Estrogen & Menopause: Body Changes and Myths Busted

“Not now!” You say, as you remove a sweater, feeling the instantaneous rush of heat, dry everything, brain fog and fatigue, and know that another day is derailed for you.

Menopause has been trending in the news and social media recently, as a new generation finds themselves on the hormonal roller coaster and wants better options than our mothers received.

Let me reassure you: these symptoms are NOT in your head! As we age (AND have cancer treatment) estrogen and other hormone levels drop, causing inconvenient and annoying vasomotor symptoms like hot flashes, sweating, joint pain, and cognitive changes.

How Estrogen Affects Your Body

Estrogen is a crucial hormone that plays a significant role in various aspects of female health.

Estrogen is actually a group of hormones that includes estradiol, estrone, and estriol. These hormones are primarily produced in the ovaries but are also synthesized in smaller amounts by other tissues such as the breasts, adrenal glands, and fat cells. Estrogen receptors can actually be found ALL OVER your body.

Without the “fuel” of the hormones to run your body smoothly, many systems become sluggish or overexpressive. You may experience changes in:

• Cognitive function (brain fog/dementia)
• Bladder control/urgency
• Joint immobility
• Bone density decline
• Increased cardiac risk
• Vaginal dryness
• Mucous membrane and skin dryness
• Weight gain
• Loss of libido

If you have survived breast cancer and are experiencing one or more signs of menopause, especially after treatment, you have options to support your body as it changes and adapts to low/no estrogen.

1. Be your own advocate. Countless women have told stories about being dismissed as they deal with this VERY real female health issue. Yet study after study proves how common, challenging, and REAL dealing with low estrogen is for women. Feel empowered to keep asking for information, tests, and conversations that will improve your quality of life.
2. Questions to ask your doctor. Be direct with your doctor (and don’t be afraid to get a new one, if yours won’t help you). ASK: What are the options for my symptoms? What has worked for other patients with these symptoms? What can I expect to realistically improve, and what should my priority be? How long will it take to see improvement?
3. Tests that provide insights. Decide which tests give you more information so you can take action. Possible tests include: hormone testing, bone density (DEXA), cardiac CT/ IMT, a nutritional evaluation (Metabolomix from Genova Diagnostics), as well as monitoring blood sugar and inflammation. ASK: Can I use bioidentical estrogen for vaginal dryness and urinary symptoms (is cream applied to the vulva safer than systemic pills, for me?)? Can I have a DEXA to know my bone density (crucial for post- menopausal women and those on aromatase inhibitors)? Can you order complete cholesterol labs (ApoB, Lpa, sdLDL, hsCRP and HbA1c) to better assess my cardiovascular/metabolic health?

What Can I Do?

Each of us weathers the storm of body changes differently. Decide what your priorities are (dryness? cognitive focus? coping with sweating?). Be gentle with yourself while you proactively address symptoms with lifestyle options:

• Move your body. Yes: exercise! Even when you’re so fatigued, getting those steps in makes a difference, but a HIIT (high intensity interval training) workout has clinically proven benefits. Maintaining lean muscle mass (vs. fat) has significant long-term health benefits. Also focus on exercises that maintain and/or improve your flexibility and balance.
• Get quality sleep! That might mean sleeping alone, or using a cooling pillow.
• Keep cool. Wear layers of clothing (for hot flashes!), carry a hand-held or portable fan. Carry ice water (insulated water bottles can be helpful!)
• Eat well. Be intentional about your diet, and give your body the healthy food it needs to give you energy. Limit simple carbohydrates and sugar. Reduce food triggers for hot flashes (caffeine, chocolate, spicy, red wine).
• Hydrate. Skin and vaginal dryness options include: estradiol products (Estring/ Vagiferm/Yuvifem), estriol (or vitamin E/hyaluronic acid) suppositories, Snow Lotus Triple Goddess Rose Oil, OTC hydrating gels, coconut oil and shea butter.
• Reduce stress. Consider mindfulness practices, music, nature, friendships, pets. Make a list of what calms you, and fit self-care into your day.
• Track your experience. Apps like Evernow, Balance, Midday, Caria, and Perry, help you monitor the frequency and severity of your symptoms over time.
• Non-hormonal supplements. A handful of natural compounds have shown to reduce symptoms, especially for women who cannot use hormone replacements. Naturopathic doctors look for products with: Ashwaganda, Black Cohosh, Gamma Oryzanol, Hesperidin, Vitamin B12 and D.
• Speak up. Talk to your female friends about their symptoms and what has helped them. Talk to your treatment team about adverse symptoms affecting your daily life. Have direct conversations with your intimate partner about how your body is changing, and what you need to enjoy sexual pleasure. Buy the products (toys, suppositories/oils) that can help you achieve satisfaction. The folks at Babeland in Seattle do a great, sensitive job of helping women find the right things for them: www.babeland.com. Or grab a girlfriend, and go on a field trip!

Please Know You Are Not Alone

Menopause side effects happen to all females, and while you may not feel like you have the energy to address how your body is changing, there are options to manage and improve your quality of life. Menopause symptoms can take a real toll on your mental health, which often gets dismissed, yet can be a real drain on your daily life. Don’t give up on finding relief.

As a naturopathic physician specializing in the treatment of women with breast cancer I can help you with integrative solutions to alleviate your symptoms and help you feel confident about your well-being after breast cancer.

Menopause Myths Busted

If you are like me, you are getting tons of ads on social media for products to help with menopause. It seems like menopause is the word of the moment, and I guess it took Gen X to make that happen. We’re the first generation of the digital age, quickly became enamoured with social media, and as a generation, we want answers about sex, our health, and our emotions as we age.

For women between 40-60, it’s Menopause Central! Hot flashes, night sweats, sleep disturbances, brain fog, low energy, low libido, vaginal dryness, joint pain, thinning hair…these are just some of the side effects of the slow loss—or rapid loss: as in surgical or chemical menopause—of estrogen in a woman’s system. If you see yourself in this list, read on…

What’s The Research Say?

Women’s health research has historically been underfunded and undervalued. But in recent years, more and more data has surfaced about the role of estrogen in the body, the complexity of the hormonal dynamic, and how the major diseases of aging are directly impacted by estrogen levels. Heart disease, dementia, diabetes, osteoporosis, and cancer all participate in that hormonal dance.

Breast Cancer and Menopause

The million-dollar question: but I had breast cancer! What are my options to manage menopause? They are not as limited as you think, and new research reveals that topical remedies are safer than previously thought. Listen to Dr. Laura’s conversation with Menopause & Cancer, for recent information about hormone replacement therapy and breast cancer.

And if you haven’t heard about it or seen it yet, check out The M Factor on PBS.org. Our Bellingham-local uro-gyn dynamo, Dr. Kelly Casperson, is featured. It’s a great discussion of the state of menopause research, workplace issues, and social issues for women in the phase of menopause.

Want to learn more about naturopathic approaches to your wellness? Please contact Dr. Laura James ND, FABNO, to explore integrative solutions that can support you before, during and after treatment.