I'm Too Young for This!: The Natural Hormone Solution to Enjoy Perimenopause (25 page)

Q: Have you ever discussed the impact candida has on hormone absorption? It blocks the cells from receiving the bioidentical hormones. After we discovered this, I went on the diet suggested by the Hotze Clinic in Houston and it changed my life
.

DR. RON ROTHENBERG: Maintaining a balance of hormones does require maintaining balance in your body. Gut health, which includes candida and other dysbioses or overgrowth infections, triggers inflammation. Elevated cortisol can increase blood sugar and this can increase your tendency for candida overgrowth. Inflammation can have negative impacts on health from head to toe. It is important to look for food sensitivities as well. Treatment of this imbalance is primarily dietary with a reduction of high carbohydrates, but also would include omega-3 fish oil, probiotics, possibly digestive enzymes, and stress reduction.

Bioidentical hormone treatment should always be done in the setting of optimizing lifestyle and wellness so it should include nutrition, exercise, stress reduction, and eliminating toxicities and underlying infections.

Q: I have candida. Talk about disrupting every system in the body. Are there natural herbal products out there that you could recommend instead of drugs that make it worse?

DR. RACHEL BURNETT: Many people suffer from yeast overgrowth and it is commonly overlooked. It is important to note that yeast is a normal organism, but given the opportunity (and there are many in our modern-day culture) it can easily overgrow and manifest as symptoms that are very troublesome. The first step would be to get tested, since some of the symptoms of yeast overgrowth such as bloating and fatigue can be due to other causes. Treating presumptively only to find out later that yeast was really not the underlying cause can prolong recovery and result in unnecessary spending. I recommend doing a stool test that uses advanced-technology DNA analysis that is very sensitive. Most functional laboratories offer these tests that your doctor can order for you. Another benefit of using a test like this is that it has the ability to test not only which pharmaceuticals the condition may
be sensitive or resistant to, but also which botanical medicine would work. Having tested hundreds of patients, I have found that my patients have the most success with a pharmaceutical-grade caprylic acid or grapefruit seed extract. It is important to note that killing the yeast is the easiest part. Preventing its re-growth is the challenge. That is where a good discussion with your doctor comes in, so you can really look at contributing factors. Oftentimes there are dietary considerations; sometimes it involves a close look at other obstacles and how to avoid them. The upside is that you will learn how yeast overgrowth manifests in you and then if it returns you will know why it came back and how to kill it.

Q: My doctor told me that, because I am overweight, he cannot accurately determine my hormone levels. He says that my estrogen levels are high because I am fat. How can I know if or when I might need to address hormone deficiencies, and how do I go about it?

DR. GAIL GAGNON: Being overweight does not prevent you from having your hormones levels tested. You can measure your estrogen level (as well as progesterone, testosterone, cortisol, and thyroid levels) via blood, urine, or saliva. If your menstrual cycle is regular (every month), the best time to measure your hormones is on day 19, 20, or 21 of your cycle. During these days your hormones should be at their highest levels. If you are deficient, then you are a candidate for hormone replacement therapy. Your excess weight could be due to insulin resistance related to estrogen, progesterone, testosterone, thyroid, and/or cortisol imbalance. All of these hormones can be measured and replaced, as needed, with bioidentical hormones leading to increased energy
and decreased food cravings, and making it easier to implement a healthy weight loss program. I recommend you find a bioidentical hormone physician, have your hormone levels tested, and, if needed, implement bioidentical hormone replacement therapy.

Q: I just saw an Internet commercial for hormone weight loss. It said that leptin is the trigger for keeping us heavy. What are your thoughts?

DR. PRUDENCE HALL: Weight loss is an important topic for most of us, because during perimenopause and menopause it is common to put on thirty pounds or more, sometimes without even changing our eating or exercise habits. The weight gain is often due to fluctuating and low levels of estrogens, which trigger anxiety eating and inefficient digestion, and decreases in neurotransmitters in the brain, which stimulate depression and hunger. This is the time many food intolerances/allergies develop, because in perimenopause and menopause, we lose our digestive enzymes and acids. This creates inflammation in the body, which packs on the pounds. Leptin and ghrelin also play roles in appetite control and hunger, but more important, our thyroid function frequently declines dramatically in perimenopause, and low thyroid hormones add lots of weight. Increased stress also does, and the female body definitely feels stressed as it experiences a decline in estradiol levels.

Q: I’ve been trying to figure out if the weight around my middle, fatigue, and horrible constipation (around my period) is caused by perimenopause. When I look at symptoms of perimenopause, none of my symptoms show up, and I’m not experiencing the symptoms that are listed. What is happening?

DR. EVELYN BRUST: The symptoms of weight gain around the middle, constipation, and fatigue may be caused by any number
of different conditions. My recommendation for you would be to work with a physician who is an expert in metabolic and hormone balance.

A thorough multifactorial workup might be indicated in your case so as not to miss anything, and to determine the best personalized treatment plan for you. Working with an expert may help you figure out how to be the healthiest you can be.

Q: Tell me about BHRT after a hysterectomy
.

DR. RACHEL BURNETT: Oftentimes, when a woman is close to menopause and if there is any abnormal bleeding or complaint related to her uterus, she is told that her best option is to get a full hysterectomy (i.e., hormone-making ovaries out, too) because, as they may tell her, her ovaries will stop working soon anyway and she will minimize her risk of uterine or ovarian cancer if she gets them out. Trusting her doctors, she goes down this path only to learn quickly that a life without hormones or with estrogen only, if her doctor puts her on any hormones, is a very different life than she imagined.

The idea here is that the estrogen may manage any hot flashes she experiences and this estrogen replacement will be at the lowest dose possible to manage the symptoms for the shortest amount of time. Libido plummets, depression starts to set in, weight gain appears, and sleep disappears. Moreover, the risk for heart disease, cognitive decline, osteoporosis, diabetes, macular degeneration, among other chronic diseases, just went through the roof. A comprehensive look at one’s hormones is critical at this point and the sooner bioidentical hormone replacement is started, the more benefit there will be in the long run. The key
tests are estradiol, progesterone, free testosterone, and DHEA-sulfate. Oftentimes thyroid (Free T3 in particular), although not an ovarian hormone, is not optimized and we will look at this also since a well-functioning thyroid helps us feel our best. Once a woman starts hormones, it is important that there is good follow-up with her doctor to make sure the levels are enough not only to make her feel better, but also to protect her from chronic disease. Many doctors do not follow up and simply give prescriptions and let women go on their way. Bioidentical hormone replacement therapy is individualized and often fine-tuned after considering laboratory results together with how the woman feels.

Q: How are hormones correctly tested after a hysterectomy?

DR. SEAN BREEN: The most accurate way to test hormone levels following a hysterectomy is through simple blood work. The specific hormones that you should have checked are progesterone, estradiol, testosterone (free and total), follicle-stimulating hormone (FSH), luteinizing hormone (LH), IGF-1 (growth hormone production), and DHEA-sulphate. If you had your ovaries removed, then you will need bioidentical hormones. If they left your ovaries in, then you just need to make sure that you are still producing enough estradiol, testosterone, and progesterone. It is quite common for hormone levels to decline slightly as a result of having the uterus removed because of mild loss of secondary blood vessels to the ovaries.

I love this letter from one of my readers. It makes me smile.…

Isn’t it wonderful to hear a woman singing the praises of her next transition? That she found the answer, and now perimenopause is a breeze
and
she’s “singing” again?

Now it’s time for YOU! It’s time too for you to find your song,
sing it
, and be fully alive. To be “of” life rather than “out of” life’s energy.

The angst is over; you now have a much better idea of who you are, and the gift of your wisdom is beginning to shine. You also have the gift of perspective. You can look back and remember when you felt like a walking ball of confusion and insecurities. Now is YOUR time to be a grown woman at her best.

We do get better with age, but up until now women have bought into the advertising that says we are “less than” as we get older. Not true! I’m sitting on top of that wisdom/perspective mountain right now and I
love
the view! I’m able to see so clearly. It makes each day light, bright, happy, and upbeat. But if I were not hormonally balanced, I would be hanging on to life by my fingernails.

I chose to take charge of my health; I feel good, I’m healthy, and I’m cutting-edge by taking control of my body and my quality of life. I am the contractor of my body. I hire qualified doctors to be my subcontractors. It’s the new way to go to the doctor;
you
are the one in charge. And you can be because you have now armed yourself with knowledge.
You
can ask the intelligent questions.
You
have information that allows you to have critical thinking, figuring out the puzzle of your own chemistry with the help of your doctor. It’s your body. No one is ever going to care about it as much as you, so taking charge and care of it should be a no-brainer.

I am happy and proud to bring information that can help you along during this difficult passage. I hope I have made it clear and broken it down, so that it is simple and easy to embrace. I’ve tried to give you the answers to the questions that so many readers have asked, so as to give you the tools to live a drug-free, healthy, sexy, happy life.

At present, our medical schools are teaching fifty-year-old medicine. Every answer to every disease and condition has a pill
attached to it. If you look around at our senior generation, you see for yourselves that they are not doing very well on all the pills they have been given over the years. It’s a cruel hoax; they trusted and they believed that medicine knew best.

We get confused because we have been raised to believe doctors are supposed to know everything. That’s a lot of pressure for your doctor. Stay with your doctor for the things he or she knows, but go to the right doctor if you are looking for hormone balance (someone who specializes in BHRT).

Doctors are good people we hire to take care of our bodies. But they are not
in charge
of our bodies … that is your responsibility. You must feed it right, sleep it properly, think good thoughts, and do your research to understand the language of your body and not allow any part of it to deteriorate. Your brain is a big part of this management. With all the chemicals and toxins abundant in our environment, maintaining health is more difficult today than at any time in the history of humanity.

As I’ve discussed an entire generation before us is lost in a sea of pills. Just when our planet needs wisdom more than ever to deal with the chaos we can’t seem to escape, we desperately need “the elders of the tribe” in order to access their perspective, but sadly we have so few to go to. Our wisdom pool has been wiped out by bad choices, environmental challenges, and allopathic medicine’s overreliance on a pill for every pain. Foggy brains, an inability to think or reason, rampant Alzheimer’s—all are tragic. Don’t let this be you.

When my book
The Sexy Years
came out in 2004, no one had ever heard of bioidentical hormones. I was attacked on TV and in print for suggesting there was a better way. But the information resonated with women readers and they started thinking for themselves. As a result, the sales of Wyeth Pharmaceutical’s main hormone drugs dropped by 72 percent. I can’t say for sure it was my book that started the change, but I’m sure my message
had impact. No wonder I was being attacked. If my theory was true, it would affect their bottom line. Regardless, many thousands of women went to their doctors and began their regimens of BHRT. And they got better.

Women came up to me on the street and cried; they said that their lives had been saved. Yet a lot of women were still white-knuckling needlessly each day, and instead taking a coterie of pills.

Your generation has a better chance. We are right ahead of you and you can look to those of us who chose to go another way to see how well we are doing. I want you to want what I have. The good news is that now you know how to get it.