The menopause symptoms that get treated as six separate problems

There is a particular kind of frustration that women describe when they finally sit down in our office in Surprise. It is not any single symptom. It is that each symptom has been taken seriously on its own, by someone reasonable, and dealt with on its own, and nobody has stood back far enough to ask why six things arrived in the same eighteen months.

Hormones control mood, energy, body fat, sleep quality, mental clarity and sex drive. That is a wide brief. When they fall out of balance, the effect is not one problem. It is a scatter of problems across every one of those systems, which is exactly what makes the underlying cause easy to miss.

The list, as women actually report it

These are the symptoms hormone replacement therapy can treat in women, in the plain terms they get described to us in:

• Brain fog, and the specific loss of a word you know you know
• Vaginal dryness
• Low libido
• Headaches
• Anxiety
• Depression
• Dry skin
• Low energy that sleep does not fix

Alongside those, there is a set of physical signs that rarely get connected to hormones at all: acne, thinning hair, unwanted hair on the face and arms, thin or dry skin, brown spots on the face, unstable blood sugar, low blood pressure. And a reproductive set: tender or enlarged breasts, painful or severe periods, debilitating PMS, painful intercourse, mid cycle pain, ovarian cysts, miscarriage or infertility.

Then the emotional register, which is the one women apologise for raising: fatigue heavy enough to tip into lethargic or anxious depression, foggy thinking, and an intolerance to exercise that is out of proportion to fitness.

It starts earlier than most people expect

Menopause symptoms can begin as much as fifteen years in advance of menopause itself. That single fact explains a great deal of the confusion, because a woman in her late thirties or early forties is not looking for a menopause explanation and neither, often, is anyone she talks to.

As many as three and a half thousand women enter menopause every day. Most do not fully recover from the change on their own, even when the loudest symptoms settle down and the outward picture looks normal again.

What actually causes the imbalance

Five things, in various combinations: the natural aging process, genetic tendency, stress, diet and exercise. Only two of those are within anyone's direct control, which is worth saying plainly, because women arriving at this point often assume they have done something wrong. Usually they have not.

Two ways to deliver the hormones

The first is pellet therapy. Bio-identical hormone pellets are placed just under the skin in an outpatient procedure that takes a few minutes. They release estrogen and testosterone steadily, and your body takes what it needs. Most women need less than a week before returning to normal life and exercise. On average, women are re-pelleted every four months, which puts the year at two or three visits.

The second is troches, which are medicated lozenges. You place one between cheek and gum and it dissolves over fifteen to thirty minutes through the lining of the mouth. Blood levels peak within an hour. Troches suit people who want to start without a procedure, or whose situation calls for a delivery method that can be adjusted quickly.

Which one is right is not a matter of preference alone. It follows from your blood panel, your history and how your body responds, and it is a conversation rather than a menu choice.

Why bio-identical is the word that matters

Bio-identical hormones replicate the molecular structure of the hormones the human body already produces. In the pellets, that means they contain nothing other than the hormone your body makes, which is also why they dissolve completely and are absorbed, leaving nothing behind.

Getting an actual answer

The first step is the comprehensive blood panel, and the second is somebody sitting down and going through it with you rather than telling you that you are within range. That is the part Sun Valley was built around. The practice was kept small on purpose so that appointments are not rushed, and Patricia Polson, FNP-C, is a board certified family nurse practitioner who has been working in the Phoenix metropolitan area since 1989.

If the list above reads like a description of your last two years, that is worth a phone call. We are in Surprise, Tuesday through Friday, and evening appointments can be arranged by request.