Menopause refers to the change in hormone production seen in women that normally signals the end of their reproductive years. Hormones are molecules derived from cholesterol that travel through the blood stream and signal the body to perform various activities. This is somewhat like a mail or delivery service. Nerves, on the other hand, provide a different way of signaling the body to perform activities, somewhat like an electrical system. Though there are many, many hormones, including thyroid hormones and adrenal hormones, menopause concerns the female sex hormones. We often talk only about estrogen and progesterone. Other female hormones include follicle stimulating hormones (FSH), luteinizing hormones, and even testosterone. The related hormonal shift seen in males is called andropause and usually passes without notice unless the prostate starts enlarging. When women’s production of reproductive hormones decline significantly, it not only affects the release of eggs from the ovaries, it also can manifest in certain undesirable symptoms. Of note would be hot flashes, thinner, dryer skin, and osteoporosis, as well as emotional fragility.
A significant lesson was learned over the past fifty years regarding supplementation of foreign substances. By foreign substances I mean anything that the body does not normally encounter in nature, including estrogens from Pregnant Mare Urine (Premarin). What happened is a matter of record. It was discovered that many of the undesired effects of menopause could be avoided by taking supplements of estrogen. Unfortunately, there were consequences of taking unopposed estrogen over long periods of time for some susceptible women. This highlights two issues. One is the untoward effects of giving isolated, concentrated substances, synthetic or not, to individuals over long periods of time. Another is that it points out the unique susceptibilities of individuals based on their genetic makeup, their dietary influences and their lifestyles.
What happened in the case of unopposed estrogen was that many women developed uterine cancer. This happened because the cells in the uterus are hormone sensitive. Over time the constant stimulation of these cells by the outside estrogen supplementation irritated the cells enough to mutate them to the point of cancerous activity. Adding progesterone provided an “opposing” force that balanced and closely approximated the natural mix of hormones. The lesson learned was that isolated, concentrated substances, used often to effect desired immediate and profound changes, when used over long periods of time can have harsh, untoward consequences.
Applying this lesson to menopause what can we learn? Number one, menopause is a natural transition that occurs normally in the lives of every human female. It can proceed quite smoothly without any intervention what-so-ever. Symptoms and concerns can be addressed on an individual basis. Take, for instance, the information we learned about osteoporosis. We can make appropriate adjustments to diet and lifestyle to compensate for particular susceptibilities. For example, we can supplement with bioavailable calcium, avoid calcium depleting foods like sodas, and stay active with weight bearing exercises like walking.
As far as taking supplements to adjust the chemistry for an easier transition in menopause, consider the value of gentle shifts with non-pharmaceutical substances such as herbs that simply modify your own hormone concentrations, rather than adding more hormones to your system. Also, you must consider the negative influences of meat and cheese, which often have high concentrations of hormones added to them.
Another consideration would be the use of natural, compounded “bio-available” hormones to help with the transition of menopause or to address particular concerns. These hormones can be specifically formulated to closely approximate your own hormones and can be mixed to any desired dosing, combination and mode of entry (e.g. pill, troche, patch, lolly-pop, etc.).
Dr. Miles is a naturopathic physician practicing at the Catalina Clinic of Integrative Medicine in Catalina.