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symptoms not only can be man- it is almost impossible to find a like the pills that we currently
aged but also you can feel better physician who has the expertise prescribe to some patients after
than how you felt before your to provide hormonal treatments their breast cancer surgery and
symptoms began. for all of our symptoms without radiation, in order to reduce the
Menopause doesn’t happen hesitation. breast cancer reoccurrence.
overnight. The hormonal decline The root of a physician’s The benefits of this hormone
begins in your thirties. For ex- hesitation to offer hormonal were discovered by Dr. Bennink
ample, women start losing bone treatment to a woman experi- in 2015 and it is currently close
density from age 30, however encing these symptoms is partly to becoming available to women
as physicians we test a wom- valid and partly due to the lack in Europe and hopefully soon, to
an’s bone density from age 50 of training and/or experience women in the USA.
onwards. (American Association of the physicians in the area of In the meanwhile, my recom-
recommends DEXA at age 50). hormone treatment. mendation is to seek an experi-
A woman could be experi-
enced physician’s care and dis-
A survey of residency pro-
Ask Dr. Sudi encing hormonal changes and grams across internal medicine, cuss the use of hormonal creams
or vaginal suppositories rather
a decline in her wellbeing for up
family medicine, and gynecology
to two decades before feeling
the physicians in training have
justified to search for treatment. residence has demonstrated that than taking hormonal pills.
In the past 20 years of my
The definition of perimeno-
By Dr. Sudabeh Moein pause and menopause can maybe 1 or 2 total hours focused practice, I have had great suc-
on menopause. The same survey
cess with treating my patients’
Moein Health restrict a woman from believ- has demonstrated that only symptoms prescribing mostly
ing that she is having multiple about 7% said that they felt hormonal creams and/or suppos-
“ I am 45 years old and I have symptoms due to a decline in her prepared to treat menopausal itories.
all the symptoms my mother had hormonal balance. A classic and women. I believe that the secret to my
when she was going through complex example is that women Part of the fear and discom- success is partly due to my train-
menopause. I’ve tried getting experience a decline in their sex fort of the physicians in their ing in the field of integrative and
care but it seems like there is no drive long before discussing it hesitation to initiate a conver- holistic medicine which equipped
standard for treatment. Where with their physician. Another sation about menopause with me with the knowledge to look
can I get help? What is going on example is, in women with a their patients is due to the fear at every patient as an individual
with my body? How can I reverse history of depression or anxiety of medical/ legal consequences, with unique needs. This gave me
these symptoms? Are there any who experience worsening of partly due to lack of experience the ability to treat them holistical-
treatment options for me?” their symptoms in their 40’s and and partly due to the increasing ly in order to create a balance in
not knowing that a decline in sex of a patient’s risk of breast cancer their health and wellbeing. This
“Sometimes around age 40, hormones (estrogen, proges- from hormone therapy. (HRT) was accomplished by providing
the perimenopause changes be- terone, testosterone) affects a Results of past published them advice on how to take part
gin: Maybe hair frizzes. Perhaps decline in their cognitive func- medical studies, which contained in improving their diet, take prop-
nails become brittle. The tummy tioning and mood. some inaccurate data, caused er supplements and nutrients,
might sprout an additional layer In some cases, when a wom- undue concern. This data, which increasing their physical activity
of fat. Periods may get shorter, an goes through perimenopause, was later corrected, caused fear and practicing mindfulness on a
or longer, or heavier, or lighter, we discover that they have had among the medical community daily basis while receiving HRT to
or could become wildly unpre- depression and anxiety from a and patients as well. This fear help their transition.
dictable. There could be vaginal young age, that they have coped increased the gap and caused I don’t envision any patient
dryness. Or brain fog. Moodiness. with without seeking treatment a delay in seeking care on the being on HRT for the rest of their
Anxiety.” and now they are worse due to patient's behalf life if they commit to daily mind-
Here is a list of all the the compounding effect of their Nineteen years later, we fulness, exercise, and healthy
overwhelming symptoms that a decline in their sex hormones. now know that the risk of breast eating. I have enjoyed observing
woman can experience while go- Some of the symptoms of cancer for women on HRT is .03% my patients in the journey of
ing through perimenopause: ir- perimenopause are directly higher than women without HRT. their healing and recovery from
regular periods, hot flashes, night related to our esthetics and (The fact is that those women their symptoms by way of taking
sweats, loss of libido, vaginal beauty. A classic example is a who have been diagnosed with control of their decisions and
dryness, mood swings, brain fog, change in our hair and skin and breast cancer have a lower rate actions related to their health
panic disorders/attacks, anxiety, we relate that to “natural aging“, of death from breast cancer in and wellbeing.
irritability, depression, difficulty but secretly it is frustrating for a comparison with women who I strongly believe that no
concentrating, hair loss, unex- woman to observe the changes did not receive HRT). woman should suffer from the
plained dizziness, fatigue, sleep and not have a medical solution I am not downplaying the 34 symptoms we listed at the
problems, bloating, weight gain, at her disposal. risks of breast cancer associated beginning of this article. These
stress incontinence, brittle nails, Estrogen has been known with HRT, however, in the past symptoms should be used as a
osteoporosis, irregular heartbeat, to directly improve the quality 18 years, the field of HRT has tool to address future negative
allergies, changes in body odor, of human hair and skin and yet advanced in a very satisfactory health outcomes such as heart
headaches and migraines, breast there is no easy access to this way that not only reduces the disease, osteoporosis, Alzhei-
pain, joint pain, burning mouth, hormone for a woman who risks but also has the potential mer’s, etc.
electric shocks, gum problems, wants to slow down her hair loss to prevent breast cancer in some
digestive problems, dry and itchy or the rapid appearance of the women. Dr. Sudi is available to answer
skin, tingling extremities, and wrinkles on her face and neck. The latest new hormone that any and all questions you
muscle tension. There are many more symp- is not yet available for use in the might have. Nothing is taboo.
You may be surprised and toms that are related to the fluc- USA is called ESTRETOL, which If you have a question for
overwhelmed by this list, but the tuation or decline of our physical has been shown to reduce meno- Dr. Sudi please contact her at
good news is that all of these and mental wellbeing; however, pausal symptoms and functions drmoein@moeinhealth.org

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