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The news is in from the
National Institutes of Health: the benefits of estrogen have been
overplayed, and its risks have been minimized. Not only have valid
studies found that estrogen replacement therapy has less protective
value for heart disease, Alzheimer's, depression, urinary incontinence,
and especially osteoporosis, but in addition, the latest studies are
confirming its increased cancer potential.
In other words, the preventive powers of estrogen replacement therapy
are much less than the drug companies have been saying, and its risks
are greater. This is especially important information for any woman
concerned about her thyroid health. Perhaps the biggest potential for
mischief in the whole thyroid field is in the arena of women's health
and menopause. Everything from minor vaginal irritations to repeated
miscarriages have been shown to be thyroid-related in a certain
percentage of sufferers. Menopause is not an illness, but it can begin
to feel that way if your thyroid is low or borderline at the time of
your change.
Women in this frustrating circumstance are often told "It's just your
menopause," as if they should expect to feel awful for years because of
a natural reduction in estrogen. Without an accurate diagnosis of low
thyroid, these women are simply given estrogen and their symptoms
linger. The ovaries and uterus need proper amounts of thyroid hormone
as much as any other organ or system.
Despite increased awareness in the medical community about the issues
and interventions surrounding menopause, tremendous numbers of women
still suffer from menopausal difficulties. They expend a great deal of
time, money, and heartache on hormone replacement therapies.
Frequently, neither the synthetic nor the natural hormones provides
complete relief. This is often because the underlying problem is
undiagnosed low thyroid. By age 50, one in every twelve women has a
significant degree of hypothyroidism. By age 60, it is one woman out of
every six.
This runaway thyroid epidemic seems to be striking menopausal women
harder than any other group of patients. Fortunately, much can be done
to help them. The standard maneuver for perimenopausal patients who
consult gynecologists is to provide a handful of estrogen samples. We
have heard too many stories of women in their late 40's and early 50's
who were given these hormones to take without any blood testing at all.
The compliant patient will follow the doctor's advice. But, in those
cases where women have been put on estrogen, and the symptoms of hot
flashes, insomnia, irritability, palpitations, and "fuzzy thinking" are
still quite annoying, the addition of thyroid hormone can be a godsend.
For those symptomatic menopausal women not wanting or benefiting from
estrogen, we advocate thyroid blood testing first, perhaps followed by
a clinical trial of thyroid hormone, even if their blood tests are in
the normal range.
Frequently, the underlying hypothyroidism is such a controlling factor
that simply correcting it returns the whole system to fairly normal
functioning. Menopause continues, but it is a more mild, gradual, and
comfortable process. If your thyroid is low, your hot flashes will be
much more pronounced, much more frequent, and more disconcerting. This
is because thyroid is your energy throttle, and you need energy to go
through the change gracefully.
How much energy people have, how well they get up in the morning, how
well they sleep, and how much stamina they have for the day is directly
related to their levels of thyroid hormone. When your level is too low,
you don't have the energy to cope adequately with anything, much less
the additional stress and emotional lability associated with the
menopausal years.
Consider the following case: a 51-year-old schoolteacher from the
midwest named Sarah. Both she and her mother started menopause at the
early age of 46. Sarah knew that her mother had low thyroid, as well as
severe menopause problems. Neither the mother, nor Sarah, nor their
doctors connected these two situations. When Sarah herself began to
have the same severe menopause problems as her mother, she accepted it
as her genetic predisposition. She was sometimes so hot and sweaty
during a school day that she would need to keep a change of clothes in
the teachers' lounge. Needless to say, the kids got on her nerves
easily, and she was not enjoying her previously satisfying job.
Faced with these difficulties, Sarah did what her mother had not done:
she began taking Premarin and Provera immediately. The hoped-for
relief, however, was only minimal, even when the gynecologist increased
her dosage. Fortunately, Sarah was referred to our office, and we
discovered that her previously normal TSH was now, with advancing
menopause, 6.2, clearly in the abnormal range. This indicated that her
thyroid hormone levels were not keeping up with the extra demands of
her changing metabolism. Once on thyroid medication, Sarah began to
feel like her old self in a matter of weeks. Her menopause symptoms
faded into the background, and her life became more balanced and
enjoyable. Best of all, she no longer needed the Premarin and Provera
to maintain this more graceful version of menopause. Thyroid hormone
alone resolved the problems.
Other menopausal symptoms are equally amenable to treatment with
thyroid hormone alone. Atrophic vaginitis, or thinning of the vaginal
wall as the result of falling estrogen levels, can lead to itching,
discharge, and painful intercourse. All of these symptoms are much more
severe when your thyroid is low. Women who have had unremitting vaginal
dryness that was unresolved with vaginal creams or estrogen pills are
often found to be low thyroid, if checked carefully. In addition to
getting an important part of their intimate life back, once treated
with thyroid medicine, these women are pleased to find that their
problems with dry hair, dry skin, and cracking nails are often resolved
as well.
We don't intend to belittle the persistent difficulty that some women
have at this time in their life. Not everyone will be helped as quickly
or as completely as was Sarah. The dance of the hormones is very
complex, so the idea that you can take just one hormone, or even two,
and experience total relief, is not always borne out successfully. You
need to look at the whole picture. That's what we mean by holistic
health.
Contrary to what the pharmaceutical industry and your doctors may be
telling you presently, a blue ribbon panel of specialists from around
the world have confirmed that estrogen's benefits have been over-rated
and its risks minimized. Optimizing your thyroid can be a far better
way to achieve the smoother menopause and the preventive health care
you may desire.
Drs. Richard and Karilee
Shames have a private practice in Marin
County, California and also do nationwide telephone thyroid coaching.
They are the authors of Thyroid Power, published by
HarperCollins. For more information, please visit their website at www.thyroidpower.com or call
toll-free (866) 468-4979.
Shop for books
& CDs about Menopause
Related Info:
Menopause: Symptoms & Common Sense
Solutions
Dr. Christiane Northrup
on Menopause and Nutrition
Hidden Signs of Heart
Attack in Women
Living Well: A Guide to Anti-Aging
Do You Have Thyroid
Problems?
The
Truth About Hormone Replacement Therapy
Balancing Your
Energy Hormones
Preventing
Osteoporosis
Feeling Fat, Fuzzy or
Frazzled?
The Hormone Question
Reduce the Effects of
Aging with Natural Supplements
Estrogen, Menopause, and Your Thyroid
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