As a society we’re conditioned to think of menopause as the end of our youth and the beginning of old age. In 1966, American gynecologist, Robert Wilson wrote in his book Feminine Forever that “without estrogen, women turn into undesirable hags”. This misogynistic statement seems harsh but there is also some truth to hormone decline effecting all aspects of health – where women simply stop feeling like themselves. Decades ago, women may have suffered through menopause silently, but not in 2023. They are actively talking about menopause everywhere – from podcasts to TikTok, women are tackling this issue head on. But it’s a confusing and complex topic to understand. We interviewed Quicksilver’s Hormone Clinical Advisor, Carol Petersen, RPh, CNP to help clarify exactly what we need to know about menopause.
What Exactly is Menopause?
You can think of menopause in two stages: perimenopause and menopause. There is a third stage – post menopause, which is quite similar to menopause, so for simplicity’s sake, we will cover the two phases in this discussion.
Throughout these stages, the ovaries begin to atrophy causing a decline in the production of estrogen and progesterone (the hormones that stimulate the menstrual cycle). In perimenopause, the first symptoms are often related to progesterone deficiency and estrogen excess and include sleep disturbances, irritability, and anxiousness “Cycling still occurs and it is possible for women to have heavy bleeding during this time,” explains Petersen. But this isn’t always the case, periods can become irregular with shorter or longer cycles.
A woman is officially in menopause when they’ve gone a full year without a period. As the ovaries shut down production, the adrenals will take over producing a small amount of sex hormones, but stress, both emotional and physical, can impact the health and function of the adrenals lowering hormone levels further and influencing the negative symptoms of menopause.
“As for timing, the beginning of menopause commonly happens in a woman’s 40’s and 50’s but it can occur much earlier.” Petersen goes on to say, “everyone’s body is different, and regardless of when it starts, symptoms associated with menopause can last up to a decade.
What Are The Symptoms Of Menopause?
“Over the years, I have spoken with thousands of women going through menopause and their primary concern was that they were losing their minds,” says Petersen (slightly tongue in cheek). That may sound dramatic, but not all that surprising when you see a list of menopause symptoms: weight gain, apathy, brain fog, hair loss, hot flashes, night sweats, sleeplessness, panic attacks, low libido, and lack of energy. Perhaps Oprah explained it best when she said “I thought my life force was being slowly drained.”
“When these changes start to happen, one of the fastest ways to improve how you feel is to fill up your hormone tank, so to speak. Luckily, there are bioidentical hormones available to accomplish this job” says Petersen.
Managing The Woes Of Menopause Through Hormone Replenishment
According to The Menopause Charity, hormone deficiencies can produce serious long term issues such as bone loss, cognitive issues, insulin resistance, cardiovascular conditions, and more. Hormone supplementation or Hormone Replacement Therapy (HRT), as it’s more commonly called, has been around for decades and has supported women through perimenopause and menopause. “Replenishing hormones like DHEA, progesterone, and estrogen in perimenopause and menopause can reduce symptoms and make you feel like yourself again,” explains Petersen. Unfortunately, many women find their initial request for supplemental hormones may be met with resistance by some doctors. “It’s not uncommon for a perimenopausal woman seeking help for mood, sleep issues, irritability, and nervousness (all symptoms of hormone decline) to be offered antidepressants and anti-anxiety medications rather than bioidentical hormones.” This may have to do with many healthcare practitioners not feeling confident or well-versed in hormone therapy. “If you think hormone imbalance may be an issue for you, advocate for a comprehensive hormone panel before blindly accepting a medication as your remedy,” says Petersen.
Another option for symptoms like these, says Petersen, is finding an over-the-counter topical progesterone serum or cream on your own. “Progesterone is often the first hormone to become deficient and replenishing with a high-quality, bioidentical progesterone is a safe and effective way to address these symptoms.”
The “Often Overlooked” Hormones We Need
In relation to perimenopause and menopause, it’s important to think about replenishing the lesser-known sex hormones DHEA (Dehydroepiandrosterone) and pregnenolone. Petersen explains, “these two hormones can be lifesavers in several ways. DHEA is thought of as a vitality hormone supporting energy, strength, libido, healthy weight, brain function, and more. It is a precursor hormone and helps make both estrogen and testosterone. In fact, DHEA provides 100% of estrogen production in the body after menopause. Pregnenolone is also a precursor hormone to all of your sex hormones – even progesterone. This means that the more pregnenolone you have, the more opportunity for sufficient hormone levels and balance.” Thankfully, both DHEA and pregnenolone are offered as over-the-counter supplements. Petersen suggests looking for a high-quality liposomal form for greater effect.
Petersen goes on to add, “For the first time in history, women have access to real hormones without needing the intervention of a practitioner,” That’s not to say that having the support from a hormone literate practitioner isn’t a good move. “It’s important to be as informed and educated as possible and a good practitioner can offer wonderful support as you navigate through these phases of life.”