The medical definition of menopause is for a woman to go twelve straight months without having a menstrual period. Therefore, the diagnosis of the beginning of menopause can only be made retrospectively, 12 months after its actual onset. Menopausal symptoms often start prior to this however, because of fluctuating and diminishing levels of estrogen. A better definition of menopause would be the development of persistent symptoms of estrogen deficiency. The average age of the onset of menopause is 51. Today, approximately 45 million women in the U.S. are menopausal. Because we have an increasingly aging population, each year a higher percentage of the population is menopausal. Approximately 5000 U.S. women enter menopause each day. In 1900, the average life expectancy for a woman was 48 years, now it is 79 years.
This increasing life span means that the average woman is menopausal for greater than one third of her life. The most common symptoms of estrogen deficiency are hot flashes, night sweats, foggy thinking, vaginal dryness, and sleeping difficulties. Hormone replacement therapy (HRT) can alleviate these symptoms, and bioidentical HRT is most likely the safest form of treatment. If you have had a hysterectomy with removal of your ovaries, you are said to be in surgical menopause, even if you are in your 40’s or younger. Even if your ovaries were spared at the time of your hysterectomy, you will likely develop symptoms of menopause several years earlier than normal. Only 10% of women have the onset of menopause with no menopause related symptoms. By age 50, most women have had a 30% drop in their estrogen levels, with a sharp decline after menopause. There is a 75% drop in progesterone levels between ages 35 to 50, and progesterone levels are almost nonexistent after menopause. Today, fewer than 30% of menopausal women are on HRT.
What choices do you have? All women eventually reach menopause; there is nothing anyone can do to prevent it or delay it. Over 80% of women will develop unpleasant symptoms as a result of this inevitable estrogen and progesterone decline. Women also suffer from the loss of testosterone, DHEA, and thyroid hormones at this time.
When women start to lose their hormones they have only four choices:
Choice number 1 is to take no action and suffer from the symptoms of low hormones. The most common symptoms are hot flashes, night sweats, sleeping problems, mood changes, low libido, weight gain, depression, vaginal dryness, memory problems, and low energy.
Choice number 2 is to attempt to mask the symptoms with herbs or antidepressants. Herbs often are no better than a placebo and, if they do work, their effects are usually short lived. Antidepressants can reduce hot flashes and help with mood changes but they can have unfortunate side effects such as worsening libido and sexual dysfunction.
Choice number 3 is to take synthetic hormones that are foreign to the body. The body is not accustomed to recognizing these unnatural hormones and thus they often have adverse effects in the body. Most women who take hormones take the synthetic substitute hormones, the most common being Premarin and Provera. Premarin is derived from pregnant mares urine, hence the name. Provera is a synthetic progestin and it is not nearly as safe as natural progesterone. The use of synthetic hormones is often referred to as hormone replacement therapy (HRT); a more accurate description would be hormone substitution therapy (HST).
Choice number 4 is to take bioidentical hormones, which truly is hormone replacement therapy. Bioidentical hormones have the exact molecular structure of the hormones that a woman produces naturally. In other words these hormones are no different from what a woman’s body makes naturally. Bioidentical hormones are more effective at eliminating symptoms of menopause and are likely safer as well. Besides symptom relief, there is a lot of medical evidence that indicates that bioidentical hormone replacement also delays the onset of osteoporosis, heart disease and mental decline. In this day and age it is shocking that women would rather take and most doctors would rather prescribe chemical hormone substitutes or horse hormones instead of bioidenticals.