Natural Hormones

My formative years were crafted in the 1980s. And as I turned from a girl to a woman during this decade, one man was there by my side…Michael Jackson. I remember racing to a friend’s house to watch his next video, attempt his latest dance move, or simply revel in his songs. So, it was with great sadness that heard of his passing. But what is even more disturbing to me is that it appears as though hard-core sleeping pills (Diprivan) may have played a role in his death.

This is an issue near-and-dear to my heart. Insomnia runs in my family. My grandmother and mother both have great difficulties sleeping, and I tend to wake up in the night and have difficulty falling back to sleep. For me, it is more stress related, with many “to-dos” running through my head each night. However, for my mother and grandmother, it is more of a menopause symptom, closely related to declining estrogen levels.

I have avoided taking any prescription sleeping pills, as they are highly addictive, and you need more and more to achieve the same level of sleep satisfaction. This is likely the case with Michael Jackson. Many reports indicate that he had great difficulty sleeping and needed stronger and stronger medication to achieve the rest he desperately desired.

My grandmother started on the same path, frequently taking as many as three sleeping pills a night. It started to affect her behavior, her health, and her relationships. We practically had to have an intervention to simply lower her dosage, let alone try to get her off the pills. Fortunately, she was able to cut back to a lower dose and stay there. Plus, the experience scared my mother enough to give up her sleeping pills altogether.

Fall Asleep with Natural Hormones

If you also have trouble sleeping due to stress, anxiety, declining estrogen levels, or simply as a side effect of menopause, there are many natural solutions for you. The two that work the best for me are melatonin and 5-HTP.

Melatonin is a hormone produced by the pineal gland. It is made from the neurotransmitter serotonin and is responsible for setting and regulating the timing of your body's natural rhythms, including waking and sleeping. According to an analysis published in Sleep Medicine Reviews, researchers reviewed and analyzed 15 studies involving healthy adults with insomnia who supplemented with melatonin. They concluded that melatonin was, in fact, very effective in increasing total sleep and sleep efficiency.

For melatonin to work, your bedroom needs to be dark, as light suppresses its release. When using melatonin, Dr. Lark recommends that you start with a small dose, 1 mg, at bedtime to improve sleep.

5-HTP is the precursor to serotonin. Within your brain, serotonin often inhibits the firing of neurons, which dampens many of your behaviors, and relaxes you and calms you down. It plays a key role in regulating sleep, as well as temperature, blood pressure, and biorhythms. If stress and anxiety is the reason for your sleepless night, then 5-HTP may do the trick.

Dr. Lark suggests taking 50–100 mg to help you sleep. Be sure to take 5-HTP with a carbohydrate snack, such as a piece of fruit, to facilitate its uptake into the brain. In addition, take 50–100 mg of vitamin B6, to ensure 5-HTP’s timely conversion to serotonin.

In the May 8, 2009 issue of Menopause, there were two powerful studies that looked at the use of intravaginal DHEA to treat vaginal atrophy.

The researchers explained that DHEA, the “exclusive source of sex steroids in postmenopausal women, is already decreased by 60 percent and continues to decline at the time of menopause.” For this reason, they wanted to determine if intravaginal DHEA could alleviate the symptoms of vaginal atrophy, just one of the effects of menopause.

After 12 weeks, researchers found that daily intravaginal DHEA at doses of 3.25–13 mg was able to “rapidly and efficiently achieve correction of all the signs and symptoms of vaginal atrophy and improve sexual function and caused no or minimal changes in serum sex steroid levels, which all remain within the normal postmenopausal range, thus avoiding the risks of all estrogen formulations.” In other words, DHEA did not raise estrogen levels, which is good news for women who are sensitive to estrogen, or whom have cancer or blood-clotting risks.

Natural Hormone Levels

This is all great news! DHEA has been referred to as the “fountain of youth hormone.” DHEA is one of the five major sex hormones. It is made from pregnenolone, a steroid hormone made from cholesterol that is the precursor to all the other sex hormones.

Pregnenolone converts to the other four sex hormones (DHEA included) via two different pathways. In the first, pregnenolone is converted into DHEA, which is then converted into testosterone and subsequently estrogen. In the second pathway, pregnenolone is converted into progesterone. The progesterone is then converted into testosterone and, finally, into estrogen. This pathway takes place during the first half of your menstrual cycle, when estrogen is the dominant hormone.

In the second pathway, pregnenolone is converted into progesterone. The progesterone is then converted into testosterone and, finally, into estrogen. This pathway occurs during the second half of the menstrual cycle, when progesterone and estrogen are both dominant.

When you are in your reproductive years, or even during premenopause, you experience both pregnenolone pathways. However, once you enter the later stages of menopause, you only go through only the DHEA pathway and not the progesterone pathway. This is one reason why estrogen levels are so much lower during menopause.

DHEA Eases Menopause Symptoms

Low serum (or blood) levels of DHEA have been associated with risk of heart disease, cancer, and immune-related conditions. Conversely, as the study shows, supplementing with DHEA helps with vaginal atrophy, as well as other menopause symptoms, including poor memory, joint pain, increased body fat, insomnia, and more.

According to Dr. Lark, women looking for menopause relief should take 15–25 mg of DHEA before bed. Be careful not to take more than this, as overdosing may result in increased levels of testosterone, which can lead to acne, increased facial hair, or deepened voice. It can also lead to increased estrogen levels, which can cause sleep disturbances, fatigue, anxiety, and irritability.

As is the case with any hormone replacement, you should have your hormone levels checked before you take DHEA. If your levels are low (below 130 ng/dl in blood; under 40 pg/ml in saliva) and you choose to take it in supplemental form, start with the lowest dose, and increase as needed, being careful not to exceed the abovementioned dosage.

Women always ask me if they should take hormone replacement therapy to alleviate their menopause symptoms. My answer is always the same, no matter what the situation: Choose bioidentical hormone replacement therapy over conventional.

Conventional hormone replacement therapy has been shown to have a wide range of risks, including increased risk of breast cancer and heart disease. Why take this risk? Instead, choose more natural forms of hormone replacement therapy, including estriol.

Estriol is produced in the lab from active steroid molecules found in soy. The resulting molecules are structurally the same as those produced in your body. Of the three types of estrogen produced within your body, estriol is the weakest and least potent. Several research studies have found that it is as effective as the stronger, more potent estrogens for treating menopause symptoms. And unlike conventional hormone replacement therapy that may cause fluid retention, headaches, nausea, and the buildup of uterine tissue, estriol has few, if any, side effects.

One study published in JAMA found that estriol was particularly effective in treating vaginal atrophy, mood swings, and hot flashes. Researchers selected 52 symptomatic, postmenopausal women and separated them into four groups, giving each group either 2 mg, 4 mg, 6 mg, or 8 mg of estriol per day for six months. On average, women in every group experienced a decrease in their menopausal symptoms after one month of treatment. Plus, in three of the four groups, women who had ranked their symptoms as severe now felt that their symptoms were very mild.

Talk to your doctor about this safe and effective option for menopause relief