Bloom TV Gayle Guyardo | Possible Hidden Health Risks From Perimenopause

Coming up on Bloom, find out about the hidden health risks that come with perimenopause.

Little, little chemicals in your body that regulate inflammation. And as they increase, women are experiencing more inflammatory symptoms like aches and pains and weight gain, as well as brain fog.

There are hidden health risks that come with perimenopause, including inflammation, autoimmunity, and cholesterol issues. Here with what you can do about it is Dr. Shilpa Sayana, the founder of Sayana Medical and Wellness Center. It is so great to see you.

So good to see you. Thanks for having me.

So I think a lot of women are under the impression that perimenopause means hot flashes, not getting a good night's sleep. But there are so many other hidden health dangers.

Absolutely. There's so much more than that, because as your estrogen starts declining, your inflammation starts increasing. And they may not even realize the symptoms of inflammation could be brain fog, unwanted weight gain, whereas they're eating and exercising just the same or having sleepless nights or suddenly having joint pain. And during this time, inflammation increases because your hormones are decreasing.

So there is something that we can do about it other than being prescribed cholesterol medication. And this medication.

Yes. And I can't tell you how many times people come in and say, wait, six months ago, my labs were all normal, my cholesterol was normal, my blood sugar was normal. I didn't have any inflammation, and now I suddenly do. And yes, because estrogen is in charge of your immune system, and as it goes down, your inflammation comes up and your autoimmune risk increases. So things such as Hashimoto's thyroiditis, lupus and rheumatoid arthritis all increase. And women just accept this, that I, or maybe this is natural aging without checking and seeing what's really going on.

So hormone replacement therapy, which is really increasing in popularity, more and more women are looking to it. I think it was not so popular because of a very flawed study well over two and a half decades ago. But today, women are really feeling the change. Now, talk to me about the inflammation, because inflammation, from what I understand, is what leads to disease.

Correct. So as your estrogen, also, estrogen is responsible for modulating inflammation. So as your estrogen declines, you have an increase of something called cytokines. And these are like little, little chemicals in your body that regulate inflammation. And as they increase, women are experiencing more inflammatory symptoms like aches and pains and weight gain as well as brain fog.

Now, I know you flew in from the west coast, and we so appreciate when you visit Bloom, but you really go through a lot before prescribing any patient hormone replacement therapy. And what worries me is that people are just getting it online, they're getting it anywhere. And this truly needs to be tailored to each individual woman.

You absolutely. You need to first check your levels and kind of see where you are. And then depending on where you are, you kind of layer in each hormone. And especially if you have high cholesterol, your liver is already burdened. So you have to fix that with lifestyle choices, maybe cutting back on alcohol and sugar and improving inflammation before just blanketly writing a prescription.

Yeah, because people might be over medicated getting medication they don't even need in the first place. So you do it phase by phase by phase.

And who is the vessel that we're putting these hormones into and how are we actually getting these hormones to them? Are they at a place where they can tolerate them?

Yeah, and it was interesting because I know you're also into examining DNA, and my provider does that for me. And when she looked at it, she completely changed the delivery system because she wanted to make sure my liver was processing and to make sure it was safe. So, like with any medication, you have to be working with a doctor like yourself.

You really do. Because you want to know what genetics. So genetics we come in with, we can't change, but we can activate them. And giving someone hormones is something that can activate these genes. So if you have genetics that maybe don't process dirty estrogens very well, these will build up in your systems and call unwanted side effects. Another big thing is do you have genetics that make you hypercoagulable, so easily able to have blood clots? With that kind of patient, you have to be careful with giving them estrogen, because estrogen naturally increases your risk of blood clots.

But once you get the perfect balance, which I feel I have achieved, it is such a game changer. It's really hard to explain to people what a difference it makes in your life from your mood, your sleep, your emotions, everything.

Absolutely can be completely miraculous. And people finally feel like themselves again, and that's just been taken away. And it shouldn't be something that you should really seek out and find the right team who's going to look deeper. Look at your genetics, look at your hormones, look at your gut health. And if you do have things like high cholesterol or autoimmunity, these are 100% reversible without jumping to medications. You could try fish oil, you could try diet, you could try increasing your fiber you can try reducing inflammatory foods like dairy and gluten. All of that will help.

And as you mentioned, you know, a lot of the country, maybe including myself, are a little bit supplement exhausted. And I think that's the other thing of working with a provider.

Absolutely.

You're getting supplements that your body actually needs, and that supports hormone replacement therapy.

Yes. And when we use supplements in our practice, we're like, okay, this is for a certain period of time, maybe we helping your gut back bacteria, killing off bad bacteria, replacing good bacteria with probiotics. And after time, we kind of stop and we really focus on diet and nutrition. Because by the time a woman's on progesterone, estrogen, maybe testosterone, she's like, I'm tired. How many more pills do I have to take? So it's important to be mindful of that. Otherwise, there is a lot of pill fatigue.

Now, when you talk about the delivery system of hormone replacement therapy, some women stray away from the pellets because you can't really reverse that for a few months. And it sounds like you like to layer them in to begin with. So there are different ways.

Exactly. And it's really about, where is the woman at? Is she complaining of, I can't sleep through the night, or I'm drenched with sweat in the boardroom. Oh, I'm just, you know, I'm working out so hard, and I can't see a muscle. So if she's really complaining about the sleep and the mood issues, progesterone is something I would start with. And usually it's oral progesterone or sublingual progesterone. And there is one that's bioidentical and covered with insurance.

Oh, that's good to hear.

Yes.

Because I was gonna get on my soapbox and say how irritating it is that if a guy has sexual arousal issues.

Absolutely.

Insurance pay for it. But if a woman's suffering, you're on your own.

You kind of are. And there is a medication called ADDI that's very unknown. It's a medication that helps with sexual arousal in women. However, you have to. It's not covered by insurance, and it's a medication that you have to watch a webinar for it to get covered, where they finally took that requirement out. But, you know, for a man, the medications can cause a death, and we don't have to watch a webinar.

Oh, my gosh.

Pretty fast.

Very. So true. All right, Doctor, thank you so much. It's always a pleasure seeing you.

Yeah, thank you so much. For having me.

All right, we're going to share Dr. Siano's advice on bloomtampabay.com we will be back with more Bloom right after this.