Beyond HRT: Natural Treatments for Perimenopause

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Transcript

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Welcome to The Pause Podcast

Speaker 1 0:00

Welcome to the Pause , the menopause podcast , with unfiltered conversations about the symptoms you hate , the changes you didn't see coming and the hilarious moments midlife can bring . I'm your host , val Leggo , and I've been a dedicated health reporter for 25 years and I wanted to normalize something that every woman goes through menopause . So together we're going to talk about it the Perry , the Menno and the Post . Welcome to the Pause . Welcome to the Pause . I'm Val Leggo and I'm so glad you're here because that means you're accepting the Perry menopause journey that you're on , and I am so excited for you . I mean , I'm not really excited about the night sweats and the weight gain and you know the dry eye and itchy skin and all the things that come with it , but I am excited about the fact that you are looking for better ways to navigate this unavoidable time in your life other than just dealing with it , which I know many of you have been told over and over again and you're tired of it .

Speaker 1 1:06

So let's get to the topic of today's podcast . I heard from a lot of you asking about natural ways to cope with perimenopause and full disclosure here I'm on hormone replacement therapy , but I know that is not for everyone and my goal of this podcast is to make sure that you have the information that you need to make decisions about how to navigate your perimenopause

Naturopathic Approach to Perimenopause

Speaker 1 1:24

journey . So I went in search of an expert for you and I found Dr Dani Hamilton from Integrative Wellness in Grand Rapids , and she is a licensed naturopathic doctor who specializes in women's health and menopause . And she's joining us now to share natural , holistic ways to support you during your perimenopause journey , and I'm really excited to delve into what those are so that all of you who are listening can really make some good decisions for yourself . So , dr Hamilton , how does the naturopathic approach complement , or is it just completely different from , hormone therapies ?

Speaker 2 1:58

Hi and thank you for having me . First and foremost , whenever someone comes to me , if they're not on bioidentical hormone replacement therapy , I'll usually have them switch to that from conventional . But if someone is looking to do something that's more natural and not start with hormone replacement , I do have my own kind of way that I go about that , which is usually with supplements and herbs . So the first thing that I do with all of my perimenopausal women is first I track their symptoms , which is kind of what I talked about on episode one , so having a journal that we can track , so hot flashes , night sweats , vaginal dryness and more of the subtle symptoms so like bloating , new food sensitivities , depression , taking longer to fall asleep , et cetera , et cetera , because those will definitely always matter more than labs . And then after that I do actually order labs and it's very important to find a skilled practitioner and reading perimenopausal labs , because the reference ranges are very large and it'll be a waste because they'll tell you it looks normal . So I've noticed that every woman has a very different pattern , so I use herbs and nutrients based on their hormonal pattern .

Speaker 2 3:19

So , for example , some women in perimenopause will still have high estrogens , and that includes estrone , which is more of a kind of like a crappy form of estrogen , and in perimenopause estrogen levels don't just drop , they actually fluctuate wildly . So some days you might have low estrogen and other days you have estrogen spikes that are higher than normal . So typically what I do is initially sometimes I will add in estrogenic herbs and that is more for women who have really low estrogen on their labs and then sometimes I avoid using estrogenic herbs like black cohosh or red clover . Sometimes I avoid using estrogenic herbs like black cohosh or red clover because sometimes this can actually worsen the imbalance by overloading the body with extra estrogen during a high estrogen phase , or it might worsen symptoms like a heavy menstrual period or breast tenderness , and sometimes that can mask underlying progesterone deficiencies , which is sometimes a bigger problem in perimenopause than the low estrogen early on body's doing specifically and we're going to design a program for you in a natural way that

Herbs, Magnesium and B Vitamins

Speaker 2 4:43

you want to approach perimenopause and your symptoms Like .

Speaker 1 4:46

That , to me , is really interesting and I love that , and also highlighting the fact that , like we always think , you know , estrogen is the star of the show , for whatever reason . Right , she always gets talked about , but we don't talk about that . Progesterone and how important that is as well . When you're talking about the herbs , are these herbs that women would take in like pill form ? Would they be teas ? Are they like serums or lotions ? Like how do you incorporate those ? Like , how are they taking them ?

Speaker 2 5:18

I guess yeah , so there's a lot of different types of herbs taking them , I guess , yeah , so there's a lot of different types of herbs , and one of the things that I always notice is someone will tell me I'm taking , someone recommended these hormone balancing herbs and I'll find that a lot of them are going against what their body needs . So I've had a woman who had an . She's having really , really heavy bleeding , to the point of causing anemia , and she's in her 50s and she is taking an herb a balancing herb that's actually promoting more bleeding . So it's really important to actually make sure that you're looking at the whole person and knowing the properties of each herb , based on you know the symptoms and sometimes blood work . And yes , the herbs do come in different forms . So sometimes I use tinctures , sometimes it's a capsule , I think that sometimes it is a tea as well , but I usually use capsules and sometimes I use different blends or sometimes it's just a single herb .

Speaker 1 6:21

So you're and you use a lot of herbs to help with the symptoms . Do you also look at things like magnesium and the B vitamins big buzzwords right now in perimenopause and helping with symptoms ? Did those get incorporated in your therapies as well ?

Speaker 2 6:36

Absolutely so . Magnesium and B vitamins I actually use quite often , or probably with every single woman in perimenopause . I would say they're like an absolute must . They're both needed for hundreds of different biochemical processes in the body , and then our soil and our nutrients in our diet is just not enough . So I actually do check magnesium and B vitamins in blood work just to see where someone stands initially . But either way they're super safe . So there's no , I'm usually not concerned or like , if I don't do blood work , I'll still recommend those . Magnesium is actually really important to make progesterone , so it's very calming and balancing and also since progesterone drops first in perimenopause , it's really helpful to take the magnesium because it makes the transition a lot smoother .

Speaker 1 7:31

So if progesterone is the one that drops first , the hormone that drops first , do we know what symptoms are aligned ? Perimenopause symptoms are aligned with a drop in progesterone as opposed to a drop in estrogen .

Speaker 2 7:46

Okay , so low estrogen is more like hot flashes , migraines , vaginal dryness . Low progesterone is insomnia , night sweats , hair loss , anxiety , irritability , weight gain .

Speaker 1 7:58

So that's a really . I find that that's really an eye-opening way to figure out what's happening with your body .

Speaker 2 8:04

I don't think .

Speaker 1 8:05

I've ever noticed , or I don't think I've ever heard , the symptoms divided that way so that you know what's going on . And I really love having these conversations because it allows women to get more information of like what's happening with me . And so dividing out those symptoms like that is

Progesterone vs Estrogen Symptoms

Speaker 1 8:24

really kind of interesting . To know where you are in your journey of perimenopause and what's happening . We can't express it enough . Journaling your symptoms is the way to know where you are at in your journey , that you're starting it , that you're in the middle of it . Being able to talk to your provider and give them as much information of like this is all the things that I'm experiencing , so important to be writing those down . I just can't say it enough . So if you haven't started doing that , please start doing that . You would be amazed at all of the little tiny things that happen that you're writing off , thinking eh , it couldn't be that and it really is a symptom of perimenopause .

Speaker 1 9:09

And so do you have specific herbs that you suggest for hot flashes and mood swings , because those seem to be like the really big symptoms that women notice ? Like some women have high anxiety . I was a high anxiety , super high anxiety . Didn't even realize how high my anxiety was until I went on my hormone replacement therapy , which is what I chose for myself . And other friends that I have are like my rage , like someone can do something and I would literally just want to bite their head off . My rage is out of control . And other women are like I . Am sitting in board meetings and all of a sudden I'm just starting to sweat . So I feel like those are like the two really big ones that we hear about all the time . Do you have certain herbs that like help specifically with either one of those ?

Speaker 2 9:58

Yeah , so I actually don't have an herb that I use , but there is one big giant common denominator that I have found that always seems to work for all of those symptoms that you mentioned , and that is DHEA . So DHEA is still a hormone , but it's a supplement that you would take . So it's not necessarily HRT and it's just a very natural supplement . So in perimenopause , when your ovaries are starting to slow down and all that estrogen production is going on that's dropping , that's when your body is kind of relying on your adrenal glands to help fill in those gaps . So DHEA is really helpful for the adrenal glands . So that also helps that .

Speaker 2 10:40

You know , like you said , that irritability is a rage for the adrenal glands , so that also helps that . You know , like you said , that irritability is a rage , but also with the hot flashes and the night sweats . So DHEA is actually like a precursor to those hormones . So it kind of instead of just kind of giving you HRT , it's giving you that like top precursor to kind of gently balance all of those hormones instead of just doing straight HRT .

Speaker 1 11:02

So when someone comes in and consults with you and says I'm going through perimenopause and you do , you know , you do all the things . You have them journal . You take a look at it , you do the labs , you dial it in , you personalize it . Are you giving them a wide range of like herbs and supplements ? Are they going home with like a basket full of stuff or you know what does ? What does that look like ?

Speaker 2 11:26

Yeah , so usually it usually isn't too many things .

Speaker 2 11:31

So because I'm looking at the labs , so the labs have you know , I'm looking at estrogen , so like all of the estrogens , and then I'm looking at DHEA and testosterone and all of those

DHEA: The Common Denominator

Speaker 2 11:43

hormonal labs , and then I usually start with DHEA , because it's almost always low , and that kind of just supplies the rest of the hormones and I base it off of how low the DHEA is and I also start with a very tiny dose and then I also add in the magnesium and the B vitamins , just because that's really helpful as well .

Speaker 2 12:04

And then , because every woman has a different pathway , I choose an herb that helps support what pathway they need the most . So sometimes women actually need to , their estrogen is through the roof and I will use an herb that kind of brings down or metabolizes estrogen . Sometimes they need liver support , so I'll also look at liver enzymes and stuff like that . So usually they're getting one or two herbs that help move something in the pathway so they don't experience such strong symptoms , and then I'm giving them the DHEA and then the B vitamins and the magnesium . So usually it's not too many supplements , but taking those few supplements can drastically change someone's quality of life .

Speaker 1 12:49

And for the women that are listening , they're interested in doing it in a natural way , and I feel like that is a great way to really start and get a baseline and then you can make adjustments from there .

Speaker 2 13:00

Exactly so , usually just from that alone . Recently I had a woman who was having eight hot flashes a day that was steaming up her glasses .

Speaker 1 13:09

Oh , my goodness .

Speaker 2 13:10

And then , yeah , just from five milligrams of DHEA , and I used an herb , maca , so maca to help kind of just like support all of those pathways , the DHEA at five milligrams and some magnesium , and she came back in with zero hot flashes .

Speaker 1 13:28

Wow .

Speaker 2 13:31

That's really amazing and I would say , just from doing these few things without using HRT , I would say that I'm nine out of ten successful at reducing HVAC um menopausal symptoms , like almost completely .

Speaker 1 13:45

Wow , that's , that's really great and I know that probably has a lot of people who are listening excited . So we have a Facebook group that supports the pause podcast and it's called the pause diaries and these women are really engaged and really supporting each other and asking a lot of questions and I just love them to death and um . So I put it out there and said what questions do you have for you , dani ? So we're going to get to some of those . I'm going to start with Fran . Here's what Fran says . She wants to explore the benefits of organic moringa . How does it compare to other supplements and vitamins ? Can it be used in conjunction with

Listener Questions About Supplements

Speaker 1 14:21

HRT and what are the implications for long-term use and what is the optimal dosage ? A lot of questions all at one time .

Speaker 2 14:31

Yeah , that's okay . So I don't usually recommend Moringa , but I have had patients in the past tell me that they're on it and that they use it and they usually rave about it . I think Moringa is like a superfood , so it's super rich in antioxidants and minerals and nutrients and it's also considered a phytoestrogen , so it does mimic estrogen and it can be used alongside HRT , but I wouldn't necessarily consider it to be like a direct replacement because it's such a milder form and it is generally safer . You know , long-term use and usually with any supplement , moderation is super important .

Speaker 2 15:12

Excessive use can cause digestive discomfort just because it has an effect on a digestion as well , and it can also sometimes lower blood pressure . So I don't always go to that herb just because there's other herbs that work with a pathway better . But if you're using it for overall health , it is considered safe and a lot of women do really like it . It just I just typically tend to use other herbs that promote pathways a little bit more than moringa . You can use it in a powdered form , so the common dosing is using one to two teaspoons if it comes in a powdered form and it can be added to smoothies or teas , and then if they come in capsules , they usually range from 500 milligrams to 1,000 milligrams . You can use that once a day , so anything from 500 to 1,000 milligrams daily is pretty safe as well .

Speaker 1 16:05

So completely safe to use along with HRT . Just know that you might have a few minor symptoms , but you could continue to use it for as long as you feel like it's effective for you .

Speaker 2 16:17

Yeah , it's generally safe in long-term use .

Speaker 1 16:20

Okay , we're going to move on to Amy . She's currently taking something for estrogen levels , which she did not reveal what that is . She's really happy with it , but she wants to know if there's anything else out there that she should be maybe combining with that . Now , that's going to be difficult because you don't know what she's taking , but if you're only taking something for estrogen , should you be considering something for your progesterone or something else ? I think is where she's going with that question progesterone or something else .

Speaker 2 16:47

I think is where she's going with that question . Yeah , so the first thing is , if you're feeling really great , it is really important to you know , add in some of those other like , just like main nutrients , like the magnesium and B vitamins , collagen , omega-3s One of the things when someone's you know , taking something for estrogen , I do always recommend that your body is metabolizing it well . So , whether that be an herb or HRT , I do recommend just getting , like estrogens , checked on labs and looking at clotting factors and you know , like your , you know just like your basic hormones and stuff like that , just making sure everything is safe . And then the other things that I usually add in , you know , if you're feeling really great , is also just looking at like blood sugar and using herbs and supplements to kind of support like the overall health . And then I do sometimes look into progesterone , supporting herbs as well , but it , like I said , it really depends on the pathways of the particular person .

Speaker 1 17:47

Mary Kathleen wants to know if there's a particular brand of supplement that you recommend , especially to help with estrogen-related weight gain , and she wants to know if any of the supplements increase .

Speaker 2 18:04

I have found that is super helpful if you know that you have elevated estrogens meaning estradiol and estrone and you know that you're gaining weight and you know that the estrogens are elevated . I do have one that I really love and it's dim d-i-m or indole-3-carbinol , also known as as IC3 . I do not endorse any companies , but my favorite particular brand is Seeking Health and it's DIM indole-3-carbinol . It works really amazing and usually after two or three months women will find that they're able to lose weight a little bit easier . They're able to metabolize their estrogen like the excess estrogens a bit easier , especially if it's estrogen related . I do always recommend testing and knowing for sure that it's estrogen and estradiol that are elevated , and then I typically will have someone take that DIM or endo-3-carbinol for about three months and then retesting free carbonyl for about three months and then retesting , and usually , once you're back to normal levels , I'll have someone discontinue using it , but it does really help with weight loss when it's estrogen related .

Speaker 1 19:16

What is it about that that helps with the weight loss ?

Speaker 2 19:20

I think it's partially because you're metabolizing the excess hormones that are building up in the liver . So whenever there's liver congestion it is a little bit more difficult to lose weight . So I think the components of DIM are in cruciferous vegetables , so it's an isolated component of those that helps the detox pathways of the liver Wow , that's really fascinating , but this is not something you want them to stay on forever .

Speaker 2 19:48

Correct , Because I do notice that over long periods of time it will start to lower estrogens a little bit too much , so there's like a fine line . So when estrogens are elevated , then I'll use this until they become normal and then you don't need to keep using it . Usually they'll feel normal again and then they stop and they don't really need to go back to it .

Speaker 1 20:08

Now everybody's going to be like . You know , dim is going to sell out because people are going to say , yay , this is how I'm going to lose weight , like , but like . What's the realistic weight loss over three months ? I mean , it's probably not going to be 30 pounds or 40 pounds .

Speaker 2 20:23

No , no , no , it's usually just a few , just like the puffiness A cannabis helps get rid of that , that puffy feeling , and I really feel like it only helps if you know for sure it's estrogen related weight gain . If it's not estrogen elevated estrogen or the weight gain is for other reasons then sometimes it doesn't work . But if you know that the estrogens are high , then it will . It'll . It'll be more helpful that way .

Speaker 1 20:49

I feel like I could use it . I have menopause face . Have you heard of that ? We're like . We're like my . I'll look and mean now , granted , I have gained a little bit of weight and I might try dim myself just to see if , like if , things work . But I look at pictures of myself now I'm like who is that person that's like the puffy , puffy , puffy face . So , yeah , I think I don't know it's very interesting . I'm like maybe I'll read more about that . All right , I want to read on now to Carrie . This is our last

Self-Care and Final Thoughts

Speaker 1 21:20

question . Carrie had SCAD heart attacks about six months ago , so she can't take any hormones , according to her doctor , and she wants to know is there something hormone-free that can help her ? I think we've kind of covered a lot of those , but I don't know if you have something specific to somebody who is having heart issues .

Speaker 2 21:40

Yeah , so one of the things that I always like people to know is if there is a fear of eating any herbs , supplements or medications and you're really just worried of having anything hormonal , one of the things I always recommend is starting with homeopathy . So homeopathy are these little tiny pellets that you put on your tongue . They don't interact with any medications . They're really , really safe and they're really helpful for very characteristic like symptoms . So a woman who's having a hot flash that's more like in the face versus more in the chest . So very characteristic symptoms like that . You can try using homeopathy . You would just have to find a skilled , either a homeopathic doctor or a naturopathic doctor that does homeopathy . But it's a super , super safe route to start . If someone was worried about hormones or , like you know , any kind of like hormone or blood clots or anything like that or anything like that , oh , thank you so much .

Speaker 1 22:44

That was that's . It's such great information to know that there are things to investigate , right To look at , to research , and you don't have to necessarily suffer through it . There's always going to be some sort of workaround , so that's really that's really great to hear . So I want to thank the ladies for their questions . I just love being able to find expert advice for all of the members of our Pause Diaries Facebook group . So if you have it , if you're listening and you have not joined yet , I really encourage you to join this group .

Speaker 1 23:15

The women are supportive and awesome . They give each other like hey , this is what I've tried or I've got a recipe for this . They're great , I love them and I feel fortunate to have such an active group of women who are really just sort of here we are , we're embracing the change . So if you haven't joined the Paws Diaries on Facebook , please do so . Dr Hamilton , we're about to wrap this up . I do want to know do you have one small thing that our listeners can start doing today to help them feel a little bit more balanced ?

Speaker 2 23:46

Yeah , so one of the things that I think is really important to remember is that you need to always pour back into your own cup . So the one thing that I really recommend is just finding someone today to help , so like make the call today , set up with a provider that you know that's skilled in either HRT or not , or even do like a massage , or try something new like acupuncture or hypnotherapy . Just really getting in the habit of like self-love and self-care . Those are . Those are things that I find super important in this journey .

Speaker 1 24:26

Yeah , I would have to agree with that Really finding the time to take for yourself and I know there's a lot of eye rolls out there like , yeah , how's that going to happen ? You know , I got kids and I got soccer and I got sports and I got work and I got aging parents . Your oxygen mask on first , and then you'll have the time for everyone else . This is a journey that men don't understand . So you know you have a right to feel the way you do and say I need time out . I'm going for a massage on Saturday . You guys figure out how everything else gets done .

Speaker 1 24:58

Thank you so much , dr Hamilton . It was a wonderful conversation today . I truly appreciate it . Absolutely Happy to be here . All right , so until next time . Once again , I am going to ask you to join our Pause Diaries Facebook group and in there , as a bonus for listening to this episode , I've got a hormone balancing smoothie recipe that I'm going to pop into that group . So I'd love for you to let me know if you like it , if it worked for you , but I just wanted to make sure that you got a little something for listening for us today . Remember , this is not the end of anything . It is the beginning of the rest of your life and we are going to talk about it .