Tag: Hormone imbalance

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Health

May is Menopause Awareness Month

OK… I made that up. But don’t you think there should be a month set aside to help people learn about menopause?

Mayflowers

Knowledge can be medicine. Women fare better when they know what to expect and what they can do about it… and the men we spend time with can be more empathetic if they understand what’s happening to us! I suppose if you haven’t been through menopause and don’t know anything about it, you might not think it’s that important… But it can be a miserable experience when symptoms get out of control. If you’re informed, you’ll recognize the signs the “Change” is starting and will know what you can do to make it easier. It’s always best to prevent a fire, or at least put out those early sparks, then to wait until the whole house is engulfed, right?

Putting out fires

For over 10 years, as a pharmacist that specialized in hormone balance, I helped women communicate their menopausal misery with their doctors, most of whom, unfortunately, had little time to listen to what the “Change” was doing to their patients. Sadly, that’s how the system often is now… 10 to 15 minutes and only 1 or 2 “issues” per visit, please… that’s all the time available per patient. While gathering information for busy physicians, I also taught women about non-medical strategies they could try to lessen their need for medications and improve their overall health.

The stories I heard from women during consultations made me realize I got off easy during my Change. I knew my hormones were already out of balance when I was only in my mid-40s and worked with my doctor to correct it. I believe this made the entire menopausal transition easier for me and I encourage others to do the same.

But some women told me how they carried extra clothes with them in case what they were wearing became soaked during a hot flash. Others talked about needing to change the bed sheets in the middle of the night after a severe night sweat. One woman told me how she would grab some clothes when shopping (anything at all!) when she felt a flash coming on, and duck into a changing room so she could strip to her underwear…

And hot flashes are just one symptom of menopause. Heart palpitations, another symptom that’s not as well known, would send some women to their doctors, thinking they had a heart problem. “Fourmications”, a feeling of insects like ants (les fourmis in French) crawling on the skin make some women feel like they’re losing their sanity. And the mental effects of fluctuating hormones can be very distressing, with irritability, forgetfulness, insomnia, and more.

Being a Baby Boomer and a health professional, I decided at age 40 to learn about menopause. I wanted to be ready when it started… I wanted to know what to expect and to be in control. Although on average, menopause (the time when periods stop, technically the date of your last period) occurs at age 52, things almost always start to change years before. The date of the final period is only set once you’ve gone for a year with no flow, and the time from when you first notice changes until the end of that period-free year is known as Perimenopause. This phase can last for many years. After that, it’s all called “Postmenopause”.

It’s OK to talk about it…

It’s something that essentially all women go through, and we can suffer terribly, but we feel like we’re not supposed to talk about it. Is it because it’s associated with getting older in a society that values youth? Could it be because menopause and menstruation involve bleeding and reproduction?

Generations ago, pregnancies were hidden because, after all, if you were pregnant, you must have had sex, right? How silly… Women now show their baby bumps with pride and wear comfortable clothes instead of tents. It’s time to normalize another female reproductive milestone – menopause! After all, the menopause change is just another normal stage of life we pass through.

But, like everything else, this is slowly changing. Can you believe there’s a humorous novel out new this year about menopause? Yes, it’s true… it’s called The Menopause Murders. I’ve read it and it’s hilarious! While some menopausal symptoms and risks of treatments are exaggerated in places (for its comedic story value, of course) it also alerts readers to what some of the negative symptoms of menopause are, including the mental health effects. Author Mary Maloney also delves into the debate over which treatments are best to choose, while her lively characters entertain you. (Disclosure: This is a non-affiliate link, however, I was provided with a free copy of the e-book by the author and had some good laughs while reading it!)

A source of information

My long-term readers will remember that I also wrote a book about hormones, but mine was a serious one passing on the information I had learned as a pharmacist with a specialty in compounding hormones. On retirement, I sat down (on a balcony in Spain overlooking the Mediterranean!) and wrote everything I knew on the subject so the knowledge wouldn’t just “disappear”. The result was Can I Speak to the Hormone Lady? Managing Menopause and Hormone Imbalances, a fully-referenced book that explains what your hormonal symptoms are telling you, and your options to get back in balance and in control. Surprisingly, the book is selling more now than it did when I first published it. Although it’s available in print and as an e-book, it’s the audiobook that’s taking off now. I think the newest generation coming up to the menopause milestone likes to just load books onto their phone and listen and learn as they walk the dog or do household chores. Nothing like doing 2 things at once for productivity!

And, if you’d like more info about menopause and its treatments, my very first blog is a nice long one with lots of tips and non-drug ideas to improve symptoms. You’ll find it here: A Step-wise Approach to Menopause Treatment

I really love it when a reader contacts me, whether a reader of my blog or my books. Such a thrill (we writers really are so easy to please… 😊) It’s fun that we get to know each other a little, while I answer questions they may have, and we discuss our similar experiences. Sales and traffic charts are one thing but talking directly to a reader—a real person—is a completely different (and wonderful) experience for any author!

Women have helped each other through various stages of life for generations: the teen years, pregnancy, raising children, building careers. Menopause is just another stage of life where talking about it can help you and others sail through more easily. Do we avoid talking about it because approaching menopause means you’re getting older in a society that values youth? I love to say that being retired is the best job I’ve ever had (and I once had a job presenting seminars on a cruise ship!) It is life’s most wonderful reward after working hard and raising a family. I finally have time to do all the things I’ve wanted to do, and go places I want to go, and I can do it on my own schedule. What could be better than that?

Health = independence

I think another key message about menopause is that it marks the time of life with the most independence for women—as long as we maintain our health. So, part of the menopause discussion needs to be about staying healthy, both in body and mind, so we can maximize this wonderful postmenopausal time of life. While I began my blogging journey by writing about hormone balance for women 6 years ago, I’ve gradually expanded into a wider range of health information… what we should know to stay healthy and independent. And along the way, I’ve been learning a lot, both about health and how to write about it!

I hope you’re enjoying the blogging thoughts I share and having a wonderful healthful Menopause May! And let me know your burning (and non-burning) health questions… to be answered anonymously as always!

PS: Comments below are welcomed and seen by others; comments made through the “Contact” button at the top of the post are private and received through my email.

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Book review

I'm so excited!

Hi! I’m back from my blogging break, and it’s time to let you know what I’ve been up to (besides enjoying the Spanish sun)… The book I’ve been working on for 3 years, “Can I Speak to the Hormone Lady? Managing Menopause and Hormone Imbalances” has just been published in e-book and print!

It was quite a challenge to learn about editing, formatting, cover design and all that’s required to publish a book. And I haven’t had a chance to see it in print yet, since I’m still in Spain until the end of March, but the online version looks good on my Kindle. You can take a peek at parts of the e-book displayed in the “Look Inside” function on Amazon.com or Amazon.ca…

I’m so excited (and a bit nervous…) to finally have my book “out there”… Please celebrate with me! Here’s a Universal Link to the services where it is available:

https://books2read.com/u/4AJQGo

Categories
Health

Testosterone – Women need it too!

Testosterone has been described as the hormone of desire… Although it’s in the androgen hormone class, considered to be “male” hormone, both men and women produce testosterone. It’s the difference in amounts produced and the balance between estrogen and testosterone that determine male or female body characteristics.

Interestingly, many more articles have been written about overproduction of testosterone in women, as can occur in polycystic ovary syndrome, for example. Underproduction can also be a problem for women, but doctors rarely test for this.

With low testosterone, women can feel fatigued and notice less interest, not only in sex, but in doing things they normally like to do. The term “lack of a sense of wellbeing” has been used to describe how women with low testosterone can feel.

Physically, they may notice decreased muscle size and strength, and reduced hair growth on the body, particularly underarm, pubic and leg hair. These physical changes often carry more weight when speaking with your healthcare provider about the potential for this type of hormone imbalance.

Interestingly, taking hormones by mouth can lead to low testosterone effect. The liver filters virtually everything you swallow as soon as it is absorbed from your digestive system. This is referred to as the “first pass effect”, where the drug is changed or partially removed from the blood stream before it has a chance to reach the rest of the body. This is one reason that transdermal drugs (or drugs administered through the skin) are generally used in lower doses. With the transdermal route, the drug reaches the body before the liver has a chance to metabolize it. Hormone preparations are generally 1/10th the dose when given through the skin, as compared to dosing by mouth.

However, with oral hormones there is another known effect… In response to swallowed hormones, the liver produces a special protein, called sex hormone binding globulin (SHBG) that binds to hormones making them unavailable to act in the body and, essentially, inactive.

When estrogen is swallowed, such as with hormone replacement or birth control tablets, the liver is stimulated to produce SHBG, presumably a mechanism developed to protect us from accidentally ingested hormones in our food.

However, SHBG binds testosterone 10 times more strongly than estrogen. This means that taking estrogen by mouth will result in increased SHBG that will scoop up much of the testosterone your body is producing. Testosterone is still being produced but you may experience the symptoms of low testosterone. Regular blood tests for total testosterone would show a normal amount, but a test for “free testosterone” (testosterone not bound to proteins) would show the effective deficiency.

So, what can be done to correct testosterone deficiency? I always recommend treating the cause if one is identified so, for women with a secondary deficiency caused by taking estrogen by mouth, a simple solution is to change the estrogen to a patch, cream or gel formulation, eliminating the first pass effect on the liver and reducing production of SHBG.

If this is not the cause, and total serum testosterone is found to be low, testosterone replacement can be considered. Swallowed testosterone is known to be hard on the liver, with increased liver cancer reported with some oral forms. As well, available tablets and capsules currently on the market are dosed for men and contain far more hormone than women need. I’ve seen prescriptions for women to take one man-sized 40mg capsule once or twice a week, but even this is more than women would produce, and would result in swings in testosterone blood levels that would be far too high on the days immediately after taking a dose.

Women produce less than 1mg of testosterone daily. It is easy to understand that a 40mg capsule would come with the recommendation to stop taking it if she developed facial hair growth or acne. Even the cream formulas that are available come in 25 and 50mg pouches or pumps with no accurate way to measure a lower amount.

However, testosterone cream can be accurately compounded by a pharmacist and loaded into needle-free syringes for accurate measurement. I always prepared the cream as 1% testosterone (10mg/ml) making it easy to calculate the desired dose. A 1ml syringe would contain 10mg – generally enough for 10 days of testosterone replacement, although some women have reported results with doses as low as 0.15mg!

Because hormones are stored away in fatty tissues in the body, I generally recommended using 2mg daily for the first week or two (since some of this would be stored away) then reducing to 1mg or less daily to avoid any chance of overdosing. One of the first signs of too much testosterone is often an outbreak of acne. I encourage women to identify the lowest dose that is effective for them – the “normal” amount can vary from person to person, and we need to remember that we are adding to the amount being produced, which can also vary from person to person.

Men can also become deficient in testosterone. Some refer to this as “andropause”… others have jokingly called it “grumpy old man syndrome” since deficiency most commonly occurs later in life, the man may be stooped and thin due to decreased muscle and possibly the onset of osteoporosis, and his mood may have become less than cheery.

Testosterone replacement for men is readily available in capsules, injections and creams and, although somewhat less convenient, the creams or injections would be preferred to reduce the effect of hormone on the liver. However, as injections are generally given every 2 to 4 weeks, they have the disadvantage of producing a higher blood level of hormone immediately after the injection and a lower level before the next injection is scheduled. A simple blood test would confirm that testosterone is needed and that the dosing is correct.

So, if any of the symptoms of low testosterone sound familiar, talk to your doctor about it. If you are interested in more information, I would recommend “The Hormone of Desire” by Dr. Susan Rako as an excellent source of information on testosterone deficiency in women.