99 Symptoms One Root Cause

Table of Contents
Table of Contents
3 Introduction
4 What is the "Menopause Transition"?
5 What are considered “normal" menopause
symptoms?
6 Dangers of Hormone Decline
7 What can I do about the drop hormone levels
10 Symptoms Breakdown
Introduction
Midlife can be a stressful and confusing time for many women. Menopause isn’t something that is
talked about enough and the myriad of symptoms that accompany it can leave women feeling
frustrated, confused and fearful.
Hormones like estrogen, progesterone, testosterone have an impact on every system of the body
and symptoms can be experienced from head to toe. While hot flashes and vaginal dryness are
well known side effects of perimenopause and menopause, there are nearly 100 symptoms
associated with hormone decline.
One question we often hear about menopause symptoms is, "How can hormones cause all of these
symptoms?" Well, the answer is…complex. Use this guide as your handbook to understanding
symptoms you might experience and how they related to declining hormones.
Starting in your 30s or 40s, you will produce less and less estrogen, progesterone, and
testosterone. This stage is called perimenopause. Eventually, with the continued drop of these
hormones, your menstrual periods will completely stop. After 12 consecutive months of no periods,
you have completed menopause and are in the stage called postmenopause.
Affordable, Accessible Bioidentical Hormone Replacement Therapy: HealthyHormoneClub.com

What is the “ Menopause Transition”?
The entire transition with menopause is called the
"Menopause Transition" (MT) and can last 20 years

or more.
It typically starts sooner than most women think it
will. About 10% of women start perimenopause

before they turn 40!
The menopause transition includes the phases of:
• perimenopause (typically age 35-45),

• menopause (45-59), and
• postmenopause (the rest of your life).
• MT is triggered by a decrease in estrogen,
progesterone, and testosterone.
Perimenopause, menopause, and postmenopause
are normal and natural stages that aren't

"curable." But, you can alleviate the symptoms of
low hormones. Because hormone receptors are on

nearly every cell in your body, it is critical to keep
hormones balanced.
“We can’t avoid menopause, but we can avoid suffering”

Dr. Michelle Sands

What are considered to be “normal”
menopause symptoms?
Suddenly, seeing a reflection of a tummy that
looks unfamiliarly round becomes your new

normal. Some women feel overwhelmed by hot
flashes and exhausted by heavy periods or

interrupted sleep.
Untreated menopause can serve up debilitating
symptoms and severe side effects that can

completely derail a woman's life and cause
problems in her relationships.
If the drop in hormones in perimenopause is not

corrected, women are at a greater risk of heart
attack, Type 2 Diabetes, dementia, osteoporosis,

some types of cancer, anxiety, depression and
even suicide.
Over 85% of women in perimenopause will have

far-reaching symptoms - including brain fog,
anxiety, weight gain, low libido, depression,

sleeplessness, exhaustion, headaches, and stiff
joints and muscles. And these symptoms only get
worse as they move into menopause and beyond.
While all of these symptoms are common, they

are by no means “normal” for anyone at any age.

Dangers of Hormone Decline
Because hormone receptors are on nearly every cell in your body, it is critical to keep
hormones balanced.
When sex hormone levels drop, women start to experience a myriad of symptoms. Some of
the early symptoms in perimenopause include:
 Irregular or skipped periods
 Insomnia
 Fatigue
 Weight Gain
 Low Libido
 Vaginal Dryness
 Hot Flashes/Night Sweats
As years go by and hormones continue to decline, dropping steeply at the time of menopause,
more symptoms pop up. Each woman will experience menopause differently and some
women will have more severe symptoms that others,
However, all women will experience the “silent symptoms of hormone decline. These include
increased risk for many life threatened diseases including:
 Heart disease
 Diabetes
 Alzheimers and Dementia

 Major Depressive Disorder
 Osteoporosis/Osteoarthritis
 Autoimmune Conditions
 Inflammatory Diseases
 Metabolic Syndrome

What can I do about the drop
hormone levels?
At Glow Natural Wellness, we encourage
you to live your very best life. When it
comes to menopause symptoms, refuse to
''endure it" or "suck it up." Menopause
symptoms and disease risk can have a
devasting impact on all areas of a
woman’s life.
Surveys of thousands of women in

menopause transition show that they felt
more optimistic about their life, and aging,
after receiving treatment for their
menopause symptoms.. These women
experienced more hope, increased
happiness with their bodies, newfound
optimism about their careers, and are
excited about their families.
"The topical hormones worked

brilliantly... Within four days, my hot
flashes and palpitations disappeared
forever, my memory returned, and -
unexpectedly - my mood lifted and my
joints became supple. I just wish my
GP had told me about bio-identical
HRT in the first place."

Menopause is not a disease, and like puberty, it is a stage of a woman's life.
Unfortunately, the symptoms associated with menopause come as a surprise to so
many women. Even worse, 80% of doctors (including Ob/GYNs, endocrinoligists,
and GPs) have ZERO training on the treatment of perimenopause and menopause.
And, they are not educated on the latest research on the safety and efficacy of
bioidentical hormone replacement.
This means these doctors are often unaware of the connection between a woman’s
symptoms and hormone decline As a result, midlife women are offered
pharmaceutical after pharmaceutical as a band-aid for a multitude of symptoms with
a single root cause - the decline of estrogen, progesterone and testosterone.
So, this leaves way too many women suffering and thinking that they have to suffer in
silence.
Once we accept that menopause symptoms are treatable, and can be safely and
effectively treated, we can move into a phase of life that is far more welcoming. Signs
of menopause will vary from woman to woman, but please, do not ignore them. You
are not alone.
Safe, natural, bioidentical hormone replacement therapy (BHRT) is available in an

affordable, accessible and holistic way through the Healthy Hormone Club.

>>>To learn more about our accessbile, affordable and safe options for hormone
restoration, click here
Which symptoms are you experiencing?

In the pages that follow you will learn about the many symptoms of perimenopause and
menopause hormone decline. In the conventional setting, these symptoms are often
treated individually, with the root cause being ignored.
I hope that this guide will provide some insight into your own experience through the
menopause transition. My goal is to educate and empower women to take control of
their health and live vibrantly at any age.

Join the GLOW Tribe
I’d love to invite you to join my community of like-minded wellness seeking women who are
shattering the stereotype of what it means to be in menopause and changing the way the
world thinks about “the change”
This is where you can get direct access to me and my clinical team to ask questions about
your symptoms and women’s health…at no cost!
>>>>Click here to join the GLOW Tribe and let us support you too!
Or Scan the code below to Join the GLOW Tribe Today!
Remember, your final period is NOT the end of your story! Make this next
chapter the best one yet!
To your continued health and happiness,
Virtual Hugs,
P.S. To learn more about your options for hormone restoration and how to avoid the symptoms
outlined in this guide while experiencing all the joys of midlife, watch my brand new free
masterclass - What every womann NEEDS to know about Hormone Restoration. Go to
FixHormones.com to attend.

Symptoms Breakdown
Menstrual
Irregular or Non- Irregular periods are among the earliest symptoms of
existent Periods perimenopause for most women. Throughout the menopausal
transition, it is normal to have irregular periods. Eventually, you will
stop having periods entirely. After 12 months without a period, you
are in postmenopause.
Estrogen and progesterone regulate a woman's menstrual cycle. As
we age, these hormones (plus testosterone) drop steadily. Estrogen
levels rise and fall unevenly during perimenopause, and menopause.
As perimenopause starts, you can expect your periods to become
more erratic in timing and severity. You may have a heavy period,
and the following month is just spotting. This variable cycle is a
telltale sign of approaching menopause. Menstrual cycles can
shorten from 28 days to anywhere between 21 to 26 days. What's
frustrating about this phase is you don't know what to expect from
month to month and even day-to-day.
So, the length of the menstrual cycle may lengthen or shorten, and
the amount of bleeding can range from spotting to very heavy
bleeding. Occasionally you will have no periods for a month or two.
Once you've gone a year without a period, the perimenopause
phase is over. Estrogen therapy - which comes in a pill, skin patch
or cream form - remains the most effective treatment option for
relieving menopause symptoms.

Symptoms Breakdown
Vasomotor /Neural
Hot Flashes Hot flashes are probably the most recognized early symptom of
perimenopause and menopause. During a hot flash, most women
experience a sudden flush that looks like a red face and neck, often
with sweat. When you have hot flashes, your body suddenly
overheats, and you experience sweating and sometimes even chills.
Hot flashes are caused by changing hormone levels during the
menopause transition. Hot flashes occur when decreased estrogen
levels cause changes in your body's thermostat (located in your brain
called the hypothalamus). These changes in your thermostat make
your body more sensitive to slight changes in body temperature.
When the hypothalamus thinks your body is too warm, it starts a
chain of events - which results in a hot flash - to cool you down.
Hot flashes (or vasomotor symptoms) typically happen rapidly and
lasts from 1 -10 minutes. Women can experience hot flashes a few
times a week or even ten times a day. Because hot flashes are due to
a decreased production of the hormone estrogen and occur as
women approach menopause, they can be treated with bioidentical
hormone replacement therapy (BHRT).
Hormone replacement therapy is the most effective treatment to
relieve menopausal hot flashes and night sweats.

Symptoms Breakdown
Vasomotor /Neural
Cold Flashes While up to 85% of women in menopause report having hot flashes,
cold flashes also occur.
Hormonal imbalances are the primary causes of cold flashes, and
they can be as disruptive as hot flashes. A cold flash is a tingling,
shivery, cold feeling that can suddenly come over your body. It might
even cause you to shake or turn pale. A cold flash is temporary, often
lasting no longer than a few minutes.
Cold flashes are due to fluctuating hormones during perimenopause
and menopause and can be caused by the "thermostat" in your brain
becoming dysfunctional (the hypothalamus).
Hormone replacement therapy is the most effective treatment to
relieve menopausal cold flashes.
Night Sweats When you have hot flashes at night, your body suddenly overheats,
and you experience sweating, often called "night sweats." Hormone
depletion is responsible for controlling your body's temperature
drop. Spicy foods and hot drinks can trigger hot flashes and night
sweats. Just like with hot flashes, night sweats are caused by
changing hormone levels during the menopause transition. Because
of decreased estrogen levels, your body's internal temperature gets
thrown off, making it more sensitive to changes in the body
temperature and overreacts to try to cool you down. These events
can disrupt sleep and lead to sleep deprivation and fatigue.

Symptoms Breakdown
Vasomotor /Neural
Tingling The charging sensations can take a lot of forms: tingling, burning,
crawling skin, cold, numbness, the classic pins-and-needles, and
increased sensitivity. Women report symptoms from intermittent
and mild to lasting and painful, even to the point of waking them
from sleep.
Tingling sensations in the fingers and toes is common. So is a
burning sensation and some numbness, all due to the drop in your
estrogen levels. As hormones drop, it affects your central nervous
system, which relays signals to the rest of your body.
Dizziness/Vertigo Sudden unexplainable dizziness during menopause is scary but
common, and it does not usually indicate a medical disease. Up
to 37% of women may be experiencing dizziness or vertigo with
menopause.
Hormonal changes with menopause and the fatigue often felt
during menopause can lead to increased dizziness. Less estrogen
can negatively impact blood sugar levels - as those levels rise and
fall, body cells may not receive the energy they need and cause
dizziness.
Note: dizziness can also result from an ear infection

Symptoms Breakdown
Weight /Metabolism
Weight Gain Weight gain during menopause, especially around your middle, is often
caused by the drop in the hormones: estrogen, progesterone, and
testosterone. By replacing the ever-decreasing hormones - in
combination with exercise and a healthy diet- women can combat the
accumulation of belly fat. Sometimes it is called the "menopause belly."
Reduced estrogen levels can lead to menopausal weight gain, lower-
quality sleep, decreased metabolism, and lean muscle reduction.
Researchers have linked low estrogen levels with an increase in the%
of body fat, particularly abdominal (belly) fat.
Hormones control your metabolism, where you deposit fat and the
body's weight balance. The most effective way to get hormones back
on track, halt the scale creep, and return to a healthy weight is to
correct hormonal imbalances with B i o i d e n t i c a l Hormone
Replacement Therapy (BHRT). Once hormones are back in balance,
weight loss can begin.
Slowed Metabolism While you may not notice the change in metabolism from any specific
body sensation (like tingling hands), the steady weight gain tells you
something is off related to your metabolism.
Reduced estrogen may lower your metabolic rate, which is the rate
your body converts stored energy into working energy. Estrogen
levels drop at menopause, leading to a decreased metabolic rate.
Evidence suggests that HRT can increase a woman's resting metabolic
rate and caloric need.

Symptoms Breakdown
Weight /Metabolism
Type 2 Diabetes When in perimenopause, you may notice that your blood sugar level
changes more than before and goes up and down more dramatically.
If your blood sugar gets out of control, you have a higher risk of Type
2 Diabetes complications.
With menopause, changes in your hormone levels can trigger
fluctuations in your blood sugar level. Certain conditions, like
diabetes and metabolic syndrome, become more common during
menopause. The hormones estrogen and progesterone affect how
your cells respond to the hormone insulin.
In perimenopause, your metabolism slows, and you don't burn
calories as efficiently, leading to weight gain. Much of the weight you
gain is in your belly. When the fat builds up deep in the gut it raises
the risk of insulin resistance and incidence of Type 2 Diabetes.
Cortisol Menopause affects the hormone cortisol. Cortisol is known as the
"stress hormone." As the hormones estrogen, progesterone, and
testosterone drop with perimenopause, cortisol levels can increase.
This increase can adversely affecting the immune system and your
inflammatory response, leading to an increased susceptibility to
illness as well as aches and soreness in the joints and muscles.
This increase in cortisol levels and abdominal fat with menopause
can also influence the risk of cardiovascular disease, vasomotor
symptoms, mood, cognition, and bone loss.

Symptoms Breakdown
Mental Health
Anxiety Anxiety can start with the anticipation of a stressful situation,
experience, or event and can come on gradually. Anxiety is a
mood-related symptom that some women experience during
menopause. It may worsen at night or only occur intermittently
as hormone levels fluctuate.
When estrogen drops (with peri-, and menopause), another
hormone, cortisol, increases. Cortisol increases stress levels and
anxiety. Anxiety affects 1 in 3 menopausal women and may
contribute to panic attacks.
Anxiety and depression are common symptoms of peri- and
menopause. Women seek help in many forms, excessive exercise,
alcohol, and even denial. At GLOW, we believe that hormonal
causes and correlations must be incorporated into any meaningful
conversation about mental health.
There are many factors involved in mental health, especially
during menopause. Dropping hormones, life stresses, sleep
problems, changing body image, and signs of aging during
perimenopause can contribute to mood swings, stress, anxiety,
and a decreased sense of well-being.

Symptoms Breakdown
Mental Health
Fogginess and The hormones estrogen, progesterone, and testosterone have
Concentration everything to do with brain activity. As these hormones drop, so does
Difflculties your ability to focus and concentrate. "Brain fog" is common; some
60% of menopausal women report difficulty concentrating and other
issues with cognition, and the problem increases as they continue
through menopause.
Women going through menopause may feel a more negative mood,
and that mood may be related to memory issues. Women in
perimenopause often experience verbal learning, memory, attention,
and task problems.
Hormone changes are responsible for different body
processes, including how your brain works. While memory
issues during menopause can be completely normal, they can
negatively impact your daily life, and it may be time to to
explore menopausal hormone replacement therapy (BHRT).
These hormones may help with the many symptoms you
experience during menopause, including memory loss.

Symptoms Breakdown
Mental Health
Depression Women often experience anxiety due to the hormonal changes
brought on by perimenopause and menopause, specifically the drop
in estrogen and progesterone. Menopause can lead to
unpredictable mood swings, anxiety, and depression.
When women go through sudden hormonal changes with
perimenopause, they are at a higher risk for depression. Although
menopause does not cause depression, studies show that about
20% of women have symptoms of depression during this time.
Determining the cause and extent of mental changes is very
important. Depressive disorders that lead to suicide are often
overlooked or misunderstood during menopause.
Significant mood changes with peri- and menopause, along with life
changes during this stage of life, can lead to true menopausal
depression. Please, do not view these changes lightly.
Dropping hormones with menopause also influence serotonin, a
brain chemical that promotes feelings of well-being and happiness.
When hormone levels decrease, serotonin levels also fall,
contributing to increased depression.
BHRT alone or in combination with prescription antidepressants
can help with depressive disorders. Lifestyle changes like exercise,
improving sleep, and a healthy diet can also help.

Symptoms Breakdown
Mental Health
Memory Lapse While experiencing memory lapses during perimenopause and
menopause is considered "normal," those moments when you can't
remember your neighbor's name or that your glasses are on top of
your head can be scary. If you are in perimenopause, you may be
worried about lapses in your memory.
These memory lapses are typically due to the drop in hormones
with perimenopause. Mild memory problems and a general
"fogginess" are common due to the drop in estrogen, lack of sleep,
and general fatigue associated with perimenopause. For most
women, the effect is temporary.
Differences in a woman's cognitive abilities are not necessarily due
to her chronological age. The changes are related to menopausal
age and estrogen, progesterone, and testosterone levels.

Symptoms Breakdown
Mental Health
Panic Attacks Panic attacks can increase with menopause. Panic attacks are
sudden episodes of intense fear that trigger severe physical
reactions when there is no real danger or cause.
Panic attacks can lead one to think you are losing control, having a
heart attack, or even dying. During a panic attack, the physical
symptoms are often more intense than anxiety symptoms. When
estrogen drops (with peri - and menopause), another hormone,
cortisol, increases.
Cortisol increases stress levels and anxiety, and can lead to a full-
blown panic attack. Anxiety affects 1 out of 3 menopausal women
and may contribute to panic attacks. Some women develop a panic
disorder during menopause.
It is essential to recognize that panic and anxiety attacks are
different. Both anxiety and panic attacks are related to the drop in
hormones with menopause and can significantly impact a woman's
quality of life, but panic attacks are far more severe.

Symptoms Breakdown
Sleep/ Fatigue
Sleep Problems Insomnia, sleep deprivation, and interrupted sleep are common
with menopause, and for many women, are the lead-in to a world of
health problems. According to the National Sleep Foundation,
approximately 61% of menopausal women have sleep problems.
Sleep disruptions can be due to a variety of things that happen
with reduced hormones (estrogen and progesterone)
1. Night sweats that can wake you up,
2. Anxiety can keep you from falling asleep,
3. Added weight can lead to snoring and sleep apnea that
prevents you from getting a good night's sleep,
4. Dropping progesterone levels also can cause sleep disruptions.
When less estrogen and progesterone are produced, you may
experience higher body temperatures, lower sleep quality, anxiety,
and poor mood. Estrogen and progesterone help regulate
neurotransmitters that affect your sleep-wake cycle.
At the proper levels, estrogen will help keep your body
temperature low at night, which can help reduce hot flashes and
lead to more restful sleep. By taking progesterone at night, you
may improve sleep right away.

Symptoms Breakdown
Sleep/ Fatigue
Fatigue Feeling exhausted is common during menopause but not
acceptable. You can improve your sleep and regain energy by
replacing the lost hormones, especially estrogen, progesterone,
and testosterone.
Fatigue during perimenopause and menopause can be due to
changes in estrogen, progesterone, testosterone, and thyroid
hormones, making you feel exhausted. That is because these
hormones are involved in your sleep patterns, weight gain, hot
flashes or night sweats, and even regulating cellular energy within
your body.
Fatigue can be a distressing and sometimes debilitating
menopause symptom. Fatigue could result from lower quality
sleep as a result of hot flashes and night sweats or the result of
hormonal fluctuations themselves. By replacing decreasing
hormones, sleep and anxiety can improve and help with the
overall feeling of fatigue.

Symptoms Breakdown
Sleep/ Fatigue
Irritability Fluctuating hormones are associated with changes in mood at
perimenopause. With the variations in hormone levels, you may get
signs of premenstrual syndrome like irritability. Due to hormonal
fluctuations, the impact of other menopause symptoms or a
combination of both, women going through this change may find
that they feel irritable. Stress and a lack of sleep can also lead to
irritability.
Try relaxing activities and exercise or meditation to help control the
changes in your moods. Bioidentical hormone replacement therapy
(BHRT) can offer some relief for menopausal mood swings by
normalizing the hormones that play a role in mood and regulating
other hormones (like cortisol, the stress hormone) that can also
impact mood. These same hormones influence serotonin, a brain
chemical that
promotes well-being and happiness. When hormone levels drop,
serotonin levels also fall, contributing to increased irritability.
BHRT can help reduce your perimenopause symptoms and help you
feel less stressed. Most of us are walking around with higher than
normal levels of cortisol. This built-up stress can further deplete
the already decreasing estrogen levels, progesterone, and
testosterone that usually occurs during menopause. High cortisol
levels don't just make you feel stressed out or cause symptoms like
fatigue; they can impact your health and be a vicious cycle.

Symptoms Breakdown
Vaginal
Vaginal Dryness Usually, the walls of the vagina stay lubricated with a thin layer of
clear fluid. The hormone estrogen helps maintain that fluid and
keeps the lining of your vagina healthy, thick, and elastic.
Vaginal dryness can be much more than a minor irritation with
itching and burning, making daily activities uncomfortable. It can
significantly impact your sex life too. Vaginal dryness affects more
than 50% of all menopausal women in the US, yet the majority of
them are unaware that it is a treatable condition.
During perimenopause and menopause, with the drop in
estrogen, the natural lubrication of your vagina dries up.
Estrogen, progesterone, and testosterone are responsible for
vaginal (and uterine) health and lubrication. As you age the
natural ability to lubricate the vagina decreases, the vaginal wall
can become thinner. As a result, you experience vaginal dryness
and sometimes painful, uncomfortable sex.
Without treatment, vaginal dryness and irritation can get much
worse as you move into postmenopause. Vaginal estrogen cream
is also very effective at resolving this symptom.

Symptoms Breakdown
Vaginal
Vaginal Dryness Menopause can cause a series of very uncomfortable vaginal
continuation changes. If you notice changes in your vagina, including dryness,
tenderness, and painful intercourse, you are not alone. Vaginal
and Vulvar Atrophy (VVA), also known as genitourinary syndrome
of menopause (GSM), is likely what you are experiencing.
VVA and GSM are the thinning, drying, and inflammation of the
vaginal walls. They affect more than 50% of all menopausal
women in the US, yet most of them are unaware that it is a
treatable condition.
Estrogen creams and HRT can ease vaginal symptoms of
menopause, such as dryness, itching, burning and discomfort with
intercourse.

Symptoms Breakdown
Vaginal
Vaginal Irritation Vaginal irritation is another common symptom of menopause. During
menopause, the walls of the vagina become thin, dry, and sometimes
inflamed. This leads to symptoms of vaginal burning, irritation, pain
(especially during sex), bleeding, or discharge in many women.
The drop in estrogen can lead to vaginal irritation.
Vaginal Itching During peri- and menopause, the natural lubrication of your vagina
can dry up. Estrogen, progesterone, and testosterone are
responsible for vaginal skin health and hydration.
Low estrogen levels can make the vaginal tissues drier and thinner
than usual. When estrogen levels drop, your skin becomes dry and
itchy - vaginal itching is called vulvar pruritus.
Decreased pubic hair During menopause, there can be a loss of pubic hair. Women
experiencing menopause have estrogen levels that are declining
which can lead to atrophic vaginitis. Vaginitis is when the tissues of
vulva and the lining of the vulva and the lining of the vagina
become thin, dry, or inelastic. Women who have this condition
often develop sparse pubic hair too.
Decreased Labia, After menopause, the labia decreases in size, leading some to have
Vulva Size diffkulty reaching a climax with sex, and physiologic difference in
vaginal shape.

Symptoms Breakdown
Sexual
Changes in Libido Sex is supposed to be fun, and women have every right to have
satisfying sex with their romantic partners, right? But as we age and
enter menopause, sometimes, we just aren't feeling it, or maybe sex
is painful. We hear from many women that they are just 'putting up
with sex' rather than looking forward to it because they didn't feel
like participating, or it often hurts to have sex.
Some women will notice a decrease in their libido with peri - and
menopause. While there are some stories of it increasing libido, a
reduction in libido is far more common due to a host of menopause
symptoms that can make sex unpleasant.
In most cases, a lower libido during menopause is due to decreased
hormone levels. Specifically, testosterone and estrogen levels drop,
making it more challenging to get aroused.
Vaginal dryness due to reduced estrogen can make sex painful, and
poor sleep due to reduced progesterone and estrogen can make
fatigue a common reason why not to have sex. Weight gain in
menopause can make women more self-conscious about intimacy,
and the desire for sex decreases.

Symptoms Breakdown
Sexual
Painful Sex Dyspareunia, the term for painful vaginal sex, is quite common
during and after menopause. About 20-30% of women will
experience this with perimenopause. If you find yourself avoiding
sex because intercourse now means more pain than pleasure, you
could be suffering from dyspareunia (painful sex) due to
menopause.
During peri- and menopause, the natural lubrication of your vagina
dries up, the vaginal walls can thin, and the vagina can get smaller.
Estrogen helps keep your vaginal walls thick and stretchy. Falling
estrogen levels due to menopause can cause your vaginal lining to
become thinner and less elastic and your vaginal walls to produce
less lubrication.
With less elasticity and less lubrication, it is no wonder sex at
menopause can be painful. Sometimes the vaginal pain can
continue long after sex is over.

Symptoms Breakdown
Skin
Generalized Aging of First of all, hormones are responsible for the skin conditions that
Skin affect the speed of the aging process, causing different skin defects
and involving chronic skin problems. The main hormones responsible
for skin aging are estrogen, progesterone, and testosterone. The skin
is the so-called "estrogen and androgen receptors map." If we map
out where and how hormones impact our skin, we see that the most
significant map clusters are on the facial skin, legs, and within the
genital organ area.
Compared to young skin, women's skin in perimenopause (mature
skin) has pigmentation changes and the beginning of deep wrinkles.
There are clear signs of damage due to hormonal, genetic, or
environmental factors. Skin aging starts at the age of 25 (the first
minor wrinkles appear then), and visible aging symptoms begin at
about 35 years.
Wrinkles are from collagen loss, which impacts the skin's flexibility
and firmness, not enough hydration, stress, and environmental
factors (smoking, sun, drinking).
Around 50, your skin doesn't hold as much water, leading to wrinkles
because of decreased hormones. The aging process occurs in all the
skin layers. The key factors here are the skin thinning, limiting the
skin flexibility and fatty tissue depletion (e.g., "pouches under the
eyes"). This aging affects facial features like a lowered nose tip,
eyebrows, and cheeks as we age and hormones drop. The mouth area
also can change significantly.

Symptoms Breakdown
Skin
Dry, Wrinkly, Perimenopause can start to bring with it some noticeable
Itchy, Aging Skin changes in your skin. Is dry, wrinkling, itchy, and just 'aging' skin
staring back at you in the mirror? Because estrogen is related
to collagen production and skin hydration, a decline in this
hormone can lead to increased itching or dryness all over the
body.
As hormone levels plummet with menopause, your skin can
become dry, slack, and thin due to a decrease in estrogen that
decreases collagen production. Estrogen promotes water
retention plumpness in the skin.
With B HRT and proper dermatology products, you can start
increasing collagen production for a more youthful appearance,
see improvements and prevent long-term irreversible skin
changes.
Many of the skin changes you observe with age are due to
decreased hormones and environmental factors like smoking
and sun exposure. The hormones that decline with menopause
can be replaced with BHRT. How effective is BHRT at
reversing these structural changes at improving skin health?
Very.

Symptoms Breakdown
Skin
Jowls With perimenopause, our skin loses its firmness and begins to sag.
The term "jowls" describes sagging skin below the chin or jawline.
In menopause, the skin quickly loses its collagen. Studies show that
women's skin loses about 30% of its collagen during the first five
years of menopause. Collagen is a protein that makes up the
connective tissue in your body. Elastin is another connective tissue
that helps your skin return to its normal shape even after being
stretched.
Women lose about 2% of their collagen every year after menopause
for the next 20 years. As collagen levels diminish, your skin loses its
firmness and begins to sag. As collagen is lost, the cheeks and skin
surrounding your mouth lose their firmness and tightness. Once this
happens, gravity causes it to sag and drop on either side of the
mouth and chin, and we call them "jowls".
Rashes/ With menopause, skin becomes more sensitive, and women are more
Easily Irritated Skin likely to develop rashes and easily irritated skin. If you have an
existing skin condition such as eczema or rosacea, these conditions
can worsen.
Around the age of 50, the pH levels of our skin change. A lack of
estrogen can also make your skin itch or cause it to be more
sensitive than usual. This sensitivity makes you more likely to get a
rash or hives when exposed to irritating substances like itchy fabrics,
perfumes, and dyes.

Symptoms Breakdown
Skin
Clammy Feeling After a hot flash (sudden feeling of intense warmth in your face
and chest with sweating), women can have a cold, clammy feeling.
Sometimes you may awaken with a racing heart and cold and
clammy skin.
Night sweats and hot flashes can lead to that clammy feeling due
to changes in estrogen levels that trick your body into thinking
you have an elevated body temperature.
Changes in Body Odor The scent you have long recognized as your natural body odor
often changes when you reach menopause. These changes may
be due to hormonal changes and frequent sweating associated
with hot flashes, skin dryness, and anxiety.
Hot flashes and night sweats can result in an increase in body
odor during menopause. If women often feel stressed or anxious,
they may also notice sweating more.
Thin Skin Menopause often leads to thinning skin. The accelerated thinning
of the skin after menopause is due to hormonal imbalances. The
thickness of the dermis (skin) gradually decreases at the onset of
menopause, the thinning of the dermis is dramatically
accelerated. This thinning results from the gradual
disorganization of the elastic fibers in your skin. At the onset of
menopause, the skin doesn't retain water as well, resulting in a
sudden increase in the thinning rate of the skin. BHRT can help
slow the thinning of the skin.

Symptoms Breakdown
Skin
Rosacea With rosacea, the skin gets red to the point that it looks
extraordinarily flushed or sunburned. Women are more likely than
men to develop rosacea, especially during menopause. The signs and
symptoms of rosacea tend to erupt from time to time, appearing for
weeks to months and then diminishing for a while. Over time the
symptoms may persist indefinitely.
The hot flashes and anxiety that come with menopause may be
enough to trigger a rosacea flare-up. Additionally, stress and anxiety
are also factors contributing to rosacea.
Wounds Heal More During menopause wounds aren't healing like they used to.
Slowly Hormones play an essential role in healing our skin. When hormone
levels fall, the skin takes longer to heal. According to a new study,
bioidentical hormone replacement therapy (BHRT) with estrogen
can reverse age-related changes in wound healing in the skin.
Dark Circles Under Thinning skin can cause the appearance of dark circles under the
Eyes eyes. As collagen diminishes, our skin loses its firmness and begins
to sag. Jowls can also appear. Permanent lines run from the tip of
the nose to the corners of the mouth. Wrinkles that used to occur
only with a smile or frown become visible all the time. Normalizing
hormone levels with B HRT may help hydrate the skin reduce
thinning skin that can look like dark circles.

Symptoms Breakdown
Skin
Breast Tenderness Feeling soreness in your breasts, like when you are having your
period or pregnant, is a common perimenopause symptom. As
hormones shift with perimenopause, fluid can build up in your
breasts, making them feel more swollen, tender, or painful. Breast
soreness during perimenopause can strike unpredictably.
Changing levels of the hormones estrogen and progesterone are
the usual cause of breast pain during perimenopause. As you enter
perimenopause, estrogen and progesterone levels rise and fall in
unpredictable patterns before starting to taper off. The spikes in
hormone levels can affect breast tissue, making your breasts hurt.
Age Spots Age spots and larger areas of darker skin can appear on your face,
hands, neck, arms, or chest. This decrease of estrogen that occurs
can lead to decreased production of melanin. Melanin is the
pigment that gives your skin, hair, and eyes their color. With
lowered melanin production, your skin can become more
susceptible to signs of sun damage like age spots and wrinkles.
Oily Skin Increased secretion of sebum (your body's natural oils) can lead to
increased acne in some menopausal women. Declining estrogen
levels can throw testosterone levels off and result in oilier skin.

Symptoms Breakdown
Skin
Loss of Breast In most cases, the loss of breast fullness is related to:
Fullness 1. Hormone levels changing as menopause approaches,
2. Loss of tissue strength in the breasts, and
3. Gravity pulling the weakened tissues downwards.
Low estrogen levels can decrease the amount of fat tissue in your
breasts, and the connective tissue in your breast loses its elasticity.
These changes can leave breasts smaller and less full than they
used to be. Additionally, mammary gland tissue typically shrinks
during menopause. Hormone therapy for menopausal women can
slow the negative changes in your breasts.
Nipples Changes Each nipple has about nine milk ducts and nerves. During
menopause, you may notice that your nipples start to shrink and
turn slightly inward. Some studies suggest that BHRT may help
prevent these changes.

Symptoms Breakdown
Skin
Acne As female hormones drop with perimenopause, some women
develop skin acne. Perimenopause can mean the onset of pimples
and wrinkles, seemingly overnight. Acne breakouts can appear
around the chin, jaw, mouth, chest, and back. When taking BHRT,
women can look forward to skin improvements.
Neck Menopause causes many changes to your skin. Your body stops
making as much collagen. You lose some fat under your skin, and
your skin's elasticity drops. That combined with dryness caused by
hormonal changes can cause sagging - especially around the neck,
jawline, and cheeks - and fine lines and wrinkles. By taking B HRT,
you can boost collagen production, which can help prevent further
damage to your skin due to low hormones.

Symptoms Breakdown
Muscles & Bones
Chronic Pain Women in menopause are nearly twice as likely to have chronic
pain diagnoses, like flbromyalgia, migraines, and back pain than
before menopause.
Perimenopause can cause muscle pain that can affect the knees,
shoulders, neck elbows and hands. Generally in perimenopause
women start to notice more aches and pains than they used to.
Estrogen helps to reduce inflammation. As estrogen levels start
to decline, you may notice an increase in inflammation that can
lead to achiness all over the body. Don't suffer in silence.
BHRT can make chronic pain much better. About 42% of
women in a national survey say they've never discussed
menopausal symptoms with a doctor. Check-in with a Winona
doctor today to see about finding safe, effective relief.

Symptoms Breakdown
Muscles & Bones
Achy Joints and Many women experience joint and muscle pain and stiffness around
Muscles menopause, which they hadn't experienced before. Estrogen acts to
decrease inflammation in your body. There are estrogen receptors all
over the body, so declining hormone levels can add to pain caused
by inflammation. It's important to remember that general wear and
tear will also contribute to aches and pains.
Perimenopause can cause joint pain that can affect the knees, feet,
shoulders, neck, elbows, or hands. Joint injuries from long ago may
begin to ache again. Generally, in perimenopause, women notice
more aches and pains than they used to.
Estrogen helps to reduce inflammation. As estrogen levels decline,
you may notice an increase in inflammation that can lead to achy
muscles and joints and menopause-related arthritis. Estrogen and
testosterone are responsible for strengthening bones and protecting
them from inflammation. So, when hormones decrease, you can
expect some increased inflammation in the joints.
The best way to keep muscles and joints healthy and flexible is to
use them. As we get older, our activity levels decline, our weight
goes up, and joint stiffness begins. It is never too late to reverse this
cycle. If you are active and flexible and the pain persists, hormone
replacement therapy may help improve the symptoms.

Symptoms Breakdown
Muscles & Bones
Osteoporosis Osteoporosis is a condition associated with weak bones that are
prone to fractures. A significant function of estrogen is to
maintain healthy and strong bones. When your estrogen levels
lower during menopause, your bones can weaken. You can
prevent this weakening.
Osteoporosis is a silent killer. "Silent" because women may not
realize the problem until they break a bone, and "killer" because
it affects one in three women - and kills more women than all
breast and gynecological cancers put together. Bones get
progressively more brittle until they snap, and when they do, it's
terrible news.
According to the National Osteoporosis Foundation, up to 80%
of people with osteoporosis are women. One of the main reasons
is that estrogen-the hormone that protects bones-sharply
decreases when a woman reaches menopause and can cause
reduced bone density. The longer a woman's levels remain low,
her bone density will be lower. Women also have a drop in
testosterone with menopause. When testosterone levels stay
low, bone mass will become lost over time and eventually lead to
weak bones susceptible to fractures.
Hormone replacement therapy reduces the increased bone loss
caused by estrogen deficiency and, as a result, prevents bone loss
after menopause and can significantly reduce osteoporotic
fracture rates.

Symptoms Breakdown
Muscles & Bones
Twitching Twitches and spasms are most common in the thighs, calves, hands,
arms, belly, ribcage, and the foot's arches. They can involve part of a
muscle, all of it, or even a group of muscles. Doctors aren't always
sure why they happen, but a few common triggers can set them off.
Menopause or perimenopause does not, via a direct pathway, cause
muscles to twitch. However, the anxiety that comes with hormone
changes is a likely the cause. Magnesium deficiency, dehydration, and
rigorous exercise can also cause twitching muscles, and the most
apparent reason is fatigue which is so familiar with menopause.
One of the most prominent reasons for skeletal muscle spasms and
cramps is dehydration. We know that in menopause, it becomes
more and more difficult to retain water. This insufficient supply of
water and these minerals can make your muscles irritable, spastic and
can start that strange twitching.
Osteoarthritis Osteoarthritis (OA) is a progressive joint disease characterized by
joint inflammation. It is one of the top five most disabling
conditions that affect more than one-third of persons >65 years of
age. OA commonly affects hands, feet, spine, hips, and knees.
Approximately 100 million people worldwide suffer from OA.
Menopause is associated with the onset and progression of
osteoarthritis, and BHRT can render help by reducing symptoms
and progression, increasing bone mineral density, and reducing
bone abnormalities seen with osteoarthritis.

Symptoms Breakdown
Muscles & Bones
Strength Your muscles grow larger and stronger as you age - until you
are about 30. But in your 30s, you start to lose muscle.
Physically inactive people can lose as much as 3% to 5% of
their muscle mass every decade after age 30. Even if you are
active, you'll still have some muscle loss.
Symptoms can include weakness and loss of stamina, and
reduced activity further shrinks muscle mass. Lower
concentration of some hormones, including testosterone, can
lead to further loss of muscle and strength.
The best treatment for muscle loss is exercise, especially
resistance training or strength training and BHRT.
Specifically BHRT that includes DHEA and/or testosterone
that helps maintain muscle throughout your life.
Strength training is essential as women age because
osteoporosis risk skyrockets with menopause. Strength
training exercises will help build bone and muscle strength,
burn body fat, and rev up the metabolism. Everything from
dumbbells to resistance training will help.

Symptoms Breakdown
GI
Incontinence Stress incontinence is the inability to control your bladder when
you lift heavy items, laugh, or cough. Stress incontinence also refers
to a frequent or sudden urge to urinate. Some people also refer to
it as an "overactive bladder." But why is it so much worse with
menopause?
During menopause, the drop in testosterone, estrogen, and
progesterone weakens the bladder and the adjoining pelvic
muscles. The weakened pelvic floor can lead to urine leaks with
physical activity, laughing or sneezing, which put extra pressure on
your bladder.
Usually, leakage is a few drops of urine, but it can become a total
loss of urinary control. Losing the muscle strength that controls
your bladder is not only embarrassing, but it is a medical problem
that is treatable. By renewing hormones with HRT, you can start to
treat that embarrassing incontinence that sadly only gets worse
with age if not treated.

Symptoms Breakdown
GI
Bloating Bloating is a common perimenopausal symptom, and can persist
after your period is over for the month, if you are still having
periods. Uncomfortable bloating can begin up to 4 years before
menopause as hormone levels drop and continue with
postmenopause.
Our estrogen, progesterone and testosterone hormone levels
drop steadily as we age. With the variations in hormone levels,
you may get signs of premenstrual syndrome like irritability,
bloating, and breast tenderness without a resulting period.
Fluctuations in estrogen and progesterone with perimenopause
can trigger Irritable Bowel Syndrome (IBS) symptoms and
exacerbate underlying GI disease.
Women can experience bloating during menopause for various
reasons, but most likely, bloating may result from fluctuating
hormones.
Due to hormone depletion, women can experience water
retention, gassiness, or slower digestion. This type of bloating can
be uncomfortable and may negatively affect self-confidence.
Women may feel like they have gained weight or that their
stomach is swollen and sticking out.
Fortunately, BHRT may reduce these symptoms.

Symptoms Breakdown
GI
Digestive Problems What do we mean by digestive problems? Gas, flatulence,
bloating, nausea, and abdominal cramps. When estrogen drops,
cortisol increases, cortisol can lead to increased GI issues.
A wide range of digestive problems can arise during menopause,
including excessive gas, belching, nausea, and abdominal
discomfort. Hormones play a significant role in digestion - when
hormones are thrown off in menopause, breaking down food,
absorbing nutrients, and excreting waste will all be impacted.
Acid Reflux With menopause, you could experience indigestion and acid reflux.
(Barrett's Esophagus) Many perimenopausal and menopausal women say they start to
experience symptoms of acid reflux with uncomfortable burning,
upper abdominal pain and bloating. If they had mild symptoms
before, these can get significantly worse.
Estrogen tends to be somewhat protective against a disease called
Barrett's esophagus. But, the the protective effects of estrogen
wear off with menopause. HRT can reduce the inflammation in the
esophagus and reduce the likelihood of esophageal cancers.

Symptoms Breakdown
GI
Constipation Constipation is common in menopausal women and results from
declining hormone levels such as estrogen and progesterone. It
may worsen because of weakened pelvic floor muscles. No
matter the cause, constipation can often be treated by changes
in diet and exercise.
Estrogen and progesterone affect how fast food moves through
the GI tract. As the levels of hormones decrease, they may slow
intestinal movements and cause constipation. Constipation
tends to worsen with age and if hormone levels go untreated.
Rectal Pain / With changing hormone levels during menopause, bowel problems
Itching/ Hemorrhoids can increase, whether constipation, incomplete emptying, fecal
incontinence, problems with controlling gas, hemorrhoids, or pain
from anal fissures; those symptoms can coincide.
Estrogen has a role in maintaining the moisture in your cells and
helps in collagen production. As the estrogen level begins to fall with
perimenopause, your skin may become dry, leading to flaking and
itchiness, especially in those areas you would prefer not to scratch.
Many women suffer itchiness especially when lower hormones cause
increased release of histamines. Histamines can then cause further
skin irritation. Hormonal changes may lead to relaxed veins in the
anus which can make hemorrhoids more likely. Hormonal changes
may relax the veins in this area, making hemorrhoids more likely

Symptoms Breakdown
Hair and Nails
Hair Loss Thinning hair on the scalp is common with perimenopause. You
may start to notice more hair on your face and less on your scalp.
While we know that menlose their hair due to hormone changes
with age, women also lose hair on their scalp.
Many post-menopausal women find that their hair won't grow
like it used to. Age and the change in hormones (higher ratio of
testosterone to estrogen) may affect your hair volume and make it
thin. Menopause can make you lose hair faster and more easily.
During menopause, hair loss or thinning is result of androgen
dominance.. This causes the hair follicles to shrink, making hair
grow more slowly and shed more quickly. Estrogen also contributes
to hair growth and fullness. Without it, your hair may become thinner.

Symptoms Breakdown
Hair and Nails
More Facial Hair Sometimes women notice an increase in their facial hair around
menopause. While the hair on their scalp thins, the chin or upper
lip can sprout patches of "peach fuzz" and sometimes some
pretty long, coarse, dark hairs too. Some women can experience
increased hair on their chest, abdomen, and back.
These hair changes on the face are very normal; almost 40% of
women age 45 and older have an excess of facial hair growth,
especially on the chin.
The ratio of estrogen to testosterone can get thrown off and
decrease with menopause, which can cause some secondary male
characteristics (like facial hair). Balancing the estrogen and
testosterone levels definitely can help.

Symptoms Breakdown
Hair and Nails
Allergies The change in hormones in menopause may trigger a nonallergic
sinusitis reaction. That can include a severe runny or stuffy nose,
altered sense of smell, facial swelling/pain/pressure.
Brittle Nails Your nails will likely break more easily during menopause.
Estrogen is responsible for keeping your nails strong. When
estrogen levels drop, the nails can weaken, which causes brittle
nails for many.
Additionally, during or after menopause, the body may not
produce enough keratin because of dropping hormones, which
is the substance that nails need to stay strong, leading to
brittle, weak nails that crack or break easily.
Dandruff Perimenopause can start to bring with it some noticeable
changes in your skin - including the skin on top of your head
called your scalp. Like the hormonal shifts that can cause the skin
to lose moisture, your scalp and hair may also become dry and
brittle. Dandruff is a common scalp condition where dry skin bits
flake off the scalp. Dandruff may also make your scalp itch.
Because estrogen is related to collagen production and skin
hydration, a decline in this hormone can lead to increased
itchiness and a flaky scalp. Returning estrogen to pre-
menopausal levels can decrease dandruff.

Symptoms Breakdown
Hair and Nails
Eyebrows The usual cause for hair loss and brow loss in women at midlife is the
shifting and reducing hormone levels at menopause.
Prostaglandins are under the influence of estrogen and progesterone.
As they drop, so do prostaglandin levels.
Prostaglandin acts like a hormone and signals your eyebrows to grow.
As we get older, our natural prostaglandin production declines.
That's why it's common around menopause for our eyebrows to thin,
but the ones that remain grow a little longer, become coarse, and
even change color.
Eyelashes Thinning eyelashes are part of menopause, but don't worry if
your lashes aren't the same length and fullness. As we age, our
hormones (estrogen and progesterone) drop, which causes
changes in eyelash follicles. Eyelash follicles are the openings in
the skin through which the lash grows.
These changes in the follicles can slow or stop producing new
lashes altogether. BHRT can help get those lashes growing again!

Symptoms Breakdown
Cardiovascular
Irregular Heartbeat Although no menopause symptom can be considered
unimportant, heart palpitations can be particularly concerning as
they could signal a more serious health issue. From 18- 47 % of
women will experience heart palpitations during perimenopause.
Menopausal palpitations are racing or skipped heartbeats, flip-
flops, fluttering or pounding that occurs with or without
dizziness or lightheadedness.
When a woman enters perimenopause, the lead-up to
menopause, there is a significant decrease in estrogen
production associated with an increase in heart rate and an
increased frequency in heart palpitations. While some say heart
palpitations are part of a hot flash, many women experience them
independently of a hot flash.
Palpitations are their own symptom, separate from hot flashes.
The risk for developing heart disease goes up with the onset of
menopause, according to the American Heart Association (AHA).
One factor that may contribute is the decline in estrogen.
Women reporting palpitation distress was higher in those with
worse insomnia, depressive symptoms, perceived stress, and poor
menopausal quality of life.

Symptoms Breakdown
Cardiovascular
Irregular Heartbeat In many cases, palpitations aren't cause for concern and will go
continuation away independently. There are instances where someone with
heart palpitations does have an underlying heart condition or
discovers underlying heart disease that was previously
undiagnosed.
Talk with your healthcare provider if you have heart symptoms
that you're not expecting or are particularly bothersome.
Increased LDLs Menopause is associated with a progressive increase in total
cholesterol, particularly low-density lipoprotein (LDL),
lipoprotein-a, and triglycerides, and a decrease in high-density
lipoprotein (HDL). Typically, HDL is considered "good"
cholesterol (you want it), while LDL is considered "bad" (and you
want less of it). HDls move cholesterol out of your
bloodstream.
The rise in LDL cholesterol around menopause is linked to the
drop in the hormone estrogen. Hormone replacement therapy
has been shown to lower LDL levels

Symptoms Breakdown
Cardiovascular
Heart Disease Heart disease risk rises for everyone as they age, but symptoms can
become more evident for women after the onset of perimenopause.
More than one in three female adults has some form of
cardiovascular disease. An overall increase in heart attacks among
women is seen about 10 years after menopause. Heart disease is the
leading killer of women in the US.
Estrogen helps keep blood vessels open and flexible. That means
they can relax and expand to accommodate blood flow. A buildup in
the blood vessels leading to the heart or brain can cause a heart
attack or stroke. It is clear that estrogen reduces atherosclerosis by
reducing low-density lipoproteins (LDL or "bad" cholesterol) and
inflammatory processes in the vascular system, and estrogen may
also act as an antioxidant.

Symptoms Breakdown
Cardiovascular
Increased Blood Blood pressure generally increases after menopause due to the
Pressure shifting hormones. The typical increase in body weight with
menopause can further contribute to the rising blood pressure.
Changes in hormones estrogen, progesterone and testosterone
during menopause can lead to weight gain and make your blood
pressure more sensitive to salt in your diet - which, in turn, can
lead to higher blood pressure. HRT may help reduce blood
pressure by keeping arteries and veins flexible and supple so the
blood can flow more easily. "Arterial compliance" is the ability of
the arterial wall to be flexible and widen and narrow with an
increased volume of blood. Arterial compliance is the opposite of
arterial stiffness.
Women are at higher risk of cardiovascular disease after menopause.
Arterial stiffness increases with age, both in men and women. There
is a rapid decline in arterial compliance in the perimenopausal period.
Treatment with bioidentical hormone replacement therapy (BHRT)
can partially reverse the increased arterial stiffness. Studies show that
BHRT significantly inhibits the age related rigidity of large arteries.

Symptoms Breakdown
Cardiovascular
Increased Glucose Menopause coincides with insulin resistance. An increase in
Resistance insulin resistance is associated with an increased risk of diabetes,
cardiovascular disease, and breast cancer.
Studies have shown that women who have not used H RT have
increased insulin intolerance, and the risk of glucose intolerance
increases by 6% each year after menopause.
Increased Total Menopause is associated with a progressive increase in total
cholesterol cholesterol, particularly low-density lipoprotein (LDL),
lipoprotein-a, and triglycerides, and a decrease in high-density
lipoprotein (HDL).
For some women who've had normal cholesterol all their lives,
that can change at menopause. Going through menopause often
results in worsening lipid and cholesterol levels. Drops in
estrogen can cause a rise in total cholesterol levels due to higher
amounts of low-density lipoprotein (LDL), the "bad" cholesterol,
and another blood fat known as a triglyceride. Over time this
accumulation of fats can raise heart risks, a significant concern, as
cardiovascular disease is the No. 1 cause of death in
postmenopausal women in the US.

Symptoms Breakdown
Cardiovascular
Increased Blood Hormone replacement therapy delivered through the skin by
Clotting Proteins cream or skin patch does not increase the risk for blood clots.
Blood clots allow us to heal from cuts, scrapes, and bruises. But,
blood clots become much more severe if they block blood flow to
your brain or heart, leading to strokes and heart attacks. There is
another type of clot called a "deep venous thromboembolism"
(DVT) that can move up from the legs and clot in your lung - this
is called a "pulmonary embolism."
Blood clots are not something to be taken lightly. Be sure to explore
all your options - types of HRT, doses, and delivery systems (pill,
patch, or cream).

Symptoms Breakdown
Cardiovascular
Shortness of Breath A woman's lung function seems to decline during menopause.
Women could find themselves becoming short of breath. Not
only does the lung size decrease, but the ability to force air out
of your lungs is reduced. Studies show that this decline isn't
just due to age; it's due to decreased hormone levels.
The decline in lung function can be quite severe in some
women - equivalent to the damage caused by smoking 20
cigarettes per day for 10 years! This decline in lung function can
cause shortness of breath, reduced work capacity, and fatigue.
Hormonal changes related to menopause may play a role in
lung function decline because decreased hormones can lead to
systemic inflammation and osteoporosis. Osteoporosis can
compress the height of the chest vertebrae, limiting air intake.
HRT is an effective option for preventing osteoporosis and
inflammation in peri- and postmenopausal women.

Symptoms Breakdown
Urinary /Vaginal
Increased UTls Urinary tract infections (UTls) are most common in women. They
usually occur in the bladder or urethra, but more severe
infections involve the kidney. A bladder infection may cause
pelvic pain, increased urge to urinate, pain with urination, and
blood in the urine. A kidney infection may cause back pain,
nausea, vomiting, and fever.
As estrogen production falls in menopausal women, UTls can
occur more frequently. There are several reasons for this. As you
age, your vaginal tissue thins, making it more prone to infection.
You may also have trouble fully emptying your bladder, which can
increase the chance of an infection in your bladder.
Menopausal UTls, however, are related to decreased estrogen
levels and associated physical changes. Estrogen helps naturally
occurring "good" bacteria (lactobacilli) within the vagina thrive.
Lactobacilli produces an acid that lowers the pH in your vagina,
which controls infection-causing bacteria also present in the
vagina. When estrogen levels decline, the "bad" bacteria multiply
and increase your risk of UTI. Other menopausal changes that
elevate your risk of UTls include thinning and dryness/irritation
of vaginal tissue.

Symptoms Breakdown
Urinary /Vaginal
Clitoris Shrinking The clitoris can become smaller (atrophy) over time after losing
(atrophy) circulating female hormones with menopause. This is a part of a
normal condition with aging called urogenital atrophy. When
women enter menopause, many changes occur due to the loss of
estrogen and progesterone, especially in the vaginal areas.
The primary cause of urogenital atrophy in menopausal women is
estrogen loss. The symptoms are usually progressive and, if not
treated, can get worse as a woman moves through her
menopausal transition.
Atrophic changes of the vulva, vagina, and lower urinary tract can
significantly impact the quality of life of the menopausal woman.
However, hormone replacement therapy can provide patients
with help to regain their familiar vaginal area.
Hormone replacement therapy (HRT) can include pills, patches
and creams, and topical (local) estrogen cream.

Symptoms Breakdown
Urinary /Vaginal
Urinary Microbiota A resident microbial community (the female urinary microbiota,
FUM) naturally lives within many adult women's female bladders.
The balance of these microbial communities can influence
whether or not a woman suffers from urinary disorders,
particularly urinary tract infection and urgency urinary
incontinence.
Estrogen helps naturally occurring "good" bacteria (lactobacilli)
within the vagina thrive. Lactobacilli produces an acid that lowers
the pH in your vagina, which controls infection-causing bacteria
also present in the vagina. When estrogen levels decline, the
"bad" bacteria multiply and increase your risk of UTI. Other
menopausal changes that elevate your risk of UTls include
thinning and dryness/irritation of vaginal tissue.
Recent studies demonstrated that pre-and postmenopausal
women have different urinary microbiotas. Balancing hormones
may help manage the bladder's microbial community and
enhance urogenital health.

Symptoms Breakdown
Mouth
Burning Tongue/ It sounds weird, but it is real. Burning mouth syndrome (BMS) is a
Mouth Syndrome condition that causes pain and discomfort in your mouth, lips, or
tongue. The feeling is often described as a burning, scalding, or
tingling sensation and can include a metallic taste or loss of
taste.
A burning tongue during menopause can be due to dry mouth
due to reduced estrogen levels. Just like the vaginal dryness due
to decreased estrogen, the mouth can dry out too because of
reduced saliva production.
Mouth/Gum/ Because perimenopause can cause a dry mouth, it may increase
Tooth Problems your risk for gum disease and cavities.
When your mouth doesn't produce enough saliva to wash away
oral bacteria, germs can accumulate inside your mouth and raise
your risk for gingivitis and tooth decay. Gum problems during
menopause can cause your mouth to taste like metal and
decrease the ability to taste foods that you once enjoyed.

Symptoms Breakdown
Mouth
Bad Breath Menopause causes things like a dry vagina AND can also cause a
dry mouth. When your mouth is dry, you don't have enough
saliva, and it's saliva that helps cleanse your mouth and fight the
bacteria in it which can lead to halitosis or bad breath!
There are estrogen receptors in the mucous membranes of your
mouth, and hormones have a strong influence on your mouth and
its health. Hormone replacement therapy, or HRT, may improve
the oral health of menopausal women. Estrogen replacements
may help reduce the risk for tooth loss, and they may also help
strengthen the structures that support the teeth.
Changes in Taste Taste and smell can change with menopause. Falling estrogen
affects saliva, which can reduce or alter our taste sensation.
Aging and lowered hormones can lead to a reduced number of
taste buds on your tongue, and make the taste sensations less
intense.
Some females may notice changes in their sense of taste, with
the need for more robust flavors, during menopause.
Sometimes they will eat more, or richer, fattier foods to try and
improve their taste sensations.

Symptoms Breakdown
Mouth
Wrinkles Around By now, it's clear that menopause causes many changes to your
Mouth skin because of the drop in estrogen. When estrogen drops, your
body stops making as much collagen. Collagen is what keeps your
skin looking young, healthy, even 'plump.' As it drops, you lose
some fat under your skin, and your skin's elasticity decreases. That,
combined with dryness caused by hormonal changes, can cause
sagging -- especially around the neck, jawline, and cheeks -- and
fine lines and wrinkles. The lines and wrinkles you get with
menopause are often above the upper lip.
These wrinkles may indicate an estrogen deficiency and a
testosterone deficiency, both of which accompany menopause.
Chapped Lips Menopause is one of the leading causes of dry mouth, also
known as xerostomia. Menopause dry mouth can cause a sore,
dry feeling in the mouth, throat, and lips, frequent thirst, and
problems with hoarseness. Dry or cracked lips are also
frequently associated with menopause and the drop in
hormones.

Symptoms Breakdown
Mouth
Sore Throat & Hoarse A change in voice tone and a hoarse voice can occur in
Voice perimenopausal. An increasing number of women between ages
40 and 60 complain about vocal problems. Still, few realize how
their voice changes are related to menopause and hormones and
that hormone replacement therapy (HRT) can help.
That frequent clearing of your throat, cough, and vocal changes are
because of changes in your larynx, including mucus on your vocal
cords, due to hormonal imbalances.
The reproductive hormones estrogen and progesterone play an
Thirsty essential role in your ability to retain fluids and thirst in your
body. During perimenopause and menopause, hormonal
changes can cause hot flashes, night sweats, and increased
thirst. Menopause is one of the leading causes of dry mouth,
also known as xerostomia.
During menopause, a decrease in estrogen may cause dry
Sores in Mouth mouth, chronic ulcers, sloughing of gum tissue, abnormal taste
sensation, and burning-mouth syndrome. Hormonal therapy
often helps.

Symptoms Breakdown
Mouth
Preference for Sweets During menopause, many women have profound food cravings. We
and Comfort Foods associate giving in to cravings with a lack of willpower, but food
cravings have biological reasons.
As women, we are all too familiar with the food cravings that come
and go throughout our monthly cycles and stages in our
reproductive lives. Estrogen and progesterone play a critical role in
these cravings. For example, many of us felt we MUST EAT
chocolate right before our monthly periods.
During menopause transition (MT), hormone changes are likely
making you crave particular foods in higher than normal quantities.
Studies have shown that certain foods stimulate the brain's reward
regions and directly influence our food choices and eating
behaviors.
These certain foods can make us excited and create happy,
positive feelings. These good feelings make us want to keep eating
those foods regularly.
The foods that create this 'happy brain' are called hyper-palatable
foods, aka comfort foods, because they are quick and easy to
digest. Comfort foods are typically sweet, salty, and fatty, leading
to weight gain.

Symptoms Breakdown
Mouth
Preference for Sweets The good news is that you can decrease your feelings of hunger
and Comfort Foods and directly affect the appetite center in your brain that regulates
continuation your feeling of fullness and satisfaction by normalizing your
hormone levels.
Studies suggest that hormone replacement therapy can help
reduce the sudden upswing in cravings and appetite during peri-
and menopause.
Losing teeth Declining estrogen levels contribute to bone loss of the spine
and bone loss of the jawbone, raising the risk for loose teeth
and tooth loss.
Also, perimenopause can cause a dry mouth. When your mouth
doesn't produce enough saliva to wash away oral bacteria,
germs can accumulate inside your mouth and raise your risk for
gingivitis, tooth decay, and ultimately cause tooth loss.

Symptoms Breakdown
Eyes
Change in Eye Shape Estrogen, the main sex hormone in women, can cause the cornea
to become more elastic, changing how light travels through the
eye. These changes can lead to blurry vision and difficulty
wearing contact lenses.
Itchy Eyes Not many women know that menopause and the dropping
hormones can affect your eyes. Irritated, dry, red, and itchy eyes
are not uncommon but can be treated by various methods.
The fluctuations in hormones result in irritated, dry, red, and
itchy eyes in over 60% of perimenopausal and menopausal
women. Known as chronic dry eye, it can seriously affect your
vision and overall health of the eyes if left untreated.
Vision Changes Changes in the body's hormones with menopause can affect the
eyes in various ways. Menopause may contribute to glaucoma,
dry eye, and other vision problems.
Reduced levels of estrogen can help the cornea become more
elastic, changing how light travels through the eye. These
changes can lead to blurry vision.
The drop in sex hormones with menopause can influence the
level of intraocular pressure (IOP), the major risk factor for
glaucoma. Estrogen therapy in postmenopausal women is
associated with a significant improvement of IOP to reduce the
risk of glaucoma.

Symptoms Breakdown
Ears
Poor balance Vertigo, or benign vertigo, is poor or worsening balance and is
common in perimenopause. Estrogen decreases steeply during
menopause. There are estrogen receptors in the inner ear, and the
activity of the receptors decreases with increasing age.
Why is this important for balance? Otoconia are bio-crystals in the
inner ear that help maintains bodily balance. The rapid decrease in
estrogen receptor activity in the inner ear due to the sudden
reduction of estrogen impacts the bio-crystals and can lead to
balance issues.
Ringing ears You may develop tinnitus (ringing in the ears) as you approach
menopause. The relationship between menopause, hormone
replacement therapy, and tinnitus is a topic that needs more
study. Studies have shown that hormone therapy can lower the
rate of tinnitus in perimenopausal women.

Symptoms Breakdown
Ears
Hearing Changes It's possible that your hearing may change as you approach
menopause. Scientists know estrogen receptors are in the ear
but how estrogen affects hearing is still not completely clear.
In human and animal studies, reports have shown that low
estrogen levels can impair hearing, possibly through alterations
in blood flow to the inner ear. A separate study found that
women with less circulating estrogen were more likely to have
hearing loss.
Additionally, progesterone begins to drop in your thirties, and
when it falls, it can reduce receptor cells for estrogen.
Progesterone doesn't affect the inner ear (cochlea), but could
reduce estrogen receptors and blood flow to the ear.

Symptoms Breakdown
Nose
Sense of smell In menopause, it is common for women to notice a change in their
sense of smell. Since estrogen and progesterone protect the smell
(olfactory) function, changes in their levels in menopause women
influence the ability to recognize smells.
Nasal Congestion The change in hormones in menopause may trigger a nonallergic
sinusitis reaction. That can include a severe runny or stuffy nose,
altered sense of smell, facial swelling/pain/pressure.

Symptoms Breakdown
Immune System
Cortisol A woman in her late 30s and early 40s is likely moving into
perimenopause, which is the stage before menopause.
Perimenopause and menopause are both caused by changing
hormones estrogen, progesterone, and testosterone. But there is a
third hormone, cortisol, that is often thrown off during
menopause. Cortisol levels regulate a wide range of vital processes
throughout the body, including metabolism, mental function,
immune responses, and feelings of stress.
Cortisol is best known for its role in how stressed or anxious we
feel and is known as the "stress hormone." Cortisol levels are often
elevated when experiencing menopause and can make menopause
symptoms much worse. Bioidentical hormone replacement therapy
can help to normalize the levels of cortisol.
Immune-senescence A general decline in immune function has been observed in aging
women, leading to immune-senescence (immune dysfunction).
Several of these immune systems changes specifically affect
postmenopausal women. Age-related and hormone related
immune senescence may contribute to the immune system's
decline; chronic inflammatory state, increased risk for frailty,
chronic disease, and functional decline in menopausal women.
There is a role for menopausal hormone replacement therapy in
protecting against immune senescence.

Symptoms Breakdown
Feet
Thick toenails While some women will have more brittle nails, others may notice
that their toenails are getting really thick. In several scientific
studies, nail thickness was compared to women on BHRT and
those that were not. There was a significant decrease in blood flow
for those without HRT, leading to the toenails thickening.
Split Toenails For menopausal women, split toenails are often caused by drastic
hormonal fluctuations, causing nail beds to become dry from lack
of estrogen. Some of the most straightforward techniques to
care for nails are correctly moisturizing and practicing habits
such as avoiding hot baths or showers, trimming toenails after
soaking, and avoiding acetone nail polish removers. Treating split
toenails involves resolving the underlying cause of hormonal
imbalance with BHRT supplementation.
Foot callouses A recent study stated that calluses are among the most frequent
causes of foot pain in older adults. By the time you enter your 40s
and 50s, your feet have likely sustained considerable damage. Add
in menopause, and the issues compound. Foot pain affects women
more than men.
Plummeting estrogen levels impact the body's ability to retain
moisture resulting in dehydrated skin, including the feet. This
dryness can have two effects: 1) Thickening skin around the heels
can lead to fissures, painful cracks that can bleed or get infected, 2)
Existing calluses-areas of hard, built-up skin-worsen.

Symptoms Breakdown
Feet
Foot Arch Pain Women are more vulnerable to plantar fasciitis and other foot-
related pain as estrogen levels decline. Additionally, the
average woman gains one and a half pounds per year in her 50s
and 60s. Even a modest amount of added weight can affect the
arches in your feet, as extra weight on top equals increased
pressure below. Specifically, the tendon that holds up the arch,
the posterior tibial tendon, can strain or tear-the technical
term for this achy discomfort: plantar fasciitis. Arches can
weaken, start to flatten, or even collapse.
Pain in Balls of Feet Sometimes the pain feels like you are walking on rocks or tiny,
sharp stones. Middle age and weight gain often go hand-in-hand,
but when hormones drop we also tend to lose fat in certain areas,
including the face and the bottom of the feet. This new lack of
shock absorption causes pain known as metatarsalgia, often felt in
the balls of the feet.

Symptoms Breakdown
HealthyHormoneClub.com
Dr. Michelle Sands

99 Symptoms One Root Cause

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99 Symptoms One Root Cause

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Table of Contents

4 What is the "Menopause Transition"?

5 What are considered “normal" menopause

6 Dangers of Hormone Decline

7 What can I do about the drop hormone levels

frustrated, confused and fearful.

associated with hormone decline.

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The entire transition with menopause is called the

"Menopause Transition" (MT) and can last 20 years

It typically starts sooner than most women think it

will. About 10% of women start perimenopause

The menopause transition includes the phases of:

• perimenopause (typically age 35-45),

Perimenopause, menopause, and postmenopause

are normal and natural stages that aren't

low hormones. Because hormone receptors are on

“We can’t avoid menopause, but we can avoid suffering”

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looks unfamiliarly round becomes your new

flashes and exhausted by heavy periods or

Untreated menopause can serve up debilitating

symptoms and severe side effects that can

problems in her relationships.

If the drop in hormones in perimenopause is not

attack, Type 2 Diabetes, dementia, osteoporosis,

Over 85% of women in perimenopause will have

anxiety, weight gain, low libido, depression,

worse as they move into menopause and beyond.

While all of these symptoms are common, they

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 Irregular or skipped periods

women will have more severe symptoms that others,

increased risk for many life threatened diseases including:

 Alzheimers and Dementia

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Surveys of thousands of women in

"The topical hormones worked

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Safe, natural, bioidentical hormone replacement therapy (BHRT) is available in an

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Which symptoms are you experiencing?

treated individually, with the root cause being ignored.

menopause transition. My goal is to educate and empower women to take control of

their health and live vibrantly at any age.

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world thinks about “the change”

your symptoms and women’s health…at no cost!

Or Scan the code below to Join the GLOW Tribe Today!

To your continued health and happiness,

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Irregular or Non- Irregular periods are among the earliest symptoms of

existent Periods perimenopause for most women. Throughout the menopausal

transition, it is normal to have irregular periods. Eventually, you will

stop having periods entirely. After 12 months without a period, you

Estrogen and progesterone regulate a woman's menstrual cycle. As

we age, these hormones (plus testosterone) drop steadily. Estrogen

levels rise and fall unevenly during perimenopause, and menopause.

As perimenopause starts, you can expect your periods to become

and the following month is just spotting. This variable cycle is a

telltale sign of approaching menopause. Menstrual cycles can

shorten from 28 days to anywhere between 21 to 26 days. What's

month to month and even day-to-day.

the amount of bleeding can range from spotting to very heavy