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Your Menopause Type

Menopause Redefined
A New Definition
The inherent dangers and therapeutic failure of a one-size-fits-all model for menopause is evident. When we take into account biochemical individuality, the subtle uniqueness of  biochemical and metabolic processes in each individual, we are forced to reject any hope of finding a "magic bullet" that is for all women. In truth, some women do quite well on the heavily marketed estrogen tablets, or the heavily marketed progesterone creams. Yet equally as true is that fact that many women are harmed when they are subjected to an "estrogen pills for all women" or a "progesterone cream for all women" practitioner.

Looking back, we are troubled to find that women taking estrogen tablets years ago who reported abnormal vaginal bleeding were told to increase the dose. The ability of estrogens to induce endometrial hyperplasia was largely ignored years ago - and cancer was the consequence.

Today I am troubled when I hear women tell me "I told my doctor the progesterone cream was making me fatigued and depressed and was just told to take more of it". The ability of progesterone to induce insulin resistance, or depress the nervous system is largely ignored today. What will the consequences be?

The "one hormone for all women" did not work when we tried estrogen. What makes us think that progesterone is the "one hormone for all women" ? To hold such an idea calls to mind an old saying:

" One definition of insanity is doing the same thing over and over, and expecting a different result."

Sane, compassionate health care mandates that any one-size-fits-all model be rejected. By rejecting a one-size-fits-all model of menopause we are left with a new definition of menopause and a new therapeutic model. In recognizing variant patterns of senescence, we redefine menopause as follows:

"Menopause is a transition that may show up in many different ways.
There are actually 12 different menopause types."

Our therapeutic model is more inclusive:

"Treat each woman according to her own menopause type.
Treatment choices must include lifestyle, nutrition, herbs, hormone
precursors and natural hormones."

How much can menopause vary from woman to woman?
In menopause we now recognize that some women may have low estradiol, while others continue to always have adequate amounts of estradiol. We also recognize that while some women truly are deficient in progesterone, other women continue to always have adequate amounts of progesterone.

We also recognize that while some women have testosterone deficiency, and others have adequate amounts of testosterone, there are some women who have excessive testosterone levels. These variant patterns can persist into the seventh decade of life and beyond.

Understanding the 12 Menopause Types

The Plan
A well planned review of the hormones estradiol, progesterone and testosterone is required to fully understand the 12 menopause types and their unique clinical presentations as well as the morbidity and mortality risks associated with each type. This review will also demonstrate the need for specific therapeutic interventions.

Each of the 12 Menopause types has a unique clinical presentation as well as unique morbidity and mortality risks. Each menopause type has specific therapeutic    interventions that can be individualized for each woman. In addition, each menopause type has specific interventions that must be avoided.

During peri-menopause it is not uncommon to see excessive levels of estradiol, progesterone or testosterone. These erratic spikes of hormones are due to the erratic fluctuations of FSH & LH that are common during peri-menopause.

It is well known that excessive hormone levels are as undesirable as inadequate hormone levels. There is even evidence that periodic rise in hormones that occur during the luteal phase of the menstrual cycle have adverse physiological effects. Thus, luteal levels may constitute excessive levels for the post-menopause woman.

Estradiol, progesterone and testosterone receptors have been identified on virtually all cells of the human body. The far-reaching effect of these hormones on the cardiovascular, nervous, skeletal, digestive, immune and other systems are still being discovered.

The 12 Menopause Types
In menopause there are a number of possibilities:
          Estradiol & progesterone are both adequate.
          Estradiol is deficient.
          Progesterone is deficient.
          Estradiol & progesterone are both deficient.

Add to those four possibilities the fact that Testosterone may be normal, low, or high and we can understand why there are twelve types of menopause.
    Type 1 - Adequate Estradiol, Adequate Progesterone, Normal Testoserone

    Type 2 - Adequate Estrdiol, Adequate Progesterone, Low Testosterone

    Type 3 - Adequate Estradiol, Adequate Progesterone, High Testosterone

    Type 4 - Estradiol Deficiency, Normal Testosterone
    Type 5 - Estradiol Deficiency, Low Testosterone

    Type 6 - Estradiol Deficiency, High Testosterone

    Type 7 - Progesterone Deficiency, Normal Testosterone

    Type 8 - Progesterone Deficiency, Low Testosterone

    Type 9 - Progesterone Deficiency, High Testosterone

    Type 10 - Dual Deficiency, Normal Testosterone

    Type 11 - Dual Deficiency, Low Testosterone

    Type 12 - Dual Deficiency, High Testosterone

Clinical Significance

Each of these Menopause Types has it's own unique clinical presentation, and it's own unique risk factors, based on the deficiency of estradiol, progesterone or testosterone, or excess of testosterone. In physiological menopause, a deficiency of any of these hormones may be contributory to osteoporosis or heart disease. A physiological excess of testosterone may be contributory to heart disease, diabetes and some forms of cancer. Physiological imbalances may also be responsible for hot flashes (flushes), insomnia, fatigue or other symptoms.


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