The Hormone Survival Guide for Perimenopause: Balance Your Hormones Naturally Photo by Christopher Briscoe By Nisha Jackson, Ph.D. Introduction To Test or Not to Test? Why I Wrote This Book How This Book Can Help Introduction Women in ever-increasing numbers are seeking alternatives to traditional healthcare -- and for good reason. Imagine a woman between thirty-five and fifty. A spare tire is developing around her middle, and bags have made unwelcome appearances beneath her eyes. Hot flashes come and go throughout the day, and night sweats interrupt her sleep. She is exhausted, can't seem to concentrate, and alternates between depression and flying off the handle. Upset and anxious, she seeks help for the unpleasant physical and emotional changes that are crowding the good times out of her life. After a physical exam and a few questions, to her dismay her medical provider suggests that what she's going through is perfectly normal: She is simply approaching the time when her periods will cease -- menopause -- and the disagreeable symptoms she is experiencing are part and parcel of getting older. Her doctor may mention that she is probably in perimenopause, the years leading up to menopause, during which hormones fluctuate and birth control pills or hormone replacement therapy (HRT) may be prescribed. If the woman is depressed, she may be sent to the pharmacy for a bottle of Prozac or other prescription antidepressant. Or perhaps her provider, judging her to be just another hysterical female, proposes that all she really needs is to "get her stress under control and lose some weight," then sends her on her not-so-merry way. If this sounds familiar, you may be one of the multitudes of women whose perimenopausal symptoms have either been dismissed as a natural consequence of aging and/or treated with conventional therapies. A growing number of women are no longer willing to be dismissed or accept standard treatment. Armed with information from books such as this, they are demanding a level of care that their mothers could not have imagined. It is personalized, one-on-one female care that considers the whole woman in her physical, emotional, and hormonal aspects. This care gives a woman her best shot at conquering current health problems and staving off future ills. Perhaps best of all, it helps her avoid unnecessary or unsafe medications that don't provide long-term solutions to hormone imbalances. If you have been prescribed drugs containing synthetic hormones, and you use the medications as directed, chances are the results haven't been what you had hoped. Your hot flashes may be gone, your periods may return to regularity, but you may also experience a spectrum of negative side effects, including irregular bleeding, bloating, sore breasts, and weight gain. Like millions of American women, you are using powerful hormone medications prescribed by healthcare practitioners who have no way of knowing your hormone levels! You are getting a one-size-fits-all treatment that does not address the list of maladies that can accompany hormonal imbalances. This long list includes depression, weight gain, exhaustion, acne, insomnia, facial hair, food cravings, fuzzy thinking, bloating, joint pain, and loss of sex drive. Although some perimenopausal women tolerate synthetic hormones such as those found in birth control pills and HRT, others experience mild to severe side effects that can be more annoying or debilitating than the symptoms they are meant to relieve. Does this mean that women should not take hormones? No. But it does mean that women must educate themselves about the differences between synthetic and natural hormones and make informed choices. Using any type of drug, including natural hormones, is not the first course of action, however. Many perimenopausal symptoms can be relieved through a combination of lifestyle modifications, stress reduction, and use of supplements. So how do we know if our hormones, particularly estrogen, progesterone, and testosterone, are in balance? We gauge their levels with reliable lab tests so that accurate dosing and treatment decisions can relieve symptoms and create hormonal balance. To Test or Not to Test? It sounds like a no-brainer that hormone testing should be routine, but for several reasons testing is the exception rather than the rule. First, it is not "standard of care" or deemed medically necessary. This means that when you have a problem that may be related to your cycle and the hormone fluctuations that go with it, your medical provider is not required to order a test to measure your hormone levels before you are treated. Instead, he or she can prescribe birth control pills or synthetic HRT at any time, with only subjective information or a hunch that these drugs may be right for you. The reasons why hormone testing -- and prescribing natural hormones -- is not standard of care has more to do with patent law and the pharmaceutical industry than anything else. There is also the fact that most medical schools have until recently ignored natural hormones as an option in treating women's hormonal imbalances. But let's go back to the drug companies. Natural, plant-based hormones cannot be patented and marketed as exclusive products. Even though safe, plant-based sources for making bioidentical natural progesterone and estrogen are readily available, pharmaceutical companies rarely use them (although the discrediting of synthetic hormones is beginning to propel them in that direction). Instead they use lab-formulated synthetic progestins and estrogens to make their HRT formulas. When sales representatives talk with doctors, they offer flashy brochures and literature about double-blind studies conducted and/or financed, of course, by the drug companies. For some drugs -- ever heard of Celebrex or Viagra? -- manufacturers appeal directly to consumers, who in turn request that their healthcare providers prescribe these drugs. Nobody is pitching natural hormones to medical offices because, at least for now, there is no fortune to be made. In fact, mainstream healthcare providers who are familiar enough with natural hormones to prescribe them are in the minority. So it is no surprise that mainstream medical practitioners are reluctant to initiate hormone testing to determine dosing for medicines they know little or nothing about. The same goes for natural supplements and herbal remedies. These alternatives have neither private funding nor representatives hounding medical offices to tout their benefits. If medical providers want to find out about these alternatives, they must do just as you are doing -- educate themselves. Given their hectic schedules, time constraints, and demanding practices, it isn't too surprising that most healthcare practitioners haven't done so. I think it will all come around, however, because patients are going to demand it -- if they aren't already. Women are justifiably scared of synthetic HRT, and word is getting out that therapy using natural, bioidentical hormones is a safe and effective alternative for relieving unpleasant symptoms. Medical practitioners who lack education about hormone testing and treatment with the natural alternatives nevertheless claim that hormone testing is inaccurate because levels change constantly as a woman cycles through the month. Hormone levels do fluctuate, and every woman is unique, but those facts don't cancel the value and accuracy of carefully conducted hormone testing. It is being done successfully and has been absolutely invaluable in my medical practice and those of informed colleagues across the nation. Women come to me with a multitude of complaints, and I have found that testing at the appropriate time, interpreting the results, and moving forward with effective therapies are the cornerstones of care. Whether through blood or saliva, testing is an excellent way to pinpoint hormone levels as women enter the perimenopausal years. Consider a forty-three-year-old patient who has missed some periods and has perimenopausal symptoms, such as hot flashes, headaches, night sweats, insomnia, mood changes, and weight gain. Her medical provider orders the widely used FSH (follicle stimulating hormone) test, which indicates that she is not in menopause. She is advised to come back next year for another FSH test. Such testing helps determine whether a woman is nearing menopause, but it is notoriously inaccurate and at any rate does not provide information on individual hormone levels. So the poor woman is condemned to her unpleasant symptoms for another year because one questionable test says so. On the other hand, had the provider ordered a complete hormone panel, it probably would have revealed that the woman's hormone levels were either low or out of balance. Knowing a woman's estrogen, progesterone, testosterone, DHEA (dehydroepiandrosterone), and thyroid levels would not only allow for a customized treatment plan to relieve her symptoms, but also provide a baseline to observe changes as she moves through perimenopause to menopause. Testing allows an accurate prescription for safe, quick relief of symptoms. Without testing it's a guessing game -- and at the patient's expense. Why I Wrote This Book To tell you the truth, I wrote this book because I needed help myself. After the birth of my second baby, my postpartum depression was significant. I knew my "baby blues" were hormonal, but wanted more answers on how to treat it other than the usual birth control pills and Prozac. I wanted to feel well and enjoy my baby, but realized that I needed guidance beyond what I was getting. I also realized that most of my patients, at one point or another, had hormone-related problems, including depression, fatigue, weight gain, PMS (premenstrual syndrome), low sex drive, and early menopause symptoms. After intensive independent study, numerous professional workshops and seminars led by prominent hormonal specialists, and working with more than ten thousand women in the area of hormonal imbalances, I developed a specialty practice focusing on diagnosing, testing, and treating female hormonal imbalances. I am continually in contact with women across the country through my own lectures, symposia, workshops, and meetings. Women who seek my help typically have longstanding physical and emotional complaints that have been written off by medical providers as normal or genetic. I have grown to appreciate what women go through every day of their lives and have an increasing concern for the lack of women's hormonal care. I have gained a deep understanding of the intricacies of hormone testing, from conducting the tests to interpreting the results and following the patient to the point of balance. I am passionate about helping women understand their options and realize that they do not need to live with symptoms of hormonal imbalance. I know that with careful testing and treatment, just about any woman's symptoms can be relieved safely and effectively. How This Book Can Help Use this book as a step-by-step guide to feeling better, getting on top of your perimenopausal symptoms, and entering menopause without wishing you could check out! It can serve as your map to achieving health and wellness and show you why it makes sense to find a medical provider who will test your hormone levels and take them into account when prescribing treatment. It will also explain in detail how exercising, managing stress, improving your diet, and taking supplements can help balance your hormones and make a new woman out of you. The Hormone Survival Guide for Perimenopause offers solutions that you and your healthcare provider can adapt to your individual needs. It is laid out so that you may read chapters that specifically relate to your current symptoms or problems. Let it help you save precious time, money, and energy by giving you tools that will change your life -- and most likely the lives of those around you. Good luck on your journey to wellness. The best is really yet to come! Order your copy of Nisha's book today! © 2006 Larkfield Publishing This page was last updated on 5 January 2006.