The Next Chapter: Peri-menopause and Beyond, Part II

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Read Part I here:

 Peri-menopause can be quite the roller coaster, but thankfully there are options to help smooth the ride. My approach is to start with gathering information, so I’m not only addressing individual needs but also working to address the cause.

Peri-menopause is the process of the ovaries going into “retirement,” no longer producing estrogen and progesterone. Why is this fairly easy for one woman but a miserable process for another? Health is complicated and multifaceted, meaning there are often many things contributing to what we experience. My goal is to understand as many pieces of the puzzle as possible in order to assist in re-discovering health on all levels.  

An important part of gathering information and putting the pieces of the puzzle together is accomplished by ordering labs. Depending on what is ordered, these provide valuable information regarding overall health along with detail about hormones and contributing “players” like the thyroid and adrenals.

There’s a variety of lab options, from standard to more specialized. I like to start with the basics and then continue to dig with more specific testing depending on the need. Here are examples of what that might look like:

Standard serum labs

These are a blood draw, billable to health insurance and can be as simple as a CBC and comprehensive metabolic, which provide information about basic immune status, possible anemia, liver and kidney health, as well as electrolytes. There are also more specialized options such as a thyroid panel and labs to assess metabolic status and inflammation, which are important in assessing overall health.

Specifically for peri-menopause, labs such as estrogen, progesterone and FSH can be ordered as well as testosterone and DHEA-S (supporting players).

Salivary labs

These fall under the category of a specialty lab and are not generally covered by health insurance but are reimbursable via an HSA account. These are used to assess sex hormones (estrogen, progesterone, testosterone, DHEA-S) but can also assess adrenal health with 4-point cortisol measurements. Adrenal health plays an important role in the ease or lack thereof as a woman transitions into menopause. If someone is utilizing hormone therapy, depending on the form being used, salivary labs can be a good option for monitoring treatment. Saliva collections are also a great alternative for those that struggle with blood draws.

Urine-based labs

The lab I use is called DUTCH Complete and is also considered a specialty lab, not covered by insurance but also reimbursable via an HSA. This lab is unique in that it measures urinary metabolites of hormones such as estrogen, progesterone and testosterone but also assesses adrenal health. Measuring metabolites provides valuable information regarding how well the liver is processing and eliminating hormones. These details can be very helpful when assessing treatment options.

It’s important to understand available options when considering ways to approach peri-menopause, so I hope this information is useful! Stay tuned for Part III  (you can read Part I in the May issue of Tigard Life or at, and know I’m always here to help.

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