Read I'm Too Young for This!: The Natural Hormone Solution to Enjoy Perimenopause Online
Authors: Suzanne Somers
Tags: #Health & Fitness, #Healthy Living, #Alternative Therapies, #Sexuality
It’s crucial to test your blood hormone levels so your doctor can initiate a customized bioidentical hormone program that’s just right for you.
After you are placed on bioidentical hormones, some doctors (including Dr. Wright) will suggest a urine test that monitors the
amount of estrogen and other hormones you are making over a twenty-four-hour period to get a more accurate picture of where you are hormonally. The first step is to identify your baseline hormone status. This is to know the ranges of all your hormones and gives you and your doctor the best picture for your symptoms.
You can take your blood test results to your current doctor, if you believe he or she is open to and skilled at this type of treatment. Or as I’ve said before, you can find a qualified doctor near you at
ForeverHealth.com
. Forever Health’s doctors have chosen to step out of Western medicines’ “standard of care” box and specialize in bioidentical hormone replacement. These doctors are also specializing in managing the changes that happen to aging bodies.
If you suspect you are entering perimenopause, it is extremely important to test your hormone levels. I asked Bill Faloon, founder of the Life Extension Foundation, an organization dedicated to keeping their members healthy and long-lived, to briefly explain why. My question to him was if a woman concludes that she is symptomatic and her decline has begun, should she get hormones replaced without testing her hormone levels? He replied:
“Think about this.… Would you drive your car without being able to see outside the windshield? That, regrettably, is how most conventional doctors treat their patients’ problems. When a woman complains of symptoms related to sex hormone deficiency, if she’s not with a qualified doctor, he may prescribe the same dose of estrogen, and possibly a synthetic progestin drug. The doctor hopes this blindly prescribed dose will alleviate perimenopausal symptoms. In other cases, the physician may not recognize the symptoms as being a hormone deficit and instead prescribes side-effect-laden antidepressant drugs, addictive antianxiety drugs, and/or sleeping pills.
“But with blood test results in hand, a qualified physician can
determine the best individualized dose of natural estrogen, natural progesterone, DHEA, and other hormones required for preservation of healthy vitality.”
Your exact needs for replacement will be determined by your lab results, as well as your complaints. If you are not sleeping, then your balance is not right. If you have no sex drive, then your balance is not right. You will get to that sweet spot, to your place of balance. This phase takes patience. DON’T GIVE UP!
Once your lab work is established, there are options in how you will replace your particular hormones. Your age is a factor. Often in perimenopause you are estrogen dominant, which as I said earlier means you are not making enough progesterone, so you have
excess
estrogen. This is not a good place to be.
Your blood tests will show if this is your scenario. Frequently, in the beginning of perimenopause, a little progesterone cream daily is all you need to get back to your old self again. By using it, you also protect yourself from the cancers that are allowed to proliferate from estrogen dominance.
Once your hormone levels have been established and you need more than just progesterone, as I did, you have two options: static dosing or rhythmic cycling. I believe that the two different methods work best according to the age and life stressors of the woman. For instance, a younger woman with ovaries is still making some hormone, and static dosing would be sufficient. Think of it as “filling the tank.” She is simply going to need enough hormone to “top off” what she is already making in her own body. Her body is still making a “rhythm” (more on this later). An older woman such as myself (although I don’t think of myself as old)
is no longer making any hormones. I need to take my hormones in a rhythm to replicate what my body was making when I was young and fertile.
Let’s start first with static dosing.
Static dosing is taking the same amount of estrogen every day of the month and the same amount of progesterone for two weeks of each month. This creates a cycle that ends in a period each month.
To understand what I mean about age determining your choice in methods of replacement, I have been using BHRT for sixteen years. Initially, I was on static dosing. I was around fifty when I started on replacement. Knowing what I know now I should have been on replacement ten years earlier. Life would have been a lot easier, I probably wouldn’t have gotten cancer, and I would have been a lot thinner and happier. (Thank you, Alan, for hanging in there with me.)
At that time, my body was still making some hormone but not enough to create a monthly estrogen peak. Because my body was still pumping out some estrogen hormone, I was able to fill in the gaps with replacement and still create a “peak” without realizing it. My body was still making some estrogen so by adding in enough bioidentical estrogen I could feel “right.” I reached an estrogen peak, which allowed for the estrogen receptor sites to open to take in the progesterone on the eighteenth day.
Once your symptoms are discussed and their source determined, your doctor will prescribe the right amount of bioidentical estrogen every day (static dose) of the month. On days 18 to 28, your doctor will add in a static dose of progesterone based upon your lab work. This regimen is designed to match what our
bodies once did when we were making a full complement of hormones. It brings about a period at the end of each cycle (at the end of the month). This approach is used because this is how it happens in nature, we have a twenty-eight-day cycle when we are reproductive.
Once you are on static dosing, your doctor will order a new blood test after a couple of months. Or order a twenty-four-hour urine test to get a sense of your new hormone levels. Again, if you are still symptomatic, it’s important to keep track of your symptoms. It is the only way your doctor can truly know if the dosage is right for you. You know your body better than any lab test.
Many cutting-edge Western doctors (but not all of them) create this type of cycle with a period, in order to exactly replicate nature. Based upon the research I have done and information from the dozens of doctors I have interviewed, I will state firmly that I believe that cycling in this fashion is not an option, but a necessity. If we are trying to mimic normal physiology, this is the way to go.
“DO I REALLY HAVE TO HAVE MY PERIOD TILL I’M NINETY?”
Dr. Jonathan Wright, the physician we discussed earlier who pioneered full BHRT usage in the United States, reports of a study that says that creating a period makes no difference. According to Dr. Wright:
Though I always say that to copy nature is the way to go, nature’s plan is few to no ovarian steroids—bioidentical or otherwise—after menopause. But in the twenty-first century, with all of the changes of “civilization,” that path leads to Alzheimer’s, heart attack, stroke, and osteoporosis. So we’ve turned to nature’s tools and used them very carefully, to prevent those problems. By having monthly bleeding cycles,
we adhered to nature’s plan. However, the very, very large majority of women have been asking since day one of my prescribing BHRT if it’s absolutely necessary to have menstrual periods until they’re ninety-one to avoid cancer risk. At first, I told ’em there was no research on this point, but if they really wanted—and most did—to avoid monthly bleeding and stay as safe as possible from cancer they must “take a break” every month. Then test at intervals for pro- and anticarcinogenic metabolites and predictive ratios of estrogens. Fortunately, doing this, not one woman I’ve worked with using BHRT has developed an estrogen-related cancer!David Meyer’s work came along in 1993 showing that a bleeding cycle is not necessary to prevent cancer. Nature is smarter than we are and has been using monthly menstrual bleeding for something else that we’ve learned about only recently: preventing women from having heart attacks and strokes! Menstrual bleeding reduces blood viscosity (thickness). Excess blood viscosity is the major cause of arterial wall damage that leads to inflammation, plaque formation, and ultimately heart attack and stroke. That’s why menstruating women who don’t take birth control pills or smoke cigarettes rarely if ever have heart attack. For men, heart attack risk may be reduced by 88 percent [
see
Salonen
] and stroke risk may be reduced by 67 percent [
see
Meyers
] just by donating blood once or twice yearly! Same applies to postmenopausal women, although no extensive research has been done.Since this information became available, I have mentioned it to every woman asking for BHRT—and the very large majority tell me they’d rather donate blood twice yearly than have monthly bleeding. A small percentage decide to have monthly bleeding cycles. With blood donation, they’re accomplishing a lot—if not nearly all—of what nature intended with monthly blood loss. So a lot of the why for not heavily promoting bleeding cycles has been for me adhering to women’s personal choices. This information applies to postmenopausal women—those who no longer have a period—not to perimenopausal women. This is information for perimenopausal women to know for the next transition. I do push the large majority of postmenopausal women who make the “no period” choice to donate blood regularly and, in that way, copy nature!
Static dosing sounds simple, but there is a complex part. Stress affects and blunts hormone production. So if you are going through a stressful period in your life (and who isn’t?), it changes your hormonal needs. To compensate, you may need to dose up a drop or a fraction of a milligram, or even lower your doses. If the stress is severe, you may need to have another blood test to determine where your levels are now.
This is another example of what I mean by the “art form” I mentioned earlier. It is important that you work closely with your doctor and communicate your symptoms so he or she will adjust your dosages until you get it just right.
When you are a perimenopausal woman, it can be difficult to accurately measure your hormone levels because they fluctuate so much, especially in the few years before menopause. You could measure your hormones three times in one day and get drastically different readings each time. That’s nothing to panic about. Frankly, perimenopause is more difficult than menopause from my experience. Once you are in menopause, the body is drained of the minor hormones, so then replacement gets easier.
The second way to replace hormones is rhythmic cycling. I believe women of my age do best on rhythmic because we do not make any or very few sex hormones. It’s actually a simple concept. It is once again mimicking nature. In other words, you are creating hormonal peaks through replacement just as when you were making a full hormonal complement on your own. For women who are drastically depleted, those whose bodies are not making any hormones at all or almost none, this puts you back together nicely, creating an estrogen peak each month by increasing and decreasing certain of your hormones.
You need to work closely with your qualified doctor at first.
It will require you to look at your monthly calendar daily and determine how much you need to apply/take each particular day. Again, the object is to create an estrogen peak, meaning that the highest amount of estrogen you take each month is on the twelfth day (when there is a full moon, as women’s cycles have always been affected by the lunar cycle). Then it drops drastically on the thirteenth day. On the thirteenth day, you add progesterone in, and it keeps increasing until it reaches its peak.
Remember when your cycle was regular that there were days when you felt light and days you felt heavier, bluer? Remember days when you were feeling elated and days when you were feeling low? That was the rhythm you were making on your own. When you replace your hormones rhythmically, you don’t have moody days (unless you are terribly stressed) because you can learn how to dose yourself a little higher or lower and in this way control and determine how you feel.
You won’t take too much estrogen or progesterone because that in itself is uncomfortable and possibly you’ll gain weight. If you are taking too much progesterone, you will bloat or get sleepy and lethargic. If you take too much testosterone, you will feel aggressive and grow chin hairs. (Nice, huh?) If you take too much thyroid, you will get a racing heart. You will learn. When it comes to being thin, vibrant, healthy, and sexual, we are motivated to learn fast!
Rhythmic cycling is based upon the ancient cycles of nature. This concept goes all the way back to early humans, who were attuned to the planet in a way that has become completely inaccessible to us in the modern world.
In the days of early humans, there were no executives or career women, just people living in tune with the cycles of the moon and the tides, reproducing as often as was possible. Each baby occupied a year of a woman’s life, followed by breast-feeding for another couple of years. Interesting that we women reach our
estrogen peak on the twelfth day, which is the full moon. As I explained in my book
Ageless
, if you go back to early humans when there was no light, couples could make love “by the light of the moon” on the day the woman was her most fertile. (Men should take notice and take us out to dinner on the full moon!) Women menstruated to the cycles of the moon, and we fattened up in the summer with all the abundant food. Then winter arrived and darkness came earlier. We went to sleep earlier because there was no light and we could stay warm with one another. Women’s bellies grew with the baby made during the summer months. With spring we gave birth. Then the sun began to shine and the process started all over again. Simple! This was nature working at optimum before we got involved and messed with it.