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Dr. Ayla Wilson, Naturopathic Physician

By Dr. Ayla Wilson, Naturopathic Physician at Bloom Family Wellness Centre.

Women who give birth after 40 face the often challenging reality of raising young children while transitioning through menopause.  Moms in their 40’s and 50’s are turning to bio-identical hormones for a safe and effective means of coping with these changes.


Am I peri-menopausal or am I just going crazy?

I get this question a lot, so don’t be afraid to ask it!  Labile emotions, memory decline, and physical changes can cause you to feel as though you are not yourself.  Peri-menopause symptoms are directly related to hormone imbalance and hormonal decline.  This transition occurs as the ovaries fail to ovulate, and cycles become irregular or absent.  Hormone levels fluctuate, causing a myriad of uncomfortable symptoms:

  • Hot flashes/night sweats
  • Fluid retention/weight gain
  • Headaches
  • Insomnia
  • Mood swings, irritability, depression, anxiety
  • Poor memory
  • Difficulty handling stress
  • Fatigue
  • Fibrocystic breasts, uterine fibroids
  • Low libido
  • Vaginal dryness


Will I feel better on estrogen?

Many peri-menopausal women are prescribed synthetic estrogen, or experiment with estrogenic supplements when in fact, their symptoms are not due to lack of estrogen.  Despite the belief that all menopausal symptoms are caused by low estrogen levels, other hormone imbalances are more common!

A vast majority of peri-menopausal symptoms are due to estrogen dominance or estrogen/progesterone imbalance.  When too much estrogen exists relative to progesterone, using estrogen would make symptoms worse.


What are bio-identical hormones and are they safe?

Bio-identical hormones are identical to those that your body produces.  They are not synthetic or derived from animal hormones.  When used properly, side effects are infrequent, and bio-identical hormones can reduce your risk of cardiovascular disease, cancer, and osteoporosis.

Progesterone is administered topically or orally.  Progesterone is used to balance estrogen dominance, resolve fibrocystic breasts, improve sleep, mood, libido, headaches, and memory.

Bi-Est is an estrogen cream containing a mix of 2 forms of estrogen: estriol and estradiol.

Estriol cream is typically administered as a vaginal cream, and it contains estriol.  Bi-Est and estriol are used when estrogen levels are low and symptoms such as depression, brain fog, vaginal dryness, and urinary incontinence exist.

Discussing your symptoms with a physician who is experienced in bio-identical hormone therapy, and performing appropriate hormone testing will help determine what therapy is needed.

Thorough testing can also determine whether thyroid or adrenal support is necessary, and if bio-identical androgens (testosterone or DHEA) are needed.  Bio-identical hormones should only be obtained from a compounding pharmacy via physician’s prescription.


Notes For This Blog:

Dr. Ayla Wilson is a naturopathic physician with a special interest in women’s health, fertility, and anti-aging.  In her practice, she uses bio-identical hormone therapy and natural treatments to promote successful conception, hormone balance, and healthy aging.   Visit Dr. Wilson’s website (http://draylawilson NULL.com) for more information.


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14 Responses to Can Bio-identical Hormones Safely Relieve Menopause Symptoms?

  1. Tara says:

    Just a thought, women who haven’t given birth, but adopted kids after 40 or 50 are facing the same issues, I know I am.

    • Dr Ayla Wilson (http://www NULL.DrAylaWilson NULL.com) says:


      You are absolutely right. Women in their 40’s and 50’s with young children in the home have the added difficulties of entering peri-menopause while raising little ones. These issues exist among all older moms, even those who have adopted.

  2. Angel LaLiberte (http://www NULL.AChildAfter40 NULL.com) says:

    I totally agree that older women who adopt children are going to face the same stresses of raising young children while going through menopause.
    I think one of the main issues is that women do not feel comfortable sharing with others how challenging their menopause experience can be and tend to suffer in silence. I found this article on how professional women feel the need to keep their mouths shut in the workplace, for fear of being judged, very revealing: http://www.telegraph.co.uk/health/8376768/How-do-professional-women-cope-with-the-menopause.html (http://www NULL.telegraph NULL.co NULL.uk/health/8376768/How-do-professional-women-cope-with-the-menopause NULL.html). Aren’t women who have babies after 40 under the same pressure to keep quiet about the ravages of menopause for fear of being criticized?
    Also, I understand that women who give birth after 40 may also find that the birth process tips them into menopause almost right away. One mom told me that she’d be holding her baby while a hot flash came over her.
    Is this medically true, Dr. Wilson?

  3. Dr Ayla Wilson (http://www NULL.DrAylaWilson NULL.com) says:


    Some women who go through a childbirth in their late 40’s will almost immediately transition into peri-menopause. The stress of pregnancy on the body at a later age, and hormone production in over-drive can shift the endocrine system into peri-menopause.

    Having a young child can also be a burden on the adrenal glands, the endocrine organs that help us cope with stressful situations. When adrenal function is compromised, this can also contribute to a sudden transition into peri-menopause, and a more difficult time coping with these symptoms.

  4. Amanda (http://www NULL.satoricentre NULL.ca) says:

    I had a child at 42 and shortly after began peri-menopause. I don’t have severe physical symptoms but the emotional hurdle of realizing what menopause means can be a challenge. And, I agree – most women are “mum” on the topic, perhaps out of fear of judgement. Anyway, I have found meditation to be a huge help in dealing with the stress and physical symptoms. Perhaps just taking time to connect with my mind and body is empowering me to embrace change and move forth as the woman I know I am. Great article! 🙂

  5. Lylas says:

    I also began having perimenopause symptoms within 6 months of my son’s birth when I was 51. I’ve considered bioidentical hormones to relieve the symptoms but I’m concerned that hormones are hormones and increased risks of cancer. I want to be around to raise my son so I’ve decided not to take the risk. I’m also concerned that if I took the hormones, it would just delay the symptoms and I’d have to live thru them at some point. So I’m living thru them now. I’ve had all the symptoms that Angel has listed and about 10 more – at least they are always changing so that keeps things interesting.

    • Dr Ayla Wilson (http://www NULL.DrAylaWilson NULL.com) says:


      I appreciate your concern for the risks of taking hormones as there is a great deal of conflicting information out there.

      Synthetic Hormone Replacement Therapy (HRT) combines the use of a progestin and a conjugated estrogen derived from the urine of pregnant horses. Back in 2006, the Women’s Health Initiative study on HRT was stopped early due to increases in breast cancer and cardiovascular disease in women using synthetic HRT. These risks are without a doubt, concerning and substantial proof that synthetic hormones are unsafe for peri-menopausal and menopausal women.

      Your impression that “hormones are hormones” is a common belief, however the important difference here is that bio-identical hormones are identical to those that your own body produces, whereas synthetic hormones are not. Synthetic estrogens, as I mentioned above, are derived from hormones in horse urine. Progestins (not to be confused with progesterone) are synthetic progesterone mimicking molecules which act differently in the body than progesterone itself. As a result, synthetic estrogens and progestins have a great risk of side effects as their influence on the body is unpredictable.

      Bio-identical hormones are used to replenish your body’s own hormone levels to ease the transition through menopause, not delay it. Safe use of bio-identical hormone therapy involves thorough testing of hormone levels and appropriate prescribing.

      Many women that I test, prior to starting bio-identical hormone therapy, have high levels of estradiol, a type of estrogen that may predispose you to estrogen dominance symptoms and elevate your breast cancer risk. Many of these patients have been prescribed Estradiol cream by their GP, however Estriol or Bi-Est cream (80% estriol, 20% estradiol) would be safer and more appropriate. When bio-identical hormones are used properly, osteoporosis and fracture risk declines, as does cardiovascular disease and breast cancer risk.

      Another concern is that estrogens not be prescribed without progesterone. Estrogen and progesterone exist within the body in a state of balance, and giving any estrogen without progesterone may greatly elevate risk factors. Some physicians still prescribe synthetic estrogens without progesterone, and this is not considered a safe practice.

      Ensuring that your hormone levels are properly tested and that your practitioner is aware of how to safely administer bio-identical hormones is very important. For more information on this and for studies proving the safety and efficacy of bio-identical hormone therapy, Angel has brought this Suzanne Somers article to my attention and it is worth the read!

      http://www.suzannesomers.com/Blog/post/Bioidentical-hormonesthe-studies-that-back-up-efficacy-and-safety.aspx (http://www NULL.suzannesomers NULL.com/Blog/post/Bioidentical-hormonesthe-studies-that-back-up-efficacy-and-safety NULL.aspx)

  6. Hi Lylas,
    Synthetic HRT has been proven to have links to cancer. However, the story on bio-identicals appears to be quite different. Have you read any of Suzanne Somers’ books on healing from menopause symtoms? She’s done an enormous amount of research and argues that her critics arise from the lucrative pharmaceuticals industry which has a great deal to lose if menopause can be treated with natural bio-identical hormones. She’s compiled the scientific research in rebuttal to her critics in this blog article: http://www.suzannesomers.com/Blog/post/Bioidentical-hormonesthe-studies-that-back-up-efficacy-and-safety.aspx (http://www NULL.suzannesomers NULL.com/Blog/post/Bioidentical-hormonesthe-studies-that-back-up-efficacy-and-safety NULL.aspx).
    I think it would also be useful to get opinions from practitioners who work in holistic, as well as alopathic medicine.

  7. Carolyn Schweitzer (http://www NULL.mommyinthemiddle NULL.com) says:

    It’s interesting that giving birth in one’s forties can kick us over into menopause. I began having irregular cycles 4 years before giving birth to my son.

    But within two weeks of when I stopped producing breast milk for him, I started having constant and intense hot flashes. It felt like I was taking my sweater off or putting it back on about every five minutes.

    Did the end of lactation (at age 46) change my hormone balance more suddenly?

  8. Lylas says:

    Thanks for your comments Dr. Wilson and Angel. Although actress Suzanne Somers writes a compelling book for bioidentical hormones, she is neither an MD nor PhD so I am not convinced that her review of the data, literature and studies surrounding these hormones is valid. I’m sure we could argue the benefits of these drugs for a long time but until the FDA, American Cancer Society, Mayo Clinic, International Menopause Society, AMA and/or peer reviewed studies are released to state that the risk is low for these drugs, I’m going to stay the course with meditation, acupuncture, excercise and good diet.

    • Dr Ayla Wilson (http://www NULL.DrAylaWilson NULL.com) says:


      I am definitely an advocate of exercise, diet and alternative therapies in the prevention of peri-menopausal symptoms, cancer, and chronic disease. I also am very respectful of my patients’ personal decisions surrounding the use of any hormone therapies, as ultimately the choices are up to you.

      We posted Suzanne Somer’s article as it provides an accessible view of the issue to those who may not have a solid enough science background to interpret a handful of studies. The studies she references in her article are, in fact, peer reviewed studies in reputable scientific journals (JAMA, Lancet, Cancer Research, and many others) illustrating both the dangers of synthetic HRT and the evidence backing bio-identical hormone use.

  9. Angel LaLiberte (http://www NULL.AChildAfter40 NULL.com) says:

    Lylas, you know how very much I respect your opinion. I think menopause and bio-identical hormone therapy is a fascinating field, and certainly a subject of interest to women who are becoming mothers after the age of 40.
    I’m approaching this with open-minded caution. The reviews of research I’ve seen thus far have appeared from creditable sources and focus on the safe and positive effects of bio-identical progesterone therapy alone (not combined, not synthetic). In the end, it is always a personal choice and I support your approach completely.
    As an addendum, I found this article and website in my searches which you may find interesting. The writer, Ray Peat has a strong academic/research background in hormone therapy. http://raypeat.com/articles/articles/estrogen-progesterone-cancer.shtml (http://raypeat NULL.com/articles/articles/estrogen-progesterone-cancer NULL.shtml).
    All the best!! 🙂

  10. Lylas says:

    Thanks Angel.I raised the points only to make our members aware that there are conflicting opinions on the risks. And thanks for sending the Ray Peat article. No one has ever succeeded in changing IARC’s and OEHHA’s opinion on anything. It will be interesting to see how that unfolds.

  11. Positive Effects of Bio-identical hormones — Natural Wellness and Pain Relief Centers of Michigan (http://michiganwellnessandpainrelief NULL.com/2013/02/positive-effects-of-bio-identical-hormones/) says:

    […] Can Bio-identical Hormones Safely Relieve Menopause Symptoms … […]

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