Menopause: It’s Not Just a Phase

Shira Miller, M.D.Women2 Comments

Many women believe that if they just power through menopause, then everything will be okay. Contrary to popular belief, however, menopause is not a temporary phase, and “post-menopause” is a misnomer. Menopause actually lasts forever.

Menopause is the time during a woman’s life when her ovaries completely run out of eggs and she effectively ceases to produce two of her most potent hormones: estradiol (an estrogen) and progesterone. Whether you are 45 or 55 when it happens to you, the result is official infertility, loss of your monthly cycle, and a severe case of estrogen and progesterone deficiency. These hormone deficiencies are permanent and are a force to be reckoned with either right away… or eventually.

Some common problems caused by menopause are depression, anxiety, insomnia, irritability, lack of energy, fatigue, low motivation, weight gain, hot flashes, night sweats, accelerated skin wrinkling, brain fog, dry eyes, vaginal dryness, painful intercourse, loss of libido, low sex drive, loss of femininity, urinary incontinence, increased risk of heart disease, increased risk of dementia, and/or osteopenia/osteoporosis. You may get “used to” your particular first symptoms or get on a medication for it, but just as is the case with any other hormone deficiency, there are no long-term gains from a dearth of estrogen and progesterone, only further needless losses and an endless reduction in your body’s standard of living. And, unfortunately, doctors who don’t know that these symptoms are caused by hormone deficiencies may put you on multiple medications or perform surgical procedures in an attempt to help the problem.

The necessary treatment for any permanent hormone deficiency is hormone replacement. The safest and most effective hormone replacement therapy (HRT) available for menopause is bioidentical hormone replacement therapy (BHRT). Bioidentical hormones are man-made hormones which have a molecular structure which is identical to hormones naturally produced by the human body. For example, as menopause causes an estradiol (estrogen) and progesterone deficiency, BHRT is a type of HRT which contains the exact ingredients “estradiol” and “progesterone.”

Premarin, Provera, Prempro, and Ortho Tri Cyclen or other birth control pills are hormones commonly given as HRT, but they are not bioidentical hormones. Similarly, Prozac, Ambien, Detrol, Restasis, and Fosamax are frequently prescribed for menopausal symptoms, but they do not address the primary problem and are either ineffective or create a false sense of security, not to mention their side-effects. Bioidentical estrogen and progesterone, like a key in a lock, fit precisely in women’s hormone receptors and are therefore the optimal treatment for menopause. That being said, not all BHRT is the same and the best methods mimic reproductive hormone cycles as much as possible.

  • Joan

    Do they cause cancer are you more at risk?

  • Ella

    Hello,Being that one of the (many) symptoms I’m einxriepceng is brain fog, I am hoping someone will help me understand how this works.I have attempted a little research and it appears most, if not all, traditional doctors do no perscribe BHRT, but shouldn’t a person seek care from a specialist, in this case a gyn? I’m in need of an endocrynologist and even they don’t want to deal with female hormomes. What I’ve also seen is consults, and care done from afar, via phone and email. How can this be effective, let alone safe?Another issue is insurance. Mine does not cover BHRT and it isn’t possible for me to see an out of network physician. I cannot see a gyn (or any other doctor), especially in this area, agreeing to order lab work at my request, sending results off somewhere else, nor possibly monitoring results of BHRT. Without lab work ordered by an in network doctor and covered by my insurance that, too, is out of reach for me.Is there a list somewhere that gives the names and locations of physicians who do perscribe BHRT so that I can see if any of them are in network, though highly unlikely.Any tips on how to look for a reliable, knowledgeable, trustworthy, doctor working in this area? And then there are the labs. I’ve read not all are created equal. How does one go about finding out which are?I understand there is no way to know the cost of perscriptions since each is individualized, but is there an average? I have no idea if this in itself is something I can manage financially.Just to give you an idea of what I’ve been dealing with, went to my gyn 2 years ago. Had been having irregular periods for a few months (very unusual for me), asked her if it could be peri-menopause, her response was to ask me if I thought it was. She gave me 3 choices, HRT, scraping my uterus, and another I can’t recall. I left and haven’t been back. Last year I had cause to go to an endo who didn’t think HRT was a good idea. After she recieved lab resutls back for another problem she phoned. I told her I was hoping that she would be willing to work WITH ME to figure out what I am dealing with & that I am not interested in treating symptoms, but getting to the bottom of what ails me and taking care of it if possible. I don’t know if it was that or the fact that her nurse called in an unathorized persciptions for me which she found out while we were speaking, several days later she notified me that she would no longer take care of my medical needs. At a visit with my GP last year for minor problems and the result of a dexa scan which revealed osteo with a t score much lower than should be seen for someone my age which she could not explain and did no further testing to ensure it is not secondary, I asked her about the possiblity of cancer (been having specific symptoms), she told me I had enough to worry about and ushered me out of her office. I have not been to a doctor since and I need treatment and care. But I am at a total loss, frustrated, sad and mad as hell.I am so desparate to get these menopausal symptoms under control in hope to be able to have a clear enough mind (and feel human, normal) to deal with the other issues. The quality of my life has gone down hill so fast in the past year and I simply can’t take it anymore and no one is listening. When a dive from a tall bridge seems a better alternative to sleeping no more than 2 hours at a time combined with all the physical and emotional challenges, the stress, and what my family is going through as a result, I really need to find a way back, now.Any advice, info and tips are greatly appreciated, thank you

  • Moise

    Hi begins after thtriy years of age .And we were taught that life begins at forty ;)seriously though it seems that testosterone replacement therapy just makes your body dependent on it causing it to shut down its own production even more.yet more and more people are turning to it as an easy fix

  • Dr. Shira Miller

    Hi Mercedes,

    Many doctors are not aware of the benefits of hormones and are afraid of the exaggerated risks of patent hormones. However, there are knowledgeable doctors out there that know how to safely prescribe bioidentical hormones.

  • Marie Gray

    I am a 75 year old white female with many medical issues, not the least of which is hormone deficiency, as well as an uncontrollable amount of joint pain to the degree, which limits and inhibits my activity.

  • Sara

    I feel wonderful on estrogen, but when I add progesterone for 12 days I fell really bad- down, weepy, exhausted, bloated, zero libido. Obviously I’m not tolerating the progesterone. What should I do? I need P for the protection of the uterus..

  • natalie

    I’ve been going through premature menopause for over two years now, I’m 40 years old. Do you recommend HRT for someone as young as I am?

  • Ismael

    Oh,Janna, my heart goes out to you. I also had a hysterectomy in 91. And bcuseae doctors can;t seem to do anything to help, I have just done without for 15 years. Maybe a Holisic person could help you bring your total body into a better balance, so you could use some gentler hormones after that. I believe our bodies were made from God, and designed to heal itself,given the right tools. I feel you are on too many meds that are reacting on one another. Some meds you have to get off gradually, so if this at all makes sense to you( read up and do it the right way) but apparently they are not helping you, right?. But you can stop (pain,high blood pressure, diabeties) with eating the right foods and maybe some herbs. I feel you need to get off the meds. Find a holistic doc. Eat plant based foods to bring your body into balance,and then look at the hormones you body needs to help with againg. You are still very young to have all these problems.I hope this helps you some.

  • Mercedes Baena

    Why don’t doctors recommend hormones?