This is a big topic I see often in my practice. Lets cover some 101 terms and then dive into suggestions!
Menstrual Cycle hormones
FSH – Follicle Stimulating Hormone
Stimulates growth of eggs in ovaries
Estrogen – Estradiol or E2
Thickens lining of uterus to prepare for pregnancy
LH – Luteinizing Hormone
Helps trigger release of egg from ovary
Progesterone
Prepares the lining of uterus for a fertilized egg to implant and grow
Across the Lifespan terms
Premenopause – monthly menstrual cycle
Perimenopause – Can last up to 10 years
Postmenopause – 12+ months without cycle
Perimenopause & Menopause “Classic symptoms”
Changes in menstrual cycle: longer, shorter, heavier, lighter, skip a cycle or two
Hot flashes & night sweats (vasomotor symptoms)
Sleep disturbances & fatigue (insomnia, waking up at night, daytime sleepiness)
Mood changes: meno-rage, depression, anxiety
Low libido, vaginal dryness, orgasm difficulty
Brain fog or concentration issues
Other Possible Changes
Skin changes: dry, wrinkles, acne
Hair changes: rogue hairs, thinning
Vaginal changes: dryness, UTIs, yeast infections, incontinence, painful intercourse
Swelling of hands & feet
Bone & muscle loss
Chest palpitations
Aching joints or more body pain
Changes in weight distributions, abdominal weight gain
Cholesterol & cardiovascular risk increases
Dental changes: tooth & gum loss, dry or burning mouth
Eye changes: dry eyes, blurred vision, redness, cataracts
What Can Help?
Dietary changes-whole foods, protein focused
Weight lifting and movement/ exercise
Addressing underlying issues: infections, thyroid, adrenals
Hormone replacement therapy (conventional)
Bio-identical hormone replacement therapy
Herbs, supplements
Cognitive behavioral therapy
Sleep hygiene
Acupuncture
Chiropractic care
Craniosacral therapy
What Happens To Us As We Age? Women
Decrease in progesterone
Decrease in estrogen
Rise in (LH) luteinizing hormone
Eventual rise in (FH) Follicle stimulating hormone
Note that a good way to tell if you are in perimenopause if your LH level is elevated, but once your FH elevates you are in menopause.
My favorite self-order kits are from ZRT which I’ll detail at the end.
Main Hormones Affected
Luteinizing Hormone (LH)
Rises and works in over drive to tell ovaries to make more estrogen
14-53 IU/L
Peri 14-16
Menopause 16+
Follicle Stimulating Hormone (FSH)
Happens secondary to LH and stays elevated for life in response to low sex hormones
25-53 MIU/ML
Estrogen/Estradiol
Lowers in Peri/Menopause
Below 0-30 PG/L
Progesterone
Lowers in Peri/Menopause
Less than 1 NG/ML
Cortisol
Could be extremely high or low
Optimal cortisol 10-15 MCG/DL
What You May Be Experiencing in Perimenopause/Menopause
Symptom
Could be caused by
Insulin Resistance
Low estrogen
Night sweats
Low progesterone
Fluctuating estrogen
Weight gain specifically in stomach
Lifestyle choices & improper diet
Insulin resistance due to low estrogen
Lack of energy
Cortisol imbalance
Low progesterone
Low libido
Low estrogen
High cortisol
Lack of sleep
Low progesterone
High cortisol
Basic Supplement Suggestions for the Peri/Menopausal Women
Vitamin D with K – as vitamin D drops in menopause it can lead to bone loss, fatigue and insulin resistance
Fish oil – Fish oil is shown to have a positive effect on low estrogen and progesterone levels
Magnesium Glycinate – is shown to keep bones healthy and strong. Studies also show that it can help with hot flashes. It is also known to boost estrogen.
B-complex – As all of the B vitamins serve as cofactors in the production of estrogen
Peri Menopause – Additional Supplements
Black Cohosh – 20-80 MGS per day
Works specifically to combat hot flashes and night sweats
Chasteberry – 200-800 MGS/Day
Can improve mood and fatigue by balancing estrogen and progesterone
Ashwagandha – 600-1200 MGS/day
Helps with fatigue and nourish the adrenals-take at night
Berberine – 1,000-1,500 MGS/Day
Improves insulin resistance
Digestive Enzymes
As estrogen lowers it can cause a decrease in digestive enzymes and create more gas and bloating
Nutritional Considerations for the Peri/Menopausal Woman
Adequate food intake – Chronic undereating and dieting can lead to down regulation of hormones such as estrogen, progesterone, and testosterone. Likewise, it can put additional stress on the body and lead to increased Cortisol. In this case women should consider reverse dieting their calories back up to an appropriate intake. Adversely, over consuming food can lead to inflammation, blood sugar regulation issues, insulin resistance, weight gain, and mood disorders.
Increase foods high in omega 3s and 6s
Increasing omega 3s help reduce inflammation in the body and help with hormone regulation. Here are some examples: Salmon, sardines, walnuts, olive oil, flaxseed, chia seeds, and soy beans
Omega 6s can help regulate hormones. Examples of good Omega 6s are: coconut, pistachios, pumpkin seeds, sunflower seeds and primrose oil.
Focus on Fiber
As we enter into menopause due to the drop in progesterone your body may become more insulin resistant. It is important to get an adequate amount of fiber for blood sugar regulation. Shoot for a minimum of 21 grams daily.
Incorporating seeds
Flaxseed and pumpkin seeds can help boost estrogen. Try 1 tbsp of each daily.
Sunflower seeds and sesame seeds can help boot progesterone. They can also be incorporated at 1 tbsp daily.
Reduce alcohol
Excessive alcohol use can increase inflammation in the body and also decrease alcohol levels in the body.
Carbohydrate Timing
Insulin sensitivity is highest during and after workouts. Consider having your higher carb meals around your workouts if insulin resistance is an issue. Load up on healthy protein, veggies, and fats at other times of day.
Focus on Anti-inflammatory Foods
Lean proteins, healthy fats, vegetables
Dieting should be infrequent
Caloric deficits should now be infrequent and if you do diet it should not be extreme
Symptoms of Low Testosterone
Low libido (decreased sex drive)
Decreased sexual function
Decreased muscle mass and strength
Difficulty concentrating
Brain fog
Higher number of aches and pains
Wrinkled and old skin
Thinning hair/skin
Hot flashes
Inability to go to the bathroom
Depression
Higher levels or worry, anxiety, and fear
Lack of drive (feeling unmotivated)
Low self-esteem/low self-confidence
Inability to make quick decisions
Tiredness
Weight gain (especially in the mid-section/accumulating visceral fat
How to Boost Testosterone Naturally
Focus on weight lifting, but avoid overtraining
Stress management
Regular consumption of foods high in phytoestrogens (plant-based estrogens, commonly found in soy and flax seeds) can also DECREASE testosterone levels
Get 7-8 hours of sleep a night
Alcohol raises estrogen, which can create estrogen dominance; it also increases the production of SHBG (sex hormone binding globulin) of which lowers free testosterone, and depletes zinc, resulting in a lower testosterone production
Got Cravings?
Chocolate
Low on Magnesium
Eat seeds, nuts, fruits, and veggies
Sugar
Low on chromium
Eat fresh fruit
Bread, Pasta, other carbs
Low on nitrogen
Eat protein rich foods such as salmon, nuts, meat, beans
Salt
Low on chloride
Eat fatty fish, goat milk, cashews, nuts and seeds
As part of ongoing work with women 40+ I do a full clinical intake as well as a saliva hormone and cortisol panel and set up a plan based on symptoms that include dietary changes, supplements, lifestyle changes, and medical options as needed.
HERE is the ZRT panel I most use. You can order this anytime. I use these results along with your basic blood chemistry results and pull information from your symptom list to help you reach your goals in the most natural way possible.
Keep Moving Forward 😊 Sarah
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