Miss X was feeling unusually tired and fatigued. Even after she got up in the morning, she felt like a truck ran over her. She was forgetting things and missing important meetings. It seemed like a fog was engulfing her brain, and she was unable to think clearly or focus. She tried to eat healthy and go out for walks as much as she could but despite all this her waist line was growing. She looked at her feet and wondered why her ankles looked so swollen. She was feeling down and depressed for no reason. She would cry at the smallest thing and then wonder to herself, “Why am I crying?”
Looking at the mirror didn’t help her mood either when she saw new hair growing on her chin and while noticing small patches of hair loss on her head. Her relationship with her husband was suffering because she either had no strength or no interest to be intimate. Sudden bursts of anger at her spouse were not helping either. Peaceful sleep was a thing of the past as she woke up multiple times during the night either because of feeling too hot or just not able to calm herself down to go back to sleep.
She just felt broken and extremely frustrated. She had seen multiple physicians, but nobody was really able to help her. Antidepressants and anti-anxiety medications were offered, but she didn’t want to take them as she knew that her answers were not in those pills. She had her uterus removed five years ago because of fibroids, but her ovaries were left behind so that she could continue to get her hormones. She realized that her problems sort of started a couple of years back and since then have progressively gotten worse.
This story is not unique or rare. Countless women going through menopause — or even after menopause — suffer some or all of these issues. Some are affected to such a degree that their day-to-day lives are severely disturbed. Ovaries left behind after removal of uterus tend to rapidly lose their function and patients who are feeling satisfied that they are getting their daily supply of hormones actually are left with non-functioning ovaries and early menopause.
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The fear caused by a well-known Women’s Health Initiative study that circulated among doctors and beyond caused many of the physicians to refuse to give hormone replacement treatment to women who really needed it. The study showed higher risk of dying from blood clots and heart disease in women who were given estrogen or progestin. But the estrogen was derived from horse urine and progestin was completely synthetic. On top of this, the estrogen was given orally. All these factors are most likely to result in the negative findings of the study. Studies done using Bioidentical hormones (Hormones chemically resembling our natural hormones) actually showed heart and brain protective effects and even a trend toward reduced incidences of cancer in women using Bioidentical hormones.
Using specific labs to properly measure free hormone levels (I prefer Saliva Testing) and then balancing them while following the patient’s symptoms and periodic retesting, results in phenomenal improvement in the symptoms and on top of that improving heart, brain, skin, bone and immune system health. But properly dosing estrogen and combining it with progesterone — while avoiding oral route for estrogen — significantly decreases risk of breast and uterine cancer. Because of the effects of hormones on our brain and neurotransmitters, mood is uplifted with a resolution to unexplained crying and mood swings. With replenishment of healthy vaginal lining and lubrication, intimacy becomes enjoyable again. Energy and stamina are improved. Sometimes the addition of a small amount of bioidentical testosterone gives an additional boost to mood, energy and libido. Oral progesterone is broken down into metabolites, which are really good for initiating and maintaining sleep. And with the resolution of hot flashes and night sweats, sleep becomes complete and blissful again.
But just hormone replacement is not the complete picture. A complete health regime must include nutrition and supplying essential vitamins and nutrients. Working on the stressors which might be influencing the hormonal balance, relaxation techniques like meditation, breathing exercises, self hypnosis and gratitude journaling are all effective. Regular aerobic and anaerobic exercises also have an impact. It also helps to talk with a life or relationship coach or counselor. Have regular check-ups to make sure that thyroid and adrenals are functioning OK.
Just as hormones and all other systems in our body are connected, including our emotions, similarly to bring balance in these cases, we need to address all three: Mind, body, and spirit!
Dr. Sayed Shah is a Board-Certified Integrative Medicine/Functional Medical Doctor and the co-founder of Mandala Integrative Medicine.