While working with some of you recently, it became clear that I should write a note on why our estrogen and progesterone need to remain balanced.
Up until menopause, our bodies have been in a natural rhythm. In this monthly cycle, we have been able to allow the lining of the uterus to shed and begin another cycle or to maintain a fertilized egg in a built-up lining of the uterus and allow the egg to become a viable pregnancy.
In addition to this process, you are aware by now of all the other positive effects in your body that estrogen and progesterone create - the opposite of your symptoms of menopause, for starters! These functions are supported by hormone receptor sites throughout your entire body, and provide benefits such as good bone health.
If you still have your uterus, it is essential to balance the growth effects of estrogen on the uterine lining with appropriate amounts of progesterone so that the lining thickness stays within a normal range. An overgrowth due to hormonal imbalance creates a risk of bleeding and/or developing an endometrial pathology. Additionally, other physiologic changes can happen due to an overabundance of estrogen.
Although we must take into account individual differences, there are general guidelines concerning the amounts of estrogen and progesterone to create an effective balance and hopefully avoid overgrowth. Sometimes, overgrowth of the lining of the uterus can happen anyway. If that should happen, it would require ultrasound testing and appropriate follow-up, such as hormonal treatment to shed the lining, an endometrial biopsy, and/or a D & C.
If you don't have your uterus, taking progesterone is still important for all the other affected functions of your body. For example, progesterone helps to stabilize moods, facilitate good sleep, and prevent estrogen dominance. Research has confirmed that supplementation of progesterone is important whether or not you have a uterus (see references in many of the current popular books on menopause). At the other end of the spectrum, too much progesterone can result in an increased incidence of insulin resistance and possible weight gain.
In the peri-menopausal period, you need doses of hormones tailored to control symptoms. But when your body moves into the post menopausal phase, your doses of estrogen, progesterone and testosterone usually need to be adjusted to maintain the right balance for the longer term.
Making sure that your dose of estrogen is balanced with progesterone is something we cover in your follow-up visits and testing. If you haven't addressed this issue with me, this would be a good time for us to sit down and look at the full picture of what you are doing and check your balances.
Take care during this potentially busy time as we move into summer-- and plan some quiet space for yourself each day, even if it's only five minutes!

Jane Kennedy
Nurse Practitioner
Gordon Medical Associates