To Your Health

Q. My mother's menopause was tough on the whole family, but that was 22 years ago. I am only 36, and I hope there are better ways of dealing with menopause by now. Can I prepare for this time of my life?

A. I am happy to report that there have been great strides in the past decade or so in the way we look at menopause. A woman need not suffer when hormone levels change at this time.

Even at age 36, there are changes in hormone output that will be amplified over the next 20 years or so. Most women feel best when their progesterone level is about five times the level of estrogen, and for most women in their 20s this is the case. In their 30s a lot of women begin to occasionally skip ovulation, and the frequency of this increases until around age 55, when most women do not ovulate at all. Because progesterone is produced by the ovary when an egg is released, no ovulation means no progesterone. While estrogen production continues, progesterone levels drop year by year and many women eventually begin to experience hot flashes or the other signs and symptoms of estrogen excess which we know as menopause.

Fortunately, nonprescription progesterone cream is now available. The amount of the cream used can be adjusted to provide 10 to 40 milligrams (mg) of progesterone per day, which may make a dramatic difference in many perimenopausal and menopausal symptoms. To put these amounts in perspective, during pregnancy progesterone production rises to between 300 and 500 mg per day, and interestingly, this is a time when almost all women feel their best. Overuse of the progesterone cream may provoke some breast tenderness or minor fatigue, but otherwise seems to provide only benefits. Be sure to use the progesterone that is identical to the natural hormone. Wild yam cream does not have the same benefits that progesterone has.

Women still having menstrual periods should use the cream only in the last half of their cycle, to avoid lengthening the time between periods. Post-menopausal women should use 1/4 of a teaspoon twice a day every day.

Many of the past claims made for estrogen replacement, such as reduction in risk of heart disease and osteoporosis, are being proven false, but progesterone cream is actually capable of doing what estrogen cannot. In addition, the increased risk of cancer now firmly associated with use of both estrogen and the synthetic progesterone found in ProveraTM makes the appearance of nonprescription progesterone cream truly a blessing.

Progesterone cream is the most recent addition to the list of remedies for the discomfort of hormonal shifts, but there are other recognized nutritional therapies. Women these days know to increase their calcium intake as they mature, but many do not balance the calcium supplement with magnesium. Signs and symptoms of magnesium deficiency are a common observation as women approach midlife, and during that time the usual rule of twice the amount of calcium as magnesium may not hold true. If no diarrhea develops, it is OK to use the same amount of magnesium as calcium or even twice as much magnesium as calcium for a few years.

A vitamin B-6 supplement in amounts of 25 to 100 mg per day has helped many women endure the change of life. Vitamin B-6 is involved with virtually every hormone the body makes, and few multivitamin formulas provide enough for a woman approaching menopause. The progesterone cream, magnesium, and vitamin B-6 supplements also often relieve the common side effects of birth control pills. When using very generous amounts of an individual vitamin, and especially with a high vitamin B-6 supplement, it is prudent to add a good multivitamin/mineral to maintain balance among the nutrients.

There is no longer any need for a woman (or her family) to suffer with the natural process of menopause. An easy "at home" test of saliva hormone levels is available if the initial trials of the nutrients and the progesterone cream do not produce satisfactory results. Read Dr. Christiane Northrup's book Women's Bodies, Women's Wisdom (Bantam Books, 1998) and you can approach your mature years with confidence.