Peri Meno
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Peri Meno Peri Meno Presentation Transcript

  • Health and Vitality in the Menopausal Years      Women's Health Expert, Lisa Leger, reveals the principles of nutrition and natural medicine that help women go through the changes of life with energy and grace.  Find out how natural remedies are replacing the old hormone approach to menopause. or Women's Health Expert, Lisa Leger, outlines the natural way to go through menopause with energy and grace.  Find out how to surge through the menopausal years sexy, happy, and synthetic hormone-free.     A quick review of perspectives on menopause from practitioners who advocate treatments other than the classic HRT .
    • Lisa Leger, B.A.
    • Natural Health Consultant
    • Pharmasave Health Centre, Parksville
    • Phone:(250) 951-0243
    • Email:
  • Menopause
    • a natural biologic process, NOT a disease
    • Permanent end of menstruation (12 months of not having a period)
    • Loss of ovarian follicular function
    • In West, average age of 51.4 years
    • Can occur between 30s & 60s
    • Age of menopause has not changed over the past few centuries
  • Peri-menopause
    • Years immediately preceding menopause
    • Signaled by changes in menstrual cycle regularity/ appearance (Still having periods, cycle lengths changing, some menopausal symptoms beginning).
    • Hormone picture can be similar to PMS: high estrogen, low progesterone.
    • Optimum time to consider lifestyle modifications
  • Hormone Changes in the Peri-Menopausal Years.
    • Is the problem lack of Estrogen?
    • Or is the problem too much Estrogen?
    • Research by UBC Endocrinologist, Dr.
    • Jerilynn Prior shows that estrogen levels are
    • very high during the peri-menopausal years.
  • Better Living With Chemistry?
    • The Pill
    • is not a cure, it just masks the problem by imposing a fake cycle.
    • side effects can be PMS symptoms.
    • depletes B vitamins which promote energy, better mood and help with stress.
    • depletes magnesium which relaxes the muscles and reduces cramps.
  • Better Living through Chemistry?
    • “ Hormone Replacement Therapy” (HRT)
    • (which should be more accurately called “Hormone Substitution Therapy”)
    • Which is not a cure
    • Just postpones menopause
    • Side effects!
  • General Recommendations for Every Woman
    • Do some research and try things.
    • Eat healthier food.
    • Get involved in a sport or exercise class.
    • Chart your cycles and record what you try so you can assess the results.
    • Look into adrenal support, thyroid involvement, blood sugar control.
    • Take control of your body.
    • Take control of your life.
  • Marion Woodman
    • The Owl Was a Baker’s Daughter: Obesity, Anorexia Nervosa, and the Repressed Feminine
    • Binging on Dairy = seeking nurturance from the Mother (goddess, maternal figure, security)
    • “ Killing me softly with ice cream, shortening my life with each bowl…”
    • Other books: Addiction to Perfection, The Pregnant Virgin, Conscious Femininity
  • Some Popular Positions
    • Suzanne Somers – Bio-identical Hormones
    • Susun Weed – Herbs and Nutrition
    • Susan Love – Integration
    • Jerilyn Prior – Natural Progesterone
  • Lisa’s Position: Treat the Peri-Menopause like PMS
    • Nutrition
    • Supplementation
    • Progesterone support
    • Look into adrenal support, thyroid involvement, blood sugar control
  • Hormonal Levels at Various Cycle Phases
  • Estrogen Deficiency
    • Hot flashes
    • Night sweats
    • Vaginal dryness
    • Foggy thinking
    • Memory lapses
    • Incontinence
    • Disturbed sleep
    • Heart palpitations
    • Bone loss
    • Tearfulness
    • Depression
  • Estrogen Excess/ Progesterone Deficiency
    • Mood swings
    • Breast tenderness
    • Water retention
    • Foggy thinking
    • Irritability
    • Anxiety
    • Fibrocystic Breasts
    • Bleeding changes
    • Headaches
    • Uterine fibroids
    • Cold body temperature
    • Fatigue
    • Weight gain -hips
  • Progesterone Excess
    • Drowsiness
    • Breast swelling
    • Nausea
    • Depression
    • Foggy thinking
    • Oily skin
    • Increased acne
    • Excess facial hair
  • Jerilyn Prior – Estrogen’s Storm Season
    • Add Progesterone to balance out the excess estrogen.
    • She uses Prometrium instead of Provera
    • She likes topicals in general over pills because they bypass the liver and lower doses are required.
  • Natural Solutions
    • Support Progesterone
    • and/or Reduce Estrogen
    • Natural Medicine uses:
    • Botanical Remedies (herbs)
    • Supplements
    • Bio-identical hormones
    • Liver Support
  • Natural Progesterone Support
    • Vitex
    • Beta Carotene
    • Wild Yam
    • Natural Progesterone (Bio-identical)
  • Bio-identical vs. Modified Hormones
    • Bio-identical progesterone
      • Study in 2003 on Prometrium
      • No negative impact on indicators of heart disease (blood pressure, cholesterol, dilation of blood vessels)
  • What is bio-identical?
    • Bio-identical hormones are the hormones that can be naturally found in our bodies
    • May also be termed “natural”
    • Does not necessarily mean that it is not synthesized in a lab
    • Many different types
    • Estradiol: Strongest of estrogens
    • Main estrogen released by ovaries
    • Primary estrogen of menstrual cycle
    • Responsible for endometrial build-up
    • Estrone: Second most potent estrogen
    • Most abundant estrogen after menopause
    • Can be made from androstenedione (adrenal glands) or estradiol
    • Can be converted to estradiol or estriol as needed
    • Estriol: Weakest out of the most common estrogens
    • Still strong enough to produce effects
    • Made from estrone
    • Levels are highest during pregnancy
    • Likely the safest
  • Reduce Estrogen: Liver Detoxification
    • Estrogen is broken down in the liver.
    • Other estrogen stimulated disorders (like fibroids and endometriosis) are associated with sluggish elimination (constipation, congested liver, deficient kidney, bad skin).
    • Support liver with bitter herbs, milk thistle and liver detox combos.
    • Help liver emulsify fats with Lipotrophic factors (especially if gall bladder has been removed or cholesterol is high).
  • Reduce Estrogen: Intestinal Cleansing
    • Estrogen is removed from the body via the intestines.
    • Promote elimination and avoid constipation.
    • Ensure healthy bacterial environment by supplementing with probiotics (acidophilus).
  • Reduce Estrogen: Indole-3-carbinol
    • Chemical found in cruciferous vegetables (broccoli, cabbage, brussel sprouts, turnips)
    • May help to reduce risk of estrogen-promoted cancers
    • Facilitates conversion of estrogen to less-cancer promoting forms
  • Indole-3-Carbinol
    • Typical Japanese diet provides about 112 mg I3C daily
    • Western diet is much lower
    • Increase as much as possible through dietary means
    • May try supplementing if cannot tolerate foods
  • Phyto (from plants) estrogens
    • weak estrogens
    • Similar in chemical structure to naturally produced estrogen
    • Help estrogen dominance or deficiency symptoms
    • Appear to decrease risk for heart disease (May lower LDL & TG
    • Benefits osteoporosis (Inhibit bone resorption)
    • Antitumor effects
  • Botanicals that Support Estrogen (Isoflavones)
    • Soy
    • Red Clover
    • Licorice
    • Hops
  • Other Herbs in Female Formulas
    • Dong Quai – uterine tonic
    • Burdock, Dandelion – liver tonics
    • Passion Flower, Lemon Balm, Hops – nervines with sedative effect.
  • Black Cohosh
    • Most popular, well researched (6 German clinical trials of Remifemin)
    • accepted by medical authorities
    • Found to improve menopausal symptoms, hot flashes, premenstrual syndrome
    • There are warnings not to use if you have a history of estrogen-dependent tumors or endometrial cancer, but its not estrogenic.
    • Actually works on the cardiovascular system.
    • May cause nausea, vomiting, headache & hypotension
    • Use with caution if allergic to salicylates
  • Homeopathic Medicines
    • Klimakt-Heel – hot flushes, night sweats, palpitations, mood swings, exhaustion, nervousness, insomnia.
    • Hormeel – functional disturbances of the cycle.
    • Nereel – moodiness, nervousness, irritability.
    • Ignatia-Homaccord – nervousness, weariness, sadness, lump-in-throat feeling
  • Part Two
    • The History of HRT
  • Synthetic Hormones (HRT)
    • Developed to treat abnormal cycles, not meant to be used for every woman.
    • Why synthetic? $$$
    • Premarin: Mixture of conjugated estrogens from horse urine
    • Estrone, Equilin sulfate, small amounts of estradiol
    • Provera: Medroxyprogesterone, Progestin
      • Synthetically modified form of progesterone
    • Increases risk of breast cancer and heart disease
  • Nurse’s Study
    • Started the notion that hormones protected the heart.
    • Nurses who took HRT had less heart disease.
    • Now we think it was a “cohort effect” rather than an effect of the intervention (ie. the hormones).
  • Women’s Health Initiative Study (WHIS)
    • 16608 postmenopausal, 50-79 years, Intact uterus
    • Received either: Premarin 0.625 mg & Provera 2.5 mg or Placebo
    • Study stopped early because it seemed like harm outweighed benefits:
    • 41% more strokes
    • 29% more heart attacks
    • Twice as many blood clots
    • 26% more breast cancer
    • 37% less colorectal cancer
    • 33% fewer hip fractures
    • 76% increase in Alzheimer’s
  • Interpretations of the WHIS?
    • Can’t generalize to normal population
    • Subjects were older (Average age 63 years)
    • Heavier (30 % were considered obese)
    • 50% were current or past smokers
    • Absolute risk of adverse event is extremely low
    • 19 events more per year for every 100000 women if on HRT
    • Risk is even lower in younger women
  • Heart and Estrogen/Progestin Replacement Study (HERS)
    • Looked at secondary prevention of cardiovascular disease with Premarin & Provera
    • Subjects were postmenopausal women with heart disease
    • Found No decrease in future heart attacks or deaths
  • Current Medical Position on HRT
    • Only good reasons to take HRT are:
    • Osteoporosis: HRT can prevent hip, vertebral, wrist & ankle fractures
    • Severe hot flushes/night sweats: take for a limited period of time (3 yrs.)
  • Dosage forms for HRT
    • Avoid estrogen in pill form
    • Only 10% is active estrogen
      • Travels through stomach to liver
      • Liver breaks down most of it
      • Stimulates production of new proteins
        • C-reactive protein
      • Some of these proteins increase risk for blood clots, high blood pressure or migraines
  • Dosage forms for HRT
    • use minimum amount of estrogen needed to get results (prevent conversion to carcinogenic estrogen metabolites)
    • Estrone vs. estradiol
    • Progesterone capsules
      • 10% available as progesterone
      • 90% metabolized by liver
      • Some metabolites have useful effects
        • Sleepiness
  • Dosage forms for HRT
    • Estrogen given through the skin in the form of Patch or Cream
    • May take 2-4 weeks to take effect
    • Variable absorption
    • Lower dosage needed
    • Bypasses liver
    • Vaginal creams
      • Effective for treatment of vaginal dryness
      • Not as many side effects
      • Bypasses liver
      • Lower dosage
  • The Last Word
    • Don’t be a victim
    • The benefits of healthier diet and lifestyle go beyond helping with PMS and peri-menopause.
    • - lower heart disease risk
    • lower cancer risk
    • Less degenerative disease