Menopause 101. Sharzad Green, Pharm.D. Community Clinical Pharmacy
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1 Menopause 101 Sharzad Green, Pharm.D. Community Clinical Pharmacy 1
2 She has such different moods. One day she is all smiles and happiness. Other days there is no living with her. Throughout a woman s life, waves of emotions mimic the sea, so often innocent and still, yet sometimes wild and turbulent. - Semonides, 6 th Century, B.C. 2
3 Peri-Menopause During reproductive years from menarche to menopause there is a complex hormone cycle which is repeated every 28 days. Between ages 35 and 50 production of progesterone and estrogen begins to decline 3
4 Symptoms of Peri-Menopause Insomnia Mood Swings Body Fat Redistribution Decreased Sex Drive Hot Flashes and Night Sweats Decreased Energy Level 4
5 Menopause Menopause is the permanent cessation of menstruation there are no follicles remaining in the ovaries Approximate Age is 51 years Natural Menopause 12 Consecutive months without menstruating 5
6 Menopause Cont d. Medically induced Menopause Surgical Menopause Removal of the ovaries Removal of the uterus or tubal ligation can lead to premature menopause 6
7 Signs and Symptoms of Menopause Changes in menstrual pattern leading to a decline in periods Hot flashes, sweats Sleep deprivation Vaginal dryness, painful intercourse Bladder symptoms Dry Skin Foggy Memory (Omega 3 Capsules) 7
8 Signs and Symptoms of Menopause Cont d. Mood swings, irritability, depression Bone density changes (Role of Vitamin D) 8
9 Cholesterol Pregnenolone Progesterone 17a Hydroxypregnenolone 17a Hydroxyprogesterone DHEA Androstenediol Androstenedione 16a Hydroxydehydroepiandrosterone 16a - Hydroxyandrostenedione Estrone Testosterone Dihydrotestosterone 16a,19 Dihydroxyandrostenedione Estradiol 16a Hydroxyestrone Estriol 9
10 What is a Bio-Identical Hormone? Estrone (E1), Estradiol (E2), Estriol (E3), Progesterone, Testosterone, DHEA, Pregnenolone Derived from soy or yam Exact match to human hormones. When analyzed biochemically they are indistinguishable from those produced by the human body 10
11 What is a Bio-Identical Hormone? Cont d. Requires a prescription Synthetic hormones have a different molecular structure; therefore do not fit receptor sites Natural hormones cannot be patented 11
12 Goals of Bio-Identical HRT Alleviate symptoms of perimenopause and menopause Bring the body back to Hormonal Balance Imitate the body s natural process as much as possible Bring back QUALITY OF LIFE! 12
13 Symptoms of Low Estrogen Hot Flashes and night sweats Sleep disorders, insomnia Vaginal dryness, painful intercourse Bladder symptoms Mood swings, anxiety, nervousness, depression Headaches Short-term memory loss 13
14 Symptoms of Low Estrogen Cont d. Frequent urinary tract infections and yeast infections Bone loss 14
15 Cholesterol Pregnenolone Progesterone 17a Hydroxypregnenolone 17a Hydroxyprogesterone DHEA Androstenediol Androstenedione 16a Hydroxydehydroepiandrosterone 16a - Hydroxyandrostenedione Estrone Testosterone Dihydrotestosterone 16a,19 Dihydroxyandrostenedione Estradiol 16a Hydroxyestrone Estriol 15
16 Bio-Identical Progesterone Oldest known hormone Produced by the ovaries and adrenal glands Precursor to the other sex hormones Acts as a natural diuretic Natural anti-depressant May improve sleep Positive effect on bone density 16
17 Cholesterol Pregnenolone Progesterone 17a Hydroxypregnenolone 17a Hydroxyprogesterone DHEA Androstenediol Androstenedione 16a Hydroxydehydroepiandrosterone 16a - Hydroxyandrostenedione Estrone Testosterone Dihydrotestosterone 16a,19 Dihydroxyandrostenedione Estradiol 16a Hydroxyestrone Estriol 17
18 Bio-Identical Testosterone Testosterone is the hormone of desire Women produce 1/10 as much as men Produced by the adrenal glands and ovaries of the female There is a gradual decline of testosterone secretion after menopause 18
19 Bio-Identical Testosterone Cont d. Testosterone helps improve mental alertness, energy and mood Enhances libido Improves muscle strength and tone 19
20 Cholesterol Pregnenolone Progesterone 17a Hydroxypregnenolone 17a Hydroxyprogesterone DHEA Androstenediol Androstenedione 16a Hydroxydehydroepiandrosterone 16a - Hydroxyandrostenedione Estrone Testosterone Dihydrotestosterone 16a,19 Dihydroxyandrostenedione Estradiol 16a Hydroxyestrone Estriol 20
21 Bio-Identical DHEA DHEA levels peak between ages Increases energy levels Improves memory Some DHEA is metabolized to testosterone and estrogens 21
22 Hormone Testing Blood Testing vs. Saliva Testing Cost Convenience Reliability of results 22
23 Effectiveness of Over the Counter (OTC) Items 23
24 What Are Your Triggers? Alcohol Caffeine Smoking Hot or spicy food Stress 24
25 A Word About Men Andropause 25
26 Recommended Readings: Stay Young and Sexy with Bio-Identical HRT Wright and Lenard Are Your Hormones Making You Sick? Taylor Becoming Orgasmic Heiman & LoPiccolo Ageless Suzanne Somers For Women Only Berman & Berman Secrets of Sexually Satisfied Women Berman & Berman The Testosterone Syndrome Shippen & Fryer (For Men) 26
27 Thank you for your time! Questions? Comments? 27
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TEST REPORT Ordering Provider: David Getuwell, MD 8605 SW Creekside Place Beaverton, OR 97008 Phone: 503-466-2445 Fax: 503-466-1636 Samples Received 08/15/2018 Report Date 08/20/2018 Samples Collected