Menopause means the end of child bearing years because ovulation (egg production) ends. Once menopause is completed, menstrual periods also cease. Menopause is the method by which genetic programming removes women from the reproductive pool, but it certainly doesn’t mean that life is over. It does mean that women must become proactive as important health matters need to be considered.

The typical scenario of menopause commonly begins in the 5th decade (40s) of a female’s life. The time of onset can vary, but it typically begins in that decade with the actual average age of the time of the last period being 51 years (Western civilization). There are a variety of symptoms including scanty or irregular periods for women who had regular 3-5 day periods their entire reproductive life (from puberty to menopause). Many women begin to feel “hot flashes” on an irregular basis in the beginning that become more frequent as time passes. Night sweats are another common feature that gradually become more prominent as the menopausal process continues. The hot flashes and night sweats are secondary to vasomotor instability resulting from an imbalance between estrogen and progesterone. The beginning stage of menopause is referred to as perimenopause or premenopause. The beginning stage is variable in duration and different for every female. It can continue for 2-3 years or be as short as 2-3 months. Once a woman enters full menopause, the symptoms of perimenopause can many times intensify signaling the further reduction of three sex hormones, estrogen, progesterone and testosterone. The nuisance symptoms of hot flashes, night sweats, dry skin, atrophy of genitourinary tissue, irritability, lowered sex drive, anxiety and depression may worsen while some women have minimal symptoms.

When this inevitable change takes place, the majority of women rely upon the help of their gynecologist or family doctor. Many gynecologists and family doctors of today may not recognize the importance of replacing a female’s hormones only with those that adapt best to her body because they are specific for the human female. Instead and similar to physicians in other specialties, many have been misinformed and have been led to believe that chemical substitutes are just as good as the real thing (bio-identical). The doctors, who taught them, taught them improperly because they didn’t use science and logical thinking. Instead, they allowed the pharmaceutical industry to sway their opinion about how to treat. Most accepted the propaganda that is disseminated by pharmaceutical companies who profit from doctors that prescribe their products. For example, many doctors prescribe Premarin because the manufacturing company has engaged in a successful marketing campaign. Those are just two examples of pharmaceutical products that are not the best replacement alternative.  If your doctor prescribes Premarin, he/she simply believes the marketing propaganda and has become desensitized to the undeniable fact that bio-identical hormones are far superior. Bio-identical hormones have the exact molecular structure as those made by the human body. I have consulted with many female patients who actually believed that Premarin was a bio-identical estrogen combination and did not know that the compound was derived from the urine of pregnant mares (horses). The company that manufactures Premarin simply states that it’s a “natural” conjugated estrogen compound. It is “natural”, but only for horses, not human beings! Why would any informed woman want to take a preparation that is intended for a horse? The problem with Premarin revolves around the fact that prescribing physicians seemingly don’t understand the basic premise that we should not be putting hormones in the human body that are intended for horses. Unbelievable as that sounds, it is true and can be verified by asking your doctor why he/she prefers Premarin. Horse estrogens are used in a number of other brand-name products, as noted before, that your doctor may prescribe without adequate consideration. Even though your doctor may not be aware of the facts about Premarin as opposed to bio-identical hormones, it does not necessarily mean that he/she doesn’t have your best interests at heart.

Another product, manufactured by the same pharmaceutical company (Wyeth), is called Prempro. Wyeth was purchased by Pfizer in 2009, but Prempro has not changed. For many years a number of doctors and scientists had been contending that horse estrogens were probably not the best choice to use in human females and the alarm was also sounded against using an even worse hormone look-alike called progestin. It looks and acts like progesterone, but it’s a wolf in sheep’s clothing. Many doctors questioned whether or not progestins were causing avoidable problems in women, but the supporters of progestin always replied that there was no proof. As a result, a study was undertaken to look at the drug Prempro. Be aware that Prempro is a combination of horse estrogens (Premarin) and progestin, specifically, medroxyprogesterone acetate that the company labels as MPA to make it sound acceptable. A study was undertaken to determine the effects of Prempro, but it was stopped short of its intended completion date because of serious side effects. The study showed an increased incidence of cancer, dementia, heart attacks and stroke in women taking Prempro. The results were published in 2002 and instead of performing their due diligence and understanding what the study was about, many women simply stopped taking “all” hormones. This problem was made worse because many doctors didn’t understand the study results either and went along with the mass hysteria. It was actually very simple, the study was about a patented drug, Prempro, manufactured by Wyeth. It was not about bio-identical hormones that women need in order to achieve and maintain optimum health. Based upon scientific studies, we already know that Prempro increases risk for a number of very serious diseases, but the company is still selling it! You may ask yourself why your doctor doesn’t know that? The answer is: because they get most of their information from the company that manufactures the drug who further justify prescribing it by telling doctors that all drugs have side effects. I believe many doctors truly don’t recognize the tremendous difference between bio-identical hormones and chemicals. Accordingly, it is the responsibility of the patient to become proactive rather than a statistic. Critics of bio-identical hormone replacement therapy make the claim that bio-identical hormones have the same risk as their non-bio-identical counterparts. That claim is made in spite of having absolutely no supporting evidence.

Every prospective hormone replacement patient that comes to my office undergoes an initial consultation and discussion of various issues unique to them. They also undergo a number of serum (blood) tests to determine levels of pertinent hormones. In most cases, menopausal females have low levels of all sex hormones (estrogens, progesterone and testosterone) and commonly have suboptimal levels of free T3 that is manifested by low resting body temperatures.

Menopause: Quick Overview

  • Natural process that occurs in all females
  • Average age of onset in the late 5th decade (late 40s)
  • Average age of last period in early 6th decade (early 50s)
  • Age of onset and last menstrual cycle depends primarily upon genetics
  • Occurs as the result of declining hormones (estrogens, progesterone, testosterone)
  • Menstrual cycle changes seen that become erratic and then cease altogether
  • Signals loss of fertility
  • Nuisance side effects are: hot flashes, night sweats, emotional lability
  • Serious side effects are: bone loss and loss of heart and vascular protection
  • Treated by replacing all lost hormones with those identical to those lost (bio-identical)
  • Chemical hormone look-a-likes should not be used (many doctors unaware)
  • Many menopausal females are also hypothyroid
  • All women should be treated regardless of degree of symptoms
  • Replacing lost hormones can restore feeling of well-being, stop symptoms of hot flashes, night sweats while protecting the heart, blood vessels and bones. Also helps to maintain body shape, complexion, skin elasticity and hydration of skin and mucous membranes.
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