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What is
Menopause?
Beyond saying simply that menopause is the end of menstruation, there is
no empirical definition of menopause.
The lack of an empirical description of
menopause has created a competition for competing interests to describe
what menopause means between the medical industry, feminist movement and
functional medicine.
Menopause—The Disease
The definition of menopause as disease is
based upon the ideology of medicine. Medicine is oriented towards
illness. In the Traditional Medical Model, symptoms dictate the
diagnosis. The treatment is then based on the diagnosis. This
medicalization of a woman’s normal experience is not just confined to
menopause. Premenstrual tension, reproduction and childbirth are also
viewed as medical events.
The medical industry is promoting two
stereotypes of menopause to the public. The first one describes
menopause as a “deficiency syndrome”, an endocrinopathy or disease of
the hormonal system resulting from loss of estrogen.
From this perspective the menopausal woman
is in a diseased state from a pathology and should be treated medically.
By this definition, the end of menstruation is removed from the
individual woman’s control to become a matter for doctors. In short,
menopause is transformed from a stage in the normal process of aging
into a hazard of health.
The medical model of menopause has
infinitely expanded the period of menopause. Women are judged “estrogen
deficient” until they die, menopause is no longer a matter of months or
years, but a life sentence. It is a permanent condition to be
permanently managed.
Medicine argues that menopause under its
control is more normal than an “untreated” one. The word replacement in
the term “hormone replacement therapy” implies that a normal condition
is being regained by the drugs. In reality, the medicated menopause is a
mutation and an artificial remodeling of the experience of menopause.
Menopause—Feminists “Power Surges”
Feminists have sought to rehabilitate
menopause by insisting on its normalcy. Some feminists have claimed
menopause should be a period of renewal and spiritual awakening, a time
to be more contemplative and self-centered. A time when they are no
longer burdened by maternal responsibilities, now having an opportunity
to achieve things they could not previously.
Women live in the real world where they
experience the relentless process of aging and the deterioration of
their assets—their physical beauty. While the feminist attitude is
attractive, it is difficult to reconcile with the attitudes women
encounter around them. As well, some women encounter difficulties at the
time of menopause and there is no place for the feminist ideals when she
is experiencing a “power surge”.
Menopause—Functional Medicine Model
Menopause is caused by a gradual change in
the ovarian sensitivity to the neurohormones (FSH & LH), and disruption
in the negative feedback loop. These changes are reflected as imbalances
in ovarian hormone output and manifested as cessation of menstrual flow.
In menopause, while the ovaries reduce the
production of estrogen, the adrenal glands production of estrogen
increases to about 95% of what the ovaries were producing. This is due
to enhanced conversion of circulating adrenal hormone into Estrone in
fat and muscle cells, and to increased conversion of Estrone to
Estradiol. As women progress into the menopausal years, Estrone becomes
the dominant estrogen.
Assumptions about Hormones
Hormone replacement therapy
(HRT) is based upon the incorrect assumptions:
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That your body becomes incapable of producing
appropriate amounts of hormones simply because you reach a certain
age
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Your body can not make hormones if you have had a
hysterectomy
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Hot flashes are a lack of estrogen
Facts
about Hormones
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There are no “good” or “bad” hormones
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There are “good balance” and “bad balance”
hormone ratios
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The ONLY hormones that are bio-identical or
natural are the ones you body makes
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Hormone balance is a function of how healthy you
are, not how old you are
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Hot Flashes are a rapid fluctuations of any
hormone levels
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Replacing hormones in your body will impair your
body’s ability to produce the hormone on its own
Functional Hormone Therapy
vs.
Bio-Identical Hormone
Therapy
In order to
understand Hormone Therapy we must first distinguish the
difference between “Functional Hormone Therapy” and
“Bio-Identical Hormone Therapy”. Replacement Hormone
Therapy is based in identifying organs that are deficient or
non-functioning and using some type of pharmaceutical agent
or hormone to replace, suppress or support the dysfunctional
hormone system using the law of opposites i.e. If it’s too
much—make it too little. General clinical replacement
hormone therapy seems appropriate for certain genetic
disorders and disease patterns that seriously alter hormone
production or function. Many of these alterations if not
treated early may lead to a more serious condition later.
On the other hand, Functional Hormone
Therapy seeks to identify alterations in the organs
that produce hormones before they reach a disease state.
Functional hormone disorders are typically ignored in the
outdated disease based model. This means people will suffer
from a wide range of symptoms from fatigue to serious cases
of depression, allowing conditions to gradually worsen until
intervention is attempted. Memorizing signs and symptoms of
disease and supplying the magic pill to manage the condition
is not functional hormone therapy.
In order to practice functional hormone
therapy the clinician must understand the depth of human
physiology and metabolism, identifying the complex series of
vicious cycles that feed each other. Then provide support
and counseling to unlock these vicious cycles. It is not
uncommon for a clinician practicing functional hormone
therapy to optimize gastrointestinal function as a therapy
to reduce cholesterol and high blood pressure.
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Hot Flashes are not what we think they are!
When HRT was first developed, the thinking was a drop in estrogen levels
caused menopause symptoms. But in fact, it is rapid fluctuations in the
levels of any hormone that can cause a hot flash. This is why Selective
Estrogen Receptor Modulators (SERMs) are sometimes effective in
controlling hot flashes. The SERMs prevent the rapid shift in the
hormone levels by sitting in estrogen receptor sites.
Many factors can contribute to fluctuations in estrogen levels, i.e.
Faulty Liver detoxification or Gastrointestinal dysfunction. Many times
hormonal imbalances exist due to faulty liver function. This is
especially the case when the symptoms do not match the lab test. For
example strong urine odor after eating asparagus, may indicate faulty
liver detoxification. If you have detoxification issues causing your
symptoms, the use of hormones or other drugs that rely on liver
clearance has the potential to make your symptoms worse. Altered liver
detoxification may cause neurologic disorders, chemical sensitivities,
adverse drug reactions, fatigue and autoimmune disorders.
Improperly metabolized hormones can compete with active hormones and
throw-off proper hormone responses. The end result is you may have
symptoms of hormonal imbalance with lab results that do not correlate.
There is little hope of restoring the person to health if the
detoxification pathways are not restored.
Evaluating
Hormone Levels
When evaluating hormones, it is important not to focus on individual
hormones but rather on the circadian rhythm in which they are produced
and hormone ratios. This is done with Saliva tests that accurately
measure “unbound” hormone levels which allow for accurate assessment of
circadian hormone production and ratios.
Pancreas and Adrenal Function
· Cortisol
/ DHEA
Breast Proliferation Index
· Testosterone
/
Estrogen(s) + Progesterone
Uterine Proliferation Index
·Progesterone
/Estrogens
(Estrone + Estradiol + Estriol)
We Get Requests For Help!
Dear Wellness Alternatives,
Based on your credentials listed on the Wellness Alternatives website, I
thought you may concentrate in Hormon Replacement Therapy (compounding
hormones women) and anti-aging.
I
moved from California but am trying to locate a physician who
specializes in Women's Hormone Replacement Therapy and Anti-aging.
I desire a doctor who does the urine testing to test the hormone
levels and one that prescribes a compounding formula to cycle my
hormones so that I'm taking estrogen every day and progesteone two weeks
every month, allowing me to get my period.
I'm currently taking continous combined (compounded) hormone
therapy and want to change to an even more 'natural' method.
Are you familiar with any local
doctors (St Louis or Illinois (Belleville, Fairview, etc) that I can
contact to find out more information about their practices.
In
reviewing the Wellness website, I don't believe the company does HRT
compounding. If not within
the company, who do you use as the pharmacist?
Thank you for any assistance you may be able to offer.
M. C.
Our Response
Dear M.C.
We
practice Functional Medicine which includes Hormones imbalances in both
men and women. See my personal challenges in my bio. In dealing with
hormones it is important to understand hormones should be viewed in
terms of ratios and not individual hormones. It involves understanding
hormone feedback loop coordination and hormone elimination. The Hormone
test below is one of our most recent patient on hormone replacement from
her Medical Doctor. She was put on hormones for a combination of health
reasons - hot flashes, weight gain and bone loss. She was taking DHEA,
progesterone and estrogen. As you can see this woman is saturated in
hormones and still having hormone related issues which is why she came
to Wellness Alternatives.
NOTE:
The > before the
number indicates the hormone levels exceed the labs ability to measure.
Prolonged elevations of any hormone will lead to hormone receptor
down regulation or hormone resistance.
The use of hormone precursors and its impact on hormone metabolism
is important. DHEA has many important functions on human physiology
including immune support, cognitive support, lipolysis support, etc.
However the incorrect use of DHEA creates more problems than it helps.
DHEA should never be used in doses above 20 mg a day for longer than one
month. 10 mg is a safe standard for most people. It should be understood
that most cases of low DHEA are from adrenal disorders.
DHEA has a half-life of less than 30 minutes in the
body before it is converted into another hormone. When a need for DHEA
is identified it should be a red flag that a stress syndrome may exist.
Long term use of DHEA or overdosing DHEA will convert to elevations of
estrogen in men and elevations of testosterone in women. As you can see
she has high DHEA and testosterone.
Elevations in testosterone lead to thyroid (T3)
resistance. High testosterone in women causes insulin resistance. This
is why she has thyroid symptoms but has normal TSH combined with sugar
related issues and an inability to lose weight despite her rigorous
workout program. Elevated levels of progesterone, commonly associated
with topical progesterone cream cause secondary increases in cortisol.
Once progesterone levels exceed normal levels, progesterone starts
binding with cortisol binding protein. This will lead to a increase in
free cortisol levels.
High Cortisol causes the following problems:
That was the "good" news. Now for the part your doctor
will probably not discuss with you.
It is important to
understand hormones should be viewed in terms of ratios and not
individual hormones. This woman claimed the increase in
hormone levels must have happened recently and to prove it brought in
the previous lab test her doctor used to prescribe her bio-identical
hormones. Her hormones were elevated then but not in excessive levels.
This woman's Breast Proliferation Index
(BPI) was Zone 3 Hormone Overload. Zone 3 is marked by a excessive
exposure to the combined proliferative (to increase in number or spread
rapidly and often excessively, AKA: Cancer) effects of estrogens and
progesterone coupled with excessive testosterone levels. The excess in
estrogenic activity directly promotes breast tissue proliferation, and
over-primes the tissue leading to an exaggerated proliferative
progesterone effect. The progesterone effect on breast tissue is
dependent on the degree and duration of estrogen pre-exposure i.e.
priming. Excess estrogen priming can over-sensitize breast tissue
augmenting the proliferation. The only reason she is in Zone 3 is
because of the high testosterone levels.
She is also in Zone 1 Uterine
Proliferation Index (UPI).
Zone 1 known as “Enhanced Proliferation,” represents both excess
progesterone and estrogen activity. The combination of excessive
estrogenic activity and a high progesterone level encourages uterine
tissue proliferation and hypertrophy. Excessive levels of progesterone
augment the estrogen proliferative activity.
Common findings in Zone 1 UPI include:
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Uterine: endometrial thickening,
uterine bleeding, fibroids
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Somatic: Increased body fat
deposition, weight gain & water retention
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Nervous system (CNS) dysfunction:
cognitive changes, headaches, anxiety, panic attacks, insomnia and
depression with mood swings.
After bringing in her first lab test she
decided our program was in her best interest since her initial elevated
levels were ignored.
Can You Be Helped?
The woman in the next set of tests came to Wellness
Alternatives in May of 2007. She was being treated by an alternative MD,
and a DC using muscle testing to confirm she needed bio-identical
hormones. She was muscle tested 2 days prior to the test and showed she
“needed” the Bio-Identical Hormones). One of her chief complaints was
she could not wear a bra because of breast tenderness. Again she is
saturated in hormones, in Zone 1 for both Breast and Uterine
Proliferation Index and high risk of developing cancer.
Zone 1 Breast Proliferation
Index represents excessive hormone levels of the estrogens and
estrogen-dependent progesterone that encourages breast tissue
proliferation. Insufficient tissue exposure to the anti-proliferative
androgen, testosterone, allows unopposed estrogenic proliferation.
Common clinical signs of estrogenic and/or progesterone hormone excess
include:
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Breast edema, tenderness, hyperplasia and cysts.
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High estrogen activity of the nervous system e.g.
agitation, insomnia, aggressiveness and emotional lability (capable
of changing state or becoming inactive when subjected to stress).
She went through our treatment program
and as you can see her Jan. 2008 her hormones are at or near optimal
levels and all of her hormone symptoms have dissipated. Our treatment
program consisted of Blood Nutrition Analysis, Metabolic and
Neurotransmitter Assessments, and structural balancing. She is
maintaining herself through diet; lifestyle and we monitor her every 3
months with a metabolic assessment.
First, if the you are taking exogenous
hormones, you must seriously question the dosage or the type of delivery
being utilized. Many times the use of a hormone cream may lead to
overdosing and tissue saturation.
Second, body composition is not always
diagnostic for hormone levels. Obese or skinny individuals may both be
hypothyroid. Many people have insulin resistance without obesity or the
apple/pear shape. Only the lab testing done at Wellness Alternatives can
accurately determine the cause of your health problems.
Third, if a
person has poor liver detoxification pathways, urine test will have
false values. Most people with health and hormone issues have poor liver
detoxification pathways. This is why we use Blood Nutrition Analysis.
Why would you want to put your self at that much risk. The lab testing
done at Wellness Alternatives can accurately determine what your hormone
levels are and develop a safe treatment program especially for you. If
you would like more information, I would be glad to talk with you. As
you can see we do not do hormone replacement therapy for a very good
reason. Our approach repairs the cause of the hormone imbalance.
Although
women are well aware that Hormone Replacement Therapy can cause cancer,
heart attacks, strokes and blood clots, many of them decide to accept
the risks because they feel they have no other option for handling their
symptoms. What they don’t know is we now have natural nutritional
support that have been scientifically researched. At Wellness
Alternative we utilize supplement from companies that scientifically
researched their products and formulate them to provide a therapeutic
dose.
Sincerely,
Dr. Dave
“There are times when we
may fool ourselves. There are times when we can fool others. But we can
never fool our body. It is the most sensitive barometer of our inner
world.”
What is your body telling you?
There are two different types of Hot Flashes.
1. Sweating attack with feelings of being hot or cold
- This is caused by fluctuations in estrogen levels. A common treatment
for this is Hormone Replacement Therapy. This requires taking estrogen
to prevent any fluctuation in the amount of estrogen circulating in the
body. This reduces or eliminates the hot flashes but put women at
increased risk of breast or uterine cancer. Another option is to take a
Selective Estrogen Receptor Modulator (SERM), i.e. soy isoflavones,
black cohosh,etc. These supplements have limited estrogen effects and
work by playing a game of musical chairs with estrogen, both in
competition to take a seat in an estrogen receptor site to prevent the
rapid fluctuations responsible for hot flashes.
2. Sweating attack with NO feelings of being hot or cold
This is caused by fluctuation of any of the hormones including the sex
hormone, stress hormones or any others. Often this is
an indicator of impaired adrenal function. This type of "Hot Flash" is
overlooked because of a lack of understanding of the way hormones
interact. Diagnosis is made based upon age and the expectation of
menopause symptoms occurring, with all Hot Flashes being blamed upon
menopause and estrogen.
Not only are all Hot Flashes blamed upon menopause and estrogen, all
other possible factors causing hot flash symptoms are overlooked. For
example, both types of hot flashes are severely impacted by your
digestive function. All sex hormones must be de-activated in the liver
in order to be eliminated through bowel movements. Impaired digestive
function will reactivate estrogen and other sex hormones and make SERMs
unable to sit in estrogen receptor sites. One of the biggest
misconceptions is that taking laxatives, means your digestive function
is normal. What this really means is your digestive tract is not working
properly and is in need of help.
Do you know any women who have given up hope of relief from their hot
flashes? Wellness Alternatives has the expertise to assist you in truly
eliminating hot flashes and repairing, restoring your health.
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