Menopause: defined as the permanent cessation of menstrual cycles, which is confirmed when the woman has not had a period for one full year. The average age is of menopause is 51.
Peri-menopause: the time period preceding menopause, which begins approximately 3-4 years prior to the woman's final menstrual period (FMP). Oftentimes women may experience a number of physiologic changes that may affect her quality of life.
Hormone: a substance released into the blood stream at one tissue site that will travel through the blood to a distant site where it exerts it effects. We will discuss 6 hormones:
Bioidentical hormones: hormones that are have an identical molecular structure to hormones naturally made by your body. NaPro providers will recommend this type of hormone supplementation for many reasons discussed below.
Menopausal Hormone Therapy (MHT): the practice of replacing a woman's hormones to treat her peri-menopausal and/or menopausal symptoms. NaPro providers prefer bio-identical hormones.
EARLY PERI-MENOPUASAL SYMPTOMS:
- In the early peri-menopausal phase, estrogen is HIGH and progesterone is LOW (Hint! giving you bioidentical progesterone in the post-Peak phase of your cycle may make you feel much better).
LATE PERI-MENOPAUSE to POST-MENOPAUSAL SYMPTOMS:
-Towards the end of peri-menopause and once menopause has passed (no period for one full year) estrogen is LOW and progesterone is LOW (Hint! treatment may be replacing both estrogen and progesterone using bio-identical hormone. I will also pay close attention to your bone health and recommend screening for Diabetes as well as Cardiovascular Disease).
The Swan Study (Study of Women's Health Across the Nation) followed 3302 women ages 42 to 52 for fifteen years, as they progressed through their reproductive lifespan, through perimenopause (ie: "menopausal transition") and into their post-menopausal years. The research was conducted in multiple academic centers across the nation beginning in 1996, which resulted in over 600 publications and book chapters by 2021. There are several other articles currently pending approval.
In 2012, Dr. Siobán Harlow and colleagues developed the STRAW Staging System (STaging of Reproductive Aging Workshop), using the SWAN data, which is now considered the gold standard method of characterizing the stages of the woman's reproductive years though late post-menopausal years. The STRAW Staging system categories changes in the menstrual flow, hormone levels, number of ovarian follicles and vasomotor symptoms.
Reproduced with permission from :Harlow SD, Gass, M, Hall JE, et al. Executive Summary of the Stages of Reproductive Aging Workshop + 10: Addressing the Unfinished Agenda of Staging Reproductive Aging. J Clin Endocrinology Metab 2012. Copyright 2012 The Endocrine Society.
Dr. Laura Briden has a wonderful website that will teach you the difference between "synthetic" hormones typically prescribed by mainstream medicine doctors (such as in the birth control pill) and bioidentical hormones.
She also has a truly amazing podast where she discusses indications for, safety and efficacy of these supplements.
I would also highly recommend her book, Hormone Repair Manual, every woman’s guide to healthy hormones after 40. I could not put this book down!
If your symptoms warrant hormone replacement, please create a Full Scripts account to allow me to easily guide your therapy. Amazon may offer the same supplements I will prescribe for less money, but you cannot be sure of the quality of their products.
Your appointments at Natural Women's Health with me will be one FULL HOUR in length. Generally speaking, NaPro appts will follow a typical protocol as outlined below. However, every individual is different and your situation may warrant a more expeditious process. Please know, the Creighton Model Charting is very important. Your CrMS chart will help direct me to what diagnostic tests and imaging tests should be done and what treatment plan would be most appropriate.
First Appt: I will take a comprehensive medical history and order a baseline pelvic ultrasound. If you are still menstruating, the ultrasound should be done on day 5-7 of your next menstrual cycle. I will also order FSH/LH and estrogen labs, which should be drawn on day 3 of your next menstrual cycle. You will be asked to begin charting your menstrual cycles using the Creighton Model System. Please choose a Fertility Care Practitioner by clicking the button below and schedule your first Introductory Session.
Second Appt: You will be asked to return to the office in one month for a follow-up appointment to review the results of your imaging and lab tests. Together we will review your Creighton Model Chart and look for specific biomarkers in your menstrual cycle. Please upload an image of your CrMS chart two days prior to all follow up visits and send to me via the portal.
A full GYN physical examination will be preformed (unless you have already had a well-woman exam) and oftentimes additional laboratory and/or imaging tests may be considered to continue to guide your medical management.
Third Appt: You will return to the office in one month to review the results of your laboratory and imaging studies. At this time, we will consider ordering a progesterone and estrogen panel, which will be specifically timed to your CrMS chart. Please click the "laboratory tests" button below for more detail. You may be asked to start medications and/or perhaps make an appointment with another specialist such as a dietician, a sleep specialist and/or a counselor.
Follow Up Appts: You will return to the office every two months to monitor and/or make adjustments to your medications and treatment plan.
Address: 1149 Lancaster Ave, Bryn Mawr, PA 19010.
Address: 4924 Center St, Omaha, NE 68106.
*commonly prescribe for NaPro patients from the St. Paul VI Institute.
Ph: (877) 562-8577
Address: 7601 North Sam Houston Pkwy, Houston, TX 77064
*commonly prescribe for NaPro patients.
Another option is to create a Full Scripts account to allow me to easily guide your therapy. Amazon may offer the same supplements I will prescribe for less money, but you cannot be sure of the quality of their products.
Make an Appointment with Sharon Best, PA-C for NaPro Gynecological & Infertility Services.