SHIRA MILLER, M.D.
Board-Certified Integrative Medicine
Concierge Menopause & Integrative Medicine Doctor
Newport Beach, California

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.

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