Conditions that Increase in Risk with Perimenopause and Menopause

•Cardiovascular Disease and Stroke•Osteoporosis•Dementia and Alzheimer’s Disease•Arthritis•Autoimmune Disease

Health During A Woman’s Life

30 35 40 45 50 55

Age

Unh

ealth

y

H

ealth

y

PERIMENOPAUSE

Symptoms of Estrogen Decline

• Hot flashes• Vaginal dryness• Changes in skin tone• Depression• Poor concentration

and memory• Irregular periods

• Hair loss and thinning• Pain and

inflammation• Weight gain• Decreased memory

and cognitive function• Dysglycemia

Typical Management of Menopause

Changes in pro-inflammatory activity after menopause

There is now a large body of evidence suggesting that the

decline in ovarian function with menopause is associated with

spontaneous increases in pro-inflammatory cytokines.

Conditions that Increase in Risk with Perimenopause and Menopause

•Cardiovascular Disease and Stroke•Osteoporosis•Dementia and Alzheimer’s Disease•Arthritis•Autoimmune Disease

Why do some women have a smoother process than others?

• When the female hormone production starts to fluctuate the adrenal system is supposed to take over.

• The adrenal gland produces a hormone (androstenedione) that gets converted to estrogen in the fatty tissues

• If the adrenal system is strong, it compensates the loss of estrogen and the transition is smooth

What if the Adrenals are weak?

• There is no compensation for estrogen loss• this will lead to hormone fluctuations in the

body• all the typical symptoms will occur.

Symptoms of Estrogen Decline

• Hot flashes• Vaginal dryness• Changes in skin tone• Depression• Poor concentration

and memory• Irregular periods

• Hair loss and thinning• Pain and

inflammation• Weight gain• Decreased memory

and cognitive function• Dysglycemia

In addition potentially devastating mechanisms are getting activated:

• There is six factors that cause systemic inflammation in Perimenopause

• Those factors potentiate each other and have devastating effects on cell aging and tissue breakdown

• Hormone replacement is not addressing those mechanisms since they stay active once triggered

First mechanism:

• If there is a decline in Estrogen levels (specifically estradiol) in a female patient in premenopause, the inflammatory cytokine system is up-regulated and may stay up-regulated EVEN AFTER ESTROGEN LEVELS ARE RESTORED.

• Depending pre-existing inflamed areas in the body this up-regulation will determine which systems are most impacted by this process.

Preixisting Activity?

• Immune activation (which can lead to autoimmune diseases)

• Neuro-inflammation (which can lead to dementia, and many other neurological conditions)

• Free Radicals (increased cancer risk)• Higher stress response (individual loses ability

to cope with stress)• Body fat (produces inflammatory agents)

Second Mechanism