Is it Menopause?

Are you experiencing problems with insomnia, changes in mood, irritability,decreased sexual libido, hot flashes or night sweats that interfere with sleep  or daily functioning? Are there memory or other cognitive problems? Are there palpitations,or anxiety, worsening of depression,or premenstrual symptoms? Are you suffering with vaginal dryness , urinary incontinence or increased urinary tract infections? Do you have increased joint pain?

All of these can be signs of declining hormones.

Although menopause is not officially diagnosed till you have not had a period for one full year,these symptoms may happen up to ten years prior and this is referred to as the “change’ or peri-menopause.

Knowing what to expect allows you to be prepared and learn about options to deal with these issues.

Bio identical hormones

This term refers to any hormone that exactly matches those made in the body naturally.Some people may think of theses as natural, however all hormones need to be synthesized in the lab, and all of them in Canada need a prescription for use. Most hormones bio-identical or synthetic as in birth control pills are made from yams or soy so they could be all considered natural source. Bio-identical hormones are estriol, progesterone, testosterone, estradiol, DHEA, cortisol, some are available commercially i.e. all forms of the estrogen patch, and micronized oral progesterone. They do not have to be compounded by a compounding pharmacy, however some such as testosterone for women,progesterone cream, and DHEA, are not available from a pharmaceutical company and need to be specifically made for a patient with a physician’s prescription.

Compounding also allows for strengths and formats not available commercially, and for tailoring individual therapy.Hormones synthetic or otherwise may carry risks for certain patients, however bio identical hormones may have advantages over synthetic ones.

Hormone testing,saliva,blood,urine?What’s the best way to test, do you need to test?

This needs to be discussed with your practitioner. However if you are having symptoms related to hormonal imbalances it may be useful to get hormone levels, to assess which hormones need to be replaced.Testing may also be needed for dosing, monitoring of treatment, and  to avoid side effects.

Blood urine and saliva may all be appropriate in different patients, and the form of hormones used.

Blood tests measure the hormones carried in the blood that include free and bound hormones,this is not always correlated to levels of hormones available to the tissues.

Hormones measured could include estradiol, estrone, estriol, progesterone, testosterone, DHEA-S-, cortisol, FSH, and LH.

Salivary testing is non invasive and may be more convenient especially for testing cortisol levels through the day but is not covered by OHIP.

For more information please feel free to contact me.

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