Diamond Research Foundation a non-profit 501(c)(3)

Understanding Menopause

Understand what it is

Understand why it happens

Understand your options

What is menopause?

When a woman is in menopause it means that she has suffered ovarian failure and her ovaries (organs located in the pelvis that produce eggs) have been depleted of their egg supply and therefore, no longer produce ovarian hormones. After ovarian failure all of the ovarian hormones are below normal levels, which raises the risk of many serious illnesses. The medical term for menopause is hypogonadism (hi-po-go-nad-ism)*. A woman suffering from hypogonadism is at risk for osteoporosis, breast cancer, heart disease, periodontal disease and diminished mental abilities or cognitive (thinking) abilities. If a woman does not receive hormonal treatment for menopause she has untreated hypogonadism.

*Hypogonadism is the medical term for menopause. Hypo- less than or deficiency of, gonadism- pertaining to the gonad or ovarian organ function. In women the gonads are the ovaries which produce eggs and in men the gonads are the testicles which produce sperm.

What causes menopause?

Hypogonadism is not unique to women. The female gonads and the male gonads produce the same hormones, just in different amounts. There is no such thing as a male or female hormone as the gonads, whether female (ovary) or male (testis) produce the same hormones. Lower than normal levels of gonadal hormones can occur in women (menopause) or in men. Whether this occurs in a woman or man, it is called hypogonadism.

Menopause (hypogonadism) occurs when the ovaries are no longer producing ovarian hormones, resulting in lower than normal levels of ovarian hormones. Women who suffer from ovarian failure due to surgical removal, depletion of eggs from aging, or damage by chemotherapy will have subnormal levels of ovarian hormones.

What are the symptoms of menopause?

Menopause results in lower than normal levels of the gonadal hormones. A deficiency of gonadal hormones, also called hypogonadism, causes the entire body to experience poorer health because every organ system in the body uses gonadal hormones to maintain good health. Women and men with hypogonadism experience disrupted sleep, loss of intimate function, fatigue, loss of cognitive function (fuzzy thinking), and oral symptoms such as dry mouth and altered taste. The symptoms of menopause are the symptoms of hypogonadism. Hypogonadism causes diminished health in both women and men.

Limitations of clinical trials

Premarin™ has been the primary treatment for hypogonadism in women since 1942. Clinical trials like the Women’s Health Initiative (WHI) have confirmed that Premarin™ is unhealthy and should not be used for an extended period of time. Prior to the WHI, the National Institutes of Health (NIH) referred to the use of Premarin™ as HRT or hormone replacement therapy. However, since the termination of the WHI, the NIH refers to it as HT, hormone therapy or MHT, menopausal hormone therapy. Premarin™ contains over 200 different hormones, the vast majority of which are native to the pregnant horse from which it is collected via its urine. None of the over 200 hormones were measured in the WHI, either before, during or after this large clinical trial. Studies dating back to the 1970’s confirm that Premarin™ contains very high, unnatural levels of estrogens that do not represent the replacement of human ovarian hormones. Premarin™ is therefore neither replacement nor therapy for hypogonadism. The Women’s Health Initiative proved that this non-physiologic, non-bio-identical hormone regimen is unhealthy for women.

Modernization of treatment

In order to modernize and improve the effectiveness of treatment it is important to understand that replacement therapies in endocrine medicine are successful when they are based on physiologic, bio-identical replacement, restoring what is no longer produced by the body. Treatment with physiologic, bio-identical replacement maintains a person’s health better than any other type of hormone regimen. This is why people with diabetes, hypothyroidism, and growth hormone deficiency, all chronic long term conditions, are all treated with physiologic, bio-identical hormone replacement. Hypogonadism is no different. Acquired hypogonadism, once it occurs, is a chronic, lifelong condition and people are healthier when provided with appropriate treatment.

Treatment of menopause based on physiologic, bio-identical replacement would include the ovarian hormones estradiol (the main estrogen of the ovary and testis), testosterone, progesterone and perhaps the hormone dehydroepiandrosterone (DHEA). Untreated menopause may be considered normal by some but there is no medical text or authority that can or will state that hypogonadism is normal or that it should go untreated in women or men at any time in their life.

Working with your physician

Many doctors do not consider menopause to be a clinical condition that requires treatment. This form of age acquired hypogonadism has culturally been considered to be a normal part of growing older that only requires short term treatment for symptoms such as periodic episodes of profuse sweating. There is mounting data, however that suggest there are cardiovascular and other health benefits to the treatment of profound hypogonadism (menopause) at any age.

Understanding menopause is the first step toward understanding that hypogonadism is healthier treated than untreated.

Here’s to a better and healthier future for all women.