Menopause can be frustrating especially if limited options are available. Empower yourself to seek out a personal plan to transition onto the next phase.
1. Hot Flashes
in
Hot Times
We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
Enrique Saguil, M.D.
2. The First Health Approach
We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
3. Your Team
Ric Saguil, MD
Jason Gruss, MD
Joe Musolino, DC
Jennifer Green, ND
Katrina Christie, LCPC
Tom Jordan, RD
Aimee Weber, EP
Emery Paredes, PT
Lori Szczupaj, MA
Yu Zhu, MD China
Paul Kolaski, DC
Cheryl Broderick
You
4. We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
-DrRic
5. The Change
• 45-55years old
• Last 3 months up to 5 years
• Irregular periods
• Vaginal dryness
• Hot flashes/Flushing
• Weight gain
• Mood disturbance
• Sleep disturbance
12. Women’s Health Study 2001 WHI
• 26% increase in breast cancer with
undetermined benefits since study stopped
early (estrogen + progestin)
• Double risk of venous thrombosis
• Increased risk for stroke, heart ds, gyne
cancer, dementia, blood clot, colon ca
• Did help decrease hip and vert fractures
13. Personalized dose
HRT/BHRT
• Estrogen
• Progesterone
• Testosterone
• Estrogen
• Progesterone (for mood not for bone)
• Testosterone
(ie-Prometrium from peanut oil, oral/topicals from soy or yams)
Standard dose
14. DrRic’s Variables
• Nutrition
• Depletion
• Maintenance Medication
• Maintenance Meditation
• BMI
• Level of Fitness
• Breast Cancer
(Food Insecure, ETOH, Caffeine, PhD)
(from intake or meds)
(diagnosis 1 2 and 3)
(relaxation response)
15. Bottom line with hormones
• In theory, everyone needs the same/In
practice everyone should get a personal plan
(variables…)
• Plan on Exit Schedule for when to get off
hormones
• Make changes while getting rescue
meds/herb/supplement
16. Testing hormones
• Blood testing is a snapshot of dynamic process
• Salivary testing has improved and can be done
with ease but still can be variable
• Urine testing good also but can be variable
• (bottom line- if you are rich, take the saliva
- if deep into the age, take blood
-if on fringe, good history, +/- test
-be on the look out for early CA
20. Progesterone excess symptoms
• Many symptoms of estrogen deficiency +
• Somnolence
• Mild depression
• Candida exacerbations
• Gastrointestinal bloating
• Breast swelling
21. Testosterone deficiency symptoms
• Fatigue prolonged
• Memory problems
• Decreased libido
• Muscle weakness,
• Heart palpitation
• Bone loss
• Incontinence
• Fibromyalgia
• Mental fuzziness
• Depression
• Blunted motivation
• Diminished feeling of well being
• Thinning skin
• Vaginal dryness
• General aches/pains
22. Testosterone excess symptoms
• Acne
• Deepening voice
• Irritability moodiness
• Loss of scalp hair
• Male pattern hair
• Clitoral enlargement
• Insomnia
23. Other hormones to consider
• Adrenals (cortisol am or 4x throughout 1day)
• Thyroid (TSH, FreeT3, Free T4)
24. Other Rx’s
• SSRI -reduce severity, help moodiness
• Antidepressants –reduce severity like SSRI’s
• Clonidine –reduce number of flashes
• Gabapentin -to reduce number of flashes
• IUD with levo –reduce mense
• Estrogen cream low dose –vaginal dryness
• HRT –pill, patch, cream, foam, ring
25. • Soy (need the gut flora) –mixed results (+ or -)
• Flax seed -2tblsp am/pm (small study +)
• Black cohosh -40-160mg/day (liver damage?)
• SJW –ramp up 3xdaily (watch interactions)
• Kava kava -
• Wild yams –otc topical (adequate skin
conversion?)
We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
Herbal/Botanical (phytoestrogens or isoflavones)
26. Alternative Approaches
• Ayurveda (yoga)
Breath work
Movement
Meditation
• TCM (acupuncture)
+ Acupuncture
• Homeopathy
Naturopathic or Homeopathic
physician
27. Environmental control
• Decrease spicy food, alcohol and caffeine
• Textiles (clothes, bedding, hiking collars)
• Lose weight –BMI target setting
• Reduce stress or increase relaxation training
28. Mind – Body Medicine
• Relaxation therapy to slow the reaction
• Hypnosis decrease frequency/severity flashes
• Relaxation response decreases markers of
inflammation
29. Healing Injury with
Supplements and Food
Saturday, July 10th
3-4pm
Whole Foods Market Schaumburg
Call to reserve a place
847 585 5800
Notes de l'éditeur
0.3mg conjugated equine estrogen or 1mg estradiolmedroxy progesterone