Dear N

Many thanks for your question.  You are in the correct age category for peri-menopause and menopause.Your low hormone levels would definitely be as a result of this.  Menopause is a normal process for a woman, albeit not always a pleasant one.  There are 8 different types of hormones.  You do not mention your hormonal results, which I would need confirmation of in documented pathology format from a laboratory, prior to treating you.  The main hormones in your instance are oestrogen, progesterone and testosterone.  But to treat holistically, I would like results of any others done. 

I suggest that you make an appointment to see me please, with your pathology results, or alternatively see one of our resident naturopaths or homeopaths.  Your pathology results are important to see, so that the correct approach and products are recommended for you with your hormonal levels.   We have wonderful remedies which work very effectively in assisting to make menopause more comfortable.  At the same time I can assist you with your hair and skin problems.

I wish you a happy and safe festive season!

Warmest regards

Angela 

Dear T

Thank you for your question. The Million Women Study from the UK studied the long-term effect of HRT on 947 546 women over the age of 50 over a five year period. What is showed was that women on HRT are at greater risk of developing breast cancer, endometrial cancer and to a smaller extent ovarian cancer, if they were placed on HRT. These risks change depending on the duration of HRT use and the type of HRT used (oestrogen-only or oestrogen-and-progesterone). It does not reflect the affect genetic predisposition would have. 

Trisequens is a form of sequential combined oral hormone replacement therapy (HRT), i.e. containing both oestrogen and progesterone. It increases your risk of breast cancer and ovarian cancer, but may provide some protection against endometrial cancer if you have an intact uterus. Other side-effects of HRT which increase in severity the longer you use it include headaches, changes in appetite and sex drive and skin abnormalities. 

I would reconsider the necessity for HRT in you case, and the possibility of weaning you off completely. If there is an ongoing need though then consider a bio-identical form of HRT that is associated with a lower risk profile. In that case I would also increase the regularity of my screening procedures for breast and ovarian cancer while you continue on the HRT. Adjuncts to the use of HRT could include Maca powder and a pharmaceutical quality essential fatty acid supplement.

Many thanks and warm regards

Yesheen

Dear M 

Thank you for your question. I understand how distressing it must be to see your mother in ill-health and feel ill-equipped to help as much as you would like to. There are so many factors that play a role in the development of the symptoms you describe and it is quite difficult for me to offer a valuable response without getting a full history, looking at her test results and examining her personally. From the little I can get from your question it sounds like your mom may have something going on with her blood or haemoglobin levels. Have her doctors checked her for anaemia or pernicious anaemia? In addition there are several micronutrient deficiencies that may produce a similar picture. 

When in doubt go green! In cases like this where the picture is generally quite murky and a clear diagnosis is difficult to reach I often go back to basics and build up a nutritional plan that provides adequate amounts of macro and micro nutrients to allow the body to heal itself. The first step is juicing. Get her a juicer and teach her to start the day with a glass of fresh spinach, broccoli and ginger juice which is packed with phytonutrients and minerals that support bone and blood systems. Another essential item is a good quality pharmaceutical grade Omega 3 supplement.

I'm sorry I cannot be of more assistance, but the information provided is too vague and the case sounds too intricate for a forum like this. You are welcome to consult me in a private capacity and you can find contact details on my profile.

Many thanks and warm regards

Yesheen

Dear G

Thank you for your question. As I see it you have two separate but interlinked problems at present. Firstly there is the menorrhagia or heavy menstrual bleeding for which you have been receiving Minerva for two years, and secondly menopause.

You don't mention what the reason for the menorrhagia is and this may affect your choice of future management. If the issue if hormonal then sometimes an oral contraception like Minerva is prescribed in an attempt to regulate the hormonal cycle and as such regulate the volume or duration of bleeding. Minerva is a combination of cyproterone acetate, an anti-androgen, and ethinylestradiol, a form of oestrogen. Apart from all the other risks associated with oral contraceptive use, which I sincerely hope your gynaecologist discussed fully with you, Minerva may also be masking many of the symptoms of menopause you say you currently do not experience.

Menopause is basically your body reacting to the natural reduction in oestrogen and progesterone as the number of eggs in your ovaries reduces as they get released through the years. These hormones are produced in association with the regulation of the "egg-release" cycle and if there aren't any eggs to release then there won't be as many hormone molecules released either. Your use of an oestrogen-containing pill has probably supplemented your diminishing oestrogen concentration, keeping many of the symptoms associated with a decrease in oestrogen at bay. Blood tests may not be able to differentiate between the levels of normal oestrogen and that provided by the Minerva, depending on the test ordered. And blood tests do not dictate at what level of oestrogen-drop you may begin to experience the symptoms of menopause.

My recommendation is dependent on the reason for the menorrhagia. If it is hormonal then as your hormone levels diminish the occurrence of the heavy bleeds should as well, and so to should the need for hormonal supplementation. But until that stage I would recommend thinking about changing to a bio-identical form of oestrogen such as an estradiol preparation which is identical to your own oestrogen composition and has fewer associated side-effects. If the reason for the menorrhagia is physical, such as problems with your endometrium or your ovaries then I would consider managing these and re-evaluating the severity of your menopausal symptoms after the Minerva was stopped. If you then still experienced symptoms of menopause that were challenging then we could look at the use of supplementation with either a bio-identical hormone such as estradiol, natural progesterone or the use of alternate therapies such as Black Cohosh or Accupressure. When considering the use of bio-identical hormones I would prefer you use a cream, skin patch or an oral drop form instead of a pill or capsule form. You need much less of the hormone as you don't need to bypass the stomach and the liver to get it into your blood system and to your ovaries.

Irrespective of which pathway you eventually follow the following are essential for any woman who is entering this period of her life:

1. Omega 3's in doses of over 400mg per day

2. Maca Root Powder, an adaptogen from the root of a Peruvian turnip variety which has been shown to regulate hormonal imbalances

3. Exercise, at least 30-40 minutes per day

4. A well balanced nutrition plan tailored to your body type that contains plenty of green fresh organic vegetables.

Many thanks and warm regards

Yesheen

A woman's cycle can be affected by a large range of factors, including stress, diet, exercise and medication. Stress alone can cause you to miss an entire cycle. After periods have been established in a normal rhythm there shouldn't be a deviation of more than 5 days either side. Usually concern is only warranted if this becomes a regular occurence or if there are other symptoms associated, such as heavier periods or excessive discomfort. You could very well be moving into perimenopause. If you have not begun your period yet I would suggest you visit a healthcare provider or gynaecologist for a general check-up, including hormone testing. Keep in mind that there are many homoeopathic and natural treatments for menstrual problems and menopause, but a check-up is in order to exclude any sinister causes. Warm regards, Dr Megan Jones, Registered Homoeopath 

Remifemin is a herbal supplement for HRT & you should have some relief within a month. However, it is possible you stopped too soon. Furthermore I would suggest Sepia, a homoeopathic remedy, in addition to Remifemin.

Sepia takes care of the hot flushes exclusively, but not the lack of Oestrogen.

There are other natural options for HRT, and I would be very happy to assist you with the natural route before you resort to Oestrogen.

Please feel free to contact me at Wellness Warehouse , Kloof Street.

Kind regards, Felicia (Senior Pharmacist & Integrative Health Practitioner)