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Photo courtesy of Media Bakery. Funny you should ask. Most women know that hot flashes, night sweats, and menstrual irregularities are part of the hormonal changes of perimenopause. Or, women experience depression and anxiety for the first time and do not know why but find that their quality of life has diminished and just believe it is going to be that way.

She may not have any symptoms yet, but hormonal changes are happening. I always tell my patients that they can continue to age with the same or even better level of energy and vitality as they had when they were younger—but how we treat our bodies becomes much more important. If a woman has not gone a full year without a period, she can still get pregnant.

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Is it more difficult? A woman does not always ovulate regularly, and egg quality diminishes which reduces chances of a healthy conception. Besides the cycle and mood issues mentioned above, other symptoms include:.

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The hormonal fluctuations in perimenopause can cause a metabolic imbalance in our body. The most important thing a woman can do during perimenopause is optimize her health by:.

Then, I make recommendations based on overall health and symptom presentation that are a mix of elements below. Consult with your doctor or health care professional about the appropriate mix for you. This helps balance the intestinal flora, support gastrointestinal and immune health functions, and enhance digestion. Herbs such as rhodiola, eleuthro, ashwaganda, american ginseng, scizandra, and vitamins and minerals such as B vitamins, magnesium, and vitamin C all support the adrenals.

I have found that these herbs and often a combination of herbs are most successful in addressing perimenopausal symptoms: Maca; black cohosh; dong quai; a blend of Angelica gigas root ; phlomis umbrosa root ; and Cyanacum wilfordii root ; rhapontic rhubarb.

Milk thistle, burdock, dandelion root, DIM or I3C the latter two support estrogen metabolization and decrease estrogen dominance which can occur during the early perimenopausal transition.

Melatonin, Chamomile, Hops, Glycine, Phenibut, and, if cortisol is elevated at night time which can happen with stress and low estrogenhosphatidylserine. If a woman is still ovulating, hormones Hot body wellness boobs good looking pills not be necessary.

The first line of defense is nutrition and lifestyle habits, followed by herbal and nutritional therapies. Lifestyle changes should be made as soon as possible. If diet and lifestyle changes do not improve symptoms then hormones can be considered. In this situation, supplemental progesterone may be helpful. Progesterone can be taken in cream or pill form. Oral progesterone is particularly effective at addressing insomnia.

Birth control pills are also commonly prescribed for women going through perimenopause since they suppress ovulation and provide a stable, non-fluctuating level of hormones throughout the month.

I rarely choose this option since it is a band-aid approach and uses synthetic hormones; however, it may be the right decision for some woman. Symptoms such as hot flashes, night sweats, and vaginal dryness tend to be more prominent as estrogen production diminishes.

Again, if lifestyle changes do not improve the situation, estrogen and progesterone can be considered. There are many different types of estrogen. The form of estrogen that has the greatest effect in addressing symptoms of perimenopause and menopause, and the one most commonly prescribed, Hot body wellness boobs good looking pills estradiol. Estradiol can be given orally or transdermally patch or cream.

Estradiol cream or patch rather than pill form is the safest route to go since oral estrogen can increase inflammation and risk of clot formation. Estriol is a weaker form of estrogen that is very effective at addressing vaginal dryness when applied locally.

Progesterone must be prescribed along side estradiol in order to protect the uterus from uterine cancer.

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Women need to see their physician to see if hormones are an appropriate treatment option. Women with a strong breast cancer history or women with an increased risk of clotting should avoid hormones. Prior to starting hormones, I recommend getting a mammogram to rule out breast mass and pelvic ultrasound to rule out a thickened endometrial lining and assess whether there are fibroids.

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You will need to do a comprehensive hormonal panel on day 21 of your cycle or 1-week before you expect to get your period. This is when hormones should be at their peak and is the best time to assess adequate progesterone levels.

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This will also determine whether you ovulated during the cycle. This is just a baseline and needs to be evaluated knowing that hormone levels in the blood fluctuate throughout the day and do not represent the free hormones in the body. I do find that it gives a good baseline and is easy to obtain and often covered by insurance.

To do a fertility assessment of hormones, you will need to do an evaluation on day 2 or 3 of your cycle.

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A saliva and urine test can evaluate the free hormones, which are available to bind to cells to have an affect in the body. Hormones also come bound to proteins, which are essentially not active in the body. To more closely evaluate adrenal health, do a saliva test at four different times of the day.

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Every women should also get a comprehensive panel to assess cholesterol levels especially LDL and HDLblood sugar levels glucose and HgA1Cfasting insulin, hsCRP measures inflammation, ideally this number should be Fluctuating levels of hormones mostly estrogen and progesterone can cause a metabolic imbalance in the body. As hormones decline, neurotransmitters, cortisol, and insulin change in such a way that lowers our metabolism and contributes to weight gain and difficulty loosing weight unless lifestyle and hormones are addressed.

For example, as estrogen levels decline, cortisol levels increase. Cortisol is a stress hormone that contributes to midsection weight gain. To counter this, eat clean, whole foods—limited processed foods if any at alllimited sugar—and focus on exercise, sleep, hydrating, stress management, and supporting gut, liver, and the adrenals. She specializes in female hormone balancing and healthy aging. The views expressed in this article intend to highlight alternative studies and induce conversation.

They are the Hot body wellness boobs good looking pills of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is Hot body wellness boobs good looking pills, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

Q So is perimenopause just an inevitable part of aging?