A QUESTION OF BALANCE - Adequate levels of balanced hormones are three-quarters of the battle.
Diana Schwarzbein and other leading researchers show us how balance plays a powerful role in womens’ wellness and disease prevention.
Dr. Terlinsky is a Shwarzbein-certified (SRP) Level-1 Practitioner.
The “Schwartzbein Principle” rests on a basic premise: the body is a system of systems; and when one system becomes out of balance, the others are affected. While all degenerative diseases (including aging) can lead to great imbalances, even slight ones can impact a woman’s general feeling of wellness - and her functionality. Woman is unique in that her hormonal levels are shifting from puberty on. Her systems are fine-tuned, so that common factors (diet, toxins, stress, etc.) can magnify these shifts, and place her in distress.
Doctor Schwarzbein gives us 4 categories of testing to monitor virtually every aspect of your physiology: metabolic, reproductive hormones (menopause), thyroid, and physiologic. Through testing in these areas we develop your comprehensive, individualized assessment; a detailed physiological mapping that helps us develop your personalized treatment plan. There are other factors as well, including test, questionnaires, and relaxed one-on-one sessions with Dr. Terlinsky. What you have to say is important to us, because no test can adequately explain what a woman is feeling!
Metabolic Testing: analyzes your insulin resistance and adrenal (gland) functions. While often compromised by age and/or lifestyle, these are usually restorable, through changes in diet, and/or lifestyle.
Menopause
Menopause is what happens when the ovaries shut down and production of sex hormones drops drastically. (altho a few estrogens may continue production within fat cells) Menopause generally occurs between the ages of 35 and 45, or, approximately the same age as your mother. Early onset (1-2 yrs) may occur in tobacco smokers, women who live in high altitudes, and women who have never been pregnant.
Whenever it does arrive, menopause signals serious changes in a woman’s life, including general decline of energy and vitality, sexual libido, body composition, mood; and a host of other symptoms from hot flashes, to anxiety attacks, to memory loss. While men go through their own “mid-life crises,” they are spared these levels of physical and emotional distress.
We are highly sympathetic to our patient’s needs (some of us are women too!) and our objectives are to alleviate your suffering while minimizing the risk of long-term (or short-term) side effects.
Most of us are familiar with the benefits of hormone replacement therapy (HRT) and hopefully with the risks involved as well. In the end, each woman has to make the choice for herself whether to use HRT, based on her level of distress, her physical condition, family history, and so on. Our goal is to help you understand and weigh the risks, by providing balanced facts and opinions from both sides of the HRT issue - so that you can make an educated choice. (See “BIO-IDENTICAL HRT” in the next article.)
Based on our (Schwarzbein and other) training, we adhere to the following concepts and guidelines concerning Hormone Replacement Therapy:
Use only hormones that are bio-identical to those produced in the body. These are naturally occurring estradiol and progesterone - both of which are widely available in a pure, bio-identical form.
Use them judiciously, only when deficient or absent. Experiment with dosing until normal levels can be reliably duplicated
Approximate normal physiology by re-establishing cycle (and menses). This is accomplished by cycling the hormones, just as the body does.
Monitor the hormone levels and their effects. We analyze blood - not saliva - to track the effects of HRT and adjust dosages as needed to maintain a natural balance.
You may be aware that most gynecologists prescribed HRT (prior to WHI) according to a practice called “continuous combined therapy” (which essentially mimics pregnancy). The therapy featured the heavily marketed PREMPRO (TM Wyeth) product made of potent Premarin (conjugated pregnant horse urines) and Provera (medroxyprogesterone acetate) - the same combination used by the vast majority of Women in the WHI studies.
If you wonder why thousands of physicians never bothered to mimic female body’s natural cycles, the answer is simple: they did! Cycling was the standard for years. The move to continuous combined therapy was a gauged response to persistent complaints and patients’ unhappiness with restored periods - plus bloating and irritability to boot. However, instead of trying the bio-identical approach, physicians and researchers experimented with Premarin/Provera combinations until they hit upon the “continuous” tactic: in essence rendering women pregnant for years, on a cocktail of powerful equine urines and other chemicals. Somehow, the (WHI) long-term health risk findings did not come as a surprise.
Perimenopause
This is where it begins: the earliest rumblings of menopause; call them harbingers, or premonitions. The onset and intensity varies from woman to women. Some women sail through a gentle puberty to settle into an equally benign monthly cycle, continue thusly until their 45th year, at which time everything comes to a screeching halt. Others may begin to decline ten years earlier, but proceed at a slow, halting pace: normal one month, erratic the next. Most fall somewhere in between. There is broad spectrum of possibilities for perimenopause-menopause, and where you fit in is determined partially by genetics, partly by your environment, partly by your behavior, and the rest by chance.
Perimenopause is also manageable. Some women receive excellent symptom relief using low-dose birth control pills, with an estrogen content of about 20 mcg. In addition to birth-control, it corrects irregular bleeding and helps with hot flashes and night sweats - also reducing the risk of ovarian and uterine cancer. Low dose BC can also aid the transition to hormone replacement therapy after menopause.
It follows that some women barely notice perimenopause - if they happen to be using contraceptives when it occurs. This is because contraceptives release estrogen and progestin. (to “fool” the body into “thinking” it’s pregnant, thereby preventing ovulation).
You are Unique - So is Your Program
Hormone replacement therapy is a serious step, and it mustn’t be taken lightly. You can’t “play it by ear” and rub in some cream, then see how you feel. Our initial evaluation provides a safe starting “window” from which we proceed to “fine tune” your hormone levels. We track your blood hormone levels periodically along with other blood chemistry, bone, lipids, blood pressure and the condition of your uterus to make sure you are receiving optimum levels of hormones at the proper times. In other words, your program is personalized to your needs alone, and no other person’s dosages (with the possible exception of an identical twin sister!) will apply to you.
Thyroid Highs and Lows
The thyroid is a small gland with a big role in the control of your metabolism. Hormones secreted by the thyroid (T3 and T4) are called the “building hormones” because they control the production of key proteins in your body (e.g. neurotransmitters, enzymes, hormones, cells, muscles and bones).
An insufficient level of thyroid hormone is called hypothyroidism - which may result in symptoms like fatigue, depression, weight gain, irregular period, constipation, aches and pains ... because of insufficient thyroid hormones you cannot rebuild or use sugars and fats efficiently, also negatively impacting your other hormones. Fortunately, the condition is quite treatable, once diagnosed.
HYPERthyroidism - the overproduction of thyroid hormone - is a bit more complicated. Common symptoms include sweating, anxiousness, heat intolerance and unexplained weight loss. The condition has a variety of causes, some very serious. Treatment should be prompt, and must be individualized, as it may require radiological and/or surgical intervention.
Thyroid testing may be included in our programs when conflicting symptoms necessitate ruling-out thyroid - to continue diagnostics of other hormonal or metabolic issues.
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