The 90 Minute Checkup

The case of mind-body medicine.

Menopause, Bioidentical Hormones and Alternative Therapies (A Beginning)

Managing menopause and perimenopause: the beginning

Bioidentical Progesterone
It's all about balance
I have had the distinct honor of being listed in two of Suzanne Somers books. I am listed as a practitioner who prescribes bioidentical hormone replacement. In her books Ageless and The Sexy Years, Ms. Somers references two physicians in Arizona who she recommends seeing regarding menopause and hormones. I only figured this out when I discovered all of my new GYN patient appointments were filled with menopausal women. I was literally seeing ten to twenty new patients a week for hormone replacement. I soon found that most private practice gynecologists either do not know much about bioidentical hormone replacement or they don’t care for it. Since I have seen so many patients looking into these medications over the last eight to nine years I thought I would use the “The 90 Minute Check-Up” to go through the discussions I have had with my patients regarding hormone replacement and alternative methods for treating yourself with medicines and medical alternatives. I also thought it would be prudent to delve into some of the research and misinformation surrounding hormones, their functions, and the risks involved as described by the Women’s Health Initiative (WHI) years ago.

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WHERE DO I START?

The first question you need to ask yourself is this. “Can I survive in my current state or are things so bad it is effecting my life?” If things like mood lability, depression, hot flashes, vaginal dryness, vaginal bleeding, decreased libido, insomnia, or decreased mental focus has changed your life then make an appointment with your doctor. Many patients have come to rely on their Naturopath because their primary care or gynecologist will not consider medical treatment of the menopause. Women feel as though they are not being heard on this matter and I would have to agree in many cases. If your primary care doctor or gynecologist will not listen to you or you feel you are being minimized then definitely seek out a Naturopath or equivalent provider that has experience in women’s health issues.

WHAT DO I BRING TO THE APPOINTMENT?

I would recommend you gather together all of your medical records, if this is a new provider, and bring surgical history, medical history, family history, recent mammograms and pap smear results as well as any recent labs. It is also important to bring a list of your medications and nutritional supplements. Many physicians will not be familiar with supplements, but you might be surprised there are many that are familiar or use them themselves. A complete and comprehensive history is the necessary starting point when you are beginning this menopausal or peri-menopausal journey. It has been my experience that many patients have been to multiple doctors before arriving in my office and it is very helpful for me to have the notes from these previous visits to properly assess previous treatments; successes and failures.

SHOULD I STOP MY CURRENT MEDICATIONS?

I never recommend you stop any medication without the guidance of the provider who prescribed those medicines. It is also important, especially for hormonal therapy, that your history and lab results be correlated with the dosage of medicine you are currently taking. It doesn’t help me to draw your hormone levels if you stopped taking your hormones two weeks ago because you didn’t think they were helping.

In order to truly understand how you can help yourself through the peri-menopause – menopause state we will need to be on this journey for a few posts and go through estrogen, progesterone, testosterone, DHEA, thyroid, and cortisol. What are the ranges for these hormones in your blood and could you still be having symptoms even if the doctor tells you your estrogen is ‘normal’? Can nutrition help you in your endeavors to potentially avoid hormonal therapy? Are there supplements or natural compounds that could naturally ease you through the rough times? Finally, are there any mind-body therapies or integrative protocols that might make this process easier to navigate?

Stay tuned and over the next few weeks you will learn everything you wanted to know about your body, hormones, supplements, nutrition, and mind-body therapies for hormonal balance.

Shawn Tassone, MD is a board certified OBGYN practicing in Tucson, AZ.  He is the author of "Hands Off My Belly! The Pregnant Woman's Survival Guide to Myths, Mothers and Moods" Prometheus Books 2009 and the upcoming "Spiritual Pregnancy: Nine Months of Transformation Before You Give Birth" Llewellyn Worldwide 2013.  You can follow him on Twitter @WomenHealthDocs

 

Shawn Tassone, M.D., is a board certified OB-GYN, Ph.D. candidate in mind-body medicine, and author of two books.

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