Menopause is an important transition in the lives of women, and it has achieved proper recognition, finally, as a phase of our lives to be respected and supported. No longer subject to dismissive or derisive remarks, women have pushed through that barrier and have claimed their space, during the creative years that follow menopause.
Children are no longer their focus. Now women can engage in developing skills that have always interested them, and they have the time and the energy to come into their own. No more accommodating, facilitating, stepping back, compliant to the needs of growing children and stressed-out husbands, women in their post-menopausal years can finally choose to come forward in a self-motivated way, possibly moving toward a new career.
Best case, if you are now in that position, you may be able to slide through menopause and scarcely notice it. You might experience excessive menstrual flow for a while, maybe a bit of a weight gain, and then you skip a period, and then another. You think Oh, No! I must be pregnant! And the doctor smiles and tells you that at 53 the chances of getting pregnant are just about zero, but have you considered menopause? Menopause? I forgot about that!
From then on, (still considering best case) it is possible that you will not have a hot flash, or a sleepless night. You can feel enthusiastic, you are free from the menstrual cycles, although at one time you welcomed them. Now you are finished with birth control, and the endless anxious moments about unplanned pregnancy while your sexual responses can be as powerful as ever, and you enter into a state of freedom and gratitude.
If it turns out that you are not experiencing “best case,” and many women don’t, there are supportive measures that can be taken. First we need to find out what happens physiologically during this process, so that we can figure out how best to intervene if the system has become off balance.
The Physiological Process in the Menstrual Cycle
During the week before you menstruate, both estrogen and progesterone levels are dropping to a lower level. For you, this might be an easy time to navigate, maybe you just feel a little bit hyper-reactive. But if you are experiencing a significant shortage of progesterone, it will show up as high level anxiety, irritability and the exaggerated emotional sensitivity known as PMS.
As you approach the menstrual flow, the pituitary sends out signals that call for the return of estrogen with Follicle Stimulating Hormone, and for the return of the progesterone with Luteinizing Hormone. In these few days of lowered sex hormones, the uterine lining sloughs off, and breaks open the supportive capillary bed that would otherwise have sustained the implantation and growth of a fertilized egg. If the egg is not fertilized, these structures are no longer needed. The lining peels off the inner wall, and starts the menstrual flow.
Menstrual cycle
The first request from the pituitary gland, during the period of bleeding, is for a little more estrogen than progesterone. Estrogens are released, initiating the development of another egg within the ovary, and bringing it to maturity over the next several days, so that it can be ejected and sent on its journey through the fallopian tube. Estrogens are abundant in the first half of the cycle.
After ovulation, progesterone becomes the dominant hormone. Some progesterone comes from the ovaries in response to the action of luteinizing hormone from the pituitary, and an additional burst comes after the egg is released from the egg-sac. The protective egg-sac is called the graffian follicle. When the egg jumps out, the sac folds into itself. A high amount of progesterone is released as the graffian follicle folds up and disintegrates. This is why, in the second half of the cycle, progesterone becomes more abundant than estrogen. Progesterone calls for the enrichment of the uterine lining, creating the nutrient bed and collateral blood supply.
As the cycle nears completion, both estrogen and progesterone become diminished, and the body moves toward the menstrual phase. The lining lifts off, capillary blood starts to release, and the pituitary sends out the signal for the return of the estrogens and progesterone once again. When these hormones rise to a certain level, the period stops. Then the ovary begins to work toward the growth and development of another egg.
Estrogen comes in three forms:
Estradiol is the one that activates breast tissue growth, estrone acts upon the ovary, and estriol encourages smooth vaginal secretions. Progesterone creates all of these.
Estradiol
Estrone
Estriol
Sometimes the body synthesizes the estrogens incorrectly. Estrogen molecules can acquire an additional atom, or a radical, attached in a place where it not supposed to go. If a substantial percentage of the estrogens are being made incorrectly, this can have significant health effects. One error seems to be associated with endometriosis, another is associated with ovarian problems, another contributes to the initiating of fibrous cysts. These errors are not inborn nor inherited, they are acquired as a result of a strongly motivated decision to reject a parental role-model, and create a new paradigm.
In the world of biochemistry, positions on the hormone molecules derived from cholesterol have been numbered. For example in the estrone molecule there is an oxygen, O , at position #17 and a hydroxyl, OH, at position #3. Estradiol has two hydroxyls, #3 and#17. Variations in the placement of these atoms and radicals create different characteristics and capabilities of the molecules.
Nomenclature of the positions on cholesterol-derived hormones
Without knowing more about how this works, I can’t assume that the errors we have observed literally “cause” the problems we have correlated with them, but the correlations seem to be quite consistent, and they may serve as interesting clues. If someone were interested in working with this concept in greater depth, using physical equipment that would give physical verification, some important data might emerge
The Cholesterol Cascade
Cholesterol starts out the cascade of events with the synthesis of pregnenolone. Pregnenolone can go straight into progesterone, or can be converted to DHEA, dihydroepiandrosterone, and after a few more transformations it turns into progesterone. Some of the progesterone is intact, and the rest splits into two directions: One part goes into the construction of the sex hormones. First it makes androstenodione and then testosterone, and from there to the estrogens. The other part goes into the construction of adrenal hormones, cortisol, corticosterone, and aldosterone. Other essential nutrients that cholesterol gives us are vitamin D, and the taurocholic and glycocholic acids, the bile salts that are an essential part of bile synthesis.
Cholesterol
Each molecular shift in this cascade requires an enzyme to make its transition. These enzymes need essential fatty acids, (EPA, DHA, and GLA,) and various trace minerals, usually lithium and rubidium.
If there is a shortage of all the female hormones, look at the cholesterol. It needs to be from 185 to 210. If your total cholesterol is too low, (under 160) even though your doctor will probably congratulate you, you won’t be able to make enough sex hormones. Your brain will be a little fuzzy, and your adrenals will tend to be easily depleted. When there are diminished reserves of cholesterol, there will be less than optimal amounts of all these hormones.
When Progesterone is too low
Shortage of progesterone can come about in several ways, and here are three: One, as mentioned above, there might be a shortage of cholesterol. Two, there might be a shortage of the fatty acids or minerals that are required for the appropriate enzymes to facilitate the cholesterol cascade. Three, and this is a very important one that is not generally known, your progesterone could be significantly depleted by the demand for chronically high cortisol.
Progesterone
Progesterone makes cortisol, so that the synthesis of excessive cortisol could be recruiting so much extra progesterone that it is creating a shortage.
If you are taking on-going steroid medication, these steroids can block the usefulness of progesterone in another way. Anti-inflammatory steroid drugs also inhibit the action of progesterone. Even though everyone synthesizes a normal amount of anti-inflammatory steroids in their adrenals, under duress higher levels are required, and then progesterone is depleted, and calcitonin isn’t able to release.Without the invitation from progesterone, calcitonin can’t come out from the thyroid gland to pick up and deliver blood-calcium to the bone-building compounds. and there is a risk of osteoporosis.
In a bath of steroids, another event takes place. The enzyme that converts glutamate to GABA is inhibited, and the amino acid that should follow, proline, is then inhibited as well. Deprived of proline, (an essential component of collagen,) and calcitonin, (the carrier of calcium to the bone-building cells,) are then both diminished. Without these two components, the calcium in the bones will gradually become depleted. Bone density maintenance requires both proline and calcitonin. This is how prolonged stress, and/or prolonged steroid medications, can both lead to osteoporosis.
We have found out something interesting, and clinically very important. If you take biotin, one of the B-vitamins, the progesterone will be protected from the demands of high cortisol. If you also supplement with proline, bone structures will remain intact. Biotin protects the usefulness of progesterone in face your own high cortisol, as well as long-term medically prescribed steroid drugs.
Since cortisone and cortisol prevent the synthesis but not the utilization of proline, taking proline as a supplement is perfect protection from osteoporosis that would be expected with either steroid medication or prolonged stress. Fortunately neither biotin nor proline will interfere with the intended action of the drug. They will simply cancel out these specific side-effects.
Estrogen Dominance is what we often observe in our clients who are in menopause, or approaching it. This is a symptom of progesterone shortage. The way it comes about is this: Quite a while before your monthly period actually stops, maybe for a couple of years, the ovaries stop ovulating. When this happens, the extra little bursts of progesterone that used to come from the folding up of the graffian follicles are no longer available.
The estrogen is released as usual, but without this added source of progesterone, the estrogen is “unopposed.” There needs to be a proper ratio between them. When estrogen is too high and progesterone can’t be maintained, what happens then is known as estrogen dominance. This causes any number of very distressing symptoms, most of which are ascribed simply to the process of menopause itself. And, most of this discomfort can be avoided.
Dr John R Lee, in his wonderful book What Your Doctor May Not Tell You About Menopause describes the symptoms of estrogen dominance as fatigue, hypothyroidism, depression, weight gain, water retention, headaches, mood swings, fibrocystic breasts, uterine fibroids, cervical dysplasia, endometriosis, unstable blood sugar, vaginal dryness, and craving for sweets. The physicians who have not had the time or the willingness to update their information about progesterone will be likely to offer yet more estrogen to their patients who complain about these symptoms. Get a copy of Dr. Lee’s book, share it with your doctor, and then you can work out a program based upon information that might be much safer and more comfortable.
One way to increase your progesterone is to use a good quality natural over-the-counter progesterone cream, and that works really well. Another way to go is to raise your cholesterol, so that you can synthesize all your hormones more abundantly, including progesterone.
Raising the cholesterol is a little complicated. you would need to find out if it is being synthesized correctly, and if not you would locate the age and identify the incident that caused you to make that change in the molecule—and the update and release the outdated emotional decision that brought it about. If the liver makes all the cholesterol molecules accurately, usually it will be the right amount.
If there is fear of cholesterol, or “fat fear” that is keeping the level too low, you would need to release the belief behind the fear, and change the decision. Then you can ask your liver to please synthesize the appropriate amount of cholesterol for your needs—both kinds—the good kind and the other good kind. The liver is incredibly willing to do this. It has been hoping you would ask, because it wants to protect you. Your LDLs (“bad”) are what we have been talking about all this time, as this is the fraction of your cholesterol that makes your hormones. Not too bad!
Whichever way you decide to balance your hormones, you can give your doctor the benefit of this knowledge by becoming the shining example of natural hormone harmony.
Hot flashes are most often due to depleted adrenals. If you go into menopause with depleted adrenals, you will most likely experience hot flashes. Extra progesterone sometimes helps with this, but not always, as it may not be converting to the estrogens and adrenal hormones you need. That is when you would look at the synthesis of enzymes along the cholesterol cascade. Find out what minerals or fatty acids it would take to make them, supplement with these nutrients, and the right levels should stabilize fairly quickly.
Not everyone experiences estrogen dominance. Some people experience a shortage of all the hormones, and again you can either raise the cholesterol, or use bioidentical hormones and extra adrenal supplementation as the remedy for hot flashes.
The most interesting part of the menopause phase comes up when you take time out to reflect upon your skills and interests. You can go inside and commune with your inner being. Release your fears, honor your age, and imagine all the wonderful things you can do with the second half of your life. And because you are still young enough to begin a new career, you can start making plans for creating an interesting future.
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None of the statements in this commentary have been reviewed or approved by the FDA nor by any recognized scientific forum for evaluation, and none of the statements in this commentary are intended to diagnose, or offer treatment for any disease. If you have a health problem, see your doctor.