One of the biggest misconceptions I observe with patients, is that they “wait” until menopause has occurred before seeking hormone support.  Ovarian function usually starts declining in the mid-forties.  This decline of estrogen can cause symptoms such as bone loss, anxiety, depression, loss of energy, sometimes irritability, and sleep disturbance.  The textbook definition of menopause is no menses for one year.  That does not mean that patients who are estrogen deficient should wait until that deadline to seek help. 

Ovarian function in decline may still produce enough estrogen to cause ovulation, although it may take longer.  This would cause longer times between cycles and a difference in heaviness of a period.  The lowest estrogen levels are normally about 7 days prior to the first day of menses and 7 days later. Woman may note more difficulty as their symptoms of deficiency intensify at these times. 

The symptom of menopause that is easy to notice and most talked about is hot flashes. The thing that patients do not understand about hot flashes is that they are not benign.  They are associated with forgetfulness and difficulty in concentrating.  The blood flow to the brain decreases dramatically during a hot flash, especially in the areas that deal with verbal memory and short-term memory.  Studies show hot flashes increase the production of damaging free radicals in the brain.  This can lead to damaging the nerve fibers in the brain.  More damage can possibly lead to cognitive disorders like Alzheimer’s. 

Studies have shown that taking estrogen helps prevent this.  It is a strong anti-oxidant and protectant in many tissues, including nerve tissue.  When I am told that a patient is experiencing hot flashes every few hours, I can only imagine their poor brain which is squeezed and assaulted.  When these women are told to “turn on a fan” while their brains are being damaged is unbelievable, but unfortunately not uncommon.  Don’t let your body suffer, protect your brain.