The hormone androgen, commonly known as a “male hormone,” has masculizing effects, but is equally important to women as well. Androgens effect the growth of the skin, muscle, bone and organs. Women who suffer from polycystic ovary syndrome produce excessive androgens and have thicker skin, more body and facial hair and acne. Women with treatment resistant acne should be tested for elevated levels of androgens.

Studies have shown that acne occurs more frequently during the week before menstruation. These conditions remain present for about a week. The changing balances of female hormones sometimes produce skin flare-ups. Hormonal treatments exist to help moderate acne problems during menopause and can be used for women whose acne simply won't respond to regular acne treatments.

What Is Acne?

Acne is a disorder of the skin's oil glands (sebaceous glands) that results in plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Nearly 17 million people in the United States have acne, making it the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring, permanent scarring, which can be upsetting for people who suffer from the disorder.

How Does Acne Develop?

Doctors describe acne as a disease of the pilosebaceous units. Found over most of the body, pilosebaceous units consist of a sebaceous (oil) gland connected to a hair-containing canal called a follicle (see figure 1). These units are largest and most numerous on the face, upper back, and chest -- areas where acne tends to occur. The sebaceous glands make an oily substance called sebum that normally empties onto the skin surface through the opening of the follicle.

Figure 1: Normal Pilosebaceous Unit

Acne is believed to result from a change in the inner lining of the follicle that prevents the sebum from passing through. For reasons not understood, cells from the lining of the follicle are shed too fast and clump together. The clumped cells plug up the follicle's opening so sebum cannot reach the surface of the skin. The mixture of oil and cells causes bacteria that normally live on the skin, called Propionibacterium acnes (P. acnes), to grow in the plugged follicles. These bacteria produce chemicals and enzymes that can cause inflammation. (Inflammation is a characteristic reaction of tissues to disease or injury and is marked by four signs: swelling, redness, heat, and pain.) When the plugged follicle can no longer hold its contents, it bursts and spills everything onto the nearby skin -- sebum, shed skin cells, and bacteria. Lesions or pimples develop as a result of the skin's being irritated.

People with acne frequently have a variety of lesions, some of which are shown in figures 2, 3, and 4. The basic acne lesion, called the comedo (kom'-e-do) or comedone, is simply an enlarged hair follicle plugged with oil and bacteria. This lesion is often referred to as a microcomedo because it cannot be seen by the naked eye. If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo or whitehead. Whiteheads usually appear on the skin surface as small, whitish bumps. A comedo that reaches the surface of the skin and opens up is called a blackhead because it looks black on the skin's surface. This black discoloration is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.

Figure 2: Microcomedo

Figure 3: Open Comedo (Blackhead)

Figure 4. Closed Comedo (Whitehead)

Other Troublesome Acne Lesions Can Develop, Including the Following:

Macule- a temporary red spot left from a healed lesion.  They are generally light red or pink and they can last from anywhere between a day to a few weeks.

Pustule- Something likened to an inflamed, pus-filled lesion:  a small inflamed elevation of the skin that is filled with pus; a pimple.

Papule- A small, solid, usually inflammatory elevation of the skin that does not contain pus.

Nodule- Like a papule in that it is white and dome-shaped.  Characterized by inflammation.  Nodular acne is very severe and doesn't respond well to many forms of therapy.

Cyst- an abnormal membranous sac containing a liquid or semi-liquid substance consisting of white blood cells, dead cells, and bacteria.  Often very painful and they extend to deeper layers of skin.  Nodulocystic acne is when nodules and cysts appear together.

Typical Causes of Acne, Acnegenicity

Acnegenicity means the ability to cause acne breakouts. This medical condition is caused by four key factors:

• Hormones, especially during menopause
  
• Enlargement of sebaceous glands attached to hair follicles
  
• Increased sebum (oil) production
  
• Bacteria
  
• Stress
  
• Poor Dietary Habits, especially excessive consumption of sugar and refined carbohydrates

Acne Prevention Techniques

Clean Skin Gently

People with acne may try to stop outbreaks and oil production by scrubbing their skin and using strong detergent soaps. However, scrubbing will not improve acne; in fact, it can make the problem worse. Most doctors recommend that people with acne gently wash their skin with a mild cleanser, once in the morning and once in the evening. Patients should ask their doctor or another health professional for advice on the best type of cleanser to use. The skin should also be washed after heavy exercise. Patients should wash their face from under the jaw to the hairline; rough scrubs or pads should not be used. It is important that patients thoroughly rinse their skin after washing it. Astringents are not recommended unless the skin is very oily, and then they should be used only on oily spots. Doctors also recommend that patients regularly shampoo their hair. Those with oily hair may want to shampoo it every day.

Avoid Frequent Handling of the Skin

People who squeeze, pinch, or pick their blemishes risk developing scars. Acne lesions can form in areas where pressure is frequently applied to the skin. Frequent rubbing and touching of skin lesions should be avoided.

Shave Carefully

Men who shave and who have acne can try electric and safety razors to see which is more comfortable. Men who use a safety razor should use a sharp blade and soften their beard thoroughly with soap and warm water before applying shaving cream. Nicking blemishes can be avoided by shaving lightly and only when necessary.

Avoid Suntanning

A suntan or sunburn that reddens the skin can make blemishes less visible and make the skin feel drier for a little while. But the benefits are only temporary. The sun can seriously damage skin, promote aging of skin, and cause skin cancer. Furthermore, many of the medications used to treat acne make a person more prone to sunburn.

Choose Cosmetics Carefully

People being treated for acne often need to change some of the cosmetics they use. All cosmetics, such as foundation, blush, eye shadow, and moisturizers, should be oil free. Patients may find it difficult to apply foundation evenly during the first few weeks of treatment because skin may be red or scaly, particularly with the use of topical tretinoin or benzoyl peroxide. Lip products that contain moisturizers may cause small, open and closed comedones to form. Hairstyling products that come in contact with the skin along the hairline can cause burning or stinging in people with acne. Products that are labeled as noncomedogenic (do not promote the formation of blemishes) should be used; in some people, however, even these products may cause acne.

Keep Your Hands and Hair Away From Your Face

At all times try to keep your hands and hair away from your face. Your hands and you hair may contain oils and dirt. If contacted on your face it can contaminate the pores and cause acne.

Never Squeeze or Pick Your Spots

We all know this maybe very tempting, but it would only makes matters much worse. Most spots will heal on it's own. Picking at spots will just increases the chance of it spreading the bacteria or even worst permanently scarring your skin. So remember never to pick on it.

Alleviate Stress

Trying to reduce stress in your daily routine wherever possible is a great way to prevent acne. More sleep, exercise (including yoga and light cardiovascular activity), massage, warm baths and a balanced diet will all help to contribute to physical well being and, hence, prevent acne.
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But for women who have never experienced anxiety, this is a very real concern. While most women have been able to cope with stress in previous years, the added imbalance of hormones that women experience during menopause causes, for many, an inability to get through simple daily tasks. The brain is very sensitive to hormonal imbalance. Once the hormonal balance is restored anxiety often abates quickly.

Unfortunately, osteoporosis is not always preventable and is a classic symptom of aging. Normally, in the life of a healthy woman, by her late thirties and forties her bones become less dense. By the time she reaches her fifties, she may begin to experience bone loss in her teeth and become more susceptible to wrist fractures. Gradually, the bones in her spine weaken, fracture, and compress, causing upper back curvature and loss of height, known as a "dowager's hump." Osteoporosis is unfortunately more common in women than men because when a woman's skeletal growth is completed, she typically has 15 percent lower bone mineral density and 30 percent less bone mass than a man has of the same age. Studies also show that women lose more trabecular bone (the inner, spongy part making up the internal support of the bone) at a higher rate than men do.

There are three types of osteoporosis women are prone to: postmenopausal, senile, and secondary.

Postmenopausal osteoporosis usually develops roughly ten to fifteen years after the onset of menopause. In this case, estrogen loss interferes with calcium absorption, and you begin to lose trabecular bone three times faster than the normal rate. You will also begin to lose parts of your cortical (the outer shell of the bone), but not as quickly.

Senile osteoporosis affects men and women. Here, you lose cortical and trabecular bone because of a decrease in bone cell activity that results from aging. Hip fractures are seen most often with this kind of osteoporosis. The decrease in bone cell activity affects your capacity to rebuild bone in the first place, but is also aggravated by low calcium intake.

In secondary osteoporosis, an underlying condition causes bone loss. These conditions include chronic renal disease, hypogonadism (an under activity of the sex glands), hyperthyroidism (an overactive thyroid gland), some forms of cancer, gastrectomy (removal of parts of the stomach which interferes with calcium absorption), and the use of anticonvulsants.

Osteoporosis Pictures

               

Healthy bone                                                        Bone effected with osteoporosis

Our bones are always regenerating. This process helps to maintain a constant level of calcium in the blood, essential for a healthy heart, blood circulation, and blood clotting. About 99 percent of all the body's calcium is in the bones and teeth; when blood calcium drops below a certain level, the body will take calcium from the bones to replenish it. But by the time we reach our late thirties, our bones lose calcium faster than it can be replaced. The pace of bone calcium loss speeds up for "freshly postmenopausal" women who are three to seven years beyond menopause. The pace then slows once again, but as we age, the body is less able to absorb calcium from food. One of the most influential factors affecting bone loss is estrogen; it slows or even halts the loss of bone mass by improving our absorption of calcium from the intestinal tract, which allows us to maintain a higher level of calcium in our blood. In men, testosterone does the same thing for them regarding calcium absorption, but unlike women, men never reach a particular age when their testes stop producing testosterone. If they did, they would be just as prone to osteoporosis as women are.

A long list of other factors affects bone loss. One of the most obvious is calcium in our diet. Calcium is regularly lost to urine, feces, and dead skin. We need to continuously account for this loss in our diet. The less calcium we ingest, the more we force our body into taking it out of our bones.

Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake in not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.

As people age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. Both situations can result in brittle, fragile bones that are subject to fractures, even in the absence of trauma. Usually, the bone loss occurs gradually over years. Many times, a person will sustain a fracture before becoming aware that the disease is present. By the time this occurs, the disease is in its advanced stages and the damage is profound.

The leading causes are a drop in estrogen in women at the time of menopause, and a drop in testosterone in men. Women, especially those over the age of 50, get osteoporosis more often than men.

Women who are white, especially those with a family history of osteoporosis, have a greater risk of developing osteoporosis. Several other physical conditions and external factors help to weaken our bones, further contributing to bone loss later in life, they include:

• Heavy caffeine and alcohol intake . These are diuretics; they cause you to lose more calcium in your urine.
  
  
• Smoking . Research shows that smokers tend to go into earlier menopause, while older smokers have 20 to 30 percent less bone mass than nonsmokers.
  
  
• Women in surgical menopause who are not on ERT . Losing estrogen earlier than you would have naturally increases your bone loss.
  
  
• Antacids containing aluminum and corticosteriods . These interfere with calcium absorption.
  
  
• Diseases of the small intestine, liver, and pancreas . These prevent the body from absorbing adequate amounts of calcium from the intestine.
  
  
• Lymphoma, leukemia, and multiple myeloma.
  
  
• Chronic diarrhea from ulcerative colitis or Crohn's disease . This causes calcium loss through feces.
  
  
• Surgical removal of part of the stomach or small intestine . This affects absorption.
  
  
• Hypercalciuria . This is a condition where one loses too much calcium through the urine.
  
  
• Early menopause (before age forty-five). The earlier you stop producing estrogen, the more likely you are to lose calcium.
  
  
• Lighter complexions . Women with darker pigmentation have roughly 10 percent more bone mass than do women with fairer pigmentation because the former produce more calcitonin, the hormone that strengthens bones.
  
  
• Low weight . Women with less body fat store less estrogen, which makes the bones less dense to begin with and more vulnerable to calcium loss.
  
  
• Women with eating disorders (yo-yo dieting, starvation diets, binge/purge eaters). When there isn't enough calcium in the bloodstream through diet, the body will take what it needs from the bones. These women also have lower weight.
  
  
• Family history of osteoporosis . Studies show that women born to mothers with spinal fractures have lower bone mineral density in the spine, neck, and mid shaft.
  
  
• High-protein diet . This contributes to a loss of calcium through the urine.
  
  
• Women who have never been pregnant . They haven't experienced the same bursts of estrogen in their bodies as women who have been pregnant.
  
  
• Amenorrhea in childbearing years. (typically affects women athletes who do endurance activities). Studies show that women with amenorrhea have 20 to 30 percent less bone mineral content than have those with regular cycles, which is associated with faster bone resorption seen with estrogen deficiency.
  
  
• Athletes. Athletes have a low percentage of body fat needed for menstruation (see above), while excessive exercise releases B-endorphin, which researchers believe may suppress estrogen circulation.
  
  
• Lactose intolerance . Since so much calcium is in dairy foods, this allergy is a significant risk factor.
  
  
• Teenage pregnancy . When a woman is pregnant in her teens, her bones are not yet fully developed and she can lose as much as 10 percent of her bone mass unless she has an adequate calcium intake of roughly 2,000 mg a day during the pregnancy and 2,200 mg a day while breast-feeding.
  
  
• Scoliosis.
  

There are no symptoms of osteoporosis in the early stages of the disease. Symptoms occurring late in the disease include:

• Fractures of the vertebrae, wrists, or hips (usually the first indication)
• Low back pain
• Neck pain
• Bone pain or tenderness
• Loss of height over time
• Stooped posture

Currently, it's estimated that half of all women over the age of fifty are affected by osteoporosis, while more than 1.5 million fractures are caused by osteoporosis each year. Five to twenty percent of these women die from complications. These fractures usually involve the spine, hip, or wrist. This might sound like a pretty bleak picture, but there are certainly things we can do to help offset and combat osteoporosis and possibly even prevent it altogether.

Saliva testing can easily test for imbalances in each of the major hormones that have an impact upon bone health – particularly, testosterone, DHEA, cortical, estrogen and progesterone. Bone is a hormonally sensitive tissue that is affected by age-related decline in production of these hormones. Many studies show that as they age, both men and women begin to lose bone as the androgens – testosterone and DHEA in particular – start to fall off. And when these hormones are low and cortical is high, bone loss increases at an even more rapid pace.

In addition to the BioHRT therapy, the following may be helpful in the prevention of osteoporosis.

Exercise . This should include a routine regime four or more times per week. Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis. Studies show that exercises requiring muscles to pull on bones cause the bones to retain, and even gain density. Researchers found that women who walk a mile a day have four to seven more years of bone density than women who don't. Any exercise that presents a risk of falling should be avoided! Some of the recommended exercises include:

• Weight-bearing exercises – walking, jogging, playing tennis, dancing, riding stationary bicycles, using rowing machines and the elliptical trainer, etc.
• Resistance exercises – free weights, weight machines, rubber stretch bands
• Balancing exercises – tai chi, yoga, pilates
• Riding stationary bicycles

Ingest more calcium . As boring and repetitive as it may sound, the best way to prevent osteoporosis is to ingest more calcium. It's not enough to just take calcium supplements or eat high-calcium foods; you need to cut down on diuretic foods such as caffeine and alcohol. How much is "enough"? According to the National Institutes of Health Consensus Panel on Osteoporosis, pre menopausal women require roughly 1,000 mg of calcium a day; for perimenopausal or postmenopausal women already on HRT, 1,000 mg a day; and for peri- and postmenopausal women not taking estrogen, roughly 1,500 mg a day. For women who have already been diagnosed with osteoporosis, the panel recommends 2,500 mg of calcium a day. Foods rich in calcium include all dairy products (an 8-ounce glass of milk contains 300 mg of calcium), fish, shellfish, oysters, shrimp, sardines, salmon, soybeans, tofu, broccoli, dark green vegetables (except spinach, which contains oxalic acid, preventing calcium absorption). It's crucial to determine how much calcium you're getting in your diet before you start any calcium supplements; too much calcium can cause kidney stones in people who are at risk for them.

Stop unhealthy habits . If you smoke, quit smoking. Also, limit the intake of alcohol. Too much alcohol can damage your bones.

Avoid stress . Too much stress raises cortical output, interfering with calcium absorption and bone-building activity, while at the same time stepping up the activity of bone destroying cells.

Be aware of the foods that you eat . Limit the consumption of simple carbohydrates, soda, alcohol, and sugar, as well as high protein diets. Ensure that your diet includes an adequate amount of calcium, vitamin D, and protein. Supplemental calcium should be taken as needed to achieve recommended daily calcium dietary intake. High calcium foods include low-fat milk, yogurt, tofu, salmon and sardines (with the bones), and leafy green vegetables, such as collard greens. Vitamin D aids in the absorption of calcium, and 400-800 IU per day should be taken by all individuals with increased risk of calcium deficiency and osteoporosis.

The good news is that breast pain in menopause is very common. Despite the discomfort and pain associated with menopause there is very rarely cause for concern.* In fact, there are three main causes of breast pain that stem from unbalanced hormone levels:

• Imbalances of hormones based on your monthly menstrual cycle or estrogen levels
  
• Synthetic hormones that are contained in pills and birth control pills
  
• Pesticides and chemicals in the environment, otherwise known as Xenoestrogens

*Breast pain can also be caused by cysts or other benign formations.  Be sure to speak to your doctor and to have annual mammograms.

Historically, jokes have been made attributing a woman’s blue moods to her hormones. And it is true.  Puberty, menstruation, pregnancy and delivery, perimenopause and menopause are all times in a woman’s life when she is more vulnerable to depression. Are hormones the reason? The answer appears to be yes. New findings have revealed that hormonal imbalance, declining or fluctuating hormone levels, and chronically high levels of stress hormones can all cause depression.

Symptoms of Depression:

• Constant sadness or unhappiness
• A feeling of emptiness
• Continual feelings of hopelessness, helplessness, worthlessness, pessimism, and guilt
• Exhaustion
• Loss of interest in previously enjoyable activities
• Irritability, anxiety, panic attacks and increased crying
• Sudden change in appetite
• Insomnia, wakefulness
• Physical discomfort that does not respond to treatment

Depression is a serious illness that can affect all aspects of a person’s life, including relationships, self-image, work, social life, diet, and sleep. It’s more than feeling a little blue now and then, or having a few gray days once in awhile. For those suffering from real depression it’s not a question of just “snapping out of it,” or pulling themselves together. They are generally unable to lift their own spirits without professional help.

Chronically high levels of cortisol have now been linked to a number of mood disorders including depression, melancholia, and anxiety. Once depression is relieved cortisol levels usually return to normal. However, sometimes it is difficult to know if your stress level is affecting you physiologically and psychologically. Stress is so commonplace in today’s society that many of us just accept it as way of life. Monitoring cortisol levels can be a helpful tool in the diagnosis and management of depression.

Estrogen is an excitatory hormone, which means it makes things happen. In the brain estrogen triggers increased blood flow and oxygen metabolism, as well as the activity of neurotransmitters - the chemical messengers that enable your brain to think, feel, remember, decide and take action. Serotonin, norepinephrine, and dopamine are the neurotransmitters of “disposition management.” They govern our feelings of satisfaction, contentment and confidence. Both estrogen and progesterone influence these neurotransmitters. For example, the neurotransmitter serotonin affects your mood. Estrogen increases production of serotonin. When estrogen is low, serotonin production slows down. Low serotonin levels can open the door to depression. Estrogen replacement can enhance the body’s natural production of serotonin.

Progesterone is a calming hormone that is believed to bind with gamma-aminobutyric acid or GABA receptors in the brain. GABA is an amino acid that acts as a neurotransmitter. It has a calming effect on the brain and can increase feelings of well-being. When progesterone levels decline mood swings, depression and anxiety can be the result. Progesterone also balances the effects of estrogen. When there is not enough progesterone in circulation the activities of estrogen can go unchecked. Too much estrogen in the body can also cause anxiety, agitation, and irritability. Contrarily, too much progesterone in the system can lead to feelings of lethargy and apathy, also symptoms of depression.

Since estrogen, progesterone, DHEA or testosterone replacement have all been shown to be helpful in alleviating depression, it is always best to determine what hormones, if any, are needed. Saliva testing monitors hormone levels before and after hormone replacement therapy to insure that your hormone dosage fulfills your precise hormonal needs. An individualized hormone replacement therapy program can help lift your depression and rejuvenate your sense of well-being.

Depression can be a result of emotional, physical, situational or purely hormonal factors and it is extremely important to identify the cause. Speak with your doctor to determine what course of action is best for you. It could be as simple as getting your hormones back in balance.
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With Endometriosis, tissue, like the endometrium (the tissue inside the uterus which builds up and is shed each month during menses), is found outside the uterus in other areas of the body. These foreign tissues respond to hormonal commands each month and break down and bleed. However, unlike the endometrium, these tissue deposits have no way of leaving the body. The result is internal bleeding, degeneration of blood and tissue shed from the growths, inflammation of the surrounding areas, expression of irritating enzymes and formation of scar tissue.  In addition, depending on the location of the growths, interference with the bowel, bladder, intestines and other areas of the pelvic cavity can occur. Endometriosis has even been found lodged in the skin and at other outer pelvic locations like the arm, leg and even the brain.

Most physicians agree estrogen is responsible for the proliferation of endometriosis.  During pregnancy, endometriosis will often disappear, only to return again after pregnancy. This suggests hormonal involvement and that the high progesterone levels produced in pregnancy play an important part in controlling the disease. With this in mind, medical treatments attempt to create a state of pseudo pregnancy, with long periods of supplemented progestins, such as birth control pills, to simulate the high progesterone levels of pregnancy. Unfortunately, these synthetic hormonal medications are often accompanied by side effects ill-tolerated by many women. Such drugs have included Lupron™, Zoladex™ and Depo-Provera™. While these drugs do inhibit estrogen function, they also occupy binding sites for progesterone, thereby depressing a woman’s natural progesterone function as well.  Other than continual pregnancy and total hysterectomy,   traditional medical treatments for endometriosis are temporary.

Lately, physicians have recognized the significance of hormonal balance relating to endometriosis and the resulting therapy involves the use of saliva hormone testing. Levels of estrogen and progesterone can easily be tested by saliva assay.  With the low rate of success offered by traditional medicine, more women are turning to Bio-identical Hormone Replacement Therapy to regain their health.
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Many women have 2 or 3 of these energy zapping factors going on simultaneously.  Furthermore, all of these conditions are hormonally influenced in some way, resulting in stress, food cravings and reduced thyroid function.

Prolonged stress forces the adrenal glands to overproduce the hormone cortisol, leading to adrenal exhaustion and resulting in reduced cortisol with debilitating fatigue not alleviated by sleep.  Women with chronic fatigue syndrome have been found to have reduced cortisol levels and other hormone imbalances. 

Cortisol is also essential in controlling proper glucose levels and breaking down fat for energy. With a lifetime of poor nutritional habits, many women approach menopause and find they have become increasingly sugar intolerant or insulin resistant. Insulin resistance disrupts fat metabolism and women unavoidably gain weight, especially around the mid-section. Afternoon fatigue, caffeine and carbohydrate cravings are all early indicators of insulin resistance.  Frequently, women unwittingly exacerbate their condition by fighting weight gain with low-fat, high-carbohydrate diets.  When the cells won't absorb the extra glucose from carbohydrates, the liver has to convert it into fat. Fat cells are loaded with glucose receptors, so this becomes a vicious cycle. Ironically, fat cells are actually "starved" for glucose, so women feel exhausted and tend to eat carbohydrate-heavy foods in search of energy.

These extra fat cells also produce estrogen. This contributes to estrogen dominance that causes so many symptoms during the early stages of menopause (perimenopause), as well as thyroid dysfunction.

Fatigue robs women of the energy needed to keep up with the demands of modern life.  An effective treatment for fatigue must address the connection of hormonal imbalance.  Natural hormone replacement therapy offers a safe and effective solution to persistent fatigue.
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It is also helpful to know if your bleeding is heavier than it should be.  Here are a few questions to ask yourself.*

1. Do you change your pad every hour?
   
2. Does the bleeding last for more than a week or weeks(s) at a time?
   
3. Did you stop bleeding all together months ago, and has it started up again?  (If you started hormone replacement therapy during that time, the bleeding may not be cause for concern.)

*Please let the doctor know if you answered yes to any of these questions.  You may not want to rule out other serious conditions of the uterus and reproductive system that cause heavy bleeding.  Bleeding during the perimenopausal and menopausal years can also be caused by fibroids.

Uterine fibroids are benign tumors in the middle layer of the uterus, the muscular layer that causes contractions during labor. They are made of nodules of smooth muscle cells and fibrous tissue that develop in the wall of the uterus. Fibroids may grow as a single nodule, or in clusters. They may range in size from 1/10 of an inch to 8 inches in diameter (the size of small seed to a small melon). Uterine fibroids may grow in the wall of the uterus, or they may project into the interior cavity or toward the outer surface of the uterus. Although fibroids are called "tumors," they are not cancer. They are smooth muscle growths. These muscle tumors, originating in the wall of the uterus, grow under the influence of estrogen, the hormone all women produce everyday of their reproductive lives.

Approximately 40% of women have fibroids. Women approaching menopause may develop fibroids due to a growth spurt in response to a change in hormone balance. At this time in the menstrual life, the body often produces more estrogen than normal, because progesterone, the ovarian hormone that inhibits the effects of estrogen, is diminished. Some doctors see this common fibroid growth as an indication for surgery and needlessly alarm patients.

Remarkably, one out of every four women enters menopause as the result of medical treatment. In the great majority of cases, that treatment is a hysterectomy. Uterine fibroids are the single most cause for performing hysterectomies in the United States; however, most women with fibroids need no surgery at all. Even those who do require surgery certainly do not need hysterectomies.

The controversy in recent years over whether hysterectomies are necessary tends to conceal a disturbing trend:  More and more women are developing fibroids.

Natural hormone replacement therapy balances hormones to control the production and severity of fibroids and assists in the reduction of excessive bleeding.  
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The individual hair shaft's diameter decreases as well. But how can androgens (male hormones) affect women's hair loss?

Female pattern hair loss usually begins with the onset of menopause. Estrogen levels begin to decline, and it is estrogen that is a critical factor here. Estrogen blocks the action of the hormone indirectly responsible for women's hair loss. Testosterone is also present in women's bodies. Without significant levels of estrogen to inhibit it, testosterone is converted into dihydrotestosterone (DHT) by the action of an enzyme named 5-alpha reductase. Some hair follicles are especially susceptible to the action of DHT. When attacked by DHT, the growth cycle of the follicle is disrupted. It begins to shrink and miniaturize, producing thinner and thinner hair with each cycle. Eventually, the hair falls out and does not re-grow.

In a normal scalp, when a hair falls out a new young hair pushes up from the base of the follicle to replace it. Under the action of DHT the follicle ceases to produce hair. To stop or reverse women's hair loss, either the action of DHT needs to be blocked or the follicle needs to be stimulated to overcome the attack and re-grow hair. For women, blocking DHT is accomplished by estrogen replacement therapy.

In pregnancy-related women's hair loss, estrogen is also involved. During pregnancy, estrogen levels rise. Researchers think that higher levels of this hormone prolong the hair's growing or anagen phase, preventing the woman from shedding any hairs. Pregnant women often report thicker, healthier hair during this time. After the baby is delivered, and the estrogen levels in the body begin to return to normal, the abnormally-prolonged growing phase of the hair naturally terminates. The result is that a large proportion of hairs enter the dormant or telogen phase. The hair stops growing, enters an inactive state and eventually falls out. Fortunately this condition is temporary. Your hair will appear thin for a few months, but eventually the follicles will produce strong new hair.

In addition to the above hormonal imbalances contributing to hair loss, the following are added causes of hair loss.

High Fever, Severe Illness, Severe Flu - Sometimes one to three months after a high fever, severe infection or flu, a person may experience hair loss.

Thyroid Disease - Both an overactive thyroid and an underactive thyroid can cause hair loss.

Deficient Diet - Some people who go on low protein diets, or have severely abnormal eating habits, may develop protein malnutrition. To help save protein the body shifts growing hair into the resting phase. If this happens massive amounts of hair shedding can occur two to three months later. A sign of this is if the hair can be pulled out by the roots fairly easily. This condition can be reversed and prevented by eating the proper amount of protein. Its very important when dieting to maintain an adequate protein intake.

Medications - Some prescription drugs may cause temporary hair shedding in a small percentage of people. Examples of such drugs include some of the medicines used for the following: gout, arthritis, depression, heart problems, high blood pressure, and blood thinners. High doses of vitamin A may also cause hair shedding.

Cancer Treatments - Chemotherapy and radiation treatment will cause hair loss because it stops hair cells from dividing. Hairs become thin and break off as they exit the scalp. This occurs one to three weeks after the treatment. Patients can lose up to 90 percent of their scalp hair. The hair will re-grow after treatment ends and patients may want to purchase wigs before treatment.

Low Serum Iron - Iron deficiency occasionally produces hair loss. Some people don't have enough iron in their diets or may not fully absorb iron in their diets. Women who have heavy menstrual periods may develop iron deficiency.

Major Surgery/Chronic Illness - Anyone who has a major operation - a tremendous shock to the system - may notice increased hair shedding within one to three months afterwards. The condition reverses itself within a few months, but people who have a severe chronic illness may shed hair indefinitely. A relatively unknown fact is that hair transplantation surgery can actually cause additional hair loss or "shock fallout". Hairs lost from shock fallout usually don't re-grow.

Alopecia Areata - This type of hair loss is believed to be caused by the immune system reacting to hair follicles as if they were antibodies and shutting them down. The hair loss is usually limited to a coin sized area and all the hair in the area is lost leaving a totally smooth round patch. In a more severe rarer condition called Alopecia Totalis, all hair on the entire body is lost, including the eyelashes.

Fungus Infection (Ringworm) of the Scalp - Caused by a fungus infection, ringworm (which has nothing to do with worms) begins with small patches of scaling that can spread and result in broken hair, redness, swelling, and even oozing. This contagious disease is most common in children.

Stress - Stress can cause hair loss in some people. Usually it occurs 3 months after the stressful event has occurred, and it may take 3 months after the stress period has ended for the hair growth to resume. In most cases it is temporary if the person is not predisposed to genetic or Androgenic Alopecia. However, if they are predisposed, stress may trigger the onset of genetic hair loss or may worsen existing Androgenic hair loss.

Hair Pulling (Trichotillomania) - Some children, and less often adults, play with their hair by pulling on it or twisting it. This can be part of a behavioral problem or a bad habit that is often done unconsciously. If the behavior is not stopped permanent hair loss can result from the constant stress on the hair.

Hair Styling Treatments - Many people change the appearance of their hair by using chemical treatments like dyes, tints, bleaches, straighteners, relaxers and permanent waves. If correctly done and done using reputable products, its rare to have any damage. However, hair can become weak and break if any of these chemicals are used too often. Hair can also break if the solution is left on too long, if two procedures are done on the same day, or if bleach is applied to previously bleached hair. Some chemical relaxers do contain powerful chemicals and there have been instances of people getting chemical burns from these products, resulting in permanent hair loss.

Hair Braids/Weaves - Many women braid their hair, have hair weaves, wear ponytails, cornrows, and/or tight rollers. Under normal conditions these cause no problems. However, if the weave is attached too tight or the braids are wrapped too tight, they put a constant strain on the hair follicle. If this is done for an extended period of time permanent hair loss can result. This is known as Traction Alopecia and is fairly common among people who braid or weave their hair.

Along with the Bio-identical Hormone Replacement Therapy, we suggest the following lifestyle changes:

• Eat well and avoid crash diets. A balanced diet, along with a high quality vitamin is one of the most important ingredients for healthy hair. Avoid large doses of vitamin A.
  
  
• Chemicals in perms and some dyes can be rough on your hair in the long run, so use them as little as possible. Consider natural hair dyes and styles that complement your hair type.
  
  
• Protect your hair from environmental elements, such as the sun, by using products that contain natural sunscreens, such as wild pansy and coffee extracts.
  
  
• After swimming in a pool, take extra care of your hair by washing and conditioning it thoroughly, as chlorine is extremely damaging to the hair and scalp. Try to avoid chemically based shampoo and conditioner. Most health food stores carry a selection of organic products.
  
  
• Massage your scalp with rosemary oil in an olive oil base. Both rosemary oil and massaging the scalp stimulate circulation and promote hair growth.
  
  
• If your taking prescription medications, talk to your doctor and find out if your medication is contributing to your hair loss.
  
  
• Exercise, do yoga and/or meditate. Find a practice that will help to reduce stress and anxiety.

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A hot flash can feel different for each woman. Some women experience a feeling of warmth in their faces and upper bodies, while others experience sweating and chills. Some women feel anxious, tense, dizzy, or nauseous just before the hot flash, and others feel tingling in their fingers or heart palpitations just before. Hot flashes can be experienced during the day, as well as in the evening, with many women experiencing such severe hot flashes that they need to change their bed sheets or nightclothes. This may be followed by a chill that has one groping for the covers that were kicked to the floor just minutes earlier. It is usually over in seconds, and there is no telling when it will reoccur – maybe minutes, maybe hours – but it will be back.

What causes hot flashes, sweats and heat intolerance?

These symptoms occur as a response to changing hormone levels which induce confusion (doctors refer to this as "vasomotor instability") in the temperature regulating mechanism of the body. Your body "thermostat", located in an area of the brain called the hypothalamus", is intermittently fooled into believing that your body temperature should be lower. Normally, when the body is too warm, the hypothalamus sends a chemical message to the heart to cool off the body by pumping more blood, causing the blood vessels under the skin to dilate, which makes you perspire. The "sweats" some women experience is a more extreme cooling measure. Evaporation of liquid in the form of perspiration from the skin is utilized to reduce body temperature. If you recall how chilled you feel when you get out of a swimming pool or a bath, you can see how effective evaporation is as a cooling mechanism. During menopause, however, it's believed that the hypothalamus gets confused and sends this "cooling off" signal at the wrong times. A hot flash is not the same as being overheated. Although the skin temperature often rises between 4 to 8 degrees Fahrenheit, the internal body temperature drops, creating this odd sensation.

Why does the hypothalamus get so confused?

The answer is an imbalance of estrogen. When estrogen is given to replace lost estrogen in the body, hot flashes disappear. Triggered by excessive estrogen in perimenopause or falling estrogen in menopause, hot flashes arrive unannounced, and usually at a most inconvenient time; in the middle of a job interview, in the middle of an important speech or in the middle of the night, for example. Although hot flashes are harmless in terms of health risks, they are disquieting and stressful.

Women in the following categories generally experience a greater severity of hot flash symptoms:

• Women in surgical menopause . This includes: Cancer therapy, Hysterectomy, Bilateral Oophorectomy (the removal of both ovaries before natural menopause), etc.
• Women who are thin . When there's less fat on the body to store estrogen reserves, estrogen loss symptoms are more severe.
• Women who don't sweat easily. An ability to sweat makes extreme temperatures easier to tolerate. Women who have trouble sweating may experience more severe flashes.
• Women experiencing extreme stress
• Women making poor nutritional choices

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The Relationship Between Hormones and Incontinence

Does menopause affect bladder control?
Yes. Some women have bladder control problems after they stop having periods (a result of menopause or change of life). The relationship between bladder control and hormonal balance becomes increasingly important as women age and transition through menopause. After your periods end, your body stops making the female hormone estrogen. Estrogen helps to keep the sphincter muscle tight, and when estrogen levels decline during menopause, the muscle can become weak and flaccid, allowing leakage of urine.

 

You can use a mirror to check yourself. The normal appearance of the urethral tissue is pink, plump and moist. With declining estrogen it may appear very pale or almost white. This means the opening to the bladder may be weaker and less able to maintain good bladder control, or less resilient to irritation or infection.

THE DIFFERENT KINDS OF URINARY INCONTINENCE
Causes of incontinence at or after menopause include irritable bladder, diabetes mellitus, local infections such as cystitis, obesity, prior pregnancy without vaginal deliveries and episiotomies, lack of estrogen, and prior surgery such as hysterectomy.

The three types of incontinence are as follows:

• Stress Incontinence:  the leakage of a small amount of urine caused by an increase in pressure inside the abdomen when you sneeze, cough, laugh, or lift a heavy object.
• Urge Incontinence:  occurs if you wait until you need to urinate urgently.  The bladder starts to contract involuntarily and empties itself.  This type of incontinence is often triggered by a sudden change in position, such as standing up.
• Mixed Pattern Incontinence:  a combination of both urge and stress incontinence, and may be the result of two faults in bladder function.

 
Facts About Urinary Incontinence

• It is estimated 17 million US citizens experience one form of urinary incontinence.
• 85% affected are women.
• 1 in 12 people with urinary incontinence tells their doctor.
• There are a number of things that cause urinary incontinence.
• Urinary incontinence can be treated and most often does not require surgery.

Signs That You May Be Experiencing Urinary Incontinence

• Sudden leakage of urine that prevents you from participating in normal everyday activities
• Leakage of urine that began or continued after an operation (Hysterectomy, Caesarian Section, Prostate Surgery, etc.)
• Inability to urinate (retention of urine)
• Urinating more frequently than usual without a known bladder infection
• Needing to rush to the bathroom and/or losing urine if you do not "arrive on time"
• Pain related to filling the bladder, and/or pain related to urination (in the absence of a bladder infection)
• Frequent bladder infections
• Embarrassing moments due to sudden leakage in urine
• Progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying
• Abnormal urination or changes in urination related to a nervous system abnormality (stroke, spinal cord injury, multiple sclerosis, etc.)

Used in conjunction with BioHRT Therapy, following are some suggestions to help with the symptoms of incontinence.

• Empty your bladder every two hours
• Avoid diuretic drinks such as tea and coffee
• Acupuncture
• Kegel exercises

What is a Kegel Exercise?
Dr. Arnold Kegel developed a set of exercises in the 1940s to help strengthen pelvic muscles, particularly those of the urethra, vagina, and anus.  The exercises will not only combat urinary incontinence, but will also make sex more pleasurable and give women more acute vaginal sensations. 

How do I do the Kegel Exercise?
You can locate the muscles used in Kegel exercises by stopping the flow of urine mid-stream when emptying your bladder.  Kegel exercises can be done at any time and at any place:  all you have to do is draw up the vaginal muscles, hold for a count of five, and then relax.  Repeat this process five times.  You should do the whole routine at least ten times a day.

Source:  Dr. Miriam Stoppard, NeoControl
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Most often initial sleep is achieved; however, many women waken around 3:00 a.m. and are not able to return to a deep, restful sleep. Insomnia can be a serious problem, since it affects the amount of REM (or rapid eye movement) sleep.  REM sleep is important for all sorts of cognitive functions such as problem solving, creative work, and memory. Even those who get a total of eight hours of sleep may find themselves tired if they wake up frequently. Those who experience a lack of sleep in general, and a lack of REM sleep, in particular, over time will experience a number of problems, including decreased concentration, decreased memory, extreme tiredness, decreased motor skills and irritability.

Most of us fall asleep when our body temperature is declining. As heat is lost through the skin and the core body temperature declines drowsiness increases. The hormonal changes that come with menopause affect the body’s temperature-regulating mechanisms, which contribute to the increased sleep difficulty that comes with menopause and aging. Women who experience hot flashes and night sweats have poorer quality sleep than women who do not. In fact, one study showed that nearly 100% of women who experience nighttime hot flashes also experience a waking episode at the same time.

Chronic stress causes adrenal exhaustion and suppresses levels of DHEA, a vital regulator of sleep. When overstressed your body releases excessive amounts of stress hormones such as epinephrine and norepinephrine and cortisol. This excess of cortisol interferes with the production and use of vital hormones, such as progesterone, pregnenolone and DHEA, all of which act as precursors to estrogen and testosterone. Insomniacs with the highest degree of sleep disturbance secrete the highest amount of cortisol, particularly in the evening and nighttime hours when cortisol levels should be low. This means that insomniacs are producing stress hormone levels that actually prevent them from sleeping. They are suffering from sustained, round-the-clock activation of the body’s system for responding to stress. Continually living with the stress of too little sleep can aggravate and intensify other medical conditions like high blood pressure and digestive disorders, as well as weaken the body’s ability to fight off illness.

Bioidentical estrogen replacement therapy has been shown to improve sleep quality, facilitate sleep onset, and decrease nighttime restlessness and awakenings. Women taking Bioidentical estrogen replacement report feeling less tired in the morning, and throughout the day. They also report that other symptoms of menopause such as hot flashes, muscle aches, and mood swings are improved. A significant percentage of non-symptomatic women also reported improved sleep quality with Bioidentical Hormones.

Additionally, another positive effect of estrogen replacement on sleep disturbance is its ability to reduce stress reactivity. Low estrogen levels have been associated with increased heart rate and blood pressure, in response to stress. Restoring estrogen to more youthful levels enables the body to respond to stressors more effectively. 

If you are not sleeping and suspect it may be an imbalance in your hormones, you may want to procure a saliva hormone level test. Because each woman’s hormonal make-up is unique, salivary hormone level testing can be an effective tool for helping maintain a healthful and youthful hormone balance. The concept of one-size-fits-all doses of hormones for all women is out-dated. In using salivary hormone level testing, our physicians can determine precisely what you need and prescribe the dose that is adequate for you.
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Estrogen, progesterone and testosterone are key players in the maintenance of circulation, nerve transmission and cell division, so an imbalance of these hormones can easily lead to changes in sexual response. When progesterone levels decline, the result is too much estrogen in the body, relative to progesterone, and the onset of symptoms associated with "estrogen dominance" arise, such as decreased sex drive. Declining estrogen levels common to the menopausal years can dampen nerve impulses during sex, making women less sensitive to vibration and touch. And since estrogens increase blood flow to sexually sensitive areas, decreased levels can slow or diminish the arousal response.

Testosterone is also a  key player in a woman’s sex drive: it affects interest, arousal, sexual response, lubrication and orgasm. Many young women in perimenopause do not have enough testosterone and have elevated estrogen resulting in a premature loss of sexual interest.   

Natural bio-identical hormone replacement therapy has been shown to increase sex drive and even bring the drive back to life.  The physician staff at BioHRT will determine the individualized treatment necessary for your greatest benefit.  A saliva test may be ordered to measure levels of estrodial, progesterone, testosterone and DHEA-s to establish probable cause and a rationale for correcting the hormonal imbalance.
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Hormone levels do not decline uniformly when menstrual periods finally end altogether, Production of estrogen and progesterone is erratic and unpredictable at this time. The ovaries decrease their output of estrogen significantly. These low estrogen levels are linked to some very uncomfortable symptoms which may affect the life and daily activities of many women.

The symptoms of menopause fall into three groups:

The first group contains the most common effects, such as:

• Fatigue/Lack of energy
• Stress
• Depression/Anxiety/Mood swings
• Short-term memory loss/ Irritability /Confusion/Difficulty concentrating
• Dry skin/Wrinkles/Thinning skin
• Loss of hair/Excessive facial hair
• Weight gain
• Joint and muscle aches and pains

The second group is described as containing Vasco-motor symptoms, such as:

• Hot flashes
• Nausea/ poor digestion
• Lightheaded and/or Dizziness
• Headaches / Migraines
• Heart palpitations
• Night sweats
• Insomnia
• Reduced body temperature(Chills)
• High blood pressure

The third group of symptoms is called Sexual Symptoms, such as:

• Vaginal dryness 
• Incontinence (leaking urine when coughing, stretching, bending)
• Itching of the vulva
• Pain during intercourse
• Loss of libido (sex drive)

Estrogen helps protect against plaque buildup in the arteries. It does this by helping to raise HDL cholesterol (good cholesterol), which helps remove LDL-cholesterol (the type that contributes to the accumulation of fat deposits called plaque along artery walls). As a woman ages, the risk for developing Coronary Artery Disease (CAD), a condition in which the veins and arteries that take blood to the heart become narrowed or blocked by plaque, increases steadily. Heart attack is now the leading cause of death among women. Experts believe that bio identical estrogen replacement therapy may be the single most important factor in preventing heart disease in women.

For most women, the symptoms of menopause last for a few years or more. However, a woman's level of estrogen naturally remains low after menopause. This will affect many parts of the body, including the sexual and urinary organs, the heart, and the bones. So, in that sense, the changes of menopause can be life-long. Women today can expect to live as much as one-third of their lives beyond menopause. In the next decade, as many as 52 million women will be age 50 or older. Bio-identical hormone replacement therapy (BHRT) enables women to feel great and live a long, healthy life after menopause. Contrary to the old-fashioned view that life is all downhill after menopause, many women today find that the years after menopause offer new discoveries and fresh challenges.
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Hormone related headaches feel like tightness or pressure in the skull, throb intensely and may be accompanied by severe mood swings.  Headaches in women, particularly migraines, have been related to changes in the levels of the female hormones estrogen and progesterone.

 Many migraines have been stopped totally with natural progesterone applied at the onset of the symptoms related to the migraine.  A simple saliva test measures hormone levels in the body and can help determine if your migraines are hormonally triggered.

However, what separates you from other women is your exact hormone levels. That explains why your symptoms and reactions to situations may vary from those of your family and/or friends. Your hormone levels are specific to you and your body, and individualized hormone replacement is necessary to bring your body back into balance.

For some women, perimenopause bears a striking resemblance to adolescence. When you were a teenager, you more than likely experienced irregular menstrual cycles and mood swings. And, once again, you are experiencing those same feelings, but this time it’s because your reproductive life is coming to a close rather than gearing up. Your ovaries, where ova (eggs) and the hormones estrogen and progesterone are produced, now contain far fewer eggs, and hormone levels are changing. That’s why some experts refer to perimenopause as “puberty in reverse.”

The hormonal changes that make up perimenopause tend to take place in 3 stages. The first is marked by the dominance of estrogen, as progesterone levels fall. The feelings are like those experienced during PMS (premenstrual syndrome), including breast tenderness, cramping, and bloating. You feel cranky and tearful. During the second stage, estrogen levels also drop, causing such symptoms as hot flashes, vaginal dryness, migraines, insomnia, and heart palpitations. Late perimenopause is the third stage. Both estrogen and progesterone levels are nearly as low as they are in menopause. Some of your symptoms may ease, although others may persist into menopause.

In addition to irregular periods, mood swings, and the symptoms noted above, you may experience other symptoms during perimenopause:

• loss of sex drive (libido)
• night sweats
• fatigue
• loss of concentration
• weight gain, particularly at the waist
• vaginal infections
• frequent urination or lack of urinary control
• urinary tract infections
• dry or thinning hair, itchy skin

This is the perfect time to begin judicious estrogen/progesterone/testosterone therapy; thereby, guaranteeing the replacement of a failing internal supply of the essential hormones needed to restore your health and well-being.
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Some women have PMS from the time they begin having menstrual cycles, but, for most, PMS begins in the pre menopausal years, around the mid-thirties, and becomes increasingly severe as the years go on. Although it's possible to create a list of dozens and dozens of PMS symptoms, the most common in the week or two before the menstrual period are:

• Irritability, anxiety, depression, hopelessness, major mood swings
• Breast pain or tenderness, bloating, weight gain
• Insomnia, fatigue, lack of energy
• Headaches, backaches, joint and muscle aches
• Constipation, diarrhea, urinary disorders
• Food cravings, especially for carbohydrates and sugar

PMS stems from an imbalance of the female hormones estrogen and progesterone following ovulation. (Ovulation occurs at the midpoint of the menstrual cycle.) When the estrogen overwhelms the amount of progesterone in a woman's system, the brain has more difficulty producing chemicals that control mood and pain. This hormone imbalance leads to the mood shifts and food cravings of PMS. It also triggers the release of the hormone prolactin, which causes breast tenderness and blocks the liver from efficiently clearing excess estrogen from the body.

Stress is almost always involved in PMS. Stress increases cortisol levels, which blocks progesterone from its receptors. This means that you need extra progesterone to be able to overcome the blockage of its receptors by cortisol. Women with PMS usually have higher levels of the hormone cortisol. 

PMS symptoms may also be due to a chemical imbalance in the brain.  The levels of a neurotransmitter called serotonin will fluctuate due to hormonal changes. Many women report less trouble with PMS symptoms when they are under treatment to normalize serotonin levels.

The three hormones with the most profound effects on your body (the way you look, feel, and think) are estrogen, progesterone and testosterone. If you suffer from one or two of the symptoms listed above, BioHRT can help to naturally restore your hormone balance.
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Science is showing that estrogen slows the ravages of time when it comes to your skin. Estrogen increases the activity of skin fibroblasts, the cells that produce collagen. Collagen is the connective tissue that adds “plumpness” to skin, giving it structure and tone. It helps keep moisture in the skin by insuring the production of hyaluronic acid, a substance that keeps water in your tissues. The skin collagen content of women who take estrogen replacement has been shown to be considerably higher than that of women who do not.

Scientific studies have shown that estrogen replacement can:

• Decrease wrinkle depth and pore size from 61% to 100%
• Markedly improve skin hydration
• Increase skin thickness from 7% to 15%
• Increase skin lipid sebum production by 35%

Estrogen also plays a role in the way fat is distributed under the skin. Loss of this layer of fat can make skin look older than it should, by contributing to sagging and loss of fullness. 

Natural hormone therapy can have a powerful and positive effect on helping you maintain youthful looking skin. It is one of the benefits of replacement therapy that many women enjoy.  It is best to first assess your hormone levels with a baseline salivary hormone test. Hormones have an ideal body equilibrium that must be maintained.  Preserving the proper balance and ratio between your hormones, and restoring them to more youthful levels can help protect and preserve the vibrancy and vitality of your skin.
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Exposure to chemicals that may destroy ovarian follicles—solvents used in some workplaces, environmental chemicals, or some chemotherapy drugs, foe example—also causes early menopause.

A few women undergo menopause even earlier, before age 40.  Premature menopause, also called premature ovarian failure, is rare, however.  “Only about 1 percent of women go through go through menopause before age 40,”says Ralph Schmeltz, M.D., an endocrinologist and associate chief of internal medicine at McGee Women’s Hospital in Pittsburgh.

Premature ovarian failure tends to run in families.  In about half the women affected, the ovaries still function intermittently, Dr. Schmeltz says.  “A woman might be diagnosed with premature ovarian failure and then, a few years later, find out she’s pregnant,” he says.  The situation is similar to perimenopause, but happens earlier, while a woman is in her thirties.

Other causes of premature menopause include surgical removal of the ovaries, radiation therapy, hysterectomy, mumps, and an autoimmune reaction, all of which are described below.

Surgical Removal of the ovaries:  This is by far the most common cause of premature menopause.  Both ovaries must be removed for menopause to occur, since a single ovary, or even a portion of an ovary, can continue to produce ova (eggs) and hormones as efficiently as if both ovaries were still present.

Radiation Therapy:  Menopause may come early if the ovaries have received significant doses of radiation, for example, during treatment for cancers of the abdomen and pelvis.  This is why the ovaries should be protected by a lead apron when X-rays are taken.

Hysterectomy:  After a hysterectomy in which the ovaries are left behind, women usually experience a loss of ovarian function five years earlier than they would do normally.  Tubal ligation, a sterilization procedure, should not have the same effect.  If it does, it is due to interference with the blood supply to the ovaries.

Mumps:  Very rarely, the ovaries can be damaged by the mumps virus, leading to premature menopause.  Mumps may cause irreparable damage to the ovaries, in the same way that it may damage a man’s testes.

Autoimmune Reaction:  Autoimmune diseases, such as lupus erythematosus (a disease of the connective tissue), or rheumatoid arthritis, may cause a woman’s body to start producing antibodies that react against her ovaries as foreign tissue, and attach them.  This process may destroy the supply of eggs in the ovaries and reduce the output of female hormones.

Source:  Dr. Miriam Stoppard

Women who do have a premature menopause can suffer an early onset of symptoms and may need a higher than average dose of hormones in bio-identical hormone replacement therapy to alleviate them. 
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Relentless stress creates hormonal imbalance by releasing excessive amounts of the stress hormone cortisol. Excessive cortisol then interferes with the production and use of vital hormones, such as progesterone, pregnenolone and DHEA. Insufficient DHEA contributes to fatigue, bone loss, loss of muscle mass, depression, aching joints, decreased sex drive, and impaired immune function.

Because of the stress and hormonal connection, symptoms of menopause and PMS become worse. 

Since cortisol is produced in the adrenal glands prolonged stress can lead to adrenal exhaustion and possible adrenal failure. Other conditions related to stress and hormonal imbalance include insulin resistance, autoimmune disease, thyroid malfunction and cancer.

Although every woman is different, the use of hormone replacement therapy, exercise, and relaxation techniques, as well as the consumption of nutritious foods, are all essential for stress recovery.  Hormonal balance can stop the destructive path that stress creates.
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Why am I gaining this weight?  We hear this question every day. And no wonder. Despite their best efforts, most women gain weight in perimenopause — especially around the waist and hips — even when dieting!

The aging process can bring with it a decline in your hormone levels, and changes in your physiology. Perimenopause and menopause have long been considered high-risk times for weight gain in women. It is not unusual for a woman to gain between two and five pounds during these hormonal transitions, with some women gaining even more. In the perimenopausal years a women’s body produces less estrogen and starts trying to find it in other places of the body like the skin and fat cells.  Fat cells produce estrogen so the body starts to store fat. At the same time the body is also losing testosterone (which is usually associated with men).  When women lose testosterone however, they lose their best internal fat burners; their muscle tissue and their lean body mass.  The more fat burning function the body loses the more fat is likely to be stored and the more weight is likely to be gained.  There is also a hormonally related redistribution of fat that occurs during perimenopause and menopause - a shift from peripheral to abdominal weight gain, which gives many menopausal women a more ‘apple shaped’ torso.

An apple may be good for you, but an apple figure with excess weight in the middle isn’t. The risk for heart disease rises eightfold for women with diabetes and this shape. Studies show that obesity and abdominal fat gain are related to low levels of Sex Hormone Binding Globulin (SHBG). Bioidentical estrogen replacement increases the body’s production of SHBG.

Along with its many proven health benefits, bioidentical hormone replacement therapy (BHRT) can also help you with weight management. The most common reason women forgo synthetic hormone replacement therapy during perimenopause and menopause is a fear of weight gain. Numerous studies demonstrate that BHRT does not increase weight. In fact, research shows that women on BHRT gain less weight during menopause than women who are not taking bioidentical replacement hormones.

By helping your body maintain balanced hormone levels, hormone replacement may prevent weight gain, encourage weight loss, and support your body’s insulin response, energy levels, and lipid profile. Topical, or trans dermal, androgen supplementation has been shown to reduce abdominal fat, and overall body weight in postmenopausal women.

It is a proven fact that you have to get healthy before you can lose weight. You can't lose weight to get healthy. But if you heal your body and try to balance your life, you will then find you achieve and maintain your ideal weight.  Restoring hormone levels to a well-balanced physiologic level that is individually suited to you can help your body function the way it did when you were younger. A salivary assessment of hormone levels and monitoring of your BioHRT program can serve as an effective tool for managing weight.
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