Big hormonal shifts occur in menopause. For those who experience drastic changes during menopause, hormone balancing may help. To learn more about different approaches to hormone balancing and how it works, we turned to Lynne Shinto, N.D., M.P.H., who practices naturopathic medicine at the Center for Women’s Health.
By definition, menopause begins when a patient has gone 12 months since their last menstrual period. In the United States, the average age of menopause is around 51 years old. A patient may experience irregular periods or some hormonal symptoms during perimenopause, the years leading up to menopause. Dr. Shinto primarily focuses on women in menopause.
Typical symptoms that may bring someone in to see her for hormone balancing include:
- Hot flashes
- Night sweats
- Sleep disturbance (often caused by night sweats!)
- Vaginal dryness
- Cognitive changes (“brain fog”)
- Mood changes
“People don’t talk about mood a lot, but there is definitely a strong component,” says Shinto, “Sometimes that is the symptoms that is most bothersome.”
Some of her patients may have already tried conventional bioidentical hormone therapy, prescribed by an OB/GYN or primary care provider. These bioidentical hormones come in oral, transdermal or intravaginal forms and are at set doses.
“A lot of women will try that conventional bioidenticals first, and also try different doses, and may still not be feeling quite right,” says Dr. Shinto, “They may have heard there’s a way to compound the hormone dose to be more tailored as an alternative.” That’s where Dr. Shinto comes in.
Before beginning any level of treatment, Dr. Shinto will test a patient’s hormones to get a baseline. Then, she will take a look at their symptoms and line up a treatment plan.
“It’s important to see if there is a drop in estrogen, or progesterone or both,” says Dr. Shinto. “A drop in estrogen may show up as hot flashes, fatigue, mood changes. Changes in progesterone levels can really affect sleep.” Compounding hormones allows Dr. Shinto to determine a treatment plan specific to each individual.
“I always start at a low dose and give it three months,” says Dr. Shinto, “If things still are not right, we re-evaluate.” She often tests hormone levels along the way.
Hormone therapy, in general, has been shown to slow bone loss, reduce the risk of colon cancer and provide cardiac benefits to patients who start a regimen before the age of 60. However, Dr. Shinto points out that because compounded hormones are not yet FDA-approved, there is some controversy surrounding their use.
“There are a lot of women who are helped, who cannot find relief with the conventional therapies,” says Dr. Shinto, “This approach to hormone balancing offers a path to wellness that adds another choice.”
“It’s always nice to have a choice,” she adds.