Menopause Coaching & Support Solutions

Pause For Thought

Many women have severely uncomfortable PMS symptoms in their mid 30s, or irregular periods and worsening PMS in perimenopause in their 40s or early 50s. These symptoms can be extremely disruptive to women’s lives. Fortunately, we have effective ways to help them feel better. Sadly though, the best ways to treat this are rarely used by American physicians.

There is a widespread reluctance to test hormone levels (estrogen, progesterone, etc.) and just treat using symptoms and timing. There are standard “talking point“ excuses that doctors are taught to give. Women are usually told “We don’t check those levels because they fluctuate and thus are not clinically useful.” Both in the pre-menopause/childbearing and perimenopause years, levels do fluctuate dramatically during different phases/stages of the menstrual cycle. Does that make them difficult to interpret? Absolutely, but it doesn’t mean that the levels are useless clinically? For instance, when a woman is having worsening or severe PMS symptoms after ovulation, there is often a huge spike of estrogen and a deficit of progesterone which is easily treated with a prescription from your local pharmacy. Post menopause, there are no dramatic hormone fluctuations, so the excuse/talking point is not at all true. Of course, hormonal symptoms and menstrual timing are important considerations, but checking levels provides additional information to make the best clinical choice. I am surprised several times per month by hormone levels that are very different than I would have predicted from symptoms and timing alone.

If we want to be honest, the true reasons behind clinicians dodging/refusing to test hormone levels, has to do with lack of education and lack of consensus about what hormone levels we should be targeting for optimal health. I’ve had many patients tell me that their doctors say that they had little to no hormone management training, and that the knowledge they have seems outdated. I can personally confirm this lack of training during my time in medical school, internship and residency.

There are many consequences from these issues discussed above. Most importantly, there is an unnecessary decrease in women’s quality of life in addition to missing out on the multiple health benefits that hormone replacement can provide.

by Dr. Richard Sinda - one of the leading doctors in the Midwest, specializing in Bio-Identical Hormone Replacement.

Board Certified in Family Medicine, Functional Medicine, and Age Management Medicine.