cause hot flashes, such as spicy foods, caffeine, or being outside in the heat.
- Talk with your health care practitioner if you feel depressed, or have any other questions about how to relieve your symptoms
- Educate yourself about what tests you need when entering perimenopause. Oftentimes, doctors won’t prescribe them unless YOU ASK for them!
- An excellent resource for your questions about menopause — < Ask Power Surge’s Experts!
I’m going through perimenopause right now. My period is very heavy, and I’m bleeding after sex. Is this normal?
Irregular periods are common and normal during perimenopause, but not all changes in bleeding are from perimenopause or menopause. Other things can cause abnormal bleeding.
Talk to your health care provider if:
- The bleeding is very heavy or comes with clots (although clotting isn’t uncommon during perimenopause)
- The bleeding lasts longer than 7 days
- You have spotting or bleeding between periods
- You’re bleeding from the vagina after sex
- Can I get pregnant while in perimenopause? Yes. If you’re still having periods, you can get pregnant. Talk to your health care provider about your options for birth control. Keep in mind that methods of birth control, like birth control pills, shots, implants, or diaphragms will not protect you from STDs or HIV. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sexual contact. Be aware that condoms don’t provide complete protection against STDs and HIV. The only sure protection is abstinence (not having sex of any kind). But appropriate and consistent use of latex condoms and other barrier methods can help protect you from STDs.For women under 50, it is recommended that you continue some form of birth control even after your period has stopped for one year (24 consecutive months). For women over 50, it is recommended that birth control be practiced for one year after entering menopause.For perimenopausal women, it is essential that you continue some form of birth control while your periods are erratic — even if you’ve been without a period for six or seven months — you can still get pregnant. For women whose periods have stopped for twelve consecutive months, it is still recommended that you practice some form of birth control for approximately one year after entering menopause.
MaryO’Note: Links are removed from this list
There’s been a list of the “34 signs of menopause” circulating for years. The list originated with Judy Bayliss’ wonderful newsgroup, The Menopaus Listserv (That’s Menopaus without the “e” at the end).
I’ve taken the liberty of adding my own Notes to the original list. You’ll find hundreds of articles pertaining to menopause symptoms, treatments and menopause / midlife-related health and emotional issues including articles on midlife relationships, weight and fitness issues, intimacy, psychological problems associated with menopause in Power Surge’s, “Educate Your Body” extensive library.
I suggest you begin with the comprehensive article explaining what menopause is: in “An Introduction To Menopause: Signs, Symptoms and Treatments”
You’ll find remedies for most of these symptoms on the Recommendations page.
Here is the list of: “The 34 Signs of Menopause:”
1. Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling (related to increased activity in the autonomic / sympathetic nervous system). Without becoming too, technical, messages are sent to the hypothalmus because of declining estrogen production via neurons which result in vasodilation — widening of the lumen of blood vessels (lumen being the cavity of a tubular organ, i.e., the lumen of a blood vessel,) which, in turn, causes flushing or hot flashes. Tips for treating/minimizing (and even avoiding) hot flashes: Power Surge’s Menopause Survival Tips. Also, read the Power Surges (hot flashes) Forum
2. Bouts of rapid heartbeat (related to increased activity in the autonomic / sympathetic nervous system)
Note: Along with rapid heartbeat (palpitations), women can experience skipped heartbeats, irregular heartbeats. These are generally normal vasomotor responses experienced during menopause – usually due to fluctuating hormone levels. However, if these problems continue, it’s always a good idea to be checked by your health care practitioner. An echocardiogram is a common procedure to tell the doctor what he needs to know about your heart. If your health care practitioner doesn’t suggest it, ASK FOR IT! Read the Palpitations, Heart Issues, Hypertension Forum
3. Irritability. Note: Along with irritability, a host of “anger” problems can develop during menopause. Just as a perimenopausal woman can find herself suddenly crying for no apparent reason or provocation, so can she find herself reacting to given situations in an angrier manner than she normally does. This anger can sometimes feel like “rage.”
Again, this is hormone-induced, but for some women, the anger can become inappropriate and a woman can feel like she’s out of control. There’s nothing wrong with seeking counselling to discuss these issues with a mental health professional. This is a challenging time of life and some objective outside help can be tremendously useful in helping a woman cope with all the emotions she’s feeling. Remember, menopause isn’t simply physical changes, but emotional and spiritual changes as well. There’s an excellent forum on the Power Surge Message Board that deals with the issues of Anger / Mood Swings / Rage.
4. Mood swings, sudden tears. Note: Mood swings can include anything from mood shifts (happy one moment, depressed the next) to sudden bouts of crying when nothing overt has occurred to cause the crying. Mood swings can and have been misdiagnosed as bipolar disorder because one can feel such extremes of emotions due to hormone imbalance. Anxiety, depression, panic attacks and even feelings of agoraphobia aren’t uncommon during menopause. The panic attacks often can develop with the onset of hot flashes. For some women, hot flashes can be severe and quite frightening.
5. Trouble sleeping through the night (with or without night sweats). Note: This can develop into insomnia or just waking at 2 in the morning for an hour. Relaxation and breathing exercises can be useful at this time — many women may log onto the Power Surge message boards and are surprised to find so many other women there in the middle of the night. More help on the Insomnia, Sleep Disorders Forum
6. Irregular periods: shorter, lighter or heavier periods, flooding, and phantom periods. Note: A phantom period is when you experience all the symptoms you’re accustomed to having before you menstruate — but… no period comes. This is a common experience during perimenopause before a woman’s period actually stops.
7. Loss of libido (sex drive). Note: Not every woman loses her libido entirely during perimenopause, although some may temporarily. Many women simply have a decreased interest in sex – often it’s simply because they generally don’t feel well and sex is the last thing on their mind! Also, bear in mind that there are many medications that can affect one’s libido, including the anti-depressants some women take to cope with the depression and anxiety associated with menopause to anti-hypertensives.
8. Dry vagina (results in painful intercourse) Note: Click here for an excellent article about vaginal dryness, sexuality and midlife relationships. Recommended: Sexual Issues/Libido Forum
9. Crashing fatigue. Note: I’ve never been able to determine if the “fatigue” associated with perimenopause is a symptom in and of itself, or if it’s a side effect of the cumulative symptoms and general exhaustion (from them) many women experience. Take all the symptoms and “dump” them on one person — is it any wonder perimenopausal women are so fatigued? If you can, try to find time to grab a nap.
One of the things that helped my fatigue, and it’s all chronicled in my personal odyssey to find remedies, is the use of considerable amounts of soy isoflavones and protein, which I found in R Soy. I can’t say that it specifically targetted and relieved the crashing fatigue, but it helped so many other symptoms and gave me a burst of energy, that I feel comfortable in attributing the fatigue relief to R. There are various vitamins, such as those in the “B” family, that can help with fatigue as well. Also, increased amounts of vitamin C. The Recommendations page lists numerous vita-nutrients that can be useful in treating fatigue and other symptoms associated with perimenopause.
10. Anxiety, feeling ill at ease. Note: One of the biggest complaints during menopause. Read the Anxiety/Stress Forum
11. Feelings of dread, apprehension, and doom (includes thoughts of death, picturing one’s own death). Note: It’s possible that this can be a manifestation of depression associated with menopause, or possibly feelings that come from going through daily discomfort through a difficult menopause transition that can last anywhere from 3-12 years.
A woman living under these circumstances can feel totally overwhelmed and frightened by the physical, psychological and spiritual changes. When there seems to be no reprieve from the suffering, for some it can leave them feeling drained wondering when and IF they’ll ever feel well again. It isn’t unusual for women at this time of life to have thoughts about dying. One phase of their life is coming to a close (not soon enough for many). There may be apprehension and fear about moving on to the next phase of life and wondering whether things will get better or worse. Helpful: The Panic Attacks / Disorder / Fear / Apprehension Forum
12. Difficulty concentrating, disorientation, & mental confusion. Note: Forgetfulness during perimenopause is often referred to lightly and humorously as “brain fog” but it’s not always funny. Note: An excellent article, Menopause And The Mind. Also, visit the Memory Loss, Foggy Thinking, Forgetfulness, Verbal Slips Forum
13. Disturbing memory lapses. Note: See #12
14. Incontinence — especially upon sneezing, laughing: urge incontinence (reflects a general loss of smooth muscle tone).
15. Itchy, crawly skin (feeling of ants crawling under the skin, not just dry, itchy skin Note: the feeling of ants crawling on your skin is called “formication”) Visit the Your Skin: Dryness, Itching, Vaginal Dryness, Disorders, Discomfort Forum
16. Aching, sore joints, muscles and tendons. (may include such problems as carpal tunnel syndrome). Note: Osteoarthritis can develop during perimenopause – and those with existing arthritic and/or rheumatic pain may find it’s exacerbated during the menopausal transition. See the Joints Aches and Pains/Arthritis Forum
17. Increased tension in muscles.
18. Breast tenderness. Note: Breast swelling, soreness, pain.
19. Headache change: increase or decrease. Note Many women develop migraine headaches during perimenopause. However, if one doesn’t have a history of migraine headeaches, they’re generally a short-lived experience of perimenopause. Also see the Headaches, Migraine Forum
20. Gastrointestinal distress, indigestion, flatulence, gas pain, nausea. Note: For nausea, try some ginger or, as I use, boiling hot water with a few teaspoons of lemon or lemon juice concentrate in it. Many women also develop acid reflux (Gerd). For some, it can be an uncomfortable feeling of severe burning sensations in the throat. If it persists, see your health care practitioner.
21. Sudden bouts of bloat. Note: Bloating, water retention are common complaints during perimenopause. Also, Acid reflux and heartburn are very common during perimenopause. Treat them as you would if you weren’t going through menopause.
22. Depression (has a quality from other depression, the inability to cope is overwhelming, there is a feeling of a loss of self. Natural hormone therapy, ameliorates the depression dramatically). Note: There are various natural methods of treating depression. Read Power Surge’s Menopause Survival Tips.
Also, many women using progestins or progesterone supplementation experience “depression” as a side effect. Power Surge recommends only naturally compounded, bio-identical hormones. Naturally compounded estrogen and progesterone supplementation doses can be individually adjusted to suit each woman’s needs. So, if a woman is experiencing depression from progesterone, the level of progesterone supplementation can be reduced until the compounding pharmacist comes up with the right blend. The combination of estrogen and progesterone is important in achieving the desired results. Other remedies, such as St. John’s Wort can be very effective in alleviating the depression associated with menopause.
My personal experience was that my perimenopause-related depression was eliminated when I started using R Soy Protein. R is excellent for mood swings, but I was astonished by the impact it had on the hormone-related “lows” I experienced before using it. Also recommended, The Depression Forum
23. Exacerbation of any existing conditions. Note: Often, conditions women had prior to entering perimenopause become
exaggerated (worse) during the menopause transition.
24. Increase in allergies. Note: Many women who suffer from allergies develop worse allergies during the menopausal years. Many women who’ve never had allergy or respiratory problems may develop them for the first time. Many people don’t realize that histamine levels are affected by hormone levels. Women can develop wheezing, coughing and a host of respiratory problems. This generally disappears as the hormones level out once a woman becomes menopausal.
25. Weight gain. (is often around the waist and thighs, resulting in “the disappearing waistline” and changes in body shape.) A good read, Weight Gain and Fitness Issues
26. Hair loss or thinning, head or whole body, increase in facial hair. Note: There is often a loss of pubic hair during menopause. Many women are more comfortable simply shaving their pubic area instead of having patches of hair.
27. Dizziness, light-headedness, episodes of loss of balance. Note: Although common complaints during menopause, I always recommend anyone suffering from dizziness, dysequilibrium have her blood pressure checked just to be on the safe side. However, women can experience these symptoms during perimenopause without having hypertension.
28. Changes in body odor. Note: I wouldn’t be too concerned about this one. It can happen, but in 13 years of running Power Surge, I’ve heard of relatively few cases of developing body odor during menopause.
29. Electric shock sensation under the skin & in the head (“take the feeling of a rubber band snapping against the skin, multiply it (exponentially, sometimes) radiate it & put it in the layer of tissues between skin & muscle & sometimes a precursor to a hot flash.”) Note: Those buzzing sensations, as though you’ve put your finger into a live electrical socket, can be frightening. They’re all part of the hormones, nerve endings and electrical waves running through our bodies when our hormones are constantly fluctuating. Many women experience this during perimenopause, but it eventually passes.
30. Tingling in the extremities (can also be a symptom of B-12 deficiency, diabetes, or from an alteration in the flexibility of blood vessels n the extremities.)
31. Gum problems, increased bleeding.
32. Burning tongue
33. Osteoporosis (after several years)
34. Brittle fingernails, which peel & break easily.
Some additional signs from Dearest:
- Internal shaking / tremor-like feelings. Read the Internal Shaking Forum
- Acne and other skin eruptions
- Itching wildly and erratic rashes
- Shoulder pain / joints / arthritis development or flare up in
preexisting conditions
- “Heart pain” – a feeling of pain in the area of the
heart (if persistent, get checked by your health care practitioner)
- Acid reflux / heartburn / difficulty digesting certain foods
Some of the 34 signs may also be symptoms of one of the following:
- Hypothyroidism
- Diabetes
- Depression with another etiology
- Other medical conditions (see The Educate Your Body Library)
If you have reason to believe you may have one of these conditions, see your healthcare practitioner for treatment.
Dearest
Note: Remember that although these may be common complaints during menopause, they might also indicate some other health problem. Be sure to consult with your personal health care practitioner before attributing these symptoms to menopause.
“I repeat over and over on the site that any complaints a woman has during menopause should not automatically be attributed to the process of menopause. That’s an important disclaimer. In short, before assuming, not that you are, that any of the things you’ve mentioned in your message are associated with peri or postmenopause, you should be checked by a doctor you respect, trust and admire — one who listens to you and doesn’t just hand you a prescription to resolve your problems.
That having been said, let me tell you that during those “worst” years of perimenopause, I experienced SO MANY strange, inexplicable and, oftentimes, bizarre feelings in my body, I conjured up notions of having a brain tumor, Parkinson’s Disease, Lupus, Fibromyalgia, Chronic Fatigue Syndrome, Menniere’s Disease, a heart condition, paralysis, a potential stroke, glaucoma — have I left anything out? And I say none of this with humor.
Perimenopause is the singularly most uncomfortable time of a woman’s life. I’ve posted many times about the internal shaking. It’s been my nemesis and continues this day to plague me.
I had the facial tremors and buzzing sensations on a daily basis. The feelings were so strange, they almost defy description. No one could see it, but it felt as though I were having a stroke. I’d often experience numbness in my face and on my left side at the same time — a red flag would go up because I thought I was definitely having a coronary situation or stroke. Facial ticks, facial tremors, an electrical buzzing in the back of my neck and various parts of my body drove me to distraction.
The good part about this story is that most of those symptoms DO go away once you’ve been without a period for about a year or two. Those feelings, in the majority of cases, are due to the hormonal fluctuations your body is experiencing. Imagine turning the thermostat in your house up and down a dozen or more times a day. Your house wouldn’t know whether to turn on the heat or air conditioning.
Our bodies become very sensitized during this process. Feelings are frightening — we can walk around for days feeling vertigo/dizziness and/or a ringing in the ears (tinnitus). There were days I had to grab onto a bannister or railing for fear that I was going to fall over. My legs still pose a problem — becoming weak and feeling as if they’re not going to support me any longer. Pain in the feet, calves, shoulders, joints aching and paining often to the point of bringing tears to your eyes.
My suggestion to you would be to get yourself a thorough examination by your doctor. Have a blood workup, sugar test, thyroid, hormone levels, total lipid / cholesterol profile. Insist on an Echo cardiogram, not just a cardiogram.
Our bodies are composed of so many different types of hormones — not just estrogen, progesterone and testosterone. Our bodies react to the constant ebb and flow of these hormone levels. Our central nervous system, nerve endings produce electrical impulses. Those electrical impulses are felt differently by every woman. Some women never feel them, while others are fraught with all sorts of strange sensations.
Once you’ve been given a clean bill of health by your doctor, the singularly most important thing you need to do during perimenopause is do relaxation techniques. Learn breathing exercises. Use the paper bag method (I call it “brown bagging it) I have described in many areas of the Web site and on these boards. I’ll provide a link to that at the end of this message.
Feed yourself affirmations every day that this, too, shall pass — that you are not dying — that although you feel as if your body is going to hell in a handbasket and you’re never going to survive this transition, you will. That, most importantly, there is nothing to be afraid of even though it feels at times like someone is holding a gun to your head and ready to pull the trigger.
Oh, Lord, would it were so that they’d find a way for women NOT to have to go through menopause. And, further, I am sick of hearing *some* people say that it’s all in our minds, or it’s our nerves, or if we had better things to do with our time, we wouldn’t think about it. I’ve never stopped being busy during this transition, but that didn’t ease the symptoms.
To those people, I say … until you’ve walked a mile in another person’s shoes, you can’t know what they are going through. Women in menopause aren’t hypochondriacs. I have to be dragged and feeling as if I’m not long for the world before I go to the doctor. Why? Because during perimenopause, I have learned… doctors don’t have answers to most of our questions other than to prescribe tranquilizers or anti-depressants or hormones…. and although some of these medications may help in the short term and to get you over the “hump” of perimenopause, most of them don’t work in the long term — or through the duration of perimenopause and it concerns me that there are no real long-term studies on these SSRI’s (anti-depressants).
If you feel you need to take something to get through this process, absolutely take it. Don’t make a martyr or yourself. However, remember, these medications only temporarily mask the symptoms. Learning ways to relax and cope with the changes you’re undergoing works far better over the long haul than anything else.
I have provided various relaxation and breathing techniques on this, the anxiety and the panic boards that can be tremendously helpful. The one I’d recommend is something I refer to as “brown bagging it.” It’s in various places of the site, but I’ll give you a link to my article after I’ve finished this message.
It has been my experience and I believe that of many other women who’ve passed through Power Surge over the seven years it’s been online that once you are in the throes of perimenopause, for about one or two years — perhaps a third (but not often), you will experience every conceivable symptom on the list of 34+ symptoms (* see below). I went through severe migraines and was *never* a headache person in my life. They lasted about a year or two – on and off, not every day, but they eventually stopped. I went through the facial tremors, buzzing experience as though I’d had my finger in an electrical socket. The migraines and severe palpitations, hot flashes, night sweats, crying and severe mood swings, horrific depression so much so that at times I would put my head on the pillow at night and whisper to God, “Please, if I have to feel this way tomorrow, let me not wake up.”
Those feelings — horrible as they are — don’t generally last for the full transitional period. They usually occur during the worst phase of perimenopause and only last about a year or two. That doesn’t mean you won’t ever experience them again in some milder form, but the severity and frequency will certainly decrease — and hormone therapy isn’t the magical answer. Many women using hormones still experience many of these symptoms.
Just remember that as long as you’ve been given the okay regarding your health by your health care provider, these are symptoms of menopause and, yes, I say symptoms. People have said to me, “Why do you call them symptoms? Menopause isn’t an illness.”
I tell them that I know menopause isn’t technically an illness, but seeing as how I have never felt worse in my life, I will not say that I am well.
I get very passionate about this subject and one of the reasons I’ve kept Power Surge an independent entity is because it allows me the opportunity to express myself without wondering who’s going to pay the bills if I tell the truth about the medical profession and some of the techniques of the pharmaceutical companies.
I will never get rich from Power Surge, but knowing that this community has helped so many women understand what they’re going through without just dumping medical abstracts at them and pushing pills on them has been the most gratifying and “freeing” experience of my life.
Finally, let me add my favorite words — THIS, TOO, SHALL PASS. Believe me, I thought in my heart I would never, ever survive perimenopause, but the internal shaking eases up even though it’s hell while you’re going through it. The palps will stop as well. It just takes time and a LOT of patience!
Be good to your body and it will return the favor in spades.
For the “brown bagging it” reference and many other helpful suggestions, check out the Power Surge Menopause Survival Tips article.
…and the ever useful…
* The 34+ Signs of Menopause
Dearest”
Power Surge 