There is a transition before menopause that many women go through and don't really know it. It is a time when premenstrual tension can be at an all time high, moods become unbearable, menstrual periods change and there are increasing episodes of insomnia and/or anxiety and depression. This transition may start as early as the late 30's and last until the full onset of menopause where the periods begin to become less frequent before finally stopping altogether. Many times women are visiting their physicians for treatment of these complaints and prescribed antidepressants, sleeping medications and birth control pills to regulate their periods. Naturopathic medicine offers many herbal and nutritional medicines that work very effectively for this transition period called perimenopause.

Herbs such as helonias, viburnum, caulophylum, mitchella, ginseng, vitex, licorice, burdock, wild yam and dong quai work very well in the regulation of the menses both in the flow and its regularity; menstrual cramps; moods such as irritability and weepiness; night sweats; headaches; and fatigue. Many of these same symptoms may also be due to other factors such as anemia, hypoglycemia (low blood sugar) and underactive thyroid. Refer to my previous articles on these topics or call the office for back issues. I recommend that women get a complete blood chemistry to correctly diagnose the symptoms. Remember that the serum ferritin blood test is a much more accurate diagnosis of anemia and an optimal value should be around 40-50. Anemia occurs more often during this time if the periods are heavier and closer together.

During perimenopause I emphasize the importance of performing the monthly breast self exam, knowing your bone density and knowing your blood fats to evaluate cardiovascular disease and diabetes risk.

Many women rely on the yearly mammogram in place of the breast self exam. Any test has its weaknesses but many women find their own lumps during a monthly self-exam, and usually at an early stage thus making treatment much easier. I encourage my patients to perform the exam monthly, the week of their period, and to have them also examined yearly with their medical check up.

With the endemic of diabetes these days it is good to know your triglyceride level and fasting blood sugar level. I encourage many of my patients who have slightly elevated blood sugars but not yet diagnosed with diabetes to check their blood sugars at home with a glucometer before and after meals to understand the relationship different foods have on blood sugars. For instance concentrated protein foods such as beef and chicken cause a much lower elevation of blood sugar after eating than potatoes or breads. This is known as the glycemic index. Call the office for a list of the glycemic index of foods. Symptoms of hypoglycemia usually precede the diagnosis of diabetes.

Bone densities exams are done on the heel bone as well as on the spine and the hip. These tests will probably not be paid for by MSP unless you are at a high risk. In spite of this I encourage women to get a head start on knowing their bone density now. Many women find out in their 50's and 60's that they have had poor bone density and they wish they had known earlier. Knowing now makes it easier for women to make life style changes early enough to make a difference.

St. John's wort is my favorite herb used to treat mild anxiety, insomnia and mild to moderate depression. Adequate nutrition including minerals such as calcium and magnesium, and vitamins including antioxidants and B vitamins, and essential fats such as flaxoil, go a long way in treating all the above symptoms.