Our resident doctor adds more to the conversation about hormonal changes (or are they?) as we age
Saga supporter Chris Custer is an obgyn by trade, and a regular and often lengthy commenter on my articles. Here he has some valuable thoughts on an earlier article which I published using Canadian fitness trainer and Saga Supporter JennyB's input.
This is exactly the kind of discussion I was hoping to engender, so with thanks to JennyB for the first article, here then is Chris' input (with minor editing for clarity):
Ms. Hubbel/ Jenny B., I am sorry I'm not clear on who to address so from here I will address you, Ms. Hubbel. Your article bemoaning the precipitous decline of estrogen, progesterone, and yes testosterone is well-taken, but should be done only after other diagnoses have been considered.
First of all the patients should be screened about her complaints- emotional lability, weight gain, decreased libido, depressive symptoms, lack of motivation, and fatigue are common complaints. But considering other causes for emotional lability and depression are key. There may be new stressors in her life. Is the depression endogenous ( from within herself), such as hormone levels or exogenous such as a new situation in her life?
Weight gain is multi-factoral, of which hormones are only one factor. Weight gain and depression are probably the most valid argument for changing hormone levels, though an internet search showed that at best their conclusions were equivocal(1). As for decreased libido, let me count the causes.
There is absolutely no correlation between physiological levels of testosterone levels and amount of libido and plethora of factors are important such as relationship problems and self body-image.
Fatigue has many causes too many to list here. As for the timing of the these complaints with the onset of menopause there maybe a slight correlation, but hardly clear-cut. After considering these other factors and trying phytoestrogens, (please see: )
should Estrogen Replacement Therapy(ERT) be considered? Ms Barroll- McNamara approach is both measured and rational. Thanks Ms Hubbel for bringing Ms B-M to my attention (I wish I could take credit, but thanks anyway Chris)
In the last analysis, if a doctor just gives you a prescription for ERT without asking about changes in your life situation, be wary. A wholistic approach to menopausal patients will probably give one the best answer to her complaints. (author bolded
Saga supporter Trudi H had asked us about naturopathic approach vs. prescriptions to health and healthy aging, this might be valuable information. I am still working on that topic.
Thanks kindly to Chris for always adding value.
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