Ageless: The Naked Truth About Bioidentical Hormones (12 page)

Hormone replacement has let my true nature emerge. I no longer get PMS. When I do feel irritable or bitchy, I ask myself, What is going on in my life? Is it real stress, can I handle this stress better, or is this chemical? I go over my eating patterns for the prior couple of days to see if too much sugar had been in my diet in any of its forms, such as processed carbohydrates, bread, desserts, or wine. These foods can cause PMS even in menopause, even if you are on bioidenticals. Diet affects your hormones and, thus, your moods. If I find my diet was not good, I will give myself a talking- to and remember that the irritable feelings are from my choices. Then I get a grip. It’s not fun to be around a PMS-y woman, and it’s not right to take things out on others. In the end, the one who loses out the most is you.

P
ERIMENOPAUSE

Perimenopause, which is the transitional stage from normal menstrual periods to no periods at all, is not given a lot of attention because it’s seen as a precursor to menopause and not the real deal. Perimenopausal women are emotional; yet because they are still getting a period, most doctors toss it off as “nothing serious.” But here is why you should be concerned about perimenopause: You are in a severe state of hormonal imbalance that has potentially dangerous consequences. One day your estrogen goes sky-high, one day it’s low, one day your progesterone levels are off the charts, and the next day they are nonexistent. Perimenopause is about hormonal surges. It’s these surges that are causing new, unexplained weight gain. It’s these surges that are causing mood swings. It’s these surges that can set the stage for cancer, as you’ll learn later in this chapter.

Perimenopause marks the beginning of hormonal decline, and
with hormonal decline comes withdrawal symptoms. These symptoms vary in severity from woman to woman, but unexplained feelings, emotions, hot flashes, sleeplessness, lack of sex drive, weight gain, and irritability are all part of the process. The falling hormones you experience in perimenopause are the opposite of what you experienced as you entered puberty, yet there are parallels. Back then, your hormones were building up to get you ready to be a reproductive person. Remember all the crazy feelings you had inside you? Remember that lack of understanding you had when you would suddenly break into tears or that teenage rage that seemed so inappropriate? Except now, in perimenopause, the situation is reversing, so on the way down you are going to experience the same emotional and physical havoc that you experienced when your hormones first started building up. It’s no fun.

You must understand that in perimenopause you’re running nearly on empty. That’s why you don’t feel “right.” As author T. S. Wiley explains, “You still have just enough estrogen to make a thin lining in your uterus and cause unopposed hormonal growth elsewhere in your breasts and body, but not enough to cause an estrogen peak. That’s why your periods are getting shorter and shorter, your breasts lumpier and lumpier, and your mind far less agile. The fact that you don’t peak estrogen with any regularity anymore, and you haven’t since your late twenties, is the hallmark of perimenopause.”

As fully reproductive women, we make enough estrogen each month so that it reaches its peak on the twelfth day, stops the growth of cells, and makes progesterone receptors. Without an estrogen peak, your brain can’t send the signal to release any of the eggs you have left. T. S. Wiley further says, “With no peak of estrogen, there’s no feedback information to shut off follicle-stimulating hormone, so FSH pours constantly, overstimulating your ovaries and ripening all at once most of the eggs you have left. The loss of this rhythm in perimenopause actually triggers the destruction of the rest of your eggs through the action of excessive FSH, using up the remainder of your eggs. At about this time, you begin to feel the heat of hot flashes.
That’s how the system effectively shuts itself down for good. This process can take a decade.”

You can find out whether you’ve gone from perimenopause to actual menopause by having your FSH blood tested. An FSH score higher than 5 is the clinical diagnosis of menopause. So have your blood work done and ask your doctor what your FSH score is. You can stop the destruction, essentially achieve feedback, and shut off FSH with estrogen replacement.

Having no more eggs means having no more estrogen, a situation that, of course, leads to no more progesterone either. Since you’ve stopped regularly producing the small amount of progesterone that you would from a normal menstrual cycle, and there’s no steady increase of it either (that is, you’re not pregnant), nature “thinks” that you’re back in “adrenarche,” the increase in activity of the adrenal glands just before puberty. Because your estrogen is so low and you’re producing even more testosterone than before, thanks to your sleeplessness, the pubertal picture is complete.

Wiley goes on to say, “After we reach thirty, nature identifies falling (low) estrogen and higher than normal (rising) testosterone as the beginning … again. This is a perfectly reasonable conclusion on the part of nature. You must be in adrenarche, because nature knows no other template for not ovulating except pregnancy and lactation … unless, of course, you’re a man. Now nature tries to send you on your way to puberty. Only it can’t. The whole point of puberty is to get you to the next level of existence … ovulation. There’s the hitch. That developmental milestone takes eggs, and we don’t have any. It’s too late to start puberty again, but the outcome of puberty, a normal rhythm of estrogen and progesterone in youthful quantities, is something you can achieve with natural hormone replacement. You can try to fool nature by covering the fact that you’re missing eggs if you replace the hormones that they would generate in exactly the amounts and rhythm in which they would occur.”

The important thing to remember is that when you are in perimenopause, you have almost no eggs left, which means you no longer have much estrogen left, either. This is an uncomfortable place to be.
Without estrogen, we can’t think, we can’t control our body temperature, we can’t sleep well, we have no protection for our heart, and among many other things, we lose our sex drive. There is simply no sexual feeling. It’s as though the motor has died. Most women are mortified to admit this. And really, no one has to know, right? We can still “do it,” but there is no sensation and no pleasure. Any participation on our part is a loving gesture. We can enjoy the closeness; but without any feeling, it is actually more pleasurable to read a magazine.

This is the unfair part. At this point in life, our men (if they are around the same age) are at their virile peak. They would like to have sex every day and more than once if they can. How can we keep up with them? How long can we go on participating in this intimate activity without getting any pleasure? Add the lack of pleasurable feelings to the fact that without estrogen there is no lubrication, so sex can be uncomfortable, or it can hurt. Additionally, yeast infections and other conditions take hold because of the imbalance that is going on in our bodies.

Testosterone levels fall significantly throughout perimenopause and menopause and will affect desire from an early age. Circulating levels of testosterone play an important role in the psychological and sexual changes that occur in menopause. That’s why women respond positively when testosterone is added to their hormone replacement program. Testosterone helps with problems such as fatigue, poor concentration, depression, inability to have an orgasm, and lack of sex drive.

You have to understand that hormonal imbalance is a dangerous place to be. It is in hormonal imbalance that disease can proliferate. Here is a scenario that I am going to be explaining over and over in this book, because it is very important for you to understand the “nature” in you: The brain considers a fully reproductive woman to be a valuable member of the species. Remember, there really is one reason we are all here (biologically speaking), and that is to reproduce, to keep the species going. When we are reproductive, we make a full complement of hormones. There are no surges and no imbalances.
Everything is working perfectly. Each month, we are capable of making a baby; whether we choose to do so or not is up to us and nature. But when we are in hormonal
imbalance
, the brain thinks “aha, this person is amiss. The hormones are leaving her body, meaning she is no longer making a full complement of hormones. Therefore, this woman is no longer capable of making a baby due to loss of eggs.” The brain now wants to eliminate you because you are no longer a productive member of the species, since we are here only to reproduce so that the species can perpetuate itself, according to biology.

Now, of course, with today’s advancements in medicine and technology, we know this is not the end but the beginning of the second half. But the brain doesn’t know this. The brain knows only that this body is no longer working properly. The hormones that nourish and regenerate the organs and all parts of the body are missing. Here is where it gets dangerous: Cancer, viruses that live in all of us, and other diseases are allowed to proliferate. This is why when a woman hits age fifty, she has a one in seven chance of contracting cancer. She didn’t wake up one morning and find cancer in her breast. It started years ago in
perimenopause
, during the first throes of hormonal imbalance, when the disease that was hanging around inside her body had an opportunity to grow.

Disease doesn’t develop when hormones are in perfect balance. It doesn’t need to. There is no reason to grow a new “self” (cancer) when everything is in balance. For this reason, you need to take perimenopause seriously. Don’t count on your doctor, either. You have to remember that until the medical establishment catches up, we of this generation are on our own. Unless he or she is one of the cutting-edge doctors, your doctor most likely knows nothing about hormones, perimenopause, or menopause. Your emotional complaints will probably be met with pats on the back, antidepressants, and sleeping aids. At the moment, that is all most of our doctors know how to do. As I have said many times before, it’s not their fault; they were not taught in medical school. But I have to say, I am losing a little patience and am getting tired of defending their ignorance in this area. Let me ask you this: If you were an MD, an OB/GYN, or an
endocrinologist, and there was so much chatter about bioidentical hormone replacement therapy, wouldn’t you by now have made it your business to find out about it, read up, and take courses to keep up with the times? With all the negative information out there on synthetic hormones, with the alarming reports from the Women’s Health Initiative relative to synthetic hormones, with all the complaints from female patients, I have to say I find it shocking that most doctors in this country are still prescribing synthetic hormones and telling women to use them only as long as it is necessary and then get off them.

Now that you know how important it is to replace hormones with bioidentical hormones, not for a short while but for the rest of your life, you can see how uninformed a doctor has to be relative to the importance of hormone replacement to put you on synthetics and then say get off them as soon as these nasty symptoms subside. This means that this doctor doesn’t have a clue as to the importance of hormones. Hormones are what make us run; without them we die. In fact, if you look up
death
, it will say “loss of hormones.”

Without hormones, there is no quality of life. Try not sleeping for days or months on end (remember, sleep deprivation has been used as a form of torture in times of war), and see how you feel. Try having no working internal thermostat so that your body is in a constant state of “high” all the time, and see how you like sweating. It’s both embarrassing and uncomfortable. This is just the tip of the iceberg. Any doctor who tells you to “tough it out” is doing you a disservice. It means he or she doesn’t get what’s happening to you while in perimenopause. Run, don’t walk, from this doctor. You can continue to go to him or her for your other needs, but when it comes to hormones, you want someone who is knowledgeable and sympathetic.

Here’s something else about what happens hormonally in perimenopause: When estrogen rises without progesterone (in other words, your estrogen is surging higher and higher but with no progesterone to create the right rhythm), this elevation turns off a powerful cellular growth controller called epidermal growth factor (EGF-1 and EGF-2). This particular growth factor is the major player in HER2-neu breast cancer. You need the estrogen rising to high enough
levels (in other words, to reach an estrogen peak and then cascade down as it does in nature) to turn off the EGF-1 and EGF-2, or you may end up with cancer. A simpler way to explain this is to understand that imbalanced hormones are at the root of cancer. When you are in perimenopause, your natural rhythm is off; that is why perimenopause is a dangerous time for women.

By the time a woman is in her late forties, she has spent anywhere from ten to twenty years in this hormonal confusion. Most women go from doctor to doctor during perimenopause with myriad complaints. Everything gets treated—from her allergies, to backaches, to depression, to weight gain, to headaches and migraines, to sleeplessness and a hundred other maladies—with some form of drug treatment. The drugs are Band-Aids, taking away the symptoms but never addressing the underlying causes. Rarely does a woman find a doctor who actually realizes what is really happening.

The real problem is hormonal loss. The sooner you start putting back what you’ve lost hormonally, the better you will feel. It’s never too early. If you are low, you’re low. But you will have to drive this train. No one is going to do this for you. This is your life. Start now. Perimenopause is a call to action. Your body is starting to shout at you. It wants help. Please listen, hear the call, and save yourself.

When I discussed this potentially dangerous stage of life with T. S. Wiley, she told me perimenopause is problematic because as far as the brain is concerned, women are hormonally in first-trimester pregnancy range. The specific hormone ratios of early pregnancy are insulin (high) and estrogen (low) and thyroid (functioning). These levels are mimicked in perimenopause. This hormonal environment triggers fetal oncogenes to start flipping on, and oncogenes contribute to the production of a cancer. However, perimenopausal women are stranded with no source of progesterone to give the growth or death command (of the cells) to turn those same genes off, because they don’t have enough estrogen to peak in order to ovulate anymore with any regularity, and there’s no placenta on board. Without the progesterone from the remains of an empty egg sac, their low chronic estrogen is never turned off, either. The state they are in is now life-threatening. This is the backdrop for cancer.