DHEA is another hormone made in the adrenal gland. It protects against some negative effects of cortisol, and rises during times of acute stress.
Many conditions cause lower DHEA levels, including a high-sugar diet, worry, insomnia, chronic pain, and many medications. By age 70, your body produces only 25% of the DHEA that it once made. DHEA improves the immune system, protects against heart disease and diabetes, improves memory, and cognition. In postmenopausal women, DHEA improves mood and coping.
DHEA also lowers cholesterol, increases a hormone called adiponectin (which shifts the body into fat burning mode), and lowers the incidence of blood clots, diabetes and heart disease.
One of my patients has a story typical of adrenal exhaustion. Mary P. was a 42-year-old who first visited me shortly after her divorce. Initially, she was very anxious, and couldn’t sleep. In addition, her mood was depressed and her period had stopped, which confused her, since the rest of the women in her family didn’t go into menopause until after 50. Her cortisol and DHEA were high, indicating she was in the early stages of adrenal stress.
Unfortunately, she disappeared from my practice for a few years, and when I recently saw her again, her physical appearance spoke volumes. Her weight was up, and all her fat was located in her mid abdomen. Her skin was thin, and muscle tone was diminished. Her hair was dry and her eyes were dull and tired. Adrenal stress had caused premature menopause.
She complained of depression, changes in memory, exhaustion, joint pain, and could not lose weight – even though she was not eating very differently. Her periods still were absent. Bone loss was significant.
A saliva test now showed that her cortisol was low, as was DHEA. And since DHEA contributes to testosterone in women, her testosterone was extremely low.
I replaced a number of hormones, and recommended supplements to rejuvenate her adrenal function. Within six months her cycle returned.
Although this patient appeared like someone entering menopause, the menopause symptoms were actually those of chronic stress.
Phytoestrogens in Menopause
Found in plants, phytoestrogens are a group of chemicals that can behave like estrogen. Two very effective phytoestrogens are Genistein and Resveretrol. Resveretrol has been shown to be neuroprotective, bone and heart protective, and may be used as a breast cancer protective treatment while on estradiol.
Genistein helps to prevent bone loss, and protects the heart, as well as the brain. Often, phytoestrogens are very helpful in the perimenopausal years.
Hormone Safety in Menopause
The safety of any hormone replacement program ultimately depends on the patient’s ability to metabolize these hormones, which is why – for example – proper estrogen replacement is more complex than simply measuring levels of hormones. The presence of xenoestrogens and unique pathways of metabolism of hormones affect the safety of hormone treatment.
Many doctors put too much emphasis on your hormone levels, whether they are examining blood, saliva or urine. Frequently these levels fail to explain the clinical picture.
An evaluation of one patient (Judith) revealed a number of low hormone levels. She was started on DHEA, pregnenolone, testosterone gel, Biest and oral progesterone. Follow-up testing revealed her levels to be normal, but she was bleeding and had breast tenderness. The answer was not in the levels. A full evaluation of her metabolic pathways revealed a number of abnormal pathways, which could be modified through nutritional supplements, thus increasing the safety of her program.
Your Physician and Menopause
The job of your physician during perimenopause and menopause is to identify which hormones are contributing to your symptoms, changing your program as you continue to change. Your anti-aging doctor can assist you in learning about the proper nutrients to take, and recommending dietary and lifestyle changes.
The transition to menopause is a time to reassess your health. Partnering with a physician who understands the big picture can assist you in the realization of your most important health goals.