On the wall of the office at Patient Advocates for Natural Hormone Therapy in Tauranga hangs a sign with the ‘Seven Dwarves of Menopause’: Itchy, Bitchy, Sweaty, Sleepy, Bloaty, Forgetful and Psycho.
It paints a humorous, yet stark, picture of the reality of menopause for many women. Menopause simply means the last menses (period) a woman will have.Meno comes from the Greek meaning ‘month’, and ‘pause’ from pausis meaning ‘halt’. When you have missed 24 consecutive menstrual cycles you are considered to be postmenopausal. For most women, this process will occur between the late forties and mid fifties. However, the symptoms associated with menopause can begin much earlier.
Menopause is a natural part of ageing for women, but Felicity Sinden from Patient Advocates says this doesn’t mean women have to put up with the symptoms of menopause. If treated early enough during the perimenopausal years, this transition can be made significantly easier with the use of bio-identical hormones and lifestyle changes.
According to Sinden, the earliest signs of menopause include irregular menstrual cycles (especially the lengthening of time between periods), hot flushes, anxiety, weight gain, forgetfulness, poor sleep and constant fatigue.
“It’s a bit of a vicious cycle. Women experience hot flashes which impact sleep quality causing tiredness the following day. Then they reach for sugary foods or coffee to pick themselves up, which can contribute to weight gain, lethargy and anxiety. Then the cycle continues the next day after another night of broken sleep.”
Patient Advocates is a health service helping women and men achieve and maintain their optimal health through the use of natural bio-identical hormones, diet, exercise and nutritional supplementation. They have been helping women balance their hormones to relieve the symptoms of menopause for over 24 years.
Sinden initially worked as the practice nurse with Dr Fenton Bennett, a leading uro-gynaecologist who introduced bio-identical hormones and the Patient Advocate concept to New Zealand, after seeing its success in America. When Dr Bennett died in 1998, several GPs asked Felicity to continue the work she was doing with women who needed time and follow-up to help with their perimenopause and menopause symptoms.
She now works out of her Tauranga office with two other consultants, all with over five years’ experience treating hormonal conditions. While they treat people face-to-face, many of their appointments are done by telephone consultation.
So how does bio-identical hormone therapy work?
Prior to an initial appointment with the consultants at Patient Advocates, women complete a salivary hormone test to assess their current levels of progesterone hormone.
At menopause, oestrogen production drops by about 40-60 percent and progesterone 12 times more than oestrogen. Sinden calls progesterone the “grandmother of all hormones”, because it is a precursor hormone and cascades over to the other sex hormones; testosterone and oestrogen. Increasing progesterone will help bring other hormones into balance.
Because of the cost of testing and the effectiveness of progesterone treatment, Sinden advises starting with just the one hormone.
“If we change too much at once, we never know what has been most effective and it may not be needed for a large group of our patients. Once their progesterone levels are up, other hormones often come back into alignment, too.”
Once Patient Advocates have the salivary result for a patient, they have an initial 60-minute consultation to discuss symptoms, lifestyle and health conditions. They then make an ongoing treatment plan in conjunction with the patients GP. It’s a multidisciplinary approach which helps both the patient and the GP understand the use of bio-identical hormones.
Patients will have a 30-minute follow up appointment 2-3 months after starting treatment. At this stage they may test additional hormones if required. Otherwise this appointment helps to troubleshoot any problems or adjust their dose of Progesterone cream.
“I wish I’d found this seven years ago!”
Patient Advocates are usually booked about 2-3 weeks in advance. Almost half of these appointments are for menopause. According to Sinden, most of their initial consultations come from word of mouth. Junine Sanson first heard about Patient Advocates from her personal trainer who had heard Sinden speak at a seminar in Whanganui.
According to Sanson, going through menopause made her “unbearable” to live with: “I had fatigue, low energy, constant hot flushes. Basically I was miserable!”
She started using bio-identical progesterone cream in January after her salivary levels showed she had just 058pmol/L of progesterone, when they ideally should be over 5,000pmol/L
Within weeks she felt better. “It felt like a fog had just lifted. The biggest improvement was my mood and my sleep. I wish I’d found it seven years ago. I think I would have gone through menopause with half the symptoms!”