Menopause – Kathy

Profile:

• 52 year old female
• Married
• Two children in college
• Teacher

Symptoms:

• Hot flashes during the day which are mild
• Night sweat which are terrible
• Cannot stay sleep
• Short term memory low, losing words, forget train of thought mid-sentence
• Thinning hair
• Heavy periods
• Irregular / no periods
• Low libido with painful intercourse
• Mood is off, feeling nervous and wound up for no reason
• Weight gain of 25 lbs in the stomach with no major change to diet or lifestyle

Lab Testing:

Menopause Hormone Panel

Treatment Ideas:

Multifactorial process

• Lifestyle
• Dietary modifications
• Supplementation
• Possibly BHRT bioidentical hormone treatment

Menopause is not a disease.  Although the symptoms can really disrupt a woman’s quality of life.  Unlike perimenopause, there are many options for menopause.

There are lots of supplements and various types of hormone replacement for menopause. But many of these options have risk factors and side effects.  Many women are willing to take anything to resolve the symptoms of menopause.

As you can see menopause has really affected Kathy’s life.  Her PCP doc doesn’t really understand and tells her she is healthy but just getting older.  Kathy is so unhappy because she cannot do her job well and her life has really changed.

In menopause, the ovaries have ceased function.  There are not producing estrogen and progesterone.  Not to bore you with the science, but when the estrogen and progesterone have skipped town causes all the symptoms that Kathy is experiencing.  

The drop in estrogen causes the classic hot flashes.  Some women such as Kathy will have hot flashes and night sweats all night long. This not only disrupts sleep.  But you wake up not rested leaving you tired the rest of the day.

There are a lot of estrogen receptors in the brain.  When the estrogen drops, that is what causes the drop in short-term memory.  I have had many patients declare they have dementia. And I tell them, no, you have menopause.  The sudden drop in estrogen at the onset of menopause causes the loss in word recall, brain fog and dropping sentences.  

Also, the vaginal cells are primed by estrogen.  When the estrogen drops in menopause, it can cause the vaginal dryness, atrophy and decreased sensitivity.  

Now, the irritability and moodiness are from the lack of progesterone.  Progesterone is the unsung hero of the sex hormones. Progesterone is very relaxing.  So when it drops, it can cause anxiety, irritability and a low-grade worry.

Also, progesterone is really good for restful sleep.  Which is why in menopause (and perimenopause) it becomes hard to sleep through the night.  You end up waking in the middle of the night for 1-2 hours.

Now I could go on for hours on the many, many options for menopause, from supplements to conventional hormone replacement to bio-identical hormone treatment.  But regardless of the side effects or risk factors, women will take almost anything to resolve these symptoms.

Remember, menopause is not a disease.  The most important part in dealing with menopausal symptoms is to work on what the goals of the patient are.  In Kathy’s case, she really wanted to lose the weight she had gained because of menopause. She also wanted to sleep better so she wasn’t so fatigued the next day.  As well as resolve her brain fog and the vaginal dryness.

So we started with her main symptoms and worked from there using a multifactorial process involving diet, lifestyle supplementation, and bio-identical hormone replacement.  

Because Kathy and other women are experiencing menopausal symptoms, doesn’t mean you have to “just deal with it”, or it is a consequence of “getting older”.  There are safe, low-risk options to menopause.

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