One of the most common complaints driving women to my Evanston office is the complaint of feeling anxious and crazy toward the latter half of the patients' cycle.
This can also be seen in newly menopausal women as well.
Often patients relate the difficult they have in falling or staying asleep, the irritability or short fuse they feel, especially towards family, and the weight gain in their mid-section.
This new feeling is disquieting and can make woman feel as though they are losing the self they have always known to a new, less desirable self.
What is actually happening is the balance of estrogens to progesterone is shifting and contrary to popular belief, the estrogens are in excess relative to the progesterone. This is one event that can increase anxiety as progesterone is one of the most potent anti-anxiety compounds produced.
Another event that seems to be occurring is the autonomic nervous system often appears to be in stuck in "fight and flight" and the patient feels stressed even when there is nothing to stress about.
The development of IR or insulin resistance seems to intensify around menopause for many women. IR can snowball creating more insulin with a given amount of carbohydrates, which leads to hypoglycemia and then more carbohydrate cravings.
A common question is one regarding the excessive estrogens as the common wisdom is that women stop making estrogen as they approach menopause. This is not true. While cycles may be anovulatory, peripheral conversion of cholesterol into estrogen using the aromatase pathway can be very active.
My patients will tell me they had their levels checked and there is no estrogen, but the lab work they bring in only shows the estradiol or E2 level. The aromatase pathway produces E1 or estrone. Estrone must be degraded into metabolites and depending upon the toxin burden of the liver, the metabolites might be very active and stimulating for tissue growth.
I always perform a complete hormone profile on my patients to get the real picture. Excessive estrogens or their metabolites can be tampered by supplements that help the liver degrade the hormone and by supplements that decrease the activity of the aromatase pathway.
Bio-identical progesterone can be helpful towards the end of the cycle at night for proper balance and sleep restoration.
Reflex biofeedback can be a life saver when it comes to resetting the autonomic nervous system and getting the patient out of the "fight and flight" pattern. I use SCENAR for this with excellent and immediate results.
Sound nutritional support with some simple but powerful dietary changes can make a huge difference in controlling the insulin resistance that often develops, bringing back the waistline and confidence of any patient.
