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.)