Talking Perimenopause with Dr. Prudence Hall by Robin Gorman Newman

I had the opportunity to connect with Dr. Prudence Hall to pose some questions re: perimenopause.  She is founder of The Hall Center (www.thehallcenter.com).

 

I have been in perimenopause for 8 years…getting closer to menopause.  And, I’ve been highly symptomatic including things I never anticipated, i.e. tongue burn, dry eyes, etc. What are some of the most common symptoms you see?  

Sleeplessness, fatigue, weight gain, depression, hair loss, bloating and gas, loss of libido and more.

What are unexpected symptoms people might experience?  

Many of the symptoms listed previously are oftentimes completely unexpected by menopausal women.  Loss of bone mass and osteoporosis are often unexpected at menopause as well as loss of muscle tone.

Why do hormone fluctuations feel like they wreak havoc on the body?  

When the body loses its hormone balance, it throws it out of homeostasis.  It can also cause issues like thyroid imbalance and adrenal fatigue.  It can make people feel like they are not themselves and lose their zest for life.

Once a woman reaches menopause and hormones are gone, do the symptoms go away, or does she need to now accept a new “normal” way of feeling?  

No.  Symptoms continue for a woman’s entire life.  Some women stop having hot flashes, which usually tells me her adrenals have become deficient or “burned out” due to menopause.  A woman should never accept a new normal way of feeling due to menopausal symptoms.  All the symptoms can be successfully treated to restore a woman to her pre-menopausal state both in body and mind.

What makes some women more symptomatic than others?

Much of the variance in levels of symptoms is oftentimes due to the complex hormone structure that is different in every woman.  Oftentimes, stress and other life factors can affect symptom levels.  The more hormones that are deficient in menopause, the more miserable women are.  For example, if a woman loses her thyroid hormones, adrenal hormones AND her estrogen, testosterone and progesterone, she will most likely feel more miserable than a woman who has only lost her estrogen and progesterone.

What are ways to treat the symptoms other than HRT?  Pls share specifics.

I am a big believer in bio-identical hormone replacement.  However, there is no one-size-fits-all in my practice.  With each and every client, I try to get to root causes of their symptoms through in-depth testing and blood work.  Once all the variables are known, I develop a customized treatment plan protocol that may include—— bioidentical hormones, supplements, de-tox programs as well as thyroid and adrenals treatment, nutrition and fitness counseling as well as caring for the emotional component.

If through natural supplements, how do you know how much to take?  Do they work right away?  Do you need to take consistently?

Depending on individual patient testing results and analysis, I am able to make the appropriate recommendations of supplements.  In most cases, supplements may take a few days to a few weeks to take effect.  And, patients should try to be a consistent as possible with their supplements intake.

A friend has described herself as feeling not “clicked in” as a peri symptom.  Do you hear this, and what does it mean?

I have a feeling your friend is talking about the symptom of “foggy brain” which is a very common perimenopause and menopause symptom.

Have you heard of women experiencing excessive yawning as they get closer to menopause?  

Excessive yawning might be due to lack of energy and general fatigue that can oftentimes accompany menopause.

If a woman has hormonal headaches, what may she do to help alleviate?

Hormonal headaches are usually due to the precipitous drop in estrogen a few days before the period.  In perimenopause, the estrodiaol is lower than normal, so the drop can be more precipitous.

What natural ways can women treat depression and anxiety due to peri? 

Depression can be treated naturally by increasing the hormones that alleviate depression.  Not only does estrogen decrease in perimenopause, but the thyroid and adrenal hormones frequently decrease as well.  These drops result in depression.  Iodine 5 -12 mg per day will help normalize thyroid production.  Vitex Chastberry will help with estrogen and progesterone production and DHEA Pregnenalone are hormones that boost adrenals.  5HTP and L threonine help boost serotonin and dopamine.

What about supplements like Kava and Evening Primrose Oil?

Kava is a medicinal plant aiding sleep, mood elevation and anxiety.  It is calming and used in ceremonies in Fiji and other Pacific islands.  Evening oil of primrose is a gamma linolenic acid (GLA) frequently used to alleviate PMS symptoms such as breast pain and moodiness.

If a woman approaching menopause has an FSH of 31.6, is that a typical level?

A woman with a FSH of 31 is well into menopause.  Perimenopausal FSH’s are 6-19.  Above 20 is menopausal, with higher numbers indicating more advance menopause.  As the years of menopause pass untreated, the brain keeps sending out more and more FSH hormone to try and secure estrogen.  Estrogen is critical healthy brain function and dementia prevention.

If a woman has fibroids, is she more prone to perimenopause challenges?  

Fibroids can cause more bleeding in perimenopause and can also grow more rapidly during this time causing pain and sometimes a need to remove them (myomectomy).  An underlying cause of fibroids is inflammation.  As estrogen levels fall in perimenopause and menopause, inflammation rises.  Therefore, the root cause of fibroids can cause the body pain that is prevalent in menopause.

Is it possible the fibroids will shrink once in menopause?  

Yes, that is commonly the case.  Even though fibroids shrink in untreated menopause, I do not recommend avoiding bioidentical hormone replacement because of fibroids.  Estrogen that is replaced to age 35 levels and above should not cause fibroids to grow, and the benefit of BHRT far outweighs the risks of fibroids growing.

Sleep apnea can increase in women over 40, do you see this in your practice?

I see sleep apnea increased in perimenopausal and menopausal women.  Perimenopause begins in a woman’s late 30’s or early 40’s causing rapid weight gain.  The weight gain and other hormonal factors increase the likelihood of sleep apnea.

What is your view on HRT—bio identical?

I am a big believer and proponent of bio-identical hormones.  In fact, I am one of the pioneers of such treatment and have been doing so for almost 30 years.  Bio-identicals truly mimic the body’s healthy hormone balance and can truly work miracles in restoring the body’s hormone chemistry to youthful levels.

How does a woman decide if it’s right for her if she fears risk?

My experience has shown that bioidentical hormones are the most natural and safe way to treat menopause.  Too many women are prescribed antidepressants, sleep medications, Lipitor and heart medications when really bioidentical hormones are a much safer solution and help prevent many diseases and conditions.  For over 30 years in my practice, I have seen the tremendous decrease in dementia, heart disease, diabetes and inflammatory diseases as well as substantial decrease in breast cancer.  Hundreds of thousands of women have been studied regarding hormone replacement and I see how not only women regain their physical health, but also their vitality and happiness.

Are there risks, i.e. cancer?

I can confidently say that I have seen significant reductions in many types of cancer as well as breast cancer on my patient base taking BHRT.

Timing?

Depending on the route of delivery and the hormone, they are administered once or twice a day.

What type?

Thyroid is taken in the morning once a day and sometimes again in the early afternoon.  Estradiol creams are used twice daily.  Testosterone is usually used once in the morning.  Adrenal hormones are taken once in the morning

And, for how long?  

It can be taken for as long a clinician deems it safe and beneficial.

What if you stop?  

Like any medication, a patient should terminate gradually.

How often do you need to get bloodwork to monitor?  

Annually or as needed to adjust dosage based on symptoms.

Can you recommend any excellent books on the subect of perimenopause – symptoms and relief?  

Please look for my new book that should be available by October 2016.  It’s called Mindful Medicine Miracles:  Womens Journeys from Despair to Fulfillment. I also recommend Suzanne Somers book called I’m Too Young For This for which I wrote the forward.

Any coping suggestions for women going through peri and struggling emotionally?

It’s one thing to treat symptoms physically, but it is also important to be heard in terms of emotional support.  In my practice, a big component of treatment includes assessing and treating the emotional components of perimenopause and menopause.  Menopause is a great time to work through past issues and create a new paradigm of who you are.  Old conditioning falls away to create new flexibility and new ways of cherishing yourself and others.

 

About Prudence Hall, MD

Dr. Prudence Hall is a physician with a vision.   A traditional gynecological surgeon and practitioner turned pioneer of regenerative and integrated medicine, Dr. Hall foresees a future where “average” and “normal” are no longer acceptable standards of health.  Instead, she strives to help clients achieve optimal health and actively prevent disease without the use of pharmaceutical drugs when appropriate.

After obtaining a Masters degree in International Relations at the University of Toulouse, France, she attended USC School of Medicine where she obtained her MD degree.  She continued her residency in gynecology at USC’s County Hospital, attending to the sickest and most needy women in Los Angeles.

She later founded The Hall Center in Santa Monica, California as a mindful medical practice focused exclusively on regenerative medicine.  A firm believer in probing deeper into the root causes of conditions and diseases rather than simply treating their symptoms, Dr. Hall is dedicated to helping her clients achieve an unprecedented state of vitality at any age.

In addition to treating over 30,000 clients, she lectures and teaches, appearing on The Oprah Winfrey Show, Suzanne Somers Show, The Dr. Phil Show, The Doctors , The Today Show and local news programs in California.  Interviews with her have been published in a number of Suzanne Somers’s groundbreaking books and international media, Her forthcoming book You Are Not Alone, is available soon.

 

 

Tags: hormone replacement, menopause