Published Jun 24, 2009 in the North Island Weekender 

Melanie, a 55 year old woman, came to me for post menopausal complaints. She had been experiencing hot flushes since her period stopped two years ago. Now she was experiencing insomnia, anxiety, depression, physical, mental and emotional fatigue and a waning libido. She did not want to take estrogen so she was seeking other ways to help her get through this difficult phase of her life.

She had been gaining a little weight every year since her period stopped. Her blood pressure was also creeping up. She had a family history of diabetes.

I explained to her that I would like to measure her hormone levels using saliva. This measures the active unbound form of the hormone in her body. We measure estrogen and progesterone as well as cortisol, testosterone and DHEA. This gives me a good baseline to follow her progress in one year when we would check it again. I explained that I like to use herbs as much as possible to balance the hormones in the body but sometimes they are not enough so I add bio-identical progesterone. This is not Provera, the drug that was prescribed in the past as part of the HRT protocol. Provera is not bio-identical and works very differently from bio-identical progesterone.

In addition to measuring Melanie’s hormones I also did a complete blood chemistry, a physical exam and EAV organ testing. I also asked that she get her MD to send her for a DEXA (bone density) scan. These cost about $106.00 at the Campbell River hospital if her MD refused to have MSP cover it. I told her that half of the people I send for the DEXA come back as osteopenia, a decrease of the bone density that occurs before osteoporosis and is very easily treated with naturopathic measures to prevent osteoporosis. I also recommended that Melanie know her vitamin D levels, not only to help maintain her bone density but to prevent cancer. Vitamin D is good for so many things it is considered to be more of a hormone than a vitamin. I have seen it improve depression and fatigue.

The salivary hormone test showed that Melanie had low progesterone as well as low estrogen which is expected at her age. She had low testosterone, low DHEA and high cortisol. Using progesterone could possibly help improve these levels except DHEA, which is not part of the progesterone metabolism pathway. I explained that we would use progesterone first to see if it would take care of most of her chief complaints. If not then we would look at bio-identical estrogens which are used in the smallest amounts and when used in combination with progesterone have much lower risks than the traditional HRT prescribed by the medical profession.

Her blood test showed that her good cholesterol was too low, her blood sugar and triglycerides too high, her waist circumference was greater than 35 and her blood pressure was over 135/ 85, all pointing to insulin resistance. I explained to Melanie that because her insulin was not metabolizing blood sugars very well the excess was storing as fat in her body and increasing her risk for cardiovascular disease and diabetes. Targeted nutrition and lifestyle can easily reverse this trend I assured her. Her DEXA scan was normal but her vitamin D level was at 51nmol/L and the preventive level that I aim for is 120nmol/L.

One year later, Melanie’s parameters had all improved. She found that small doses of progesterone made a big difference to her. The complete naturopathic program that she had been on provided so many nutrients that she had been deficient in for so long that her energy, libido and mental function all improved as well.