Hot flashes in hot times


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Menopause can be frustrating especially if limited options are available. Empower yourself to seek out a personal plan to transition onto the next phase.

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  • 0.3mg conjugated equine estrogen or 1mg estradiolmedroxy progesterone
  • Hot flashes in hot times

    1. 1. Hot FlashesinHot TimesWe didn’t invent the practice of medicine….we’re just changing the way it’s provided.Enrique Saguil, M.D.
    2. 2. The First Health ApproachWe didn’t invent the practice of medicine….we’re just changing the way it’s provided.
    3. 3. Your TeamRic Saguil, MDJason Gruss, MDJoe Musolino, DCJennifer Green, NDKatrina Christie, LCPCTom Jordan, RDAimee Weber, EPEmery Paredes, PTLori Szczupaj, MAYu Zhu, MD ChinaPaul Kolaski, DCCheryl BroderickYou
    4. 4. We didn’t invent the practice of medicine….we’re just changing the way it’s provided.-DrRic
    5. 5. The Change• 45-55years old• Last 3 months up to 5 years• Irregular periods• Vaginal dryness• Hot flashes/Flushing• Weight gain• Mood disturbance• Sleep disturbance
    6. 6. DIY Heat Regulation - Home
    7. 7. DIY Heat Regulation - Body
    8. 8. Messages in the Hormones
    9. 9. Other TriggersDX 1,2 and 3
    10. 10. Endocrine Disruptors• BPA (clear hard plastics/epoxy/drink cans) 7+9• Poly Vinyl Chlorates (solvents) Easyoff, Lysol• Phthalates (soft flexible plastics pvc/water)• DDT/fungicides (pesticides/baby food pears)• Dioxans (CAFO fat styrofoam)• Flame retardants (PJ’s memory foam trees)• Mercury (fish fillings)
    11. 11.
    12. 12. Women’s Health Study 2001 WHI• 26% increase in breast cancer withundetermined benefits since study stoppedearly (estrogen + progestin)• Double risk of venous thrombosis• Increased risk for stroke, heart ds, gynecancer, dementia, blood clot, colon ca• Did help decrease hip and vert fractures
    13. 13. Personalized doseHRT/BHRT• Estrogen• Progesterone• Testosterone• Estrogen• Progesterone (for mood not for bone)• Testosterone(ie-Prometrium from peanut oil, oral/topicals from soy or yams)Standard dose
    14. 14. DrRic’s Variables• Nutrition• Depletion• Maintenance Medication• Maintenance Meditation• BMI• Level of Fitness• Breast Cancer(Food Insecure, ETOH, Caffeine, PhD)(from intake or meds)(diagnosis 1 2 and 3)(relaxation response)
    15. 15. Bottom line with hormones• In theory, everyone needs the same/Inpractice everyone should get a personal plan(variables…)• Plan on Exit Schedule for when to get offhormones• Make changes while getting rescuemeds/herb/supplement
    16. 16. Testing hormones• Blood testing is a snapshot of dynamic process• Salivary testing has improved and can be donewith ease but still can be variable• Urine testing good also but can be variable• (bottom line- if you are rich, take the saliva- if deep into the age, take blood-if on fringe, good history, +/- test-be on the look out for early CA
    17. 17. Estrogen deficiency symptoms• Hot flashes• Sleep disturbance• Dry skin• Heart palp• Painful intercourse• Low libido,• Night sweats• Vaginal dryness/atrophy• Headaches• Memory lapses• Yeast infection• Depresion• Bone loss
    18. 18. Estrogen excess symptoms• Water retention• Breast swelling and tender• Craving for sweets• Fibrocystic breasts• Uterine fibroid• Nervousness/anxiety/irritability• Heavy irreg mense• Fatigue• Weight gain• Mood swings• Low thyroid symptoms
    19. 19. Progesterone deficiency symptoms• Many symptoms of estrogen excess +• Swollen breasts• Headache• Anxiety• Irregular mense• Cramping• Infertility• Acne• Weight gain• Low libido• Mood swings• PMS• Fuzzy thinking
    20. 20. Progesterone excess symptoms• Many symptoms of estrogen deficiency +• Somnolence• Mild depression• Candida exacerbations• Gastrointestinal bloating• Breast swelling
    21. 21. Testosterone deficiency symptoms• Fatigue prolonged• Memory problems• Decreased libido• Muscle weakness,• Heart palpitation• Bone loss• Incontinence• Fibromyalgia• Mental fuzziness• Depression• Blunted motivation• Diminished feeling of well being• Thinning skin• Vaginal dryness• General aches/pains
    22. 22. Testosterone excess symptoms• Acne• Deepening voice• Irritability moodiness• Loss of scalp hair• Male pattern hair• Clitoral enlargement• Insomnia
    23. 23. Other hormones to consider• Adrenals (cortisol am or 4x throughout 1day)• Thyroid (TSH, FreeT3, Free T4)
    24. 24. Other Rx’s• SSRI -reduce severity, help moodiness• Antidepressants –reduce severity like SSRI’s• Clonidine –reduce number of flashes• Gabapentin -to reduce number of flashes• IUD with levo –reduce mense• Estrogen cream low dose –vaginal dryness• HRT –pill, patch, cream, foam, ring
    25. 25. • Soy (need the gut flora) –mixed results (+ or -)• Flax seed -2tblsp am/pm (small study +)• Black cohosh -40-160mg/day (liver damage?)• SJW –ramp up 3xdaily (watch interactions)• Kava kava -• Wild yams –otc topical (adequate skinconversion?)We didn’t invent the practice of medicine….we’re just changing the way it’s provided.Herbal/Botanical (phytoestrogens or isoflavones)
    26. 26. Alternative Approaches• Ayurveda (yoga)Breath workMovementMeditation• TCM (acupuncture)+ Acupuncture• HomeopathyNaturopathic or Homeopathicphysician
    27. 27. Environmental control• Decrease spicy food, alcohol and caffeine• Textiles (clothes, bedding, hiking collars)• Lose weight –BMI target setting• Reduce stress or increase relaxation training
    28. 28. Mind – Body Medicine• Relaxation therapy to slow the reaction• Hypnosis decrease frequency/severity flashes• Relaxation response decreases markers ofinflammation
    29. 29. Healing Injury withSupplements and FoodSaturday, July 10th3-4pmWhole Foods Market SchaumburgCall to reserve a place847 585 5800