So the most common symptoms that women come into my office for around peri-menopause and menopause is if there is still peri-menopause then it’s a lot of abnormal bleeding problems. That could be light, that could be heavy, that could be long, that could be short. Any way, shape, or form. Once the periods have stopped, then peri-menopause or menopausal we are talking about hot flashes, night sweats, irritability, depression, anxiety, overreacting, overwhelmed. You used to be able to handle twenty feet of stress before you got pissed off. Now you can only handle ten feet of stress before you’re triggered. Just the reserves aren’t there. Also, changes in vaginal tissue. Vaginal dryness, pain with sexual activity in the genital area. That’s pretty common, as well as less libido. So, changes in sexual function from all kinds of angles. A little less common would be maybe headaches, body aches, fatigue, heart palpitations, dry skin, itchy skin, urinary leakage. These are not as common, but pretty darn common. And then there is some less common, or even rare things, like ringing in the ears, like frozen shoulder, like burning mouth syndrome, dry eyes. These are things we don’t hear about as often, but clearly can be related to menopause. The gas and bloating, changes in bowel habits, that might be sort of a less common, but certainly not rare. The list goes on. There is hair thinning, hair loss, there is changes in the voice, the voice becomes deeper. We could probably come up with something unusual that someone has experienced. Tingling is another one that might come to mind. Even coldness. We talk about hot flashes, but coldness is sort of a subset, you might say, hot flash, kind of a chilled feeling.
So amongst all these symptoms, the woman and the practitioner has to decide which is best for her. The way I approach this is, in taking the history and doing the physical exam, maybe there are some tests that are ordered. Basically determine what…are her symptoms mild, moderate, or severe. So, symptom category is one issue. Then are the risks for certain major diseases, mild, moderate, or severe. Risk for osteoporosis, risk for heart disease, risk for diabetes. So we have to determine these to the best of our ability, subjectively and objectively. So after I’ve kind of made some kind of determination there, then I look at my whole list of “okay, what are we going to do about the symptom relief”. Is there anything in diet, exercise and lifestyle category that could improve some of these symptoms? Is there anything in the nutritional supplement category that could improve some of these symptoms? Herbal medicines. And then we have all different kinds of hormones, whether we call them…there are bioidentical hormones that are derived from a natural substance and then made into a hormone that is biochemically identical to our hormones, those are bioidentical. Those can be compounded at a special pharmacy to come up with very customized formulations and combinations and dosings that pharmaceutical companies don’t make. But pharmaceutical companies also have a small selection of bioidentical hormones in a patch or a pill or a vaginal device. And then there is synthetic or semi-synthetic hormones. So, we have all kinds of hormonal options to choose from. And not all practitioners know about all, or are skilled, or are educated about all those hormonal options. Your typical conventional minded practitioner is going to mostly use the hormones the pharmaceutical companies make. And it’s usually the alternative minded practitioner, whether it is a naturopathic physician or a medical doctor that’s going to be using the customized, compounded hormone combinations.
But the last category I want to mention is non-hormonal options. So if you have insomnia. This is why a doctor might prescribe Trazodone or Ambien, or those kinds of medications. Pharmaceuticals for depression or anxiety. There are even non-hormonal pharmaceuticals for hot flashes. Some of the blood pressure drugs are actually used for that. Some of the anti-depressants are even used for that. So we have all these categories. In the herbal category maybe Black Cohosh. Maybe a Maca Extract. Maybe a combination herbal formula that can… either one of those three choices can address kind of a nice array of menopause symptoms. But perhaps you specifically have insomnia. So we’ll use Black Cohosh and Valerian for example. But there are lots of specific nutrients and specific herbs for specific menopause symptoms. And then the hormones are nice because they target a broad array of symptoms. You can have kind of almost any menopause symptoms and a good menopause practitioner can determine what’s the best hormonal approach for this particular situation.
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