(as seen on The Marilyn Denis Show Sept 18th, 2019)
Pre-menopause, peri-menopause, and menopause make up years of a woman’s life – so it’s pretty important to understand what is going on with our body. At Clear Medicine, we take women’s health seriously which is why I have recently launched a program entirely for women. The Three Stages of Menopause programs purpose to help you navigate this time of your life with proper care by a Naturopathic Doctor. We want you to feel good as your body changes and hormones fluctuate. Call today to enquire or book online now.
Pre-menopause: The Reproductive Years
As a woman,
during reproductive years, we should normally not have any other symptom than
blood loss each month. Unfortunately, this is not the case for up to about 75%
of women, as most experience the symptoms of excess harmful estrogen associated
Dr. Turner ND’s number one selling product Clear Detox – Hormonal Health specifically deals with balancing these symptoms. When combined with the diet and workout philosophies of The Hormone Diet, hormonal balance and relief from these symptoms can be achieved usually within three menstrual cycles.
programs are based on Dr. Turner ND’s bestselling books, The Hormone Diet and The Supercharged Hormone Diet, which address
this condition commonly referred to as Estrogen Dominance.
Fluctuating thyroid, estrogen and progesterone during the menstrual cycle can cause an array of symptoms. Should you come to the clinic in person for our women’s hormonal health program, we will determine the best time to assess your hormones. For instance, if you have irregular periods, that come too far apart or not at all, we will measure your day three estrogen and all of your thyroid hormones. If you have bloating, breast tenderness, headaches, insomnia or anxiety we will assess your progesterone and estrogen on day 19 – 21.
Peri-menopause: The Lead Up to Menopause
Peri-menopause, or menopause transition, begins several years before menopause. It’s the time when the ovaries gradually begin to make less estrogen, but it is progesterone that declines first during this stage. It usually starts in a woman’s 40s but can start in her 30s or even earlier. Peri-menopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of peri-menopause, this drop in estrogen speeds up. At this stage, many women have menopause symptoms. The average length of perimenopause is 4 years, but for some women this stage may last only a few months or continue for 10 years. Women in peri-menopause have at least some these symptoms:
- Hot flashes
- Breast tenderness
- Worse premenstrual syndrome
- Lower sex drive
- Irregular periods (may come too close or further apart)
- Vaginal dryness; discomfort during sex
- Urine leakage when coughing or sneezing
- Urinary urgency (an urgent need to urinate more frequently)
- Mood swings
- Trouble sleeping
In our clinic, we often establish the diagnosis of peri-menopause based on symptoms and blood tests are also very helpful. We recommend testing on day three of your cycle – FSH. LH, estradiol and then on day 19 -21 estradiol and progesterone. Day three tells your ovarian reserve; your estrogen should be about 100 and FSH less than 10 to indicate you are NOT in perimenopause. Day 19 – 21 progesterone should be about 20 – 30.
Recommendations for peri-menopause:
- Adrenal gland support – as once you are into menopause your adrenals and your fat cells are the only sources of estrogen. So, you can assess your stress hormone cortisol in the blood and you can also do the orthostatic BP test to indicate how well your adrenals are working. The sooner you start treatment, the better your menopause will be. So consider herbs like Clear Ashwagandha (Dr. Turner ND’s favorite choice for balancing cortisol and boosting thyroid function), Clear Energy, (which contains Rhodiola, Dr. Turner ND’s favorite choice when impact on serotonin, dopamine, mood, and focus are desired along with restoring cortisol), or Clear Balance (which contains relora, an extract of magnolia bark that has been shown to reduce cortisol, raise DHEA and reduce waking during the night within two weeks).
- At Clear Medicine, in many cases we suggest natural progesterone cream to balance the hot flashes, reduce anxiety, headache, improve sleep and reduce spotting and PMS. You can see one of our ND’s that practices Bioidentical Hormone Replacement, which can be used in a cream or pill form and it is best taken at night. You can also use the herb Chasteberry Plus (vitex) to regulate periods and improve progesterone with evening primrose oil. Red clover can also help to lower FSH and keep healthy estrogen levels.
- Dr. Turner ND’s diet for managing all three stages of menopause is outlined in this Simple Weight Loss Kit, and it is essentially The Hormone Boost Book. Think of eating for cortisol balance – so always eat a protein rich breakfast within 45 mins of rising and never miss the 2 – 4 pm meal these are the two most important times for balancing adrenal gland function. Dr. Turner ND’s recommended breakfast for women of all ages, and that which is a fantastic alternative to intermittent fasting is a mixture that contains three powders: Clear Recovery, Clear Nova Scotia Marine Collagen, and a protein powder of your choice. You can read about the benefits of this mix and purchase it here.
Menstruating woman between the ages of 40 and 55 are naturally approaching menopause. Lowered production of the female sex hormones estrogen and progesterone cause these signs of menopause. Menopause is defined after a period of 12 months without any menses.
Signs and symptoms:
Symptoms of menopause may begin suddenly and be very noticeable, or they may be very mild at first. Symptoms may happen most of the time once they begin, or they may happen only once in a while. Some women notice changes in many areas and most of the symptoms are due to a deficiency of estrogen. Some menopausal symptoms, such as moodiness, are similar to symptoms of premenstrual syndrome (PMS). Others may be new to you. For example:
- Your periods have stopped for at least one year
- You might have hot flashes and problems sleeping
- You might experience mood swings or be irritable
- You might experience vaginal dryness, making sex uncomfortable or painful
- You may have less interest in sex and it may take longer for you to get aroused
- You may experience increased abdominal weight gain – thickening of the waist
- Your skin may thin and change due to the lower estrogen.
- Your memory may change due to lower estrogen – especially for names and items.
Other possible changes are not as noticeable. For example, you might begin to lose bone density because you have less estrogen, increasing the risk of osteoporosis. Changing estrogen levels can also raise cholesterol levels and increase your risk for heart disease ad stroke and the lowered levels of estrogen and are also linked to increased risk of Alzheimer’s disease.
**One note of concern – if you develop uterine bleeding after one-year period free, go to your doctor for a pelvic ultrasound as this is considered abnormal uterine bleeding. **
My Seven Recommendations for Menopause:
- Essential recommended testing which is included in our Women’s Hormonal Health Program include tests such as a cholesterol panel, complete thyroid panel, hormone testing (I also recommend testing for the harmful estrogen estrone – as if it is elevated it can increase breast cancer risk), vitamin D, vitamin B12, and more – all of the factors that help you to age well after entering menopause. We may also request that you visit your MD for a breast ultrasound, pelvic ultra sound and the sooner you do your bone density test the better – studies show if you are losing bone mass the faster you start hormone replacement, the better – don’t wait until you are 65 to get this test done which is what most doctors recommend. We want to be proactive – not reactive.
- Once the testing has been done we can handle the declining levels of estrogen and progesterone with Bioidentical Hormone replacement in the form of estrogen cream, progesterone cream. Vaginal suppositories of estrogen can also be very helpful for dryness and urinary urgency, if you do not want to use hormones, herbs like Red clover, Hops, Black Cohosh, Don Quai and Sage.
- Strength Training is a must here to maintain your bones – half an hour three times a week. At Clear Medicine our trainers specialize in this form of training so that you can learn how to exercise to build strength, bones and to prevent the spike in cortisol or suppression of thyroid function. Walking should be combined with this – one hour a day 4 – 6 days a week. Along with the strength training take Melatonin for sleep, breast health and bone health. Here are my recommendations for the perfect exercise week:
The Hormone Diet Exercise (Cardio Component) Prescription for Fat Loss, Reducing Stress, Preserving and Building Muscle and Boosting Metabolism: four to five times a week – Pick depending on your time, energy and brain space:
Long/Low/ Slow: Walking minimum an hour at a time as it needs to be this long for fat loss
Red/Hot/Sweating: Sprinting 20 seconds X10 or do intervals on the treadmill or bike – max twice a week for sprinting.
per week (more important than cardio!)
Your goal is to lift heavy (with proper form and move continuously for 30 minutes, resting when you need to rest). I recommend seeing a trainer to ensure you are doing the exercises correctly. We have excellent trainers at Clear Medicine and a wonderful private gym.
Metabolic Workout 1: See a trainer or check YouTube if you do not know how to do these movements.
- Dumbbell squat and press
- Lunge and curl
- Bent over row
- 10 – 12 reps
Metabolic Workout 2:
- Squat or leg press
- Chest DB press
- Tricep Dips
- Shoulders press (curl and press)
The goal for both options is continuous moving 30 mins
- Diet – you must change your carb selections as your ability to metabolize carbs decreases with menopause – so go for beets, carrots, peas, quinoa, squash as your choices rather than rice, potatoes, and sweet potatoes, and have only one serving a day at dinner. The list of recommended starchy carbs are included in The Supercharged Hormone Diet and The Hormone Boost books as well as in the free PDF that comes along with the Simple Weight Loss Kit AND – protein is a must! You will lose muscle as you age so you must consume at least 30 grams or 4 to 5 ounces cooked four times a day to maintain your muscles, bones and to prevent diabetes. Even if you do not strength train the protein will maintain your muscle. And the same rules for meal timing in perimenopause apply here. See my Instagram for my post on 30 grams of protein.
- Use a plant-based omega – like Pure Form Omega – it maintains hormone balance and unlike fish oil, preserves bone density. Combine this with vitamin D3.
- Take a formula for bone health – I made my own that contains all the nutrients for bone health called Clear Bone Protect and Repair available at Clear Medicine or online for Clear Medicine patients.
- Add extra B12 for brain and bone health. University of Toronto researchers found that B12 should be well into the high end of the reference range for brain health, so I strive to get my patients levels between 600 – 1200.
Clear Medicine’s newest program The Three Stages of Menopause is for all women. I created this with my patients and girlfriends in mind. I hear women’s complaints daily about how tired they are or the fact that they are just feeling different, something unexplainable – it’s almost ALWAYS our hormones. Great news – at Clear Medicine we can help you fix this. It is never too early or too late to get yourself assessed and get a comprehensive and individualized lifestyle plan made which will help you with all the stages. I am a true believer that the sooner you get your hormones in check the easier that peri-menopause and menopause will be on your body and mind. We will work with you to ease these symptoms. Read more here and call for more information today or to make an appointment click this link.