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EP165 The One About Menopause

Transcript Of Today's Episode

Dr. Martin, Jr.: You're listening to the Doctor's In Podcast from Martinclinic.com. Although we share a lot of practical and, in our opinion, awesome information, what you hear on this podcast is not intended to diagnose, cure, treat or prevent any disease. It's strictly for informational purposes so enjoy.

Hi, I'm Dr. Martin, Jr.

Dr. Martin, Sr.: Dr. Martin, Sr.

Dr. Martin, Jr.: This is the Doctor is In Podcast and this [00:00:30] is Episode 165. Now today, we're actually near the end of 2018 which is just incredible to think about. We're recording this episode, it's towards the end of December less than a week away from Christmas. It just seems like this year ... I remember recording the first podcast of this year, I mean, that's how fast this has gone by.

Dr. Martin, Sr.: Yep.

Dr. Martin, Jr.: Today, what we want to do is we want to talk about something that we get asked a lot via email, a lot of times via live [00:01:00] chat on our website. We see this a lot in the clinic and it has to do with menopause, so today we're gonna talk about menopause and, specifically, what is normal, what's abnormal, and what might be due to something else. That's one of the tricky things with menopause, is you like about the Bermuda triangle or hormones which is the connection that the adrenals, and the ovaries, and the thyroid have, so when any one of those things [00:01:30] get affected the other two go along with it. It's rare that a person that has a lot of menopausal symptoms don't have other issues but we'll talk about that.

The first thing I want to do is if somebody comes in to see you, so they come in to see you and they start talking about menopause. They say, "I'm menopausal and I have these symptoms." What in your head triggers something that says, "Okay, this is more than it should be, this is more than normal, there's something else going on or there's something ... "

Dr. Martin, Sr.: Yeah. Listen, just to make people understand. Women know this [00:02:00] but we're just gonna, we'll give you a little. From the day you ovulate until the day you die, ladies, you need to have estrogen and progesterone. Those come out of the ovaries and those are hormones that you absolutely need to have balance. From the day you have your first period until the day you have your last period, you've got to have estrogen and progesterone functioning at the same level.

Menopause, what is that? Obviously, menopause [00:02:30] is when now you're not going to be secreting near as much estrogen and near as much progesterone, you're not going to have a baby, and you're getting older. It's very, very normal, menopause is normal, it's just stop having a period, it's just simple as that. Your body is lowering its levels of estrogen and progesterone and I have a lot of patients that menopause, they were [00:03:00] praying for it. They said, "I don't want to have anymore menses, I'm tired of that, and blah, blah, blah. I'm praying for menopause,"

I always say this. I say, "Be careful what you're praying for because menopause can be a wonderful thing because, hey, no more periods, blah, blah, blah, ladies, but you better be balanced." If there's any imbalance ... I always say it's almost like you're flying in an airplane and everything is smooth, and then all of a sudden you hit turbulence. Then [00:03:30] you're holding onto the seat, you're going up and down and that's what can happen as a woman's body starts to change. If everything is equal, estrogen/progesterone are equal, smooth sailing, very little turbulence.

They might get the odd [inaudible 00:03:45] flash, they might get a little bit of night sweats at night, but generally they're feeling very good. Their energy is good, they don't have any big changes in moods, and they don't have any belly fat that's coming on or whatever. These are [00:04:00] symptoms that when you know you hit turbulence, in terms of hormones, is when you literally think, for some women, that they've been invaded. Like somebody from outer space has come over and ...

Dr. Martin, Jr.: The body snatchers.

Dr. Martin, Sr.: The body snatchers have come over and taken over their body. They're moody. I mean, they are literally up and down, they can fly off the handle in five seconds. They can have anxiety ...

Dr. Martin, Jr.: That tells you that they've [00:04:30] got a problem with cortisol which we'll talk about.

Dr. Martin, Sr.: Yeah.

Dr. Martin, Jr.: Big time.

Dr. Martin, Sr.: Right. A lot of them cortisol, a lot of them are thyroid symptoms where they're gaining weight. I mean, "Doc, I never gained weight. I always had the same pair of jeans and the same size," and all of a sudden they got belly fat, well that's cortisol but even hair loss. Their hair's thinning out, they're dry, dry, dry, dry, dry, so sexually think about that. Their skin is dry [00:05:00] and their lubrication is something they're missing and sex can become painful for a woman. It's very traumatic, think about that.

Men, what do we got? Men, we don't have anything like that. They said there's such a thing as andropause for a man ...

Dr. Martin, Jr.: Which would be the testosterone issue that a lot of men experience.

Dr. Martin, Sr.: Yeah, yeah, and they can get that.

Dr. Martin, Jr.: Yeah.

Dr. Martin, Sr.: Sure enough, they have symptoms but we're big babies.

Dr. Martin, Jr.: We're not supposed to admit that publicly, that's something that is ...

Dr. Martin, Sr.: But we're woman doctors.

Dr. Martin, Jr.: [00:05:30] That's a code that's been passed down from generation to generation, we're never supposed to publicly admit that. It's ...

Dr. Martin, Sr.: But my wife and your mother knows, and I'm sure your wife knows we're big babies compared to them. Anyway.

Dr. Martin, Jr.: See, science would back us up a little bit because the concept of the man [inaudible 00:05:49], it is a funny thing. There's actually a lot of funny memes or little funny pictures that ... I like to put one up every once in awhile because it's funny. It just says, "Only after the experience of childbirth [00:06:00] can a woman even slightly understand what men go through when they have a fever." We are, we're big babies. We'll be the first to admit that.

Dr. Martin, Sr.: Oh yeah, for sure, for sure.

Big changes, so it depends on, remember now, the cause is imbalance. It's not disease, menopause is not a disease. It is imbalance, it is a fluctuation.

Dr. Martin, Jr.: Which is why menopause, the generic term menopause, in a sense, is a symptom of an unbalance, [00:06:30] like you mentioned, right? It really is ... When somebody has a very unpleasant menopause or really peri-menopause is really what's going on, it tells you they're unbalanced.

Dr. Martin, Sr.: Yeah. Oh, for sure, it's just coming out. Again, just on a little bit of a negative side, when you look at the, just off the top, some of the things that are done, you have thousands, and thousands, and thousands, and thousands of women that are put on antidepressants. They live on antidepressants [00:07:00] for hormonal issues. Really, they've hit turbulence and they are put on ... You hear a knock in the engine and let's turn the radio up because you didn't fix it, you didn't balance out the hormones, and that is a major issue or can be, especially in menopause, where you don't feel good, and your energy is not what it used to be. You're not sleeping, obviously, if you've got ... Think of those symptoms of hot flashes, and night [00:07:30] sweats, and you're hot, you're cold, and the covers are off and the covers are on, and your fluctuation body temperatures, weight gain.

I always tell women, "My goal for you is to be healthy and balanced," and then the patient stops me and says, "Okay doc," "Yeah, and?" "When am I gonna lose weight?" I'll say, "Well, you're hormonal. Your hormones are off balance and that's a big issue when it comes to that. These are all possible symptoms, some of them are caused ... We [00:08:00] always say cortisol is, it's the accelerant. You've already got an imbalance because of estrogen/progesterone and listen, the other treatment, just to come back, one of the things that doctors like to do is to put women on estrogen, and synthetic estrogen.

Dr. Martin, Jr.: That's got a long, bad history.

Dr. Martin, Sr.: Listen, they are warned with their lives, doctors. You've got to be careful with giving out that stuff. They don't necessarily like to give it but they, "What am I gonna [00:08:30] do, I've got to get ..." I'm very careful with estrogen. Usually the problem is you already got too much estrogen. It's not estrogen, per se, it's the imbalance.

Dr. Martin, Jr.: That's something that I think needs to be said or explained because this is something that people have a hard time understanding. They think menopause, they naturally associate I'm losing estrogen, and then they get all the symptoms of estrogen dominance and it's like, "Well, that doesn't make sense. How could I be estrogen dominant yet I have less estrogen." Here's the thing, [00:09:00] what's happening in menopause is they lose the estrogen, as you mentioned, and they don't make as much progesterone.

Estrogen dominance doesn't necessarily have to do with the amount of estrogen you have but only the amount you have in relation to progesterone. You could be estrogen dominant and have less estrogen but you have even less progesterone and so you get estrogen dominant symptoms.

Dr. Martin, Sr.: As you're getting older, you're going to have less estrogen, that's normal, it's part of menopause. You're going to ... [00:09:30] Or peri-menopause you're gonna have less estrogen. That's not the key, the key is how much ... The progesterone is always the one that levels those two out, you've got to have, it's like a teeter totter, you've got to have both. If you're up with estrogen, you're going to be down with progesterone because it's always in relationship. By the way, I don't know if I've ever seen this, and I mean that. I don't know if I've ever seen some woman ... No, I can't say that I have, with too much [00:10:00] progesterone, where they're secreting too much progesterone ... I just haven't seen it so the key is estrogen, the key is balance. These are some of the main, main symptoms that grow.

Dr. Martin, Jr.: Seems like such an increase in peri-menopausal symptoms in women. As you mentioned, there's an accelerant which just makes things worse, which is cortisol. What's interesting is cortisol and progesterone, they are made from the same, they call it the mother hormone [00:10:30] which is a pregnenolone. Think about it. If you always need to make more cortisol, you're gonna do that at the expense of making progesterone so you can imagine ...

Dr. Martin, Sr.: That's why women are so different. Stress hits them so much differently than a man.

Dr. Martin, Jr.: Yeah. Stress in a guy can affect their testosterone levels, and it can affect their insulin levels, and it can do a whole bunch of stuff there, but with women it hits them in that Bermuda triangle of hormones that you always talk about. It accelerates that problem [00:11:00] and then it will make menopause that much worse. There was an interesting study that was done that looked at, basically, the greater amount of hot flashes and the intensity of it and they looked at the cortisol patterns of all these women. Of course, the study's saying it might be more of a cortisol problem.

Dr. Martin, Sr.: Is it more stress than it is ... Is it more stress than it is ...

Dr. Martin, Jr.: It's just that when you're menopausal or peri-menopausal, stress will give you night sweats and hot flashes. [00:11:30] When you're younger, less of that but it will still give you different symptoms, which makes it very interesting. Stress ... Cortisol will make menopause nuclear, makes it that much worse.

Dr. Martin, Sr.: The accelerant.

Dr. Martin, Jr.: Their night sweats are worse, their insomnia's worse, all those things get worse they're going through because of too much cortisol, which is interesting. All right, so we talked about the symptoms, abnormal symptoms in a sense. If somebody comes in, these are abnormal symptoms, right? [00:12:00] What's your approach to this?

Dr. Martin, Sr.: Well, again, I like to look at ... Functional medicine is always looking at symptoms and seeing what is the primary factor because sometimes ... We talked about it. You can have three things really get messed up, your estrogen/ progesterone levels, your thyroid levels, and your cortisol which is coming out of your adrenal glands. By the way, ladies, a lot of women go, "Why am I having trouble, I had [00:12:30] a hysterectomy." You would think everything's gonna be hunky-dory but what has to be taken into account, and women often don's know this because nobody's told them, is that yeah, you might ... Even if you've had a complete hysterectomy, that doesn't mean that you're not secreting any more estrogen or progesterone because your body has Plan B.

Your adrenal glands will take over and make sure that you are secreting. You're not gonna secrete obviously as much [00:13:00] as you used to have but even ... Because a lot of women, they have a partial hysterectomy and they have, because of either endometriosis or they had terrible bleeding, they were anemic, they had polycystic ovarian or whatever, and maybe they saved one ovary and the other one's gone and they ... but, because I've had women say, "Well, if I have a hysterectomy everything's gonna be perfect after that."

What they don't realize is, yeah, but you've got to remember, you've still got [00:13:30] your adrenals and you've still got your thyroid. Your body will still secrete some estrogen and progesterone because you've got Plan B so don't think ... If you're out of balance and you, obviously if you had a hysterectomy you were out of balance, you had way too much estrogen. Compared to your progesterone, that's the cause of any kind it. Any kind of women anatomy, when that thing goes south and they start having trouble it's always estrogen. [00:14:00] Estrogen is the dominating hormone, gives them all sorts of trouble.

Okay, so what do we do? I always look to get them back to balance. I want to lower their estrogen. If it's menopausal, I want to elevate their progesterone levels, we can do that naturally. We look at cortisol, it's a huge, huge factor, we look at the thyroid. If there's thyroid symptoms, we address the thyroid because if you don't address all of it you're not gonna fix it. [00:14:30] This is generally what we do. We look and see what is the major things, what are the major symptoms. We treat those symptoms, we treat the symptoms because they've got to get relief and that's what they're ... They're not coming to see me for any other reason, right?

They come to the Martin Clinic, they want results so we just got to figure out, and sometimes we've got to tweak certain things but, generally, we've got a great protocol to fix the key issue and get that balance back in the hormonal [00:15:00] triangle that we're talking about.

Dr. Martin, Jr.: Yeah, so just to recap that. When you approach peri-menopausal or menopausal symptoms that have gone crazy because of an imbalance in the Bermuda Triangle of hormones, which is basically what you walk about quite a bit. You will address the issues in the Bermuda Triangle of hormones. You'll address the adrenal issues, you'll address the estrogen/progesterone issues, and the thyroid issues.

Dr. Martin, Sr.: Yeah.

Dr. Martin, Jr.: What's interesting is that if they're having ... [00:15:30] Unfortunately, we always talk about this often about how the thyroid, it's kind of like that wack-a-mole game. Remember you go to a carnival and there's that little mole that pops up, you got that sponge hammer and then you're hitting it, right?

Dr. Martin, Sr.: Yeah.

Dr. Martin, Jr.: You never know if you're hitting it or whatever, it just seems to pop up all over the place and these artificial points show up on the board all the time that you're hitting this thing. That's the thyroid. The thyroid is the mole and everything hits it. If you have a cortisol problem your thyroid's gonna get messed up. You have an estrogen problem [00:16:00] your thyroid's gonna get messed up, which is why a lot of times a lot of women think they have a thyroid problems because they do have a thyroid problem but it may not show up on a blood test.

Then we talked about this as well off air and we wrote a newsletter about it a couple weeks ago. This is interesting because it's a visual thing for people. Everybody always think that the hormones, you just make all these hormones, thyroid hormones for example. You make buckets of it and buckets of it all year. [00:16:30] The reality is, the thyroid is so powerful, it is so powerful that if you were to add up the amount of thyroid hormone secreted in a full year, so 365 days, a full year of thyroid hormone in a healthy woman, this is a healthy thyroid, it's about a teaspoon worth of thyroid hormone. It's not much.

The body does not need a lot of hormones, it needs the right amount of hormones, and any [00:17:00] deviation from that ... That's what makes the thyroid so frustrating because, if you think about it, it's only ...

Dr. Martin, Sr.: How do you measure that?

Dr. Martin, Jr.: It's a teaspoon.

Dr. Martin, Sr.: How do you measure that?

Dr. Martin, Jr.: If somebody makes a drop less than a teaspoon they may be so sensitive, and that's the thing. Their levels, they may be more sensitive to it or more resistant to it but even the slightest change of that messes them up so bad they go get tested and the testing is not good enough. It really isn't, at this point.

Dr. Martin, Sr.: You know how many women tell us, "I knew it was my [00:17:30] thyroid." They come in, I go, "Your thyroid's not working properly," and they go, "I knew it." It's amazing, I say, "I already saw five women this morning."

Dr. Martin, Jr.: If you have the symptoms of thyroid, if you have thyroid symptoms your thyroid's not functioning properly. That's the reality of it. You can go get it tested and get these numbers and all these kind of things but the reality is, your body is giving you symptoms of a thyroid because your thyroid's not working. It's not optimal. We always use this term optimal, right?

Dr. Martin, Sr.: Yeah, yeah, [00:18:00] we know that.

Dr. Martin, Jr.: Your numbers could be okay but it's not optimal for you specifically, and so these labs, they use these ranges. Well, those ranges, some of the ranges are ridiculous. For example, testosterone in men. It's like ...

Dr. Martin, Sr.: Wow, isn't it 20 to 1,000?

Dr. Martin, Jr.: Yeah, that's ridiculous. That's ridiculous.

Dr. Martin, Sr.: What if you're at 400? Is that good, bad or ugly?

Dr. Martin, Jr.: Yeah. If a person needs to be at 800 and now they're at 400 the test would say they're normal.

Dr. Martin, Sr.: Oh yeah.

Dr. Martin, Jr.: If it drops 400 points [00:18:30] for that guy he may not feel good at all. Thyroid's the same way. Your thyroid is so finely tuned and it's so powerful you don't need a lot of it so the slightest microscopic decrease in the amount of thyroid hormone you produce will have drastic effects on how you feel. That's why the question, we always say this. This ultimate question is, how do you feel? When it comes to menopause, menopause is really telling you ... If you're having a hard time with menopause, you're an unbalance in that Bermuda triangle [00:19:00] of hormones. You've got to fix those things and then it's amazing what will happen.

All these other symptoms you've never even associated with it, it's amazing what happens.

Dr. Martin, Sr.: Well, think about anxiety/depression, it's so common it's unreal. Come on, people that have never been depressed, now they're not sleeping and they got ... Oh man, oh man. I mean, the cascade of possible ramification symptoms from being [00:19:30] imbalanced. Women become extremely frustrated because generally, and just generally, I don't ... Physicians are not listening. They're not listening. They're testing but they're not listening, and we got to listen because, hey, you got clues and your body's screaming at you, I'm imbalanced, but you've got to listen to that because you've got inside information.

Dr. Martin, Jr.: A lot of times, you know that old TV show, House [00:20:00] MD, where every week was the weirdest, oddest, strangest, never seen medical condition. He's like a medical Sherlock Holmes. The reality is, the body is not that difficult. Most of the time, the body will tell you what's wrong if they're listening, and that's the problem. A lot of times, the body will pretty much say my thyroid's not working and just are people listening to it, right? Is the doctor listening to it?

Dr. Martin, Sr.: The thing is too, and [00:20:30] this has sort of been the motto at the Martin Clinic for years. What trumps lab tests? Your symptoms, right? It trumps it because they're more important. You know your body ... I always tell my patients, "You know your body better than I know it so you tell me, tell me how you're feeling." This is why I'm all into questions because I want to know if they've got inside information. Then people come in and they go, "I got to fill out a questionnaire, you [00:21:00] asked me the same question 10 times." I meant it though. I mean it because I want to know. You're gonna give me some, and then I know exactly. With all the years of experience, both you and I know that. We go in and target because we ask specific questions because those are huge clues.

Same thing with menopause. You're getting symptoms and I go, "Naw, you're not balanced." They go, "My blood work was good. I got this tested and ..."

Dr. Martin, Jr.: Yeah, but they got bad hot flashes, they're not sleeping, they're feeling [00:21:30] anxiety or depressed and ... No, it's an interesting discussion and, again, we do get that question asked a lot of times, but a lot of times they're asking about menopausal questions but that's not necessarily ... That triggered, in a sense, that decreased production triggered a cascade of chemical reactions that now are leading to this but the problem is really in that Bermuda triangle of hormones that you talk about so often.

We talk about that in our metabolic storm program which is now available [00:22:00] for free on our website. That program there is fantastic, it's helped so many women understand their hormones and then also what to do with them. You can get that on our website. If you go to martinclinic.com it's right on our main page.

Dr. Martin, Sr.: I've told physicians to go there.

Dr. Martin, Jr.: Yeah, it's great.

Dr. Martin, Sr.: I said, "You need a refresher course on hormones."

Dr. Martin, Jr.: It's practical, in a sense, because we talk a lot about symptoms and it's a great program. Like I said, it's a free thing, it's a lot of information but it's a fantastic program they can go through. You [00:22:30] can google our website, our home page, martinclinic.com and access that program. Again, we want to thank you for listening and have a great day.

Dr. Martin, Sr.: Thanks for listening to The Doctor is In Podcast from martinclinic.com. If you have any questions, you can reach us at info@martinclinic.com. If you're not a newsletter subscriber, you can head to our website and sign up for free. We also have a private Facebook group that you can join, it's a community of awesome people. [00:23:00] Finally, I do a Facebook Live every Thursday morning at 8:30. Join us again next week for a new episode.