At SCV Birth Center, we are passionate about body literacy. We believe that understanding why your body is changing is key to navigating perimenopause and menopause with confidence.
In a recent Midwife Monday, we sat down to discuss the specific medical and holistic nuances of the hormonal journey. We moved beyond the typical OB-GYN approach that dismisses your discomfort as “just a normal part of aging,” and outlined the specialized, data-driven approach we use to help you optimize this transition.
Here are the key takeaways from that conversation.
1. The Symptoms the General GP Misses
Traditional OB-GYN care frequently focuses only on classic hot flashes. However, the drop in estrogen and progesterone affects nearly every system in your body.
We watch for symptoms that people often don’t associate with menopause or perimenopause. It is vital to watch for:
- Systemic Joint Pain: Including specific issues like frozen shoulder. Renee shared her personal experience with chronic shoulder pain that only resolved when she started hormone therapy.
- Sleep Disruption: Waking frequently in the night, or getting up often to pee.
- Brain Fog & Emotional Shifts: Noticeable increases in anxiety and depression.
- Urogenital Changes: Thinning vaginal tissues and decreased lubrication, combined with more frequent UTIs and bladder infections.
2. The Midsection Weight Gain
Many women experience weight gain, specifically around the visceral (midsection) area. There is a biological reason for this!
During your childbearing years, estrogen receptors are concentrated in the hips and buttocks. As you enter menopause, these receptors move to the midsection (visceral area). Your body alters its structure based on this hormonal shift, making your waist thicker. This is a biological change, not a failure of diet or exercise.
3. Our Philosophy: Treating Symptoms vs. Labs
We often get phone calls from women wanting to get their hormones and thyroid checked. While we do run labs, our fundamental philosophy is this: We treat the symptoms, not just the lab values.
The standard medical model looks at lab values and says everything is “in range,” even when you are highly symptomatic. Modern research shows that if a patient is experiencing joint pain, sleep disruption, and systemic issues, we must treat the symptoms.
However, we do run a comprehensive baseline panel before starting Hormone Replacement Therapy (HRT). This panel includes:
- Hormonal Panel: Estrogen, Testosterone, and Follicle Stimulating Hormone (FSH).
- Metabolic Markers: Hemoglobin A1C to check for insulin resistance (as menopause naturally increases insulin resistance).
- Inflammatory Markers: C-Reactive Protein (CRP), because menopause causes more systemic inflammation.
- Nutritional Markers: D3 levels (for bone strength) and CBC/Ferritin to rule out iron deficiency and fatigue.
- Thyroid Panel: TSH with a Free T4 reflex to rule out thyroid issues, which are incredibly common during this time.
It is crucial to know that bone loss starts 10 years before menopause. Therefore, checking your D3/K2 status is vital long before your period actually stops.
4. The HRT Journey: Starting Low and Titrating
If you are symptomatic and choose HRT, our methodology is a personalized, step-by-step titration.
If you have been without estrogen for a certain amount of time, those receptors essentially shut down. Starting HRT at too high of a dose can confuse your system. Renee shared her personal case study to explain this process:
- She started on a very low dose (0.5 mg estradiol). This resolved her symptoms and kept her stable for a year and a half.
- However, as those hormone receptors “woke up” and her body was ready to receive more, her symptoms (like vasomotor and night issues) came back.
- She slightly increased her dose to satisfy those awakened receptors and is now totally stable again.
We utilize individualized titration and check in frequently. For example, we might start a symptomatic patient on low-dose estrogen first, checking in with her after two weeks to see how she feels before starting oral progesterone. We walk with you through this entire process.
5. The Optimal Movement Formula
The generational model for exercise used to be “all aerobic” (spending hours on treadmills or ellipticals). The modern model prioritizes optimizing your metabolism and bone health through strength.
- Metabolism and Muscle: As you go through menopause, your metabolism slows down. While aerobic activity is great, we now know that muscle mass is what actually keeps your metabolism up.
- Bone Health: Heavy lifting and weight-bearing exercises are absolutely essential to minimize the bone loss associated with menopause.
6. Optimizing Aging
Aging is inevitable, but raging against it is optional. Our goal is not to just help you “get through it”; it is to optimize your health so you can thrive during the process.
If you have questions about specialized menopause care or are looking for a relationship-centered approach to your health, give the center a call.
Santa Clarita Birth Center (661) 254-3000