The Beginner's Guide to Natural Living
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Dr. Angela Agrios, ND
My very talented Naturopathic Doctor
She treats a wide variety of conditions
Office & phone appointments available
Los Angeles, CA (Pacific Palisades)

Perimenopause
Naturopathic Medicine Treatment
Interview with Dr. Angela Agrios, ND
My personal naturopathic doctor. Dr. Agrios is in Los Angeles and
accepts office and phone appointments.

Bioidentical Hormone Treatment Reverses Perimenopause
Perimenopause is the normal transition period between when we have regular menstrual cycles and the cessation in menstrual cycles. So another way of saying this is that perimenopause is the time period between fully functional ovaries and when our ovaries are no longer functional and are no longer putting out hormones. Typically, this is going to happen for a woman in her mid- to late forties. It can happen when she’s younger, and it can happen when she’s older. Our ovaries are responsible for the production of estrogen, progesterone, and testosterone. Our adrenals do make a little bit of hormone—they do make some progesterone and some testosterone, and we’ll also get a little bit of estrogen production from the fat cells in our body. But our ovaries are the primary producers of our sex hormones.


Perimenopause Symptoms: Perimenopause Means Less Progesterone
As ovarian function declines, the primary thing that’s dramatically going to stand out in perimenopause is the decline in progesterone. A lot of the symptoms that women have during the perimenopause period really have to do the bottoming-out of progesterone. Any time progesterone is low in relationship to estrogen, we call this “estrogen dominance.” And estrogen dominance can set up many symptoms for women: a woman might start to have a lot of anxiety; she might start to have a lot of irritability or mood swings; she might notice that she’s no longer sleeping well, or that she actually has insomnia. She might have low libido. She might have symptoms that resemble PMS: she might have things that look like breast tenderness, or her periods may actually become too frequent or her bleeding could become very heavy.

Conventional Treatment for Perimenopause Symptoms: Drugs
When a woman has these symptoms, she may go to visit her doctor, and her doctor may end up giving her separate drugs for each of these different symptoms. For example, she may be given a drug like Ambien for the insomnia, she may be given Xanax for the anxiety; she may be given Prozac for the depression—and the problem is none of these drugs are actually addressing the root cause, which is that she has a hormone deficiency or an imbalance. And in addition to not addressing the root cause of the problem, she may actually experience side effects from the medications she’s now been put on.

Conventional Treatment for Perimenopause Symptoms: Synthetic Hormones
Some doctors recognize that these symptoms are related to low hormone levels, or imbalanced hormone levels, and they’ll choose to prescribe synthetic hormones like oral contraceptives and Provera. Oral contraceptives are often used to help regulate irregular cycles, and Premarin is often used to help bring up low estrogen levels, whereas Provera is used to bring up low progesterone levels.


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Natural Medicine Perimenopause Treatment: Bioidentical Hormones
There’s another way of doing hormone replacement, and that’s with bioidentical hormones. Bioidentical hormones are plant-derived and under the microscope, look identical to human hormones. The advantage of using bioidentical hormones is that all of perimenopausal symptoms, and any symptoms associated with hormone deficiency or imbalance, will be alleviated without the side effects or symptoms of synthetic hormones.

Natural Medicine Perimenopause Treatment: See A Naturopathic Doctor
If a woman is experiencing the symptoms I mentioned earlier, or thinks she’s in perimenopause, I recommend that she seek out a naturopathic doctor. A naturopathic doctor can take a thorough history, perform a physical exam, and order appropriate labs. Labs would include blood, saliva, and urine, and based on all that information, a naturopathic doctor can put together an individualized treatment plan that would include a prescription for bioidentical hormones.

Natural Medicine Perimenopause Treatment: Nutrition & Bioidentical Hormones
A typical treatment plan that I would prescribe contains a section on diet, lifestyle, supplements, and bioidentical hormones. In the diet section, I make recommendations that a woman decrease her alcohol, caffeine, sugar, and refined foods. I also advise that she increase the amount of whole, organic foods she’s eating, and that she increase her consumption of vegetables. I also advise that she increase the amount of fiber she’s taking in, and that she increase the amount of filtered water that she’s taking in to half of her body weight in ounces per day. And under the lifestyle section, I recommend that 30-5 minutes of some type of movement occur daily (e.g., exercise)—this is really important to help improve circulation of blood and lymph. In the supplements section, I’ll prescribe B vitamins, I’ll prescribe essential fatty acids like fish oil and evening primrose oil, I’ll prescribe magnesium, and I’ll also prescribe vitamin E. These are essential nutrients for hormone regulation. If a woman has a lot of stress in her life, I’ll also put her on an adrenal support formula to help reduce adrenal fatigue, and if there’s any indication that her liver needs support, I’ll also put her on a liver support formula. Finally, I prescribe a custom formulation of bioidentical hormones. The bioidentical hormones are compacted into a cream base that my patients apply to their skin every day. And after just a few short months, my patients experience a complete resolution of their perimenopause symptoms.

Interview with Dr. Angela Agrios, ND

Also See: Dr. Angela Agrios, ND Naturopathic Doctor Health Series