Today I want to talk to you about menopause. You may not be there yet, but now is the time to prepare! Yes that’s correct, you can and should prepare for those years when you will no longer have a menstrual cycle.
Let me demonstrate with a picture.
When we think about hormones, we almost always think about the sex hormones right?
LH (Luteinizing Hormone)
FSH (Follicle Stimulating Hormone)
While we have all of these hormones from puberty through our reproductive years and into menopause, they are definitely in varying amounts depending on the physiological needs of the body.
The balance of these hormones is achieved through a coordinated effort of the hypothalamus , pituitary, ovaries and endometrium (lining of the uterus).
It’s also important to remember is that we also have thyroid hormones, pancreatic hormones, adrenal hormones, etc.
There are many things that can trigger menopause. Four of the more common ones are:
- Normal aging of the reproductive system
- Chronic stress resulting in a decrease of hormones produced
- Hysterectomy or the removal of ovaries
- Ablation or cauterization of the uterine lining (usually for a heavy cycle)
So you can see that the general rule of “not having a period for a year” means you have reached menopause, does not always hold true.
Lets look at the natural aging reproductive system first. As the ovaries prepare for retirement anytime between the ages of 40 to somewhere in the 50’s, in a healthy woman there is a gradual transition of hormone production from the ovaries to the adrenals. The pituitary keeps calling the ovaries who are preparing to retire, but it is a process. They are part time for anywhere from a few months to a few years!! The pituitary calls and says “Hey we could use some estrogen and progesterone here in the body.” The ovaries may or may not answer the pituitary. If they don’t answer, the switchboard operator generally reroutes that call to the adrenal glands who then begin the process of making a new kind of estrogen, E1 and progesterone.
If this happens, all is great! However, there can be a glitch in the system. If there is stress, and I don’t know anyone who doesn’t have some level of stress, the adrenals will prioritize stress over making sex hormones. What that means in the long run is that if you are under chronic stress prior to the menopausal transition, your adrenals may be in no shape to assume the added responsibility of making additional hormones.
Next let’s talk about some ways the body can be forced into menopause. If you have had a total hysterectomy, your pituitary is no longer receiving messages from the ovaries and the ovaries are no longer answering the phone, so to speak, when the pituitary is trying to communicate its need for more hormones particularly estrogen and progesterone. The result of this type of forced menopause is that there has been no gradual transition of the responsibilities of the ovaries over to the adrenals. The shock to the body and nervous system can be drastic. Many times the MD (surgeon) will recommend bioidentical hormones or synthetic hormones depending on the age of the patient. This is not always a bad option, but should be evaluated on a case by case basis. ALWAYS however, as we have discussed earlier, the adrenals must be supported as the body adapts to the idea that you are now in menopause. It is now their job to make a new kind of estrogen, E1 as opposed to E2, and progesterone, so you can see how important adrenal support can be during this transition.
Finally, lets talk about ablation, another type of forced menopause. From about 15 years of age to 50 years of age, we as women are supposed to cycle. That means the hormones are supposed to flux each month: Estrogen rising and falling, progesterone in a bell curve over the last 2 weeks of the cycle, all coordinated by the HP axis. During these last 2 weeks the lining of the uterus or the endometrium is thickening in preparation to receive a fertilized egg should one be presented. If not it should shed during days 1 to 5 or so of your new monthly cycle. Well, we know that would be in a perfect world and sadly many of us don’t have that experience. New technology came up with a procedure that cauterized the lining of the uterus resulting in no longer having periods. What they didn’t consider is what would that do to the feedback loop from the uterus and ovaries to the HP axis. Research is showing that many of these procedures have resulted in early onset menopause, not an outcome they were hoping for. We have 20 and 30 somethings experiencing hot flashes, insomnia, bone density issues and foggy brains. Some of the luckier ones are finding that the body is stronger than the ablation and they are resuming their normal cycles.
So what happens in these situations of forced menopause or stress, is that the HP axis is often down-regulated requiring a reboot of the system. This can be done with herbs, or protomorphogens of the hypothalamus and pituitary to re-establish the communication of the HP axis to the ovaries which are generally still intact.
We also need to support the adrenals so that they can take on the added responsibility. That can include lifestyle modification, exercise, meditation, eating better, and sometimes herbs or nutritional supplements during particularly stressful times of the year.
Chronic stress can cause other health complications for menopausal women as well, such as hypothyroidism. If we think of the thyroid and the adrenals as two ends of a teeter – totter, we are looking to have some balance between the two. If the adrenals are always up in the air under stress, the thyroid is going to be metaphorically on the ground or under-performing. This results in thinning hair, weight gain, slow metabolism, sluggish bowels, dry skin, etc.
Many of us are particularly concerned about weight gain, so let’s address that symptom in particular for a moment. Why on earth would the body add 10-20 lbs suddenly when nothing else changed other than stopping having periods? Well, it’s because the body needs that estrogen that the ovaries used to make, BUT, they are retiring right? And the adrenals that are supposed to step up and make the new kind of estrogen, are incapable due to stress. The body is really smart and says to itself, “Well, fat makes estrogen and I need some really bad, so I am going to add some right here around the belly!” And that is exactly what happens!!!
It’s a bad situation, but there are solutions:
- Support the HP axis
- Support the adrenals
- Get lab tests (either blood or saliva) to see hormone and thyroid levels
- If necessary, also support the thyroid
- Make lifestyle changes to decrease stress and eat healthier
I am available to order and review labs over the phone or in person to help you with this transition. It doesn’t have to be prolonged, and suffering is optional. Let me help you. If I haven’t seen you before, you can call for a free 15 minute consultation with me regarding your hormone balance, or schedule a new patient appointment (about an hour). If you are able to send your labs in advance I can review them before your appointment!
Dr. Virginia S. Irby D.C.,DABCO, ACN
2371 Iron Point Rd. Ste. 130
Folsom, CA 95630