Hormonal decline can start in the 30’s for many women. The first hormone to go is progesterone. Progesterone counter balances the main female hormone estradiol. When the balance it lost, women become dominant in estradiol.  Since estradiol is stimulatory, and progesterone is calming, increasing problem with anxiety can occur. Many women will consult with a physician who practices standard medicine, and will then get started on Xanax or other sedatives. They are treated for Xanax deficiency, when in fact they have progesterone deficiency.  PMS becomes much more prominent in mid to late cycle, and alternately an anti-depressant can be prescribed. My philosophy is to fix the underlying problem and not put a Band-Aid on symptoms with a pill. Other symptoms commonly occur, as progesterone calms the body to allow sleep, sleep disturbances can occur and a prescription for a sleeping med can also occur. Another symptom can be increasingly severe cycles with heavy and frequent bleeding. Many times a woman will be recommended an ablation or put on birth control pills to “regulate” her system, IMO any of these Band-Aid treatments are inferior to first fixing the underlying problem with progesterone replacement.

Menopause can start as early as 35. In addition to the symptoms of progesterone deficiency as above, anxiety, moodiness, PMS, heavy erratic cycles, sleep disturbance, hot flashes, and magnified problems with mood and sleep occur. As estrogen is stimulating, fatigue can be more prominent and libido can be low. Cycles become quite irregular often missing months. Estradiol also improves blood sugar metabolism. With time, the deficiencies can weigh on overall health. Estradiol improves memory, bone density cardiovascular health, skin health and more. As deficiency continues, osteoporosis, cardiovascular disease, diabetes, aged skin appearance and elasticity, and worsening memory issues may become the more dominant health issues that are often not attributed to estradiol deficiency.

Treatment of these deficiencies achieves two main results, first is quality of life, including better energy, sleep, mood, and sex drive and function. The second benefit is improved internal health. Their replacement corrects the developing health issues so that bone density, cardiovascular health, blood sugar metabolism, and aging skin make for improvements in the right direction.

Many fear the risks of hormone replacement, and estrogens are amongst those. I address these concerns in the hormone section, but briefly, estradiol has been taken off the list of cancer inducing agents, and bioidentical progesterone has strong cancer protective properties. If bio-identical hormones are used, these risks are no more than baseline, and actually less with progesterone. For a full discussion of the risks and benefits it is best we discuss your case face-to-face.