Newbie - Menopause Issues

rachelray

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I am awash in confusing information here and elsewhere and have no idea where to start on my own. So, I'll start small:

I am 1 year into menopause. I'm trying to find a protocol to follow / dr to trust w/ my money and my life after years of increasing but from my perspective vague, shifting symptoms that have curtailed all forward movement in my life. Just a few most recent issues: long term fatigue is a constant, joint and tendon/ligament inflammation, hair loss was much worse a few months ago but comes and goes, I feel some tightness behind my knees when I kneel down which is concerning - edema? - but no edema elsewhere -ect. A few years ago I went to a Naturopath with a focus in bio identical women's hormones and she put me on estriol suppositories and progesterone but it didn't work. The estriol helped the dryness and pain but messed with my overall hormones in a bad way as did the progesterone (oral, 12mg tablets - I understand, now, that this is not the recommended way to take it).

Four questions to start:

Can someone point me to a beginning point with the peat way? All I find are articles about specific issues and substances/foods and their effect in the body. I need help navigating what appears to be a long road with layers of recovery. I have no idea what the sign posts are.

has Dr. Peat addressed 1. progesterone causing fatigue?
I've tried small (20mgs) and large (200mg) amounts of topical progesterone when I was still under the influence of crazy perimenopausal hormones and I think it helped -in a general way I can't explain, it just felt right, supportive, in some way, (maybe just because I was sleeping so well) but it made me really tired, foggy in the mind -this part did not feel 'right' and I gained weight in the middle on it.

2. what to do about vaginal pain if estrogen is out?
I read his book on menopause (but a few years ago) and don't recall anything about this - it doesn't even list vaginal atrophy as a symptom but it is common.

I read a review on MoisturePom on the web that RP recommended this pomegranate ointment - "I heard about it from Dr Ray Peat who says it is the only estrogen supplementation he recommends!" -true ?

I tried something with DHEA in it and my hair fell out even more than before.

Thanks!
 

Giraffe

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Hi Rachel,

I think there is no such thing like ready-made protocol which works for everyone. It's all about doing things that are good for you and avoiding things that aren't. The beginning point is your diet.

I do not know so much about DHEA, but what I understand from what I read in the forum, this is something that works better for men. In females it is mainly converted to androgens (e.g. could cause hirsutism).

There has been a long thread about progesterone viewtopic.php?f=3&t=227&hilit=peatarian+progesterone. Maybe you find useful information there. Do you cycle progesterone use?
 

HDD

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2. what to do about vaginal pain if estrogen is out?
I read his book on menopause (but a few years ago) and don't recall anything about this - it doesn't even list vaginal atrophy as a symptom but it is common.


This is a link to a new supplement that lists a study using dhea vaginally with success.
viewtopic.php?f=3&t=7426&hilit=Pansterone
-- Daily intravaginal DHEA administration at DHEA doses of 3.25-13 mg was able to rapidly and efficiently achieve correction of all the signs and symptoms of vaginal atrophy and improve sexual function and caused no or minimal changes in serum sex steroid levels (Labrie, 2009)

You might want to ask about your hair falling out from dhea in the thread I linked.
 

tara

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:welcome rachelray

Not sure exactly where to point for a start, but maybe include the stickie thread about food in the Diet subforum.
Personally, in most cases, unless there are really clear signs of needing thyroid or progeterone, I tend to favour doing what you can to make sure nutritional and other needs are well met first. Sometimes such changes can make a difference on their own, and even if it doesn't help enough, you need good nutrition to support hormone supplements anyway.
Diet-wise, first up minimise consumption of polyunsaturated fats (PUFAs, esp liquid vege oils, margerines, etc), and favour more saturated fats like coconut oil, butter, and the fat that comes with beef and mutton.
Aim to get a significant proportion of calories from carbs - Peat tends to favour sugars from fruit, juice, milk, honey etc over more starchy foods, and he does not generally recommend much in the way of grains.
Get enough protein - for hypothyroid folk, 80-100g; some people do better with more.some of us don't store glycogen all that well, and eating smaller meals regularly can help keep blood sugars more stable. Low blood sugar can cause unnecessary stress.
Attend to micronutrients, preferably by food, but there may be a case or some supplementation if it's hard to get it all from food. Some of us use cronometer or similar to check whether a typical day's diet covers the bases. Peat recommends a serving of liver weekly for vit A, and oysters for zinc. Some of us supplement some or all the fat soluble vitamins, nicinamide, and some other minerals and vitamins for particular reasons, eg magnesium, other B-vits.
We need regular sunlight, or in the absence of real sun, extra red light.
Sleep is important.
Some regular movement, but not overdoing it on a regular basis.

You can monitor your body temps and pulse to help get an idea of what's going on with thyroid metabolism - eg at waking, half an hour after breakfat, and sometime in the afternoon. Thyroid matabolism can be low for various reasons - eg damage to the thyroid gland, or that the body has downregulated metabolism to better survive hunger or overwork or other stress that can sometimes be modified. PUFAs. can interfere with thyroid metabolism in several ways, so that's a key reason to minimise them.

Optimal progesterone dosage seems to vary a lot. Some women get all they need with ~10 once a day from after ovulation till before menstruation. Others use 100mg or more continuously for a while. I think going by what feels right to you is probably as good a guide as anything - enough to help against bad symptoms without sedating you too much.

I know Peat's articles take a bit of reading, and they are not all terribly explicit about what they advise, but I'd really recommend reading them. Depending on what interests you most, you could start with the ones on fats and/or sugars, or something else, and keep going. Or listen/read interviews.

What you get here on the forum will be varied perspectives - there are some different interpretations of Peat's writing, and also what works for people varies a bit. You can get ideas here, but it still comes back to learning, observing, thinking about your own situation, trying the ideas that make sense to you and noticing how different measures affect you.

Good luck :)
 
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rachelray

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Giraffe; Thank you for the link ! I skimmed through and when I have a little more info under my belt will circle back to it. - I never was able to take progesterone long enough to cycle it.
HDD: Thanks for the link also - pansterone sounds very promising and interesting and I've emailed them for more info
Tara: Thanks for the good suggestions - I do eat very well I think but, probably get more grain and pufa's than RP would think is good. It's hard to avoid these though I try. Cronometer and checking body temp are good ideas that I'll implement. Your last paragraph is true and I'm so discouraged trying to do it myself as I have done for years. I just need help as I simply don't have time to become a nutritionist myself. So, I guessed the other day that I'd find a naturopath to help me discern which tests to do and interpret them and then I would at least have some targets for my further reading. Many thanks to all!
 

Blossom

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rachelray said:
post 93869 2. what to do about vaginal pain if estrogen is out?
I read his book on menopause (but a few years ago) and don't recall anything about this - it doesn't even list vaginal atrophy as a symptom but it is common.
You can try cocoa butter with vitamin A vaginally. I used this myself a couple years ago when I was getting off bioidentical estradiol.
I would melt 2 tablespoons pure cocoa butter in a double boiler and add 20,000 IU of vitamin A (per application-so for 7 applications use 140,000 IU) mix well and form into a cylinder shape. The supplies you would need are: an empty egg carton, aluminum foil, wax paper and a pencil. Turn the egg carton upside down, place aluminum foil with wax paper covering it over the egg carton and use the pencil to press down on the center creating a mold. Pour the cocoa butter/vitamin A mixture in the mold and let it set/ harden in the refrigerator. Once hardened you can cut this into equal pieces. I would store my pieces covered in the refrigerator.
I used this every night for several months and was gradually able to reduce the frequency of use but I certainly needed it intermittently for over a year. I'm not sure if you are definitely already in menopause if you would be able to discontinue this without the vaginal dryness and atrophy returning? I think you could try the cocoa butter with dhea as HDD mentioned instead of vitamin A as well. I used the vitamin A because I had read somewhere from Dr. Peat that it might be helpful but I can't find a link atm. Sorry I'm so late to this thread but if you are still struggling with this issue maybe this will help.
* I actually just used aluminum foil but a forum member pointed out that the wax paper might be a good idea for potential concerns over the aluminum foil touching the mixture.*
 
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rachelray

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Blossom, thanks a lot for the suggestion! This seems easy enough to do. Is that much A ok to apply? Is it taken up into the body generally - ? OR does it stay local?
 

Blossom

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rachelray said:
post 99290 Blossom, thanks a lot for the suggestion! This seems easy enough to do. Is that much A ok to apply? Is it taken up into the body generally - ? OR does it stay local?
The idea of it is to help restore the sex steroids in that area but I would suspect some of the vitamin A could be taken up by the body in general. I searched high and low for where I had read this approach suggested by Peat but couldn't find it! His books are the only place I haven't looked yet. I will continue my search and if anyone here remembers seeing it please chime in :) . I never had any problems with the cocoa butter and vitamin A like I did with the estrogen I applied to that area.
 
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rachelray

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Actually, just did a quick search of Vit A here and it says Vit A reduces estrogen - sorry for my ignorance -isn't it lack of estrogen that causes vaginal atrophy ?-sheesh I hate that term. Thanks again.
 

tara

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rachelray said:
post 99440 Actually, just did a quick search of Vit A here and it says Vit A reduces estrogen - sorry for my ignorance -isn't it lack of estrogen that causes vaginal atrophy ?-sheesh I hate that term. Thanks again.

Hi Rachel,
From Peat's PoV, a lot of published research conclusions about estrogen and progesterone are suspect for a few systemic reasons. This was his area of research expertise. I think these articles are worth reading, if you haven't yet seen them. There are more related articles on his site too.
http://raypeat.com/articles/articles/pr ... ions.shtml
http://raypeat.com/articles/articles/pr ... ries.shtml
http://raypeat.com/articles/articles/ti ... ogen.shtml
http://raypeat.com/articles/articles/es ... ncer.shtml
 
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rachelray

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Thanks Tara. Sorry, what I meant was, the links I found on Vit A here on the forum indicate that taking it opposes estrogen, which I understand RP feels is a good thing (I do have his book on Menopause and rudimentarily understand his research on estrogen (bad) and progesterone (good)), and lowers libido. I just wasn't clear then how Vit A will help with vaginal atrophy - which I thought was due to declining estrogen in the tissues. Blossom had said that it helps to restore the sex steroids in that area, which I thought was primarily estrogen for this particular symptom (though I get that sex steroids might be a complex of different ones). I was just asking..

I have tried Estriol suppositories and it helped immediately and fantastically with the vaginal issue but I felt that it was taken up systemically (even though they said it would not be) and led to a cycling of some of the negative symptoms of estrogen for me. So that wasn't good and I decided to stop.

I looked again through the links you sent, searching for "vaginal" and nothing came up about atrophy and I didn't find this symptom in his book which I still have and haven't found much on the forum about it either (though the commenters to my initial question did point to some good links and ideas- -and nothing specifically from RP about it that I could find, but, there must be something out there somewhere from him I would think as it is such a common issue.

I have tried taking progesterone -12mg tablets (x1) and various dosages of the cream up to 100mgs and all of it made me very very tired and the after effects took some time to cycle out of my system so I've been wary of trying it again, even though I wish I could the way RP talks about how good it is. My naturopath who recommended the tablets, when I told her they made me tired, simply said "ohh. Well just stop taking it then and continue with the Estriol suppositories" which I interpreted to mean that I did not tolerate Progesterone for some reason. I did not go back to find out what else she might recommend. I can't seem to find any info about *why* Progesterone makes some people so so fatigued either. Just that it does. I also put on weight around the middle on it, which seemed like a sign something was not happening correctly with my systems at that time on Progesterone. Progesterone never helped with the atrophy and pain of intercourse. So, not sure what to do. I was just curious then, about the Vit A and why it works given my experience that it is estrogen that seems to be deficient for me... and that Vit A seems to decrease estrogen.. Thank you for your time!
 

tara

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Hi Rachel,

rachelray said:
post 99457 I just wasn't clear then how Vit A will help with vaginal atrophy - which I thought was due to declining estrogen in the tissues.
I guess I don't know enough about vaginal atrophy. Where does the idea come from that it is the result of low estrogen? I was perhaps incorrectly guessing it might have come out of some the many dodgy studies. As far as I can tell, the normal pattern for most women with aging and menopause is for estrogen in most tissues to increase (though this may not be measured by a blood test), and for the ratio of estrogen to progesterone to increase.

My understanding, from Peat, is that there is a role for estrogen, but it is brief and occasional, just to kick some particular processes off, and then it needs to be quickly counteracted by enough progesterone.

Some creams and suppositories have substances in them that oppose the effects of progesterone - don't know if yours do, but you could check their ingredients.

Peat has also talked about the possibility that sometimes too small a dose of progesterone will be enough to get the estrogen out of tissues and into circulation, but not be enough to oppose it thoroughly.

Progeterone can be anaesthetic for anyone in large enough doses, and how much is too much varies. Reducing stress hormones can also feel like fatigue if one is accustomed to running on stress hormones.

I think you are probably right that some of the supplementry estriol could get into general systemic circulation.

How is your overall metabolism?

Are you eating enough? Have you checked that you are covering basic nutrient needs?

Did you see this from Haidut about DHEA?:
haidut said:
post 93675 -- Daily intravaginal DHEA administration at DHEA doses of 3.25-13 mg was able to rapidly and efficiently achieve correction of all the signs and symptoms of vaginal atrophy and improve sexual function and caused no or minimal changes in serum sex steroid levels (Labrie, 2009)[/list]

I think if the progesterone was making you feel worse, that's pretty good grounds for discontinuing it, at least for a while.

Since Peat doesn't seem to have written much about vaginal atrophy, maybe this would be a good question to ask his opinion about (including what you have tried, etc).
 
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sweetpeat

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tara said:
Progeterone can be anaesthetic for anyone in large enough doses, and how much is too much varies. Reducing stress hormones can also feel like fatigue if one is accustomed to running on stress hormones.

I was thinking along these lines as well, that the progesterone is lowering stress hormones but metabolism is low.
Rachelray, have you been able to start tracking your temps and pulse?
 

Blossom

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I had the same experience with vaginal estrogen cream. It really did work but the side effects were awful. That's when I stumbled upon the vitamin A suppository idea. My understanding is that it helps our body make whatever it needs by providing the raw materials.
Perhaps I shouldn't have posted on this since I'm thus far unable to find the original source. Anyway I apologize and I hope you are able to find a solution to this issue.
 
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rachelray

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Hi Blossom; I greatly appreciate your suggestion ! Since every one is so different I was just try to understand the mechanism so I could (try) to discern if it would be right for me-- you know how crazy-making a loop can be when it's not the right thing for you. It can take forever for things to settle down again and they may not land in the same place you started. So, I wasn't opposing what you said, just trying to understand is all. It sounds very promising and in a way the least disruptive possibly. I couldn't find liquid A in my local store so am waiting to hear back from haidut if I can get samples from him/her/them.

Sweetpeat: I haven't yet started to track and I didn't know about tracking pulse. I can't find my thermometer. It's here somewhere.
My fatigue is lifelong but with Progesterone it is much worse along with weight gain and edema. To complicate things, I was trying it about 9 months ago when I may have still perhaps been under the influence of peri-menopause which was positively awful - much worse than menopause. It was then that I really experienced what I came to understand were the bad effects of estrogen dominance (sleep, skin, worse fatigue, hair, mind fog etc). I've been scared to try it again because of the loops I mentioned above. I just wanted to have a little more to go on somehow - tests or something. Something concrete to measure before I dive in randomly and desperately. It impacts my ability to work.

Tara: I eat well and plenty I believe. Don't eat red meat but believe covering basic nutrient needs. I think my metabolism is good. Don't have a weight issue really (if that's indicative of metabolism?)

Your "too small a dose of progesterone will be enough to get the estrogen out of tissues and into circulation, but not be enough to oppose it thoroughly.." Yes, I'd heard that elsewhere as well and that the way to deal with that was to megadose on Prog. I applied 100mg 2x daily (according to them not really mega dosing) for a while and I think it did oppose the estrogen. I think that's why it felt good in some ways. But, I was still very tired and the weight gain / edema. Maybe I just didn't do it long enough. But it didn't help with the vaginal thing.

The estrogen treatment for vaginal atrophy I think I got from Dr Lee's book and elsewhere on the web. But, most importantly from experience.
I wasn't sure that Peat had not written about this but that seems to be the case, so, thanks for the suggestion to write to him about it.

Thanks to all for your time and attention and suggestions! I'll report back if I sort it out. Sincerely, rachel
 

tara

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rachelray said:
post 99555 Tara: I eat well and plenty I believe. Don't eat red meat but believe covering basic nutrient needs. I think my metabolism is good. Don't have a weight issue really (if that's indicative of metabolism?)

I think people can have low metabolisms at low, medium and high body fat - they all show up here - it can get people different ways. I'd guess maintaining stable weight at about 2300+ for a ~menopausal woman who is moderately active (not an athlete) might be a good sign. Body temps and resting pulse are also good indicators, and other symptoms. Low thyroid/metabolism can sometimes go with other hormones getting out of whack.

Another thought about progesterone: I think it can cause increased salt loss, so I wonder if that could be at play with edema etc. If you decide to give it another go at some stage, you could try eating a bit more salt too, and see if that makes a difference.
 
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Giraffe

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Blossom said:
post 99517 Perhaps I shouldn't have posted on this since I'm thus far unable to find the original source.

Was it this one?

From PMS to Menopause Female Hormones in Context

THE CERVICAL CANCER SCARE AND OTHER APPROACHES TO CANCER
Many women with abnormal Pap smears, even with a biopsy showing the so-called "carcinoma in situ," have returned to normal in just two months with a diet including the following: 90 grams of protein, 500 mg. of magnesium as chloride, 100,000 units of vitamin A, 400 units of vitamin E, 5 mg. folic acid, 100 mg. pantothenic acid, 100 mg. of B6 and niacinamide, and 500 mg of vitamin C, with progesterone and thyroid as needed. Liver should be eaten once a week, because of its high B-vitamin content. Some of the women apply vitamin A (not carotene) directly to the cervix.
 
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tara

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Giraffe said:
post 100701 5 mg. folic acid, 100 mg. pantothenic acid, 100 mg. of B6 and niacinamide, and 500 mg of vitamin C
That's interesting, higher folic acid than is usually considered safe for regular use, much higher B6 than Peat usualy recommends (10mg as a large dose), and I have not seen Peat recommend vit-C often. I guess his views on some of these may have changed since he wrote that, or they are very specific recommendations for cervical cancer issues.
 
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Blossom

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Giraffe said:
post 100701
Blossom said:
post 99517 Perhaps I shouldn't have posted on this since I'm thus far unable to find the original source.

Was it this one?

From PMS to Menopause Female Hormones in Context

THE CERVICAL CANCER SCARE AND OTHER APPROACHES TO CANCER
Many women with abnormal Pap smears, even with a biopsy showing the so-called "carcinoma in situ," have returned to normal in just two months with a diet including the following: 90 grams of protein, 500 mg. of magnesium as chloride, 100,000 units of vitamin A, 400 units of vitamin E, 5 mg. folic acid, 100 mg. pantothenic acid, 100 mg. of B6 and niacinamide, and 500 mg of vitamin C, with progesterone and thyroid as needed. Liver should be eaten once a week, because of its high B-vitamin content. Some of the women apply vitamin A (not carotene) directly to the cervix.
Thanks for finding that quote Giraffe. That isn't the one I was thinking of but I appreciate your help!
I packed up all of my home office including the notes I'd made on Peat's work several months ago because I'm trying to sell my house. It's probably in a box somewhere. :oops: :shock:
 
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