Recently, a dear friend confided that she was really starting to suffer with some perimenopausal symptoms. She just happens to be in the late perimenopausal stage and will probably be transitioning into menopause soon. Like many, if not most women in their 40s and 50s, she is also under a significant amount of stress. She said something that was sad, chilling, and all too common. Her comment was, “I can see why women going through this commit suicide.”
For quite awhile now, I have been reading about the link between hormone loss and its link to brain disfunction and mood disorders, including suicide. The website Hormones Matter has posted many articles by women who developed depression, hopelessness, and suicidal thoughts following hysterectomy. A study in Korea showed that women who had premature ovarian failure (ovaries that weren't producing hormones normally) had a much higher rate of suicidal thoughts. A study of Japanese mothers of teens showed that suicidal thoughts increased significantly during perimenopause and menopause.
What is the common denominator between hysterectomy, premature ovarian insufficiency, perimenopause, and menopause? Obviously, it’s the loss (or fluctuation) of hormones.
Unfortunately, in my opinion, one of the biggest problems for women who have had a hysterectomy or those who have just gone through menopause naturally, is that they haven’t been given appropriate hormone replacement.
The vast majority of women who have had a hysterectomy are placed on estrogen alone (or sometimes estradiol plus testosterone) being told that they do not need progesterone since they don’t have a uterus.
Progesterone is necessary for health. The only women who need progesterone are those with a brain, breasts, or bones! Pretty much every cell in our body requires progesterone to function optimally.
Also, for the vast majority of women, including those who have had a hysterectomy (or gone through menopause naturally), androgen levels are never addressed. The loss of DHEA and testosterone can cause severe fatigue, apathy, depression, loss of libido, brain fog, memory issues and loss of brain, muscle, and bone tissue. These hormones should be measured and replaced appropriately.
Stress and its impact on cortisol is another big issue that needs to be addressed. All women who have had a hysterectomy, and most women who are perimenopausal or have gone through menopause naturally, have had tremendous stressors. Yet most women never have had their cortisol levels measured. Chronic or severe stress can cause adrenal fatigue, with resultant brain fog, memory problems, exhaustion, depression, and overwhelming hopelessness. Adrenal health needs to be addressed. If a woman has adrenal fatigue, she will benefit from getting all hormones optimized. She may also need targeted and thoughtful supplements, improved sleep environment, gentle movement, healthy relationships (sometimes with improved boundaries), and stress reduction and stress management techniques.
How do you determine if each of these hormones (estrogen, progesterone, testosterone, DHEA, and cortisol) are depleted or in ideal range?
By accurately measuring tissue levels of these hormones through saliva testing. Once hormone levels are known, women should work with a specialist who utilizes saliva testing and uses low-dose, bio-identical hormone replacement to get each hormone into ideal range.
Being able to recover after hysterectomy or natural menopause requires looking at and replacing all of the missing pieces, not just estrogen.
Progesterone is one of my favorite hormones. Learning about the importance of our natural, God-given progesterone during my first functional medicine course was life-changing personally. It also probably marked the beginning of the end of my career in Western Medicine. Learning about progesterone (and other hormones, vitamins, minerals, and lifestyle modifications that actually could improve our health and reverse disease) taught me that allopathic medicine might have been able to treat symptoms, but not help us feel better or live longer.
Progesterone is vitally important for optimal health in women, and yet it is almost totally ignored by most medical practitioners–including those prescribing hormone replacement.
Women are told that they don’t need progesterone if they don’t have a uterus. Or that synthetic progestins have all the benefits of natural progesterone.
Both of these statements are untrue and harmful for women of all ages, from teens with PMS and acne, to women struggling with infertility, to postmenopausal women with poor sleep and osteoporosis.
Progesterone is important for all areas of the body, but especially for the brain, bones, and breast tissue. I would go so far as to say that it might not be possible to have a healthy brain without progesterone.
And yet many women who are given prescriptions for hormonal replacement are not given progesterone if they have had a hysterectomy. And even if they still have a uterus, many women are prescribed unnatural, unsafe, synthetic progestins. Progestins are molecules that are shaped similarly to progesterone but can behave the opposite of progesterone. Progestins can cause bone loss, mood issues, and an increased risk of breast cancer-and more.
And it’s not any better online. Some social media “experts” are recommending that women use dosages of progesterone that are up to 10 or 20 times more than a young healthy woman would make. Most of the time this is because they are using blood or urine tests to measure hormones. Using these tests can cause women to massively overdose on progesterone, estrogen, and testosterone.
Another reason women are overdosing on progesterone is because they are being instructed to use oral progesterone vaginally or rectally. This is very problematic for a few reasons. When progesterone is used orally nearly all of it is metabolized by the liver and only a very small amount remains as progesterone. Oral progesterone dosages are often 10 times higher than the amount made by healthy young women. When oral progesterone is used vaginally or rectally, it doesn't go into the gut initially and isn’t broken down by the liver. This usually leads to massive overdosing of progesterone. And that much excess progesterone can convert to cortisol-causing yeast infections, poor immune system function, high blood sugar & insulin levels, resulting in weight gain.
When it comes to progesterone, like many things in our bodies, more is not better.
Understanding the differences between routes of administration and dosages are extremely important. And knowing which delivery systems and testing is necessary to know how much progesterone is being absorbed is vital.
