Managing Your Menopause Type^® Educational Class

Session One - Redefining Menopause

What Are Ideal Levels Hormone Levels

Ideal Levels

As mentioned earlier, the goals of the Managing Your Menopause Type^® Educational Class include enhancing the quality of your life and decreasing the risk of diseases associated with menopause.

Since proper levels of estradiol, progesterone and testosterone play such significant roles in these goals, we must maintain ideal levels of these hormones. The challenge comes in trying to define what are "ideal levels" for each of these hormones.

Before coming to terms with ideal levels there are two hurdles that must be crossed. First is the false belief that any single hormone can decrease the risk of a disease in and of itself. Second is the false belief that any single hormone can decrease symptoms and enhance the quality of your life in and of itself.

Decreasing the Risk of Diseases

Even if a specific hormone has ideal levels, it may not decrease the risk of disease if there are other deficiencies or imbalances. In the recent past, it was expected that ideal levels of estradiol would prevent osteoporosis. When normal levels did not achieve this objective the estrogen dosage was increased. However, the higher estrogen dosage only increased the risks of some cancers and did nothing more than the "ideal" levels would be able to do if other deficiencies and imbalances were addressed.

In a two-year study comparing a combination of estrogen and methyltestosterone against estrogen only in surgically menopausal women they found that the estrogen/methyltestosterone combination significantly improved bone mineral density over the estrogen only therapy ¹. The "estrogen only" model does not prevent osteoporosis.

We now know that estradiol, progesterone and testosterone levels are all required to maintain healthy bones. We also realize that calcium, vitamin D, other nutrients and exercise are also required to prevent osteoporosis. When it comes to decreasing risk of disease there is an important point to keep in the forefront of our minds:

"No hormone acts completely independent of other hormones and nutrients."

Therefore, "ideal levels" do not mean any single hormone must accomplish the formidable task of preventing disease all by itself. Estradiol, progesterone and testosterone levels must all be balanced to achieve proper function of bone, heart, brain and other tissues. In addition, proper nutrition and exercise are also required.

Enhancing the Quality of Your Life

Like decreasing risk of disease, controlling symptoms and enhancing the quality of your life management cannot be accomplished if there are other deficiencies or imbalances. Until recently, it was widely believed that hot flashes could be controlled by estrogen replacement therapy. The medical profession was hard pressed to explain why some women continued to have severe hot flashes while taking estrogens. It was expected that adequate levels of estradiol would control hot flashes.

As with osteoporosis, when normal levels did not alleviate hot flashes the estrogen dosage was increased to higher levels. The high levels did help some women. Unfortunately the high estrogen dosage also increased risks of some cancers. The question was; "Can we give less estrogen if we give a little testosterone with the estrogen?"

In a study involving ninety-three naturally menopausal women, researchers concluded that the women had better relief from mild-to-moderate hot flashes when taking a lower dose estrogen-testosterone combination when compared to higher dose estrogen-only treatment ². The greater benefits of combination therapy demonstrated that the "estrogen only" model is inferior managing symptoms.

We now know that estradiol, progesterone and testosterone levels are all required to manage hot flashes and other menopause related symptoms. We also realize that regular physical activity, a balanced diet, avoidance of alcohol and caffeine, and stress reduction may be of additional help in decreasing vasomotor flushing ³. Vitamin E is also a valid choice in the management of hot flashes ⁴. So when it comes to symptom management the important point to keep in mind is:

"The symptoms associated with any condition (such as a hormone deficiency) are rarely symptoms that are exclusive to that condition."

Therefore, "ideal levels" do not mean that any single hormone is capable of managing menopause-related symptoms in and of itself. Estradiol, progesterone and testosterone levels must all be balanced to achieve decrease symptoms and enhance the quality of your life. In addition, proper nutrition and exercise are also required.

Ideal Levels

With the understanding that hormones work best when they are all balanced, and when proper nutrition and exercise are incorporated into your life, now is a good time to discuss ideal levels.

Recalling previous slides we recognize the following about hormone levels:

"The beginning of the estradiol cycle is the follicular phase, which represents the baseline levels of estradiol before they increase with and after ovulation."

"The first phase is the follicular phase with baseline levels of progesterone."

"The testosterone cycle begins with the follicular phase, with baseline levels of testosterone."

In all cases the follicular phase represents the baseline levels of the hormone. The follicular phase shows us what the hormone levels are before they are obliged to increase so that the body is prepared for conception to take place. The "ideal levels" for estradiol, progesterone and testosterone are demonstrated by the red rectangles in the picture.

The baseline levels of estradiol, progesterone and testosterone are the ideal postmenopause levels of these hormones.

As noted earlier, your objectives are to decrease risks for diseases and enhance your quality of life. You can accomplish this by helping the body maintain normal baseline levels of estradiol, progesterone and testosterone. We see that these normal baseline levels occur in the follicular phase. But why is it so important to avoid the higher hormone levels that are typically seen in the midcycle and luteal phase?

Remember that the luteal phase is the part of the monthly cycle that includes premenstrual symptoms in women affected by such conditions. The luteal phase, with higher hormone levels, may have increased problems with digestive system function¹, heart function², appetite and increased food intake³, as well as breast tenderness, bloating, headache and mood changes⁴. Obviously, we do not want to cause any of these symptoms by creating the same hormone levels that occur during luteal phase.

Maintain physiological baseline levels of estradiol, progesterone and testosterone will help decrease your risks of diseases and enhance your quality of life. Avoiding higher hormone levels, such as those typically seen in the luteal phase, will decrease risk of causing side effects.

What this means to you

Maintaining ideal baseline levels of estradiol, progesterone and testosterone will help decrease your risks of diseases and enhance your quality of life. Avoiding higher hormone levels, such as those typically seen in the luteal phase, will decrease risk of causing side effects.

What's Next?

The next slide discusses the wide range of menopause choices available to you.

The Managing Your Menopause Type^® Educational Class is provided to the public without charge. This information is provided for educational purposes only, and is not intended to prescribe treatment. Consult a physician, pharmacist or other healthcare professional regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.