Definition of Menopause
Menopause is defined as the permanent cessation of menses (periods), which is caused by a decrease in the production of sex hormones (estrogen and progesterone). It is a normal and natural occurrence in a woman’s life, unless it is artificially induced via surgery (with removal of ovaries and/or uterus), chemotherapy or radiation. Most women reach menopause between ages 50 and 52, although changes may be experienced earlier. “Peri-menopause” is the term to describe the time between the onset of changes and menopause (the cessation of menses).
Hormone Replacement Therapy
Hormone Replacement Therapy (HRT) replaces the sex hormones that your body isn’t making enough of. Once your hormone levels rise, most people find relief from their menopausal symptoms. Making decisions regarding management of problems that may arise during peri- and post-menopausal years can be difficult. HRT is one form of management, and naturopathic physicians have the expertise to help individuals assess whether or not HRT would be beneficial.
HRT is approved by the US Food and Drug Administration for vasomotor symptoms in women without contraindications; the prevention of bone loss and fractures in postmenopausal women at high risk for osteoporosis or fracture; and premature surgical menopause, hypogonadism, and primary ovarian insufficiency until average menopausal age is reached (as long as there are no contraindications). And for women experiencing only genitourinary menopausal symptoms, low-dose vaginal estrogen therapy is first-line, rather than systemic, therapy.
(Synthetic) Hormone Replacement Therapy
Synthetic hormones are not natural to the body and may be taxing to the liver. Many dosage forms of synthetic hormones are available (tablets, capsules, patches, creams, injections, etc.) A naturopathic physician will evaluate past medical history, current medical problems, medications, and physical exam findings. They may also conduct appropriate testing to determine the optimal way to prevent and manage menopausal symptoms.
Natural Hormone Replacement Therapy
Natural hormone replacement is another management option. Potentially safer plant-based molecules (from wild yam and soy predominantly) that are similar to the human hormones collectively known as estrogen and progesterone are pharmaceutically altered to the human molecular forms that our bodies recognize as such. This type of hormone replacement can be dosed in many forms such as tablets, capsules or sublingual drops (that can be more specifically, individually and minimally dosed).
Naturopathic Medicine as a Compliment to HRT
There are certain medical situations in which HRT may be recommended or necessary, such as surgically induced menopause. In these cases, naturopathic therapies are aimed at reducing the risks and side effects of hormone therapy, while enhancing overall health and reducing the risks of osteoporosis and heart disease. Naturopathic physicians can also advise women about safer forms of estrogen and overall hormone balance.