Hormone changes affect everyone, yet 73 percent of women in the U.S. do not seek medical help for menopause, according to the 2021 “State of Menopause Study” by Bonafide. These changes are one of the top reasons women come to see me. As a functional medicine doctor, I’ve helped women manage this stage of their lives for more than 20 years. It’s the visible symptoms that bring them in: night sweats or loss of hair. However, there are silent results of changing hormones that are equally as important to address. Before I explain a solution, I want to walk you through why women experience those symptoms, the different types of symptoms, and finally, what you can do to combat some of the issues.
In typical cases, hormones start to change in your early forties. Most women will feel like they have “estrogen dominance” symptoms. This is not because they make too much estrogen, but rather their ability to make enough progesterone which counters the effects of estrogen slows down. The symptoms may be heavy, irregular, and painful periods, breast tenderness and moodiness, insomnia, painful sex, vaginal dryness, and loss of libido. Symptoms tend to be worse, especially just before they start their period.
Several years later, usually between 48-52 years old, woman transition to menopause. This is a particularly difficult time as women may start having heavy periods off and on, worsening mood swings, highs and lows with irritability, insomnia, hot flashes, night sweats, weight gain, painful intercourse, vaginal dryness, urinary frequency, loss of libido, hair thinning and loss. Then, when a woman hasn’t had a period for a year, she has officially entered menopause.
When it comes to hormone changes, women see me for two specific reasons: feelable and invisible symptoms. Feelable symptoms are the ones you can physically feel. These affect your daily life. They can range from hot flashes to night sweats, insomnia to mood swings, irritability to memory loss, and even weight gain and hair loss.
These are symptoms you cannot feel but greatly impact your life. Hormone changes can wreak havoc on your bones and muscles in the form of osteoporosis or osteopenia, leading to hip fractures which can be life-changing. Your cognitive health can decline as well as increasing fears of memory loss and Alzheimer’s dementia. You may experience heart disease in the forms of high blood pressure and high cholesterol which are leading causes of strokes and heart attacks. Another silent symptom is an increase in insulin resistance leading to “belly fat” weight gain and diabetes.
Bioidentical Hormone Therapy
Many women feel they just have to deal with all of these changes. That could not be further from the truth. The information I’m about to provide can be an absolute game changer in your life.
Bioidentical hormone replacement, as opposed to synthetic hormone replacement, is using hormones like estradiol, that your body recognizes as biologically identical to the hormones that you naturally make. Synthetic hormones, like the ones found in Premarin, come from a horse’s urine and are not identical to what your body naturally makes.
The old thoughts that hormones are dangerous for you are based on studies done on synthetic hormones that are bad for you. However, I’ve found that bioidentical hormones are recognized by your body and it reacts accordingly.
How Does Bioidentical Hormone Therapy Work?
I use specialized testing to look at how a woman is breaking down estrogen. The goal is to make sure her body can process the hormones properly. The next step is to balance hormones using bio-identical estrogen, progesterone, and testosterone. Once a balance is established, there is lab testing before and during to make sure the dosage is correct. Of course, I have follow-up visits to make sure symptoms have improved. When you combine all this together, not only do you not have to live with these menopause symptoms, but you can safely navigate this period of your life and improve longevity and vitality for years to come.
Is Bioidentical Hormone Replacement Therapy Safe?
If hormone replacement therapy is done properly, it can reduce the risk of heart attacks, strokes, Alzheimer’s dementia, and broken hip bones. Not to mention improving quality of life, improving libido, vaginal dryness complaints, insomnia, hot flashes/night sweats, mood stabilization and decreasing risk of depression.
Clinical trials, including Heart and Estrogen/Progestin Replacement Study I and the Women’s Health Initiative, have shown that conventional hormone replacement results in increased thrombotic events, an increased risk of breast cancer, and dementia. However, biodentical hormone therapy used by functional medicine doctors do not carry these increased risks.
Using transdermal creams or patches or bioidentical estrogen hormones and progesterone, not progestin, does not afford the same risks. This is why current and more advanced hormone replacement therapy is safer.
Additional Ways To Combat Changing Hormones
I have found additional ways to help my patients navigate their changing hormones. However, you would want to consult your doctor if you have any questions about trying these yourself.
For Feelable Symptoms
In addition to bioidentical hormone replacement therapy, there are things you can do to limit your symptoms and yes, it does start with your diet. I recommend limiting your processed foods. Essentially, this is anything that comes out of a box or a bag. Try to eat about 3 to 4 cups of vegetables, 1 to 2 servings of fruit, healthy fats, and proteins every day.
Get a good night’s sleep, exercise, and make sure you incorporate self-care, like a bath, sauna, or massage to alleviate stress. I also recommend taking magnesium, taurine, NAC, and B complex vitamins to help mitigate some symptoms.
For Invisible Symptoms
You can help your bone density by doing weight-bearing exercises or joining a club called OsteoStrong. There are some supplements I recommend like Ossopan MD. It’s a highly absorbable form of calcium plus essential minerals that you can get from a functional medicine doctor along with Vitamin K2 and D3.
If you’re concerned about heart disease, you should limit simple sugars, basically anything white like bread, pasta, candy, and ice cream. The foods I recommend are whole food oils like avocado and olives, proteins, and foods found in the Mediterranean diet. I will also recommend Omega-3 fatty acids, magnesium, CoQ10, niacin, bergamot, berberine, alpha lipoic acid, and taurine based on a specialized lipid study. HITT workouts and intermittent fasting can also help lower your risk for heart disease. Always consult with your doctor first.
The final invisible symptom I would like to address is cognitive decline. In addition to exercise and sleep, I highly recommend Grain Brain by Dr. David Permutter. You can also find other suggestions in my previous article about improving cognitive function.
Hormone changes are inevitable. I strongly recommend arming yourself with information and asking lots of questions. You may have to live with changing hormones, but that does not have to adversely change your life.