Symptoms of Menopause: When Sex Hurts

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At the time of menopause, women who had previously enjoyed sex may develop vaginal dryness and pain with intercourse. They may also experience difficulty achieving orgasm. A milder version of this can occur in perimenopause, the time interval that precedes menopause. Perimenopause can last for three months or as long as ten years before menopause. The age at which natural menopause occurs tends to be similar to that of your mother.

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Estrogen – The Good, the Bad and the Ugly

Estrogen is an essential hormone that has over 400 actions on a woman’s body. It’s what defines a woman. It’s been in your body since you were born and increases greatly at the time of puberty. It’s easy to take it for granted when everything is working automatically. When a young woman’s menstrual periods become irregular, painful or accompanied by severe mood swings, anxiety, depression or acne, that’s an indication of a system that’s gone awry. Birth control periods or Depo-Provera are a bad, ugly way to treat these problems. When prescribed, they do little to correct the underlying problem. These signs and symptoms are the way the body communicates to you that it needs help. A better approach is to determine the root cause that’s driving the problem. [click to continue…]

Does Estrogen Make You Gain Weight?

Does estrogen make you gain weightPostmenopausal women suffering from hot flashes, may hesitate to take estrogen because they’ve heard it can cause weight gain. Who needs any extra help to gain weight? Is there any truth to all this?

What are Bioidentical Hormones?

When you’re replacing deficient estrogen, it’s important to respect the wisdom of the body. No drug we give can approach the amazing complexity of the endocrine system. However, you can start by giving a hormone that is identical to the hormone that’s missing. We call these bioidentical hormones.

Another important factor is the route of administration. Estrogen is most commonly given as a pill that’s taken orally. It’s convenient and easy to pop a pill. But easy isn’t always the best. If we’re wanting to mimic the body, how does the ovary deliver estrogen to your tissues? I assure you the ovary doesn’t dump a big load of estrogen in your stomach once a day!! A more natural way to take estrogen is by applying it to the skin as a patch or cream. Estrogen taken in a pill form overloads your liver with excessive amounts of estrogen that increase harmful proteins, clotting factors and proinflammatory substances leading to various problems. Let me explain how oral estrogen leads to weight gain.

Weight Gain & Oral Estrogen

Weight gain from oral estrogen causes visceral obesity, the medical term for increased fat around your middle from fat that gets deposited in vital organs like the heart, kidneys and liver. This increased fat mass leads to increases in leptin produced by the fat cells. Topical, but not oral, estradiol prevents this increase in body fat and leptin. An interesting fact about visceral obesity is that women who take NO estrogen can also get weight gain around their middle because they develop insulin resistance. This is a frequent complaint from older women who are not on estrogen!

Oral, but not topical, estrogen increases the production of thyroxine-binding globulin (TBG) the carrier for thyroid hormone. Higher levels of TBG lower the amount of available thyroid hormone thereby lowering your metabolism. Oral, but not topical, estrogen also suppresses IGF-1, a marker for growth hormone. Growth hormone is needed to build muscle and burn fat. All this explains a common complaint I hear from women who’ve been on oral estrogen. “After starting oral estrogen, I gained 15 pounds in the first month and I didn’t increase my calories or lower my exercise. Now I’m eating less and exercising more and I just keep gaining!” Estrogen from injections or pellets can also lead to weight gain because the blood levels produced are much too high.

Weight gain from oral or injectable estrogen occurs because these preparations violate the natural physiology of the body. The ovary is amazing…it releases tiny bits of estradiol throughout the day directly into the blood stream. Even topical estradiol preparations can’t reproduce this same elegant effect, but it’s the closest delivery system we have. That’s why your chances of maintaining a healthy metabolism and weight are best when you choose topical estradiol preparations.

References:
O’Sullivan, AJ, Crampton LJ, Freund, et al, “The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women,” The Journal of Clinical Investigation, vol 102, (1998): pp 1035-1040.
Lwin R., Darnell B. Oster R, et al, Effect of oral estrogen on substrate utilization in postmenopausal women,” Fertility and Sterility, vol. 90, no 4, (2008): pp 1275-1278
DeCarlo C, Tommaselli G, et al, “Serum leptin levels and body composition in postmenopausal women: effects of hormone therapy,” Menopause, vol 11, no 4 (2004): pp 466-473
Nachtigall LE, Raju U, Banerjee S, et al, “Serum estradiol binding profiles in postmenopausal women undergoing three common estrogen replacement therapies: association with sex hormone binding globulin, estradiol and estrone levels,” Menopause, vol 7, (2000): pp 243-250.
Slater CC, Hodis HN, Mack WJ, et al, “Markedly elevated levels of estrone sulfate after long-term oral, but not transdermal, administration of estradiol in postmenopausal women,” Menopause, vol 8, (2001): pp 200-203

Look & Feel Younger with Estrogen

 

Look & Feel Younger with Estrogen

The beginning of the new year is a time when many women want to lose weight and improve their appearance. Why not do this by restoring deficient hormones that occur with aging? It often starts with telltale signs like fine wrinkles around the eyes or mouth and dry, sagging skin. Menopausal women often deny themselves estrogen because they’re fearful of breast cancer. Yet, they’re not informed there are more risks from NOT taking estrogen! Heart disease and strokes kill more women each year (400,000) than the next sixteen causes of death including diabetes, all forms of cancer, AIDS and accidents! Estrogen decreases Alzheimer’s and dementia by 50% and osteoporosis by 40%. I wrote my book, “Outliving Your Ovaries: An Endocrinologist Reviews the Risks and Rewards of Treating Menopause with Hormone Replacement Therapy,” to give women a guidebook for evaluating and selecting the safest forms of estrogen.

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Is it better to go through menopause naturally?

December 20th, 2015

 

I’m often asked by women, “Isn’t it better to go through menopause naturally?  If God’s design was for us to go through menopause, why should we still be taking estrogen?”

 

Menopause simply means the end of a woman’s ability to bear children.  In 1900, the average age of menopause was 51, just like it is today, BUT in 1900, the average life expectancy for a woman was 50!  Many women in the 1800s died in childbirth and men often remarried because of this loss.

 

Today in 2015, life expectancy for women is pushing 80!  So essentially with modern medical advances, God has graced women with 30 extra years of life!  What are we to do with this precious gift of 30 extra years that He’s given us?? Are we to squander that gift by letting our bodies fall apart?

 

I think of my body as God’s temple that He’s given to me on loan.  God expects us to be good stewards and care for our bodies.  Taking estrogen is simply putting back a substance that’s part of your original design. Estrogen is a vital hormone that has over 400 actions on a woman’s body.  When you were twenty, you took estrogen for granted because everything worked automatically.  When you become menopausal and your estrogen levels fall, only then do you appreciate it’s significance

 

Women who don’t take estrogen have a higher risk of heart disease, strokes, osteoporosis, dementia and Alzheimer’s.   If this risk can be reduced with estrogen, why would you want to deprive yourself of this potential benefit?

 

I’m not saying ALL women should take estrogen, but every woman at some time in her life needs to make this important decision.  I want women to make that decision based on facts, not from fear and misinformation!  That’s why I wrote my book, “Outliving Your Ovaries:  An Endocrinologist Review the Risks and Rewards of Treating Menopause with Hormone Replacement.”

 

As I close on this weekend before we celebrate Christmas, I want to take a moment to thank God for all the blessings that he’s given me. With all the flurry of gift-giving and social activities at this time, it’s easy for us to forget that Jesus is the reason for this season.

 

Merry Christmas and Happy New Year!

 

Dr. Johnson

Can Estrogen Protect Women Against Heart Disease?

Can Estrogen Protect Women Against Heart Disease?

 

Topical Estrogen Gives Better Protection Against Heart Disease – A compelling recent study in the European Heart Journal, September 2008 was designed to answer the question: Does estrogen cause heart attacks? A group of 698,098 healthy Danish postmenopausal women were followed for six years. The women were divided into groups by the TYPE of HT they were taking and compared to those women on no HT. The women on oral estrogen plus progestin had a 35% HIGHER occurrence of heart attacks as compared to women on no HT. The women on topical estrogen (patches, gels, NOT COMPOUNDED) had a 38% LOWER occurrence of heart attacks compared to women on no HT. So in essence, oral estrogen causes heart attacks while topical estrogen protects against heart attacks!

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The Silent Connection Between Estrogen and Osteoporosis

Dr Marina Johnson Discusses Osteoporosis and Estrogen Deficiency

 

After menopause without the use of estrogen, a woman can lose up to 20% of her bone mass. This increases her risk for osteoporosis leading to loss of height, hip fractures, chronic pain, and disability. Of women who suffer hip fractures, 24 percent die of complications within a year of the injury. Osteoporosis of the spine leads to the familiar “dowager’s hump.” A dowager’s hump is a prominence on the back resulting from collapse of the spine from spontaneous vertebral fractures. When it’s severe, the woman is totally bent over and cannot stand up straight. It is tragic to see a woman suffering from something that could have been prevented.

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Could Your Insomnia Be Due To An Imbalance In Your Hormones?

What causes insomnia?

Bonnie has always been able to enjoy good sleep in the past. No matter how stressed she might be, she could count on laying her head on her pillow, falling fast asleep and waking up the next morning refreshed and rejuvenated. However, when she reached her mid 40’s, her periods started changing and she began experiencing sleep problems. First, she would just have insomnia the night before starting her period. As her periods became more irregular, she started waking up in the middle of the night around 2 or 3 am and would find herself wide awake and unable to go back to sleep. With so little sleep, she would be exhausted the next morning. Over-the-counter sleep aids would make her feel sluggish the following day. By the afternoon and early evening, she would be crashing. She came to see me on maximal doses of prescription sleep medicine and still was sleeping poorly.

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Resuming HRT in Breast Cancer Survivors

Resuming HRT in Breast Cancer Survivors

I am often asked whether breast cancer survivors can ever safely initiate HRT. In addition, they are often taking estrogen blocker drugs, like tamoxifen, especially if their breast cancer was positive for estrogen receptors. These women frequently suffer severe symptoms of estrogen deficiency.

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Is It Too Late For Me to Take Estrogen?

Dr. Marina Johnson answers the question: Is it too late for me to take estrogen?

At the time of menopause, each woman has a window of opportunity during which she needs to make the important decision of whether to take hormones. As the estrogen levels fall, her body begins to go through degenerative changes that accelerate her risk of heart disease along with the other changes we have previously described. The sooner a woman starts HRT after menopause, the fewer degenerative changes she will experience. If a woman waits 10 years to start HRT, the heart protection from estrogen is greatly diminished. The same applies brain protection; once brain cells have been lost, it becomes difficult to retrieve normal function. However, for protecting bones, estrogen is effective even when started after age 75.

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MARINA JOHNSON
M.D., F.A.C.E.
MEDICAL DIRECTOR

BOARD CERTIFIED
IN ENDOCRINOLOGY
& METABOLISM AND
INTERNAL MEDICINE

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Suite 510
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