Moira Fitzpatrick, Phd ND
May and June are the times of the year when I think about honoring women and men. We are different biologically as our hormones determine our physical characteristics and expression. Spiritually there may be a divine masculine and a divine feminine that we all embrace individually, as we incorporate masculine and feminine qualities into our lives. I suggest that Divine Masculine and Divine Feminine are not gender specific. Some characteristics that are described as masculine include being action oriented, logical, strong, aggressive, externally focused, involved in doing. Some feminine characteristics include sensitivity, compassion, receptiveness, being, peaceful, nurturing. Each of us expresses both energies in our own unique individual way. We are the same as each of us open to love, be it friendship, a brother or sister, a romantic expression, a destiny that shakes our foundation and opens each of us to who we are.
Women are cyclical beings in sync with the moon, the seasons, the ebb, and flow of the tides. It is our hormones that connect us to our cyclical nature. Attunement to the menstrual cycle is the source of our power as it connects us to ourselves.
Men have cycles as well. Testosterone levels are often higher in the morning. The seasons can affect hormones, although most men are not attuned to these subtle changes in their hormones.
The time in life where both women and men experience a more abrupt change in hormones is the peri-post menopause journey for women and andropause for men. Perimenopause typically begins for a woman in her mid-40’s and ends in her early 50’s. Andropause typically affects men in their late 40’s and early 50’s.
Perimenopause begins with variation in the menstrual cycle of greater than 7 days. It is a time of fluctuating hormone levels that can be felt like “perpetual PMS”. It can also be a time of emotional turmoil as your children are leaving home. It is a time when women need to mother themselves and become a priority. When women enter this time of life stressed, the journey through menopause can be more tumultuous. This transition is also an opportunity to evaluate your health and consciously choose how you want to create this next chapter of your life.
Early perimenopause is a time when progesterone is gradually declining which affects the estrogen-progesterone balance. Signs include irregular periods and often excessive vaginal bleeding, bloating, mood swings, and weight gain.
Later perimenopause is marked by a decrease in estrogen. Women often experience night sweats and hot flashes accompanied by increased heart rate, tingling, and feeling chilled. A woman may grow fibroids, experience urinary tract infections, dry skin, bone loss, insomnia, and loss of sexual desire.
There is individualized support for women going through the perimenopausal journey. Adaptogenic herbs such as Lepidium Peruvianum (FemenessencePro-Peri) and herbs to support the second half of your cycle such as Vitex (Chaste Tree) can be beneficial when prescribed by a health care practitioner. You can support yourself through a food program based upon whole foods, regular physical activity, sleep, rest, and setting boundaries to protect your self-care.
Individualized support for later perimenopause is available through herbs for hot flashes, such as Sibiric Rhubarb, or you may consider the option of bio-identical hormones. When a woman wants to take Bio-Identical hormones, I recommend a comprehensive assessment including physical exam, labs, lifestyle, review of risks and benefits and each woman’s goals and preferences.
The North American Menopause Society in their most recent statement, 2022, indicate that hormone therapy is the most effective treatment for vasomotor symptoms (hot flashes), prevention of bone loss and genitourinary syndrome of menopause. Treatment should be individualized to maximize the benefits and minimize the risks, with reevaluation during therapy. The benefit-risk ratio is favorable for women younger than 60 or who are within 10 years of menopause.
Genitourinary Syndrome of menopause is the most prevalent and preventable problem for post menopause women. Signs include vaginal dryness, burning, irritation, dyspareunia, urinary symptoms of urgency, burning, and recurrent urinary tract infections. Treatment includes botanicals (intravaginal Pueraria mirifica gel), intravaginal estrogen or DHEA.
Andropause is that time in a man’s life when his testosterone levels gradually decline. Reduced testosterone is related to increased adiposity, reduced muscle and strength, decreased bone mineral density, erectile dysfunction, depression, fatigue, and poor concentration. Testosterone replacement therapy has a good safety profile in men with lower levels of testosterone. It has beneficial effects on bone density, muscle and strength, plus increasing libido, and energy. There are multiple studies indicating that men with cardiovascular disease demonstrate significantly lower testosterone levels and higher estradiol levels, suggesting an imbalance in testosterone/estrogen. As is the case with women in menopause, testosterone replacement therapy needs to be individualized for each man, considering his risks and benefits, physical exam, labs, and evaluation of his lifestyle.
There are herbs that will support men’s hormone health as they age including Maca root and Chrysin. A popular herb today is Eurycoma longifolia Jack, known as Tongkat Ali, is native to Southeast Asia. It is known traditionally as an aphrodisiac. One mechanism of action is it reduces leptin levels, with a concurrent increase in testosterone. However, there are no human clinical trials as to its effectiveness. It is also noteworthy that this plant is endangered.
Men can improve their health through lifestyle including an anti-inflammatory food program, regular daily exercise with resistance training, and quality sleep.
As we age, we become wiser, have a deeper knowledge of who we are and can if we choose, to create a life that supports our health on a mind, body, and spiritual plane. This begins with reflection and deciding how we wish to age, creating a lifestyle that supports this intention, seeking the support to actualize this lifestyle and creating a purpose that brings meaning into this chapter of our lives.