Night sweats? Brain fog? Anxiety? Sleep issues? Hot flashes? Does it feel like you woke up one day and the perimenopause bundle ‘hit’ you? You hoped you would be one of those lucky women that can sail through their perimenopause era without any symptoms but unfortunately, it doesn’t look like that’s your case.
The secret? Even though your own hormones are fluctuating significantly, you can still get relief through either naturopathic medical care or seeing a nurse practitioner.
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Our nurse practitioner can help you navigate the world of Hormone Replacement Therapy (HRT), order bloodwork for testing your hormones, and figure out if you should be on combination HRT (estrogen and progesterone) or if solely progesterone is okay. It’s true, as long as you are using bioidentical progesterone, known as Oral Micronized Progesterone (OMP) or branded as Prometrium, you can take it alone. Progestin may be used alone too but the type may matter (medroxyprogesterone acetate is a progestin that can be used alone). It’s finding the right practitioner that can prescribe OMP as many are quick to prescribe a progestin.
Why would you want to take OMP over a progestin? Both OMP and progestin have similar effects when it comes to hot flashes and night sweats and progestin like medroxyprogesterone has a longer half life in the body but OMP has been shown to be superior to medroxyprogesterone when it comes to improving sleep and anxiety (1). This is because progesterone binds to GABA receptors in our brain helping reduce anxiety and promote sleep. Progestin, unfortunately, cannot bind to these GABA receptors. OMP, however, since it is identical to our body’s progesterone, can bind to these GABA receptors and that is why it can improve sleep and lower anxiety.
While progesterone or progestin can be used alone, estrogen is never prescribed alone in women who still have their uterus!
Our nurse practitioner will perform an assessment, run some testing if needed, and be able to prescribe you the best HRT option for you, including when in your cycle to take it and how much to take.
BUT wait, you aren’t fully ready to take hormones.
This is where naturopathic medicine can come in. There are herbal hormone modulating agents we can use to see if they help you feel better and alleviate the symptoms.
There are other nutritional and herbal supplements that may help address the sleep and anxiety.
Often perimenopause/menopausal symptoms can be related to an increased histamine load because of the estrogen-progesterone imbalance that occurs. Ensuring your body is able to eliminate histamine is key - this means assessing liver detoxification pathways, gut health and immune regulation is important.
Acupuncture can be beneficial in providing support from perimenopausal symptoms and some find an added bonus of a 30 minute ‘acunap’ where they can get a quick nap during their treatment. Extremely beneficial when you are experiencing insomnia.
Did you know stress can also play a role in the intensity of your symptoms? Managing stress and improving your cortisol regulation is also important. As your ovaries decline hormone production, the majority of your estrogen and progesterone come from your adrenal glands - those same glands that make our stress hormone friend, cortisol. If we keep feeding our adrenals stress, we get more cortisol. This “robs” the adrenal glands from making progesterone and estrogen. Adrenal regulation is so important during perimenopause! If you are approaching this era of your life and feel burnt out or like your cortisol may be high, running a 4-point cortisol rhythm test may be right for you. Speak with our naturopathic doctor to learn more during your assessment.
Ready to take the next step in your perimenopause / menopause journey?
You don’t have to push through this on your own, and you don’t have to wait for answers.
Ready to dive in and explore HRT and if it is right for you and your options? Schedule an assessment today with our nurse practitioner as long as you are in Alberta.
Feeling a bit hesitant to take hormones and want to address stress, histamine, sleep and anxiety with naturopathic recommendations? Schedule an assessment with our naturopathic doctor - this is available whether you are in Alberta or Ontario.
Your appointment may be covered by your extended health benefit plan or you may get reimbursed from your health spending account for either your NP or naturopathic appointment(s).
This post is for general information only and isn’t a substitute for personal medical advice. Talk with a qualified health care provider about what’s right for you.
Reference:
(1) Montplaisir, J., Lorrain, J., Denesle, R., & Petit, D. (2001). Sleep in menopause: differential effects of two forms of hormone replacement therapy. Menopause (New York, N.Y.), 8(1), 10–16. https://doi.org/10.1097/00042192-200101000-00004
