Menopause 101

Sharzad Green, Pharm.D.

Community Clinical Pharmacy

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“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, 6th Century, B.C. 2

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

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Symptoms of Peri-Menopause

Insomnia

Mood Swings

Body Fat Redistribution

Decreased Sex Drive

Hot Flashes and Night Sweats

Decreased Energy Level

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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

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Menopause Cont’d.

Medically induced Menopause

Surgical Menopause

Removal of the ovaries

Removal of the uterus or tubal ligation

can lead to premature menopause

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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

Signs and Symptoms of

Menopause Cont’d.

Mood swings, irritability, depression

Bone density changes (Role of

Vitamin D)

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Cholesterol

Pregnenolone Progesterone

17a – Hydroxypregnenolone 17a Hydroxyprogesterone

DHEA Androstenediol

Androstenedione Testosterone

16a – Hydroxydehydroepiandrosterone

Dihydrotestosterone

16a - Hydroxyandrostenedione Estrone

16a,19 – Dihydroxyandrostenedione Estradiol

16a – Hydroxyestrone Estriol

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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

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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

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Goals of Bio-Identical HRT

Alleviate symptoms of peri-

menopause and menopause

Bring the body back to Hormonal

Balance

Imitate the body’s natural process as

much as possible

Bring back QUALITY OF LIFE!

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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

Symptoms of Low Estrogen

Cont’d.

Frequent urinary tract infections and

yeast infections

Bone loss

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Cholesterol

Pregnenolone Progesterone

17a – Hydroxypregnenolone 17a Hydroxyprogesterone

DHEA Androstenediol

Androstenedione Testosterone

16a – Hydroxydehydroepiandrosterone

Dihydrotestosterone

16a - Hydroxyandrostenedione Estrone

16a,19 – Dihydroxyandrostenedione Estradiol

16a – Hydroxyestrone Estriol

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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

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Cholesterol

Pregnenolone Progesterone

17a – Hydroxypregnenolone 17a Hydroxyprogesterone

DHEA Androstenediol

Androstenedione Testosterone

16a – Hydroxydehydroepiandrosterone

Dihydrotestosterone

16a - Hydroxyandrostenedione Estrone

16a,19 – Dihydroxyandrostenedione Estradiol

16a – Hydroxyestrone Estriol

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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

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Bio-Identical Testosterone

Cont’d.

Testosterone helps improve mental

alertness, energy and mood

Enhances libido

Improves muscle strength and tone

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Cholesterol

Pregnenolone Progesterone

17a – Hydroxypregnenolone 17a Hydroxyprogesterone

DHEA Androstenediol

Androstenedione Testosterone

16a – Hydroxydehydroepiandrosterone

Dihydrotestosterone

16a - Hydroxyandrostenedione Estrone

16a,19 – Dihydroxyandrostenedione Estradiol

16a – Hydroxyestrone Estriol

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Bio-Identical DHEA

DHEA levels peak between ages 25-

30

Increases energy levels

Improves memory

Some DHEA is metabolized to

testosterone and estrogens

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Hormone Testing

Blood Testing vs. Saliva Testing Cost

Convenience

Reliability of results

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Effectiveness of Over the Counter

(OTC) Items

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What Are Your Triggers?

Alcohol

Caffeine

Smoking

Hot or spicy food

Stress

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A Word About Men

Andropause

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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)

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Thank you for your time!

Questions? Comments?

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