Unlocking the Secrets of Menopause & BHRT
With Dr. Tanya Teggatz, MD
Tuesday, March 4th 2025
DEFINITIONS
Menopause/Post-Menopause: Cessation of menses for 12 months
Perimenopause: The time leading up to menopause lasting 7-10 years
- Normal age for menopause is 45-55, average age is 52.
- Perimenopause can start as early as 35 years old and is considered normal
- Can start even earlier in premature ovarian failure
- Symptoms in perimenopause results from loss ovarian function with resultant decline in estrogen, progesterone and testosterone, missed ovulation and fluctuation in hormones as ovarian function declines
- Terms menopause and post-menopause are used interchangeably
- Once you’ve reached menopause symptoms can last another 10 years or more
LIFESTYLE
Nutrition
- “Eat food, not too much, mostly plants.”- Michael Pollen “In Defense of Food”
- Eat whole, real foods, increasing vegetables, produce and fiber.
- Increasing variety in foods and eating the rainbow
Movement/Exercise
- Strength training is non-negotiable
- Cardio goal 150 minutes/week
- Step goal 10,000 steps/day
Sleep
- Bedtime routine with no screens 3 hrs before bed, no caffeine after12pm max
- Keep bed for sleep and sex only and keep room dark and cool
Stress Management/Purpose/Relationships/Service
- Take inventory
- Seek out your passions, purpose, and community
- Mindfulness, Breath Work, Yoga, Spiritual practices, Meditation, etc
- Acupuncture
Perimenopause/Menopause symptoms
- Hot flashes, warm rushes, temperature dysregulation
- Weight gain especially around the middle
- Fatigue
- Irregular, often heavy periods, skipped periods, longer periods, uncontrolled bleeding
- Loss of libido
- Brain fog and difficulty with memory and cognition
- Mood changes- from mild anxiety, irritability and depressed mood to full blown panic attacks, rage, and suicidal thoughts and attempts
- Vaginal dryness
- Sleep disturbances and insomnia
- Changes in skin texture- lose 50% of collagen in the first 3 years after menopause!
- Pain with intercourse
- Joint pain
- Muscle Weakness
- Hair loss and hair texture changes
- Palpitations
Toxins
- Dysregulates hormones
- Found in food, water, soil, personal care and cleaning products, toothpaste, deodorant, clothing, furniture, receipts, cookware and food storage
- Refer to ewg.org
Supplements
- All women benefit from: Vit D, Multivitamin with Iodine, Omega 3 with EPA/DHA
- Some women benefit from probiotic, higher doses of iodine, DIM-I3C
- Menopausal Symptom specific: Rhubarb extract, Black cohosh, dong quai, Inositol, vitex
CBHRT: COMPOUNDED BIOIDENTICAL HORMONE REPLACLEMENT THERAPY
Compounded: Produced in a compounding pharmacy to create a personalized therapy for each patient without added chemicals, solvents, etc
Bioidentical: chemically identical to hormones produced by a woman’s body
Hormone Replacement: Goals of treatment is to improve immediate quality of life AND prevent long-term negative health consequences of menopause
Safety
- 80+ years of studies on estrogen show safety of estrogen
- HRT is safe, does not cause breast cancer and leads to better brain, cardiovascular, bone health and can lengthen your life up to four years
WHI: Women’s Health Initiative
- Flawed study
- Used oral, non-bioidentical, horse urine source of estrogen called “Premarin” with artificial progestin in late post-menopausal women
- Study DID show statistically significant decreased risk of breast cancer
Benefits
- Bones, brain, cardiovascular, urogenital, muscles, joints, life expectancy
Timing
- <10 years since last period = greatest benefit
- >10 years since last period = lesser benefit and increase risk if cardiac disease present
- Ultimate goal for MOST benefit: start early, continue indefinitely as benefits STOP when BHRT is stopped
MENOPAUSE METHOD
Dr. Rosensweet
- Functional Medicine physician 50 years
- Treating menopausal women with BHRT for 40 years
Hormones
- Topical Bi-Est: Estradiol AND Estriol: they bind to different receptors, both important
- Topical Progesterone
- Oral Progesterone
- Topical Testosterone/DHEA
- Woman titrates to find her ideal dose: takes approximately 3 months to find optimal dose
IMPORTANT LINKS
Link to free download of Happy, Healthy, Hormones book by Dr. Rosensweet:
Link to Dr. Jenn Simmon’s website (Self breast exam, A Smart Woman’s Guide to Breast Cancer book, Keeping Abreast podcast):
Link to mediocremom’s instagram page:
https://www.instagram.com/mediocremom76/
Link to our vendors:
https://www.careprohs.com/services/compounding-pharmacy
Link to our insurance page:
https://theteggatzclinic.com/insurance-information/
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