The Hormone Survival Guide for Perimenopause: Balance Your Hormones Naturallyby Nisha Jackson
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Explaining why women between the ages of 35 and 50 often experience significant changes in mood, weight, sex drive, and general well-being due to hormonal imbalances, this guide shows women how to regain control of their hormonesand their livesand feel good again through natural means. Women who have had long-standing physical and emotional complaints written off by doctors as normal or genetic are provided with step-by-step solutions to such hormone-related problems as weight gain, fibroids, sex-drive doldrums, adult acne, depression, anxiety, irritability, chronic fatigue, and facial hair. Perimenopausal women will be able to regain control of their health by putting together a game plan for renewalincluding hormone balancing and weight management plans that will help them feel betterwith dramatic, life-changing results.
“This is a great book, giving women concrete actions and guidelines for managing their own health.” —George Gillson, M.D., Ph.D., author, You’ve Hit Menopause: Now What?
“Dr. Nisha Jackson has done an excellent job of understanding the healthcare plight of the perimenopausal woman.” —Neal Rouzier, M.D., author, Natural Hormone Replacement for Men and Women
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The Hormone Survival Guide for Perimenopause
Balance Your Hormones Naturally
By Nisha Jackson
Larkfield PublishingCopyright © 2004 Nisha Jackson
All rights reserved.
Why Hormonal Chaos?
In This Chapter:
Current Medical Thinking About Hormones
The Hormone Roller Coaster
Hormones and Aging: Decline and Confusion
What Is Perimenopause and Why Do I Have to Go Through It?
There is no doubt that women's hormones are meant to operate in harmony. Hormone interactions have been compared to a ballet, a symphony – even barbershop harmonies. A stumble, a missed note, a voice off-key – all can trigger an unpleasant realization that something is not quite right. And so it is with hormonal balance. Complex hormone interactions and fluctuations throughout a typical menstrual cycle contribute in a major way to a woman's vibrancy and emotional and physical well-being. If hormones are out of sync, it's no secret. Most women, if asked the right questions, can describe how they feel and know intuitively when they are off-kilter. It is incredibly rewarding to help women understand their bodies, to know when systems are out of balance, and to guide them as hormonal problems begin to emerge during the aging process.
If you are experiencing unpleasant changes with age and are acutely aware that how you feel now is different from how you felt when you were younger, especially regarding your menstrual cycles, this book is for you; it will help you create harmony throughout your entire body.
You can be wonderfully healthy between thirty-five and fifty years of age if you are knowledgeable about what creates excellent hormonal balance and what to do if you find yourself out of sync. You may feel that your periodic upheavals are way out of control and worry that this is something much bigger than you can handle, but rest assured; if you know where the problem lies, and you take direct steps toward correction, relief is likely. Whether you are constantly dragging with fatigue, feeling irritable and headachy, or accumulating fat like never before, believe that you can move forward to create, maybe for the first time in your adult life, hormonal balance.
Current Medical Thinking About Hormones
In today's fast-paced medical world, doctors are pushed beyond their limits for time, resources, and patient management. Many are frustrated with packed schedules, sicker patients, and a burgeoning array of ever-changing medical tests and treatments. This is not a positive environment for a woman in her forties who is experiencing headaches, emotional lows, weight gain, and hot flashes. For many medical providers, responding to her complaints generally requires just a few minutes in the exam room. She is told that she is stressed out, has a poor diet loaded with too many calories, and, besides, she is probably depressed. More often than not, she is prescribed birth control pills and/or antidepressants and advised to reduce stress and clean up her diet. Wow, what a concept!
I find it completely crazy that if a woman complains of pain and numbness in her hand, she is quickly scheduled for myriad tests that may include X-rays, blood work, and sometimes even costly MRI (magnetic resonance imaging) scans. But if a woman in her forties reports to her medical provider that she is depressed, anxious, tired, and not sleeping at night, the provider rarely orders diagnostic tests. Instead the woman is reassured that her symptoms are normal for her age and that perhaps with the use of expensive, risky medications – such as synthetic contraceptives, antidepressants, antianxiety agents, and sleeping pills – her problems will disappear.
I am not sure how we ever got to the point in medicine where we cannot look logically at the female cycle and, with current understanding about the decline and fluctuation of women's hormones with age, simply explore, test, educate, and treat them. Instead, underlying hormone-related symptoms are masked – but not corrected – with medicines that most women do not need.
The Hormone Roller Coaster
Over the past two decades, hormone-related problems have escalated. Fibroids, PMS, endometriosis, infertility, breast cancer, cystic breasts, polycystic ovarian syndrome, and dramatic perimenopausal problems are more prevalent and are starting much earlier in women's lives.
It is at once fascinating and frightening to have witnessed firsthand these changes over the years and wonder why they appear to be on the rise. What is even more staggering is the number of hormone-related cancers. The 1997 "Report of Cancer" predicts that by 2015 the incidence of breast cancer will rise from 8.6 percent to 11.6 percent. The breast cancer risk has more than tripled in the past thirty years.
Premenstrual syndrome Commonly known as PMS, premenstrual syndrome is another hormone-related affliction that is increasing dramatically. This syndrome plagues girls as young as ten, as well as women nearing menopause, at much higher rates than ever before. Not only are women experiencing more emotional changes with their cycles, but they are also suffering significant physical and mental side effects with their hormonal upheavals. I have seen in my own practice the growing number of women with disturbing monthly changes, women who typically did not have these problems in the past.
A survey conducted by the Women's Nutritional Advisory Service (WNAS) shows that 80 percent of women who suffer from PMS have had problems with depression, anxiety, and aggressive feelings; 52 percent of these women have contemplated suicide in the days leading up to the monthly period. The WNAS concludes that PMS is a twentieth-century phenomenon and a direct result of poor diet and increased stress. It is also interesting to note that this advisory team states that 90 percent of women who suffer from cyclic problems have complete resolution of symptoms within just four months when diet, exercise, and stress are managed.
Fibrocystic breast disease Now afflicting approximately 25 percent of all women, those tiny, painful breast lumps that come and go with the cycle are closely related to estrogen and progesterone balance. Most often these lumps are benign, but women who suffer from them find it difficult to perform monthly breast self-exams. Fibrocystic breast disease also contributes significantly to an increase in the number of women needing additional mammography screens. When women's breasts are densely fibrocystic, identifying the normal tissue, versus a solid lesion, is difficult for the radiologist, frequently necessitating additional screening. Women suffer more discomfort; more radiation to sensitive breast tissue, probably unnecessarily; and certainly more anxiety! Other hormone-related female problems are on the rise as well.
Fibroids These muscular growths within the uterine walls are estrogen driven. We know this because they often shrink in menopause and are not present in girls prior to menstruation. In my own practice, the number of women with fibroids is rapidly increasing. I routinely diagnose five to eight cases of fibroids weekly; just ten years ago, when my patient load was approximately the same, I saw perhaps two to three per month. An increase in the incidence of fibroids is most likely related to the escalating estrogen levels in women stemming from unnecessary use of medications, poor liver health, chronic stress, fat gain with age, obsessive intake of empty sugar-laden calories, and lack of exercise. All of these negative influences contribute to a poor hormonal environment that can promote estrogen dominance and fibroid growth. Unfortunately, stress, lifestyle behaviors, and the uniqueness of each woman make hormone-related conditions extremely difficult to research. As a result, there are no definitive studies that demonstrate with cold, hard facts some of the correlations that we know to be true in our medical practices.
Hormones and Aging: Decline and Confusion
Female hormones change dramatically with age. Their rise and fall may cause significant symptoms in some women, whereas others seem to skate through without any notable discomfort. What's normal for one woman may bear scant resemblance to what's normal for her best friend. So getting our arms around exactly what is happening – or what exactly we can expect to happen – can be confounding. The important thing to note is what's normal for one woman may not be normal for another.
Hormone Levels Decline with Age
Estrogen:A 30 percent drop occurs by age fifty, with significant fluctuations during the forties and often the early fifties. In the first five years of menopause, the level declines sharply.
Progesterone: A 75 percent loss occurs from age thirty-five to fifty and continues to decline.
Testosterone: A 50 percent loss occurs from age twenty-five to fifty, and another 50 percent loss takes place by age eighty.
The hormones we are most concerned with in this book are estrogen, progesterone, and testosterone. It is important to understand the roles these three hormones play in the female body and what happens when they are out of balance. I offer my patients the metaphor of a symphony orchestra: When all members are playing in harmony, the sound and the effect are beautiful; when our hormones are playing from the same score, we can waltz through life. But when their notes are off-key, we begin to lurch and stagger. Too much estrogen and not enough progesterone and testosterone can make for some sour notes, and a true cacophony can be created by severe imbalance.
Figure 1-1 illustrates the steady decline of female hormones as women enter the perimenopausal years, thirty-five to fifty. Most women I see in my practice do not realize how hormones decline with age and are mystified that they are feeling so very different from when they were younger.
For some of my patients, hormonal harmony has never been a reality. I see numerous women in their forties who have had menstrual problems, PMS, infertility, depression, and acne since they started their periods. They don't know what it's like to feel good. Other women in their late thirties may have always felt healthy, but the good times have come to a screeching halt. All of a sudden, they realize that they are worn out, irritable, and crying at things that didn't used to bother them. Worse yet, they have lost all interest in sex, when in the past they were insatiable.
It is crucial to start treatment before the bottom drops out. If I can work with a woman when she first begins to notice changes, the turnaround is often brief and she can go on her way. But if a woman comes to me after twenty years of hormonal havoc and has been on multiple medications and maybe has resorted to hysterectomy or other surgical interventions, the evaluation is more complex and the treatment more tedious. The good news is every woman can benefit from in-depth evaluations, testing, lifestyle changes, supplements, and natural hormonal intervention.
What Is Perimenopause and Why Do I Have to Go Through It?
Perimenopause is simply the years before menopause. Menopause is that one-day event when you get your very last natural period. Pretty simple, huh? I am not sure how we have made it so complicated. I work with women every day who say, "I just want to know where I am. Am I in menopause at thirty-five, or am I just losing my mind?" Some women insist on a "hormonal definition" of what category they fit into, and I always say the same thing: "What does it matter what you call it?" Not to sound unfeeling, but it is of little consequence what you label your particular stage in midlife unless you are trying to get pregnant and want to know for sure whether you are ovulating.
But think about it for just a moment: Your body is moving inevitably toward menopause, and when the time is right, you will have it. This biological event cannot be postponed. What we can do is change how we experience menopause and the years leading up to it. Basically, perimenopause is a matter of age. Women between thirty-five and fifty could be experiencing perimenopausal symptoms, which may be constant or occurring intermittently. Age-related hormonal changes are taking place and will lead to the inevitable event: the final menstrual period.
As this fifteen-year stage begins, hormone levels fluctuate and periods begin to change. They may last a little longer or become farther apart than in the past. Some women experience mild headaches or insomnia in the days before the period begins. Other perimenopausal women are hanging on for dear life as they ride the hormonal roller coaster, plunging from the highest highs to the deepest lows in a matter of twenty-four hours. During these years each woman's response to hormone over- or underproduction is unique and dramatically affected by her lifestyle, environment, and genetic makeup.
As I see it, women experience perimenopause in one of three general ways:
1. There are women who are completely symptom-free until the day they stop having periods. Lucky them!
2. There are women who have mild hormonal dips and bumps, producing some symptoms before their periods or intermittently throughout their cycle. Their symptoms gradually increase with age and usually become significant before menopause.
3. There are women who have significant unpleasant symptoms, often on a daily basis. The days that are good are few, and there is a pronounced difference between good and bad days. Without intervention and lifestyle changes, the symptoms for these hard-hit women remain fairly constant until menopause.
Where do you fit in? Are you among the lucky women who skate through these years, or are you on the hormonal roller coaster? If you're like most women, you are experiencing a range of hormone-related symptoms from mild to horrendous. The following chapters will educate you about natural hormonal changes and offer detailed information about how to achieve balance and optimal health. Use this knowledge to journey successfully through some of the most important years of your life.CHAPTER 2
Know Your Hormones in and out of Balance
In This Chapter:
Perimenopause: The Change Before the Change
How Do Hormones Tip out of Balance?
The Hormonal Domino Effect
Hormonal Highs and Lows
Julianne was forty-three but felt fifty-five. Even though she had never had PMS, she was faltering now. She appeared in my office in tears, wondering why all of a sudden she'd gained 15 pounds, had night sweats and headaches before her period, and, perhaps worst of all, had lost all interest in sex. Depression and bouts of explosive anger had become unwelcome parts of her emotional life. She was exhausted and unhappy, and her self-image was in the toilet.
I had to tell Julianne, "Welcome to perimenopause!" I also reassured her that balancing her hormones was going to make a huge difference and that before long she would be feeling herself again. I said this with confidence because I have seen it time and again. When women between the ages of thirty-five and fifty experience significant changes in mood, weight, libido, and general well-being, unbalanced hormones are most often to blame. I have also seen that with careful testing and treatment, unbalanced hormones can most often be brought into equilibrium.
Sure enough, Julianne's estrogen levels were elevated, and her progesterone level was low. Progesterone has a lot to do with mood, and low levels are associated with depression, among other things. She was also deficient in DHEA, the energy and vitality hormone. Julianne started a regimen of bioidentical prescription progesterone, DHEA capsules, and a low-sugar diet, which increased her energy and reduced her body fat in short order. She noticed within one menstrual cycle that she had less cramping, a 75 percent reduction in PMS, no more night sweats, and better mood control. Three cycles later all of her hormone levels tested within normal range. Two years have passed since her original visit, and Julianne enjoys life free from perimenopausal or other hormonal problems. In addition, she has learned better nutrition – including proper use of supplements, stress control, and relaxation techniques – and the important role that regular exercise plays in physical and emotional well-being. She is also able to identify symptoms that could mean trouble and now takes care of them on her own.
Excerpted from The Hormone Survival Guide for Perimenopause by Nisha Jackson. Copyright © 2004 Nisha Jackson. Excerpted by permission of Larkfield Publishing.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Meet the Author
Nisha Jackson, PhD, is the owner of Southern Oregon Health and Wellness, P.C., a practice dedicated to hormonal health, and Body Analysis Clinic, Inc., a medical weight management center. She lives in Medford, Oregon.
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