Hot flashes, vaginal dryness, memory loss, bone loss, tooth loss, skin wrinkling, irregular heart beat, mood changes—menopause impacts the entire body. But the number one symptom that drives women to their doctor is the hot flash.

“I was showing a million dollar property and suddenly turned beet-red and sweated profusely. The client looked at me, and asked if everything was ok.”

More than 20 yrs ago, I also experienced debilitating hot flashes while trying to see patients in a busy ER. For professional women, hot flashes really disrupt work.

Hot flashes begin usually at night. The first time it happens, the woman might wonder if the room temperature or covers changed. Over time, the night sweats usually increase in intensity causing insomnia, exhaustion and irritability. Night sweats lead to day hot flashes, sometimes occurring multiple times a day.

The number one symptom that drives women to their doctor is the hot flash.

Seldom do technical articles discuss the blood levels of hormones: the first hormone to exit the body is progesterone, not estradiol. However, this article does note that progesterone blood levels are lower than estradiol in the time of the change. Estradiol can surge and become high and then low, so estradiol prescription in most perimenopausal women actually worsens symptoms.

“…disturbed feedback relationships causing higher and unpredictable estrogen and lower progesterone levels occur throughout perimenopause, especially during regular cycles” (Endocrine. 4/05, vol 26, issue 3, pp297-300)

Progesterone helps with vaginal dryness by increasing the thickness of the secretions—without progesterone, the moisture is watery and profuse. Progesterone has a calming effect on the mind, enhancing sleep and soothing the mood. The bone loss is lessened by all 3 hormones, testosterone as well as estradiol and progesterone. Skin wrinkling may be due to loss of collagen and the irregular heart beat is also due in some cases to hormone fluctuations.

Testosterone decreases in perimenopause also before estradiol. Without testosterone, the zest for life maybe diminished, sex is no longer a priority, but more of a duty.

Blood levels guide therapy to correct the detrimental hormone deficiencies. Of course, not everyone experiences menopause symptoms, and hormones are not for everyone. Some earlier studies linked hormone replacement therapy with cancer, stroke, and heart disease, while later studies showed other results. Studies are on-going.

Dr. Donna Becker, a physician trained in Emergency Medicine, now practicing hormone replacement therapy for the past 15 years. www.antiagingsa.com 210-545-5224