Adrenal Fatigue

While there are a variety of reasons why you are tired, in many cases it has to do with your adrenal glands and their inability to handle stress. When your adrenal system is overworked and depleted, you may experience debilitating, relentless fatigue. Exercise makes you feel worse instead of better and fatigue is not alleviated by sleep.

There are two thumb-sized adrenal glands, one sitting over each kidney. They regulate your body's response to stress by controlling the release of cortisol, the main hormone produced to manage stress. The highest amount of cortisol is secreted in the morning to get you going, with levels decreasing throughout the day. The adrenals also secrete cortisol in response to low blood sugar, stress, exercise, and excitement.

The stress caused by hormone imbalance is a huge contributor to adrenal fatigue. When you are under constant stress, your adrenal glands go into overdrive and the hormones that should be used sparingly in emergencies are depleted. Excess cortisol is produced and with continued stress, cortisol levels go from high to low. Since cortisol is produced from progesterone, depleting cortisol also decreases your progesterone levels.

  • Symptoms

  • Treatment

  • Inability to fall asleep
  • Waking up in the middle of the night
  • Mid-day fatigue
  • Anxiety
  • Depression
  • Reduced tolerance for stress
  • Cravings for sweets and salty foods
  • A tendency to feel cold
  • Increased susceptibility to infections

The four point saliva test is the most accurate and reliable test to measure your cortisol levels. Getting enough sleep, stress management and hormone balance are the foundation for healthy adrenal glands. Proper diet and specific supplements can support and nourish your depleted adrenal glands while encouraging adrenal cortex secretions that help maintain optimal hormone balance. Bioidentical Hormone Replacement Therapy (BHRT) is used to correct imbalances that may be causing additional stress.


The saying that we start dying the day we are born is true, though we really don’t start noticing significant changes until after a few decades. Then your muscles and joints start to inflame and hurt. Old injuries resurface. You can’t do the physical activities of your youth. You’re more tired and can’t recover as quickly. Sleep is limited. Thinking and memory diminish. Some days it feels like you are only a few years away from being put down. Many people just accept these symptoms and limitations, attributing them to aging.

Many of the aging processes are due to changes in your hormonal system. Since hormones contribute to essentially every bodily function, it is important to pay close attention to them. Remember that you cannot stop aging, but you can replenish lost hormones to minimize the symptoms of aging.

For example, progesterone levels start to decrease in your thirties and decline dramatically in your forties and fifties. Progesterone is a major hormone that regulates blood sugar and converts fat into energy (weight and fat), builds bones (fractures), promotes brain activity (memory, concentration, mood and depression), regulates thyroid hormone production (fatigue, metabolism), reboots your libido (sex drive), helps with sleep (insomnia) and boosts your immune system (illness and disease). That’s not everything that progesterone does, but it’s a good short list and demonstrates the importance of just one of many hormones (estrogen, testosterone, DHEA, thyroid).

A critical aspect of healthy aging that is often overlooked is that hormonal imbalance has a significant relationship to long-term health risk, illness and disease. Most of us notice the immediate limitations of aging, but forget about the underlying health implications. Hormone imbalances are directly linked to osteoporosis, arthritis, Alzheimer’s, heart disease, cancers and other chronic diseases. These conditions tend to sneak up on us gradually over time until one day you wake up and you have something.

  • Treatment

While proper diet, supplementation and exercise are important components of healthy aging, correcting hormone imbalances is critical. Laboratory testing of your hormones can identify imbalances that are responsible for or are contributing to the symptoms of aging. Dr. De Monte then uses Bioidentical Hormone Replacement Therapy (BHRT) to replenish the hormones you are missing and make up for deficiencies.

Studies have shown that the restoration and maintenance of hormone parameters at youthful levels can improve health and vitality, and decrease some of the physical and mental signs of aging. You’re not likely to run a marathon a day, but you’ll be at your best to do whatever you enjoy doing. In addition to optimal daily performance, BHRT plays a important role in the prevention of illness and disease.

Breast Cancer

The most frequently diagnosed cancer in women is breast cancer. While there are multiple factors that can cause breast cancer, many are hormone dependent. Estrogen increases the proliferation of breast cells and when uncontrolled, this results in cancer. Studies have shown that high levels of unopposed estrogens increase the risk of breast cancer.

This does not mean that the body’s production of estrogen is too high, because as we age estrogen levels usually decrease. Progesterone levels, however, decline significantly as we age and upset the delicate balance between the two hormones. Unopposed estrogens occur when there is not enough progesterone to counteract the negative effects of estrogen. This leads to a condition called estrogen dominance where estrogen levels are too high relative to progesterone.

Eighty-two per cent of breast cancer diagnoses occur after age 50. These are the years when hormones change dramatically, estrogen in particular becomes excess in the absence of progesterone that has declined to almost zero (unopposed estrogen). Very seldom is breast cancer diagnosed in young women when their estrogen levels are at their peak, because their progesterone levels are high enough to be protective.

Xenoestrogens, estrogen-mimicking chemicals in the environment, are one of the biggest contributors to breast cancer. Hundreds of toxic chemicals found in prescription medicines, pesticides, plastics, cosmetics, foods, perfumes, water and air can disrupt your hormonal system. They alter normal hormone metabolism by blocking non-estrogen hormone receptor sites, upset hormonal balance and increase the risk of breast cancer.

  • Treatment

One option to potentially prevent breast cancer is to maintain a proper balance between estrogen and progesterone. Since production of progesterone starts to decrease in your thirties, hitting near rock bottom in your fifties, early assessment and treatment is recommended. Dr. De Monte identifies your hormone levels through laboratory testing and prescribes Bioidentical Hormone Replacement Therapy (BHRT) to correct imbalances, the most important being the replenishment of low levels of progesterone. While progesterone is needed to oppose the negative effects of estrogen, progesterone also inhibits cell proliferation and studies have confirmed its anti-cancer properties.

If you have breast cancer, BHRT can be used to balance hormones during menopause. While there has been a long standing awareness that excess estrogen (estrogen dominance) can cause breast cancer, estrogen can still be prescribed. There are three main types of estrogen, and estriol, a major hormone used in BHRT can be prescribed. Studies have shown that estriol does not increase the risk of cancer and actually provides protection against the growth of cancer. Protective estriol is prescribed, progesterone is taken to oppose estrogen, and the result is no increased risk of breast cancer.

In addition to hormone balancing, treatment must also address diet, lifestyle factors, stress, and the elimination of xenoestrogens.


Endometriosis occurs when small packets of tissue, similar to that found in the lining of the uterus, grow outside of the uterus. Common locations for this growth include the ovaries, fallopian tubes, vagina, bladder, and the pelvic sidewall. This misplaced tissue reacts in a similar way to the menstrual cycle causing bleeding and scarring.

There is no certainty as to what causes endometriosis. It often takes a long time to develop endometriosis and diagnosis is difficult. One belief is that too much estrogen stimulates the cell growth of the displaced tissue. Too much estrogen can result from estrogen dominance. This occurs when the ratio of estrogen to progesterone is disrupted by the dramatic decline of progesterone that occurs naturally starting in your thirties.

Excess environmental estrogens called xenoestrogens can be absorbed by your body. They are found in food, air, water, packaging, industrial chemicals, cosmetics and body care products. Xenoestrogens are extremely similar to estrogen in structure and disrupt your endocrine system. Seventy-five years ago in Canada there were very few xenoestrogens in the environment and there were less than a dozen cases of endometriosis, compared to an estimated 500,000 cases today.

  • Symptoms

  • Treatment

  • Pelvic pain
  • Painful periods (cramping)
  • Bloating
  • Infertility
  • Painful bowel movements
  • Irregular periods
  • Heavy bleeding
  • Painful intercourse
  • Fatigue

While endometriosis is often treated with surgery, many factors need to be considered, in particular, environmental exposures because they can have a big impact on your hormonal system. Treatment should first be directed at lowering estrogen levels through diet, botanical medicines, supplements and balancing the negative effects of excess estrogen with progesterone. The main goals are to reduce inflammation that causes scarring and balance hormone levels with Bioidentical Hormone Replacement Therapy (BHRT) to correct the estrogen to progesterone ratio. Supporting liver function is critical because the liver is the major clearing house for excess estrogen. Since a combination of factors are likely the cause, treatment has to be multifaceted.

Erectile Dysfunction

Also called impotence, erectile dysfunction (ED) is defined as the inability to keep and maintain an erection firm enough for sexual intercourse. The causes can be related to hormones or your cardiovascular and nervous systems.

ED is a common occurrence for men with hormone imbalances. Testosterone affects the ability of men to produce erections. A normal age-related decline in testosterone can result in erectile dysfunction and a loss of sex drive (low libido).

In some instances, the libido (sex drive) is there but men are incapable of an erection. The usual mechanism is for the brain to signal the release of nitric oxide that in turn relaxes the muscles of the penis, allowing blood flow. If there is too much plaque in the arteries (advanced atherosclerosis), not enough blood gets delivered to the penis and erections are impaired.

High levels of the stress hormone cortisol can cause testosterone levels to decrease. High levels of prolactin, a chemical secreted in the pituitary gland, also cause reduced levels of testosterone. Liver disease can cause high levels of estrogen in men, contributing to erectile dysfunction. The constriction of blood vessels, diabetes and blood pressure medications are also leading causes of erectile dysfunction.

  • Treatment

Determination of your hormone levels through laboratory testing and a complete assessment identifies the Bioidentical Hormone Replacement Therapy (BHRT) best suited for you. Nutrition, exercise, supplementation and stress relief must also be addressed and incorporated into the treatment program. If there is a cardiovascular issue that is contributing to erectile dysfunction, additional treatment is required to improve blood flow.

Estrogen Dominance

Dr. John Lee coined the term ‘estrogen dominance’ to describe what happens when the normal ratio of estrogen to progesterone in your body is upset by too little progesterone or too much estrogen. The most common occurrence is too little progesterone to balance the negative effects of estrogen. Your estrogen levels could be low, normal or high, but if progesterone is insufficient, estrogen dominance still occurs. The key factor is that progesterone levels are low relative to estrogen.

When not kept in check by progesterone, estrogen because of its potency can run amuck causing all kinds of symptoms and illnesses. Since progesterone levels begin to decline naturally in your thirties, drop dramatically in your forties and are pretty much depleted by your fifties, estrogen dominance is a major health concern. Premenopausal and perimenopausal women can have cycles where they do not ovulate. They make enough estrogen to have their periods, but they can’t ovulate because they aren’t making enough progesterone.

Estrogen levels can also be elevated from exposure to xenoestrogens (environmental toxins that mimic estrogens) in plastics, pesticides, body care products, car exhaust, meat, carpeting and furniture. These chemicals are aggressive foreign estrogens that throw off hormone balance. Other causes of increased estrogen include too much body fat, birth control pills, too much stress resulting in excessive amounts of cortisol, insulin, and norepinephrine, a low-fibre diet deficient in nutrients and high quality fats, and impaired immune system function. Some of the common symptoms and conditions associated with estrogen dominance include:

  • Symptoms

  • Conditions

  • Treatment

  • Anxiety
  • Breast tenderness and swelling
  • Depression
  • Fatigue
  • Fluid retention
  • Foggy brain
  • Hair loss
  • Headaches
  • Insomnia
  • Irritability
  • Irregular menstrual periods
  • Low libido (sex drive)
  • Memory loss
  • Mood swings
  • Weight or fat gain (women on the abdomen and hips, men around the middle)
  • Breast cancer
  • Cervical dysplasia
  • Endometriosis
  • Fibrocystic breasts
  • Gallbladder disease
  • Hypoglycemia (low blood sugar)
  • Hypothyroidism (low thyroid function)
  • Infertility
  • Ovarian cancer
  • Premenstrual Syndrome (PMS)
  • Prostate cancer
  • Uterine cancer
  • Uterine fibroids
  • Yeast infections

After lab testing of hormones levels, Dr. De Monte prescribes bioidentical progesterone, a practical solution, to balance estrogen and combat estrogen dominance. For women who are still menstruating, progesterone is often given during the second half of the menstrual cycle. A hormone balancing diet that emphasizes cruciferous vegetables (broccoli, cabbage, kale, turnip, etc.) and other foods to help eliminate excess estrogen is recommended. Losing excess body fat and getting regular exercise is encouraged. Decreasing stress by learning to say no to excessive demands on your time is advised.

Hypothyroidism (Low Thyroid)

The thyroid is a small gland located in the lower part of your neck. It produces hormones that play a major role in your metabolism and energy. The primary thyroid hormones are triidothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH). Thyroid imbalances occur when your thyroid produces too few or two many of these hormones. An overactive thyroid (hyperthyroidism) occurs when the thyroid glands produce too many hormones. Symptoms range from heart palpitations and anxiety to weight loss, heat intolerance and muscle weakness. The most common imbalance, however, is an underactive thyroid (hypothyroidism) that affects as many as one in every seven adults.

Thyroid hormone levels are closely associated with progesterone and estrogen levels. If progesterone is too low relative to estrogen levels, this can block thyroid function. Since progesterone levels decline naturally and significantly starting in your thirties, low thyroid function is a common condition that develops before menopause.

  • Symptoms

  • Thyroid Testing

  • Treatment

When the thyroid gland is underactive, your metabolism slows down and you may suffer from the following symptoms:

  • Brittle hair and nails
  • Cold intolerance
  • Constipation
  • Depression
  • Dry skin and hair
  • Fatigue
  • Hair Loss
  • Heavy menstrual periods
  • Loss of outer third of eyebrows
  • Muscle aches and weakness
  • Puffiness or swelling in the face
  • Unexplained weight gain

Many women with hypothyroid (low thyroid) symptoms are told that their lab tests are "normal" and there is nothing wrong with their thyroid gland. These conclusions are usually based upon the blood test for TSH. This test is often not sensitive enough to determine if your thyroid is underactive. In 2002, the Society of Endocrinologists announced that the standard testing ranges for TSH were inaccurate and that many people with hypothyroidism were undiagnosed. To identify the presence of an autoimmune thyroid disorder, Dr. De Monte tests for T3 hormone, T4 hormone and thyroid antibodies. If such a disorder is diagnosed quickly, treatment may be able to prevent permanent damage to your thyroid gland.

In conventional medicine, hypothyroidism is generally treated with synthetic T4, which can correct your T4 and TSH levels. Unfortunately, many people cannot efficiently convert T4 to T3. This creates problems because T3 is the more active form of thyroid hormone. As a result, even when your T4 and TSH levels are optimal, if your T3 levels are low, you may still experience symptoms.

Dr. De Monte takes a more thorough approach to treating thyroid disorders. Once your current levels of all your thyroid hormones have been tested, she customizes an individual thyroid replacement therapy regimen designed specifically for you. Treatment usually focuses on a combination of T3 and T4 to keep your thyroid hormone levels in an optimal range. If estrogen dominance is an issue, progesterone is prescribed to oppose estrogen and thereby help the thyroid gland function better.

Hysterectomy Induced Menopause

There are two types of hysterectomy. A partial hysterectomy is a surgical procedure that removes only the uterus (womb). A complete hysterectomy is the surgical removal of the uterus, ovaries and fallopian tubes. While hysterectomy is a solution for constant bleeding and/or pelvic pain, the suffering is often replaced by a new set of symptoms such as insomnia, hot flashes, night sweats, low libido, memory loss and depression. These are all indicators of hormonal imbalance.

  • Instant Menopause

  • Progesterone Protects

  • Treatment

It doesn’t matter how old you are, if you have a complete hysterectomy, you will be thrown into instant menopause. With your ovaries gone, you can’t make any hormones (except for small amounts in the adrenal glands). Your hormone levels drop dramatically with no chance for gradual adjustment. Symptoms can be sudden, severe and debilitating. After a partial hysterectomy, hormone imbalance is not as severe and not as sudden, but symptoms can still be significant.

The Center for Disease Control in the United States has reported that as many as two thirds of the hysterectomies performed every year are unnecessary. Many women can avoid hysterectomy through improved diet, increased activity, reduced stress, nutritional supplements and Bioidentical Hormone Replacement Therapy (BHRT) to correct hormone imbalances. When surgery is absolutely necessary, as in cases of uterine cancer, BHRT is essential to replenish your hormone levels.

Historically, the only hormone most women have been prescribed after hysterectomy is estrogen. They have been told that they don’t need progesterone because with no uterus there is no worry about uterine cancer. Progesterone has always played a role in protecting the uterus from the cancer causing properties of estrogen. Unfortunately, time and research has shown that when estrogen is taken alone without opposing progesterone, there is also increased risk of stroke and breast cancer. The risk of blood clotting, fluid retention and weight gain are also increased.

Following a complete hysterectomy, you will need a brand new supply of hormones immediately. Estrogen is not enough. Dr. De Monte always prescribes progesterone with estrogen to counteract the negative effects of the estrogen alone. Progesterone is mandatory and testosterone may be necessary. No testing is required until you’ve been on hormone therapy for a couple of months. Then it’s time to assess and adjust doses. After a partial hysterectomy, most women can benefit from hormone balancing. Testing is needed to determine baseline hormone levels before BHRT is initiated.

Male Hormone Imbalance

While most people think that hormone problems are only experienced by women, men also have to endure a midlife decline in hormone production. Andropause (male menopause) refers to the physical and psychological symptoms associated with a decline in androgens (male hormones). Compared to women’s hormone levels that decrease quickly and significantly with menopause, men’s levels decrease gradually. The onset of symptoms is subtle and they are often just dismissed as part of aging. Noticeable changes usually start around age 40 and follow the slow but steady decline in testosterone, DHEA and progesterone, negatively impacting health.

Men can become estrogen dominant when progesterone levels drop dramatically as they age, resulting in too little progesterone to balance estrogen. Zinc deficiency, excessive consumption of commercial beef and poultry, constipation, environmental toxins and too much alcohol raise estrogen levels. Estrogen competes with testosterone in the body and when in excess it nullifies the beneficial effects of testosterone. Health conditions associated with low testosterone and excessive estrogen include benign prostatic hyperplasia (enlarged prostate gland), osteoporosis, heart disease, diabetes and prostate cancer.

  • Symptoms

  • Treatment

  • Anxiety
  • Bone loss (lost height)
  • Breast enlargement
  • Decrease in libido (sex drive)
  • Depression
  • Irritability or grumpiness
  • Erectile dysfunction
  • Lack of energy
  • Disturbed sleep
  • Loss of muscle mass
  • Loss of motivation
  • Memory loss
  • Reduced cognitive function
  • Poor concentration
  • Urinary problems
  • Weight gain

Testosterone is the major male hormone of concern during andropause. Testosterone losses can be attributed to an age related decrease in testosterone producing cells in the testes (production peaks at age 25), and an increase in Sex Hormone Binding Globulin (SHBG) that binds with testosterone rendering it ineffective. SHBG levels increase with age, high levels of thyroid hormone, liver disease and high levels of estrogen. In addition, anti-depressant drugs, and medications that lower cholesterol (statins) and blood pressure also lower testosterone levels.

Since hormone imbalance can be a contributing factor to many of the major causes of death for men, restoring balance is critical. Balancing, however, is not a simple matter of more testosterone. Dr. De Monte measures your hormone levels to identify any deficiencies or excesses, and then prescribes Bioidentical Hormone Replacement Therapy (BHRT) to balance your hormones, particularly estrogen and progesterone. Together with lifestyle and diet changes, this is often sufficient to elicit changes.

For decades, testosterone therapy has been discouraged because studies showed it increased the risk of heart disease. The medical research, however, did not actually use testosterone. The studies reported on the use of methyltestosterone, an anabolic steroid. It is not the same as testosterone; it’s a drug that mimics testosterone, and it does have significant health risks. Despite the documented risks of methyltestosterone, it is still used by some doctors today. The testosterone used in BHRT is human-identical hormone, and provides many health benefits without risk of heart disease.


A unique form of headache, migraines are due to blood vessel changes inside the head. First the arteries contract, and then overexpand. When the arteries contract, there is inadequate blood flow to parts of the brain, producing an aura that affects vision and cognition. Most auras last a few minutes and warn of the impending artery overexpansion or stretching that produces the pounding, debilitating pain. Light and sound are troublesome. There can be vomiting and nausea. Downtime can be considerable.

While there are many causes for migraine, the connection to hormones is significant. Since one of the functions of estrogen is to help keep blood vessels open, a sharp drop in estrogen can cause arterial narrowing, the first part of a migraine. It’s the rapid and steep fall in estrogen a week or so before menstruation that results in a premenstrual migraine. Some women suffer throughout the cycle due to the dramatic fluctuations of estrogen.

Migraine headaches are also a symptom of estrogen dominance (too much estrogen relative to progesterone). Estrogen dominance becomes prominent starting in your thirties when progesterone levels start to decline. With respect to PMS, however, reduced production of progesterone in the week before menstruation creates estrogen dominance that can lead to headache and migraines.

  • Treatment

Dr. De Monte measures your hormone levels, particularly estrogen and progesterone. For premenstrual migraines that are unresolved with lifestyle changes, estrogen may be prescribed, but always with progesterone. For migraines caused by estrogen dominance, progesterone provides relief and protects women from the effects of too much estrogen.

Migraines are often complex requiring complex solutions, but hormone imbalance should always be suspected and in these situations Bioidentical Hormone Replacement Therapy (BHRT) can be effective. Another major factor is food allergies that can be readily identified with food allergy testing.


You cannot feel or see this bone thinning disease as it develops, and most people do not suspect osteoporosis until they break a bone. Osteoporosis (porous bones) is usually diagnosed by DEXA (dual energy x-ray absorptionometry) scans of bone density. It is most often associated with fractured hips. Bisphosphonate drugs such as Fosamax are used to increase bone density. A common result of drug therapy, however, is brittle bones that look good on a DEXA scan.

Bone growth is a dynamic process. Progesterone causes bone growth and estrogen takes it away so that new bone can grow next month. Osteoporosis starts when we run out of estrogen and progesterone. Estrogen levels decline with menopause, and starting in your thirties, progesterone levels decrease significantly. There is a strong hereditary component, so if you have osteoporosis in your family, one of your primary concerns should be hormone balance. While low testosterone levels can contribute to osteoporosis in women, they are responsible for about half the cases in men. Excess cortisol hormone secretion by the pancreas, usually in response to high stress, also contributes to bone loss.

Women on birth control pills are at risk because they are not ovulating and therefore have decreased progesterone. After hysterectomy and the removal of the ovaries, the resulting instant menopause increases the risk of hip fracture by 700%. Women between the ages of 50-65 have the largest bone loss. Postmenopausal women, therefore, are at the greatest risk for osteoporosis. Surprisingly, more women die from the complications of a hip fracture than from breast cancer, making prevention a top priority.

  • Treatment

Dr. De Monte begins by measuring your hormone levels and balancing them with Bioidentical Hormone Replacement Therapy (BHRT). Unless progesterone is replenished to stimulate bone growth, not much bone will grow from estrogen replacement alone. Vitamin D is critical to aid in the absorption of calcium from the diet and the deposition of calcium into bone. Vitamin K2 balanced with vitamins A, D and E ensures that the calcium you get in your diet or supplements is carried to the bones.

While the traditional emphasis has been on scans and drugs, a better approach to bone health is the judicious use of BHRT combined with proper supplementation and lifestyle changes. Treatment also prevents osteoporosis, decreasing the fear of declining bone density and fractures. BHRT can not only slow down osteoporosis, in some cases it will reverse bone loss.

Polycystic Ovarian Syndrome

Affecting 5-10% of women, polycystic ovarian syndrome (PCOS) is a collection of symptoms with a few classic signs – obesity, Hirsutism, acne, infertility and irregular periods. Often under diagnosed, PCOS is a hormonal imbalance linked to the way your body processes insulin, a major hormone produced by the pancreas that regulates blood sugar (glucose). The underlying cause of PCOS is insulin resistance that occurs when the cells fail to utilize insulin to convert glucose to energy. The glucose remains in the blood stream, causing elevated levels of blood sugar which are sent to the liver. There, the sugar is converted into fat and stored via the blood stream throughout the body, leading to weight gain and obesity.

Excess insulin stimulates the ovaries to produce large amounts of testosterone. This can cause increased facial and body hair, loss of hair from scalp, oily skin and acne. Ovulation is blocked by high testosterone within the ovaries, resulting in heavy, painful periods. It’s harder to get pregnant and the risk of uterine cancer increases. Metabolism is abnormal and your body becomes insulin resistant increasing the risk of diabetes. Because ovulation usually stops, the production of progesterone also ceases, leading to estrogen dominance and increased risk of breast cancer, high blood pressure and heart disease.

While some women may have a genetic predisposition to insulin resistance, most women develop the condition due to a diet high in sugar and refined carbohydrates, inactivity and high stress.

  • Symptoms

  • Treatment

  • Acne
  • Alopecia (hair loss)
  • Acanthosis nigricans (brown skin patches)
  • Decreased sex drive
  • Depression
  • Hirsutism (excessive facial or body hair)
  • Infertility
  • Irregular or no periods
  • Mental exhaustion
  • Obesity
  • Skin tags
  • Weight gain (mainly on the upper body and tummy)

While PCOS is characterized by cysts on the ovaries, not all women will have cysts, and the cysts usually go away by themselves and are harmless. The condition is really about the hormonal imbalances starting with insulin and the accompanying symptoms. No woman will have all the symptoms, but there will be enough for a diagnosis, even if it’s just acne and irregular periods.

Symptoms for PCOS are unique to each woman and as such, Dr. De Monte’s treatment is specific to each individual. Measurement of hormone levels, balancing with Bioidentical Hormone Replacement Therapy (BHRT), and diet and lifestyle changes form the basis of the treatment. Since PCOS is a hormone problem that affects so many bodily functions, it is often misdiagnosed or not diagnosed. Many women suffer needlessly for years, but with proper assessment and treatment, PCOS can be successfully managed and symptoms relieved. Lowering insulin levels is the key.

Premenstrual Syndrome (PMS)

Women can experience fluctuating hormone levels each and every month for years, causing pre-menstrual symptoms (PMS). Estrogen and progesterone are the main hormones involved. During a monthly menstrual cycle estrogen increases for about two weeks and then starts to decrease, at which point progesterone begins to rise for about two weeks and then declines. For many women these fluctuations are more drastic, resulting in estrogen dominance and severe symptoms. Diet, stress and chemicals in the environment can also contribute to the hormone chaos resulting in irregular periods. PMS is exacerbated by the fact that women are losing their hormones earlier compared to previous generations.

  • Symptoms

  • Treatment

  • Anxiety
  • Back pain
  • Bloating
  • Breast tenderness
  • Cramping
  • Cravings
  • Depression
  • Fatigue
  • Irritability
  • Mood swings
  • Nausea
  • Water retention

This rise and fall of estrogen and progesterone also alters neurotransmitters (chemical messengers) in the brain that are responsible for emotions, mood, pain and pleasure. The levels of the neurotransmitter serotonin are affected, causing changes in appetite (cravings for chocolate, sugar and carbohydrates), depression and weight gain. Other affected neurotransmitters are GABA and endorphins. GABA is active in keeping us calm, but when levels fluctuate this can result in irritability and anxiety. Endorphins regulate pleasure and pain, but irregular levels can cause tension, anxiety and irritability.

Exercise, diet and lifestyle changes need to be addressed. Botanical medicines can help significantly. Gut and liver support are often required. If these do not provide sufficient relief from symptoms, Dr. De Monte prescribes BHRT to balance your hormones. Since many symptoms are related to the overproduction of estrogen, progesterone is prescribed to eliminate estrogen dominance. Progesterone not only balances estrogen and makes you feel better, but it also protects against long-term cancer risk.

Uterine Fibroids

Often discovered during routine examinations, uterine fibroids are growths of muscle and connective tissue on or in the walls of the uterus. They usually grow in clusters and can cause heavy or irregular bleeding. Most uterine fibroids, however, do not cause symptoms. Hysterectomy is often used to eliminate uterine fibroids by removing the uterus.

There are a number of contributing factors that can cause uterine fibroids, including unbalanced hormones. Perimenopausal women are particularly at risk because of declining hormone levels. Estrogen and progesterone have a natural equilibrium in your body. One function of estrogen is to stimulate cell growth in the uterine lining, while progesterone works by balancing estrogen and thus inhibits cell growth. This balance is critical for optimal health. If your body lacks progesterone or has too much estrogen (estrogen dominance), this can contribute to excessive fibroid growth. In addition, stress prompts the release of cortisol (an adrenal hormone) that can contribute to uterine fibroids.