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Dr. Northrup:
Thank you so much. All right. Now Vicky from Ontario, Canada, joins us on the phone. What's your question, Vicky?

Vicky:
Hi, Dr. Northrup. I'm 52 years of age. I've been in menopause since I was the age of 47, and I'm going to a new doctor in another week and I'd like to know what type of tests I should be asking her for regarding my menopausal state.

Dr. Northrup:
Well, first of all, I would ask you, are you having any symptoms whatsoever?

Vicky:
I am. I'm having a lot of symptoms. And I'm not feeling—I'm almost like that lady from Burlington.

Dr. Northrup:
Okay.

Vicky:
And so I'm not feeling very well, and I'm confused and I'm feeling down and all kinds of things. So I really don't know where I've at as far as that's concerned.

Dr. Northrup:
Right. So I would get your thyroid hormone tested. TSH and free T3 and free T4. And I would also get your vitamin D tested. I know we didn't get into this on the show, but a huge number of women are deficient in vitamin D. And it results in all kinds of aches and pains and a feeling of less well-being than you could have. And you're way up there in Canada where there's not a lot of sunlight at this time of the year.

Vicky:
No, there's not. No, there's not.

Dr. Northrup:
So try that. And then a good doctor who works with hormone replacement can often just start you on a low dose of some good hormones and see how you do. It's often not necessary to do the kind of testing that you saw on the show, and the testing is highly controversial. So it's easier, actually, to just start with perhaps a low dose of estrogen, a low dose of progesterone, get your thyroid tested, and that may be all you need. Also, though, I want you to know that menopause is a turning point for your lifestyle. So you need to stop much of the white foods, the sugars, you have to exercise, take some good fish oil for omega-3 fats, and then look at all the relationships in your life. If you're irritated at the things going on in your life, this causes an increase in stress hormones, and the stress hormones change the way your own body's hormones are metabolized.

Vicky:
Okay.

Dr. Northrup:
Does that sound like something you can do?

Vicky:
Absolutely.

Dr. Northrup:
Very good. Okay.

Vicky:
Thank you very much, Dr. Northrup.

Dr. Northrup:
Thank you. Now we have Patty from Johnsburg, Illinois. She's on the phone. Patty?

Patty:
Hi.

Dr. Northrup:
Hi.

Patty:
My question is, I have been on depression meds for 15 years, and how do I know if I have depression or if it's a hormonal imbalance?

Dr. Northrup:
What a great question. Can you give me your age?

Patty:
I am 49 next month.

Dr. Northrup:
Forty-nine. So you've been on antidepressants from the time you were in your 30s.

Patty:
Yes. Mm-hmm.

Dr. Northrup:
Okay. And what were your symptoms in your 30s? Was the depression coming on mostly premenstrually? Or was it all month long?

Patty:
Back in my 30s, it was all month long.

Dr. Northrup:
Okay. And do the antidepressants work for you? Are you feeling better on them?

Patty:
I am for the most part. But I still have other symptoms that I've tried different medications that, you know, have not gone away.

Dr. Northrup:
Okay. And you said you're 49 now.

Patty:
Mm-hmm.

Dr. Northrup:
All right. Sometimes, it's true that the sex steroids—progesterone, estrogen, testosterone—do have an effect on the brain. They have an effect on nerve cells in the brain. And those might be helpful to you to add to the antidepressants. What you don't want to do, and for anyone listening, you don't want to stop antidepressants ever cold turkey. So I would work with your lifestyle. Do you exercise regularly?

Patty:
I try to walk, yes.

Dr. Northrup:
Okay, how much?

Patty:
Maybe three times a week for to 20 to 30 minutes.

Dr. Northrup:
Okay. Up that to five. In mild to moderate depression, exercise works as well as mild antidepressants, just so you know. So that's the data on that. Step up the exercise a little bit. Also, it's very important to get on some good omega-3 fats. Do you take fish oil or flaxseed oil, anything like that?

Patty:
I have recently started taking the fish oil.

Dr. Northrup:
Okay, very good. Very good. I would go to your doctor, discuss with your doctor the idea of perhaps some progesterone. Natural progesterone, widely available in both pharmacies and compounding pharmacies, is very calming in some people. So that's worth a try. But at this point, work with your doctor, and if you do decide to taper the antidepressants, go very, very slowly and work on all the lifestyle stuff. All right?

Patty:
Okay, great.

Dr. Northrup:
Okay.

Patty:
Thank you.

Dr. Northrup:
Mm-hmm. And we just got an e-mail from Elaine in Sanford, North Carolina. And she writes, "Why do I go through cycles of having hot flashes, then no hot flashes, and then after a few months, I go through another cycle of terrible hot flashes and night sweats?" I'll tell you why. It's because during the perimenopause, you get times when the ovaries are, in fact, producing eggs. And you have progesterone sometimes, and then you'll go for three months and you'll stop producing eggs, and the hormones get out of whack again. And that's why it's a process, not an event. You'll also notice that when you're on vacation and you're completely relaxed and you're getting enough sleep and you don't have to go to work and so on, many women get rid of their hot flashes and night sweats. So this is very much in tune with what goes on during the perimenopause. You can, again, stop a lot of those hot flashes if you are willing to stop white sugar and stop wine and even stop caffeine and experiment with it. So maybe no—no wine for a couple weeks, see what it does to the hot flashes, increase exercise, get on those omega-3 fats. That alone may be all you need. But it sounds like everything is happening normally. All right. Linda from Rancho Cucamonga, California, is on the phone. Hi, Linda.

Linda:
Hi, thank you for taking my call.

Dr. Northrup:
Yes.

Linda:
I am 64 years old. I've been on anti—or the—the HRT pill—

Dr. Northrup:
Yeah.

Linda:
For years 19.

Dr. Northrup:
All right.

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