Menopause and peri-menopause are natural events all women experience.
Acknowledging that there can be adverse physical and emotional consequences for women once menopause arrives, we evaluate and treat each woman as the unique individual she is.
Bio-identical hormones are strongly recommended in place of standard pharmaceutical products and we utilize the most expert compounding pharmacies. Hormone therapy is thoroughly discussed , including all therapeutic options, and each woman is guided towards making her own decisions.
Many factors must be considered when determining how to use hormones in the menopause, including how the patient metabolizes her estrogen, her GI function, her lifestyle, her family history and other risk factors, and her desires. We strongly believe that it is inappropriate for doctors to take a weekend course and then begin prescribing hormones, as they are not qualified to treat the side-effects and complications.
Only a skilled gynecologist, with expertise in the use of hormones,
is competent to deal with all of the issues.
Although we believe that most women benefit from bio-identical hormone therapy, those who must or prefer to avoid hormones can be managed in many alternative ways, including Acupuncture, Reiki, Aromatherapy, Homeopathy, and with herbal remedies.
A new area of hormone use in menopause entails the use of cream versions of estradiol and progesterone given in a manner to replicate a natural menstrual cycle. This approach is not mainstream, but is used by thousands of women who believe that mimicking nature is always the best approach. Dr. Gersh is trained and skilled in the use of Rhythmic Hormones and prescribes them to women who wish to go that route and are fully aware of the unorthodox view taken on it by “conventional” doctors.
The negative effects associated with menopause
The negative effects associated with menopause have less to do with the passage of time, than with the inevitable inflammation caused by the loss of estrogen and progesterone. And though testosterone decline is independent of menopause, it certainly has an impact during the perimenopause and thereafter. Most women and doctors think of these hormones in terms of their reproductive effects, but they do so much more than that.
Estrogen, now thought to be the most ancient of all hormones, is involved with regulating many of the body’s activities, including the deposition and location of fat, the constant ticking of circadian rhythms, the immune system, appetite and sleep, cognitive functions, bone and muscle health, gut health, the flexibility and vitality of arteries, liver and pancreatic function, and literally all metabolic activities. Estrogen also works to enhance the function of other hormones, such as thyroid and testosterone, helping them to work properly and maintain optimal function.
The loss of ovarian production of estrogen results in metabolic dysfunction and a generalized inflammatory response, related to alterations of the intestinal track’s bacteria (microbiota) and the loss of control of the cells of the inflammatory immune system, called macrophages. In turn, this creates worsening insulin resistance, hypertension, gut issues, arterial stiffening and atherosclerosis, osteoporosis, loss of muscle, and memory problems. It is the loss of estrogen which leads women to have nearly triple the incidence of Alzheimer’s Disease that men have.
So, why aren’t women doing everything they can to maintain and replace these hormones?
Unfortunately, in the wake of publication of the Women’s Health Initiative 14 years ago, women were advised not to seek hormone replacement therapy and doctors were discouraged from prescribing it to women in the menopausal years. However, that data and its analysis were quite flawed and have since been repudiated – albeit quietly and with little fanfare, so that we still see it being inappropriately referred to in the media. Scientific data clearly supports the health benefits of hormone therapy in the menopause.
At IMGI, we encourage each woman to decide for herself whether or not she wishes to be treated with hormones, but believe hormone therapy can be very beneficial, as a part of the health plan for women reaching menopause. We absolutely prefer that the hormones used be bioidentical to human hormones – not chemicals mimicking hormones (endocrine disruptors such as Provera, etc.) or substances found in the urine of a pregnant horse (Premarin).
Conventionally, hormones are prescribed in a manner one could describe as “low dose static.” That means that a small amount of estrogen and progesterone are used in a constant daily dosing regimen, a program not in synchrony with the rhythms of a healthy, reproductive female. This manner of dosing hormones was originated, not by nature, but by pharmaceutical companies, as a convenient and cost effective way to mass produce and distribute female hormones.
We believe, in general, that mimicking nature is best – this way, hormones are delivered to the body’s cells in the manner in which they were designed to receive them. Although not yet mainstream, the scientific foundations for cyclic dosing – varying hormonal levels according to the natural cyclic rhythms of women – are sound and based on our current understanding of hormone receptor function. At IMGI, all menopausal and perimenopausal women are given thorough counselling on the value of maintaining natural hormone levels, along with the options for varying dosing schedules. Though we believe that most women would get the greatest benefit from the use of cyclic hormones, we absolutely encourage each woman to make her own decision concerning hormone use.
To successfully “Tame the Flames of Menopause,” each woman is evaluated as the unique individual she is, incorporating an individualized array of advanced laboratory testing, and a fitness and body composition analysis. This is then followed by a coordinated plan of lifestyle change, including options such as an exercise prescription, nutritional counseling, a detox, recommending the fasting mimicking diet, stress control, herbals and nutraceuticals, and more, so as to complement the selected hormone strategy (or no hormones, if wished.)
Comprehensive Menopause Program
Why choose our menopause program?
Menopause happens to all women, an unavoidable fact of being female. What it means specifically, is that our ovaries can no longer release eggs, and we are now functionally sterile. Well, most of us females can live with that.
We don’t wish to have babies forever. But sadly, the end of fertility also marks another turning point in our lives – the beginning of the gradual deterioration of our bodies. One can try to put a candy-coated spin on menopause, and many have done so, but I prefer to call a spade a spade. Menopause and the loss of ovarian production of estrogen (and progesterone) signal the beginning of system-wide decline and dysfunction. You see, estrogen is involved in so much more than reproduction. It essentially manages everything in the body, including brain function, with the maintenance of both cognition and mood. Progesterone and testosterone play key roles throughout the body, as well.
The reason you should see me as your physician, now that you are in, or approaching, menopause, is that I truly understand the meaning of menopause in all of its many dimensions. I can help you if you wish to maintain the figure of a young, healthy woman. I can also help if you want to be mobile, strong, smart, pain-free, active, funny, rested, and sexy. Yes, I did say sexy. Hormones are a critical part of feeling sexual, being sexual, and being sexually vibrant. But sex aside, virtually every body system requires estrogen for proper function – heart, intestines, bones, muscles, arteries, joints, skin, eyes, ears, gums, brains, bladders, blood cells, and more.
As you get older, you will experience vaginal dryness and atrophy – at least the statistics say you’ve an 80% chance of this happening. This is simply one of the visible manifestations of the processes occurring throughout your entire body! Sadly, menopause is about drying up and shriveling! Eyes dry up, bladders dry up, arteries dry up, brains dry up, bones dry up, and so forth. While I may be taking a bit of artistic license here, the reality is that without the right amounts and rhythmic timing of hormones, the very unpleasant process of rapid aging of all body parts accelerates.
I understand hormones, and lecture around the world on that topic, teaching other doctors. I believe in hormones and use them myself! They are what differentiate us from men and children…they are the essence of the communication system in the female body, controlling all that happens. Without adequate hormones, dosed as a healthy female body requires, the very functions of our organ systems degrade. Hormones – administered correctly – are our friends; not our enemies!
If you want an expert in hormones and the organs they impact – if you want to get the best shot at keeping your youthful mojo – then I am the right doctor for you!
If you are new to our practice and wish to experience our approach to medicine and healing before committing to a long-term relationship, feel that you do not require much therapy or many visits, or if you have completed a course of therapy and no longer need intensive treatment and counseling, you may choose to pay for individual services, as the need arises.
All laboratory tests obtained at our office are charged a collection and handling fee only – there are no mark-ups on lab tests. Charges for all tests are available to you at the time of the specimen collection.
For those who wish the peace of mind which comes with a prepaid membership, as well as for those who prefer a more comprehensive and inclusive package that is designed to produce more rapid resolution of medical problems, we offer a 12-month membership program. Patients who choose to become practice members are also eligible for significant discounts and benefits.
- Unlimited visits with any of the physician providers, including an annual combined appointment with Dr. Felice Gersh and one of our Naturopathic Doctors for a comprehensive integrative medical evaluation lasting 2.0 hours (1.5 hours spent with the doctors)
- 6 prescribed treatments, including any combination of acupuncture, IV therapy, Reiki, massage, facials, microdermabrasions, and individual fitness classes
- A year of therapy with ProLon – the unique 5-day fasting mimicking diet developed at the Longevity Institute at USC: 6 courses of ProLon, including product and lifestyle coaching – 3 sequential months, then once every 3 months for a total of 12 months of therapy
- An annual 4-week Detoxification package, including all of the detox supplements
- A comprehensive fitness evaluation – including a fitness assessment, fitness prescription, and wireless activity tracker
- 10% discount on all regularly priced office supplements, services, and products
- All office educational programs are complimentary
- Access to the providers at all times: 24 hours, 7 days a week
- Personal concierge assistant to help coordinate your care and provide for your needs
Finding knowledgeable and compassionate medical care in any community can be challenging, particularly when complex medical conditions are involved. And finding a fellowship-trained integrative medical doctor may be impossible. To answer this need we offer the following telemedicine options.
TeleMedicine Appointments for California Residents
Though we always encourage initial visits to be in person, in-state residents have the option of scheduling initial and all follow-up visits via phone or Skype, during which all aspects of health can be specifically addressed. Callers under 18 years old require parental consent.
TeleMedicine Appointments for Residents Outside California
Differing state laws make telemedicine more challenging, though certainly not impossible. Your first visit must be at our Irvine, California, office. Follow-up appointments can be accomplished by phone or Skype, but periodic visits to our office are required. State laws are expected to change and will become less restrictive in the future. International patients have more flexibility with appointments. Callers under 18 years of age require parental consent.
If you would like to arrange a TeleMedicine Appointment, please call our office at 949-753-7475.