Occasionally I see someone who has been given natural hormones after filling out a quiz, or even after testing their hormone levels, but for whom no follow up has been arranged. There are some places that send regular supplies of hormone troches or cream without ever re-testing the blood levels to see if the dose given is adequate.
The body responds in different ways in different people. One dose does not fix everything!
If a decision is made to prescribe medication, including and especially natural hormones, then a follow up test is essential to assess the amount absorbed. Then the doctor knows whether to increase or decrease the dose depending on the efficiency of absorption.
The other reason for follow up testing is to custom-make the script for the stage of menopause the woman is going through. It is not widely recognised that menopause is not a fixed state. It is a process involving the slow settling of the receptor sites, the gradual release of oestrogen from fat cells and the body’s need for different hormonal balance depending on the stress levels and age of the patient.
The prescribing of a fixed dose does not allow for progress through the various stages of menopause. Firstly there might be a missed period or two, where the FSH goes up gradually, but not rapidly. This has been called the peri-menopause.
Then there is the cessation of periods altogether, the true menopause, but even then there may be a brief, or sometimes longer, period when there are few if any symptoms. Although she is menopausal, this women may have enough oestrogen stored in her fat cells to alleviate the demands of the receptor sites.
Lastly the stored oestrogen has runout but the receptor sites have not calmed down and the FSH is still high, so the full symptom pattern of menopause breaks through; hot flushes, dry vagina, low libido, insomnia, mood swings, the whole nine yards!
Clearly the same dose of hormones will not suit each stage and so regular re-testing is required. Also the balance of oestrogen, progesterone and DHEA or testosterone has to be kept on an even keel.
Under these circumstances, how can anyone manage with just one test? Or one script? Since natural hormones are a private script, i.e. full cost borne by the patient, it is essential that she has the right amount for her particular body, and the balance is delicate!
So, if you have not had your hormone levels tested for 3-4 months, get them done ASAP. You may be surprised at the results. And be sure to take home a record of the levels for comparison next time.
