Understanding Hormone Replacement Therapies

While hormone loss is a naturally recurring process as we age, the use of bio-identical hormone replacement therapies can safely help women and men regain their health, confidence, and youthful state of being.

Menopause, PMS, and  Andropause

Menopause is a natural stage of life, affecting different women in very different ways, with symptoms that vary widely, in number, variety and strength.  The average age of the onset of menopause is 51.4 years, although some women stop having periods in their early forties, while others go on until their late fifties.  And, the symptoms can last for up to two years after the final period, with some women experiencing hot flashes for up to ten years.

Menopause can be a challenging time.  Besides the physical symptoms of menopause, there are emotional changes as well, including worries about growing older, sense of personal attractiveness and self-esteem.  Common symptoms of menopause include:

  • Bleeding gums
  • Body Odor
  • Bouts of rapid heartbeat
  • Breast tenderness
  • Brittle fingernails
  • Burning tongue
  • Clammy feeling
  • Depression
  • Difficulty concentrating and mental confusion
  • Dizziness and light headedness
  • Fatigue
  • Feelings of anxiety, dread    and apprehension
  • Flatulence and gas pain
  • Hair loss or thinning
  • Headache
  • Hot flashes, flushes, night sweats and cold flashes
  • Increase in allergies
  • Increase in facial hair
  • Indigestion and nausea
  • Irregular periods
  • Irritability
  • Itchy, crawly skin
  • Loss of libido
  • Memory lapses
  • Mood swings and sudden tears
  • Muscular tension
  • Sensation of electric shock
  • Sore joints and muscles
  • Sudden bloating
  • Tingling in the extremities
  • Trouble sleeping through the night
  • Urinary tract problems
  • Vaginal dryness
  • Weight gain

Natural menopause is caused by ovarian failure due to aging.  At birth, women may have as many as two million eggs within their ovaries.  By puberty, this is reduced to about 300,000 and at menopause, the eggs are virtually absent.  The accompanying declines in estrogen and progesterone production cause the characteristic symptoms of menopause.

Since periods rarely stop without warning, the transitional stage during which most women begin to become irregular prior to stopping altogether is called peri-menopause or pre-menopause.  Typically lasting for two to three years, peri-menopause may last up to ten years before complete cessation of the menstrual period.  During this time, women may experience a combination of PMS and menopausal symptoms or no symptoms of menopause at all.

Women who have had both ovaries and/or uterus (hysterectomy) surgically removed will experience a dramatic reduction in the production of all sex hormones, in effect, an artifically induced state of menopause called surgical menopause.


Premature menopause (ovarian failure before the age of 40) exhibits the same clinical symptoms and complaints associated with natural menopause.  This version of menopause may be due to a range of factors including radiation exposure, smoking, cancer, drugs or other causes.


Premenstrual Syndrome (PMS) is real.  PMS is caused by an imbalance of estrogen and progesterone, the two primary female hormones and affects millions of women.  Estimates indicate that 85% of menstruating women experience some form of PMS.

PMS is attributed to a range of conditions.  In some cases, it may be caused by a lack of communication between the hypothalamus, the pituitary and the ovaries, the glands most involved in menstruation.  Depression, stress and low levels of certain vitamins and minerals are also speculated to be among the contributors to symptoms of PMS.

Symptoms of PMS occur monthly, generally 7 to 14 days prior to menstruation, and may seem to increase as menstruation approaches and subside at the onset of menstruation or soon thereafter.  Some of the common physical and emotional PMS symptoms are:

  • Acne or skin eruptions
  • Abdominal bloating
  • Aggression
  • Appetite changes and food cravings
  • Anxiety
  • Backache
  • Breast tenderness
  • Change in sexual drive or activity
  • Clumsiness
  • Crying spells
  • Depression
  • Difficulty concentrating
  • Fatigue
  • Headache
  • Hot flashes
  • Inability to relax
  • Joint or muscle pain
  • Lethargy
  • Low abdominal pain
  • Mood swings
  • Nausea
  • Tension
  • Weight gain from fluid retention

There is no single treatment for PMS because of the wide range of symptoms and variety of contributors to the cause of the condition.  Common treatments that may help include bioidentical hormone replacement therapy, diet changes, exercise, vitamin supplements, medications, education and psychological counseling.


Andropause, sometimes referred to as male menopause, may have a mythic status due to many men’s “don’t ask – don’t tell” unwillingness to acknowledge the condition.  According to the World Health Organization (WHO), “male androgens progressively decline with age.”  This male hormone deficiency – andropause – or “male menopause” really exists.

Between the ages of 40 and 55, men can experience a condition similar to menopause due to a decline in male hormone (androgens) levels, primarily testosterone.  Body changes occur gradually and may be accompanied by symptoms similar to those of menopause.  Symptoms of male hormone deficiency or imbalance include:

  • Accelerated aging of the heart
  • Diminished cognitive function
  • Changes in attitudes and moods
  • Decreased physical agility
  • Depression
  • Erectile dysfunction
  • Fatigue
  • Lack of sex drive
  • Decline in sexual function
  • Loss of competitive edge
  • Loss of energy
  • Rapidly falling level of fitness
  • Increased abdominal fat
  • Shrinkage of muscle mass
  • Stiffness and pain in the muscles and joints

Although andropause may demonstrate a low level of total testosterone, it is better indicated by a deficiency of free testosterone – the form of testosterone that is most bio-available to the body.  Triggers for andropause symptoms that add to the normal effects of aging seem to include:

  • Excess alcohol use
  • Inactivity and lack of exercise
  • Infections
  • Obesity
  • Stress
  • Vasectomy

Hormonal imbalances can also be caused by too much testosterone, free testosterone, estrogen or progesterone. These forms of male hormone imbalances are correctable by establishing baselines with the proper blood tests and using available drugs and nutritional supplements.