The increased incidences of cancer, heart disease, and stroke, seen in the national study with PremPro are not simple issues. It is not accurate to blame the whole of these illnesses on hormones. In this large scientific study, the incidence of breast cancer was increased in women who were treated with PremPro, as compared to women who did not receive this treatment. This increase of incidence is shocking and tragic, and the study was abandoned. Among many things that can be said, it is a miracle in America that diligence and a free press can lead to massive exposure of wrongness in a New York minute. Also to be considered is that the vast majority of women being treated did not get breast cancer. Certainly the women that did get ill had other vulnerabilities and frailties related to immune system, toxicity, nutrition and stress, all of which play a fundamental role in the development of any life-threatening illness.

It will not be good enough to conclude that hormones are bad and should never be used. The symptoms from hormone deficiency are no picnic, and, these deficiencies are often detrimental for health. Behind the abandoned PremPro study, was the strong suspicion that hormones could make a beneficial difference for heart and bones. Many women with severe symptoms and many doctors who treat menopausal women know that simply stopping all treatment with hormones will not fly.

Hormones, like any remedy, can be used impeccably or, can be abused. Elegance and safety can be increased with scrupulous care to discover the details of the individual woman, with regards to risk factors, hormonal needs, balance and dosages. It should be emphasized that it is of the utmost importance to use natural, molecularly-identical hormones prepared by Œcompoundingı pharmacists. Also important is for each individual woman to be an active participant in the determination of her optimal dosages.

We understand a great deal about what puts a woman at risk for severe illness and, with care and effort, these details can be evaluated and minimized. Again, there are so many other factors that determine increased risk for severe illness. As far as risk relates to hormones, the hormones of concern are the estrogens. This large scientific study involving PremPro had many problems: horse derived genotoxic estrogens, one-dose-fits-all, and failure to evaluate and eliminate from this study women at significant risk. It is time to end, among these other issues, the use of horse-derived estrogens and remove these from the market.

Even when using natural estrogens under the most ideal and refined of programs, we are not quite able to guarantee safety. We do not have sufficient experience with widespread impeccable usage of natural estrogens, nor do we have information collected via longterm adequate scientific studies. So we offer this book as a guideline to the details that can help each individual woman make the wisest, safest and most empowered choices possible.

In approaching menopause, it is time to discover that every single individual womanıs situation needs to be evaluated in significant detail for needs, risks, benefits, safety and personal preferences. At this time in history it is optimal for each woman, to the best of her ability, to become sufficiently informed on the whole topic to be an active, aggressive, and knowledgeable participant in her own program. It is ideal for those whose situation seems favorable and safe, to use natural molecularly-identical hormones, and to discover, through trial, individually tailored dosage levels; no less, and certainly, no more than is optimal.

This book is about knowledge, individualizing, optimal treatment, natural hormones and multidimensional issues. This book is about making menopause as absolutely safe and elegant as possible.

CHAPTER ONE
Menopause: An Elegant Experience

Women, at times, may experience menopause to be uncomfortable or unhealthy, and may choose to seek treatment. Hormonal treatment has been extremely common for decades, and the most commonly prescribed hormones for menopause have been animal derived and genotoxic. They can be dangerous. There are other methods of treatment. For one thing, naturally derived bio-identical hormones are available.

There are fundamental principles of treatment I hold as essential. Committed attention to the biological details of you as an individual, and the whole process of menopause is the first. It is crucial to assess all possible choices in the context of your personal risk factors. And, to treat menopause elegantly, it is essential to go beyond hormones and include the rest of your body and your life. This book is about treating menopause elegantly.

You may be troubled by symptoms, such as sleep disturbance, hot flashes, emotional instability, weight gain, bone loss, low energy and difficulties in relationships and life. You may be concerned about risk for heart and female organ disease, hip fracture, and other problems. Hormonal deficiencies and imbalances can underlie many of these issues. It is a great time to pause and consider all of this. Itıs a time in life to pause and heal.

You can find and choose something different. Begin by learning about menopause, and becoming empowered from your learning. Continue by being one of the most important participants in identifying your personal hormonal needs, making choices in the context of your overall health and specific risk factors, choosing natural bio-identical hormones when hormones are appropriate, and discovering your right dosages and balance. This book is about learning, discovering, identifying and choosing.

In my thirty-two years of practice as a medical doctor I am grateful and excited to be treating women in a time when we have a much more thorough understanding of menopause. The human body is so complex, intricate, amazing and miraculous! Today we have a far more extensive knowledge of the biology of the body than ever before.

Menopause involves hormonal issues. Hormonal products are now available to you that are molecularly identical to hormones produced in your ovaries, and, are derived from natural sources. High-resolution testing is also obtainable, when needed, that can focus in on your individual hormonal picture, and help define aspects of risk.

Years ago, I did not have the same enthusiasm about being able to help women in menopause. Understanding was limited. Also, treatment protocols and products being used were of questionable safety and effectiveness. Safety: Primum Non Nocere, Do No Harm! Safety is a key issue and the highest priority in the treatment of menopause. Hormones are involved and hormones are potent. They are beneficial when used with care, expertise and accuracy, and harmful when not.

Forty years ago the incidence of severe female-related illnesses was so much less than it is today. Hormones are a part of this deterioration. When I was in medical school in the mid 1960ıs breast cancer was a rare disease. This is not so now. I have worked with women, even in their late thirties, who have had breast cancer and it is tragic! At times, their medical history reveals obvious suggestions of hormonal overload, imbalance, even toxicity, or aggravation by hormones and toxins found in the food supply. I have witnessed so many incidences of incorrect prescription of hormonally active medications, including, in some cases, birth control pills. There is more to an illness so profound as cancer than just hormones. Yet, hormones can play a role. Knowing what we know now and paying attention to details can avert so much of this tragedy.

Many women avoid taking hormones because of safety concerns, even though reduced levels of their ovarian hormones are causing personal discomfort or even impairment of their health and well-being. All of the safety issues call for an examination of the multitude of details and risk factors pertaining to the uniqueness of each woman. The ability to make safe choices derives from a thorough knowledge of the individual woman as well as prescription of the safest hormones available.

A wonderful thing about this time in history is that we know enough details about the process of menopause and the causes of illness. We have safe enough and good enough hormones to utilize. The knowledge and tools exist. However, it does require a willingness to individualize each womanıs situation. Because of the complexity, this can take real care and effort. A remarkable thing is that with diligence, attention to details, and at times, unravelling issues that go beyond hormones, awesome and safe things can be accomplished. You can be a most significant determiner of that success and that safety. This book is about bringing as much safety to this process as possible. This book is about you taking as much responsibility for that safety as is possible.

Why Treat Menopause?
In addition to the biological factors in menopause that you may face, there can be challenges in your relationships, jobs, and other core life issues. Hormones can dramatically affect your mood, energy, vitality and sexuality. If you do not successfully treat the biologic issues of menopause, you may have more difficulty resolving the other issues in your life. With unbalanced and insufficient hormones you could be operating out of tiredness rather than vitality, sleep de-privation rather than being rested, mood swings rather than emotional stability, and even disease rather than health. Emotions, mind, life, and body are all interwoven. The stress from unresolved issues of life can result in significant glandular fatigue, and then further hormonal reduction and imbalance. All of this can compound physical hardship!

I can picture specific women in menopause who have come to me in emotional crisis. These were strong women with good lives, and they were in breakdown! They insisted that I forget about how I had known them to be and wanted me to carefully attend to the horribleness of how they felt. To our delight, careful evaluation and right treatment got them back into life with gusto!

I do not want to alarm you and suggest that menopause has to be ever so hard. Many women have passed through menopause with hardly a ruffle! Many women take nothing for menopause. You could also have an easy time. This book is about making menopause as easy as possible.

Individuality
Menopause is a biologically complex process in and of itself. Additionally, considerable variations exist from woman to woman in hormone levels, hormone balance, biologic individuality, and general health. The infinite individual variations in body size and biological makeup are natural and of critical importance. Your soul speaks to you through your body. And each individual woman embodies a unique expression of All That Is. This is a magnificence of your soul. Every single face, body type, and shape is needed to express the whole.

Hormones are one of the influences in the development of body type, shape, proportion, and size. In order to manifest this myriad of biological variations, there are as many differences in hormone levels and balance, woman to woman, as there are body sizes and types of women on earth. Of course, hormones are not the only factor that determine body shape: health habits, for example, also play a very significant role.

All of the possibile individual differences make theı one-dose-fits-mostı approach of commonly prescribed Œhormone replacement therapiesı (HRT) hard to figure. There are just too many variations in hormonal balance, woman to woman, to oversimplify dosage to 1 or 2 sizes.

I believe the optimal approach to elegantly treating menopause is for each individual woman to have a significant understanding of the biological process. This includes developing an awareness about how your own individual body works, uncovering and reducing possible personal risk factors related to female organ disease, and making choices for treatment accordingly. It is also crucial, if you choose treatment by hormones, that you use the best quality, combinations and doses of bio-identical hormones. This book is about charting your course, and giving you a roadmap.

Coming up with, and implementing, a strategy about menopause is especially important during perimenopause, the time when a womanıs cycle becomes irregular but menstruation is still occurring. During perimenopause hormonal fluctuations can be dramatic and may require that a woman continually adjust her treatment program. During perimenopause, if ovulation ceases, estrogens will overdominate and this is not healthy or even safe. Designing a roadmap and charting a course can be significantly helpful, even before you enter menopause.

It is also of crucial importance to have a kind, understanding, professional practitioner to be a partner in this process and add expert support and guidance along the way. They can often sense or evaluate difficulties that call for specific action. You can benefit most with an experienced professonal who listens to you, and what you want and need. Then, together, and with quality information, you can develop a treatment program specifically tailored for you.

When it has come to the practical understanding and application of the biochemistry of hormones by health professionals however, there has been considerable variation and lack of uniformity amongst them. There have been thousands of doctors, pharmacists, and practitioners that, for decades, have identified difficulties with conventional methods of treating menopause. They have researched and found far more thorough, encompassing, and safer methods of evaluation and treatment with hormones. These findings have for the most part, been ignored. There is a lag time in medicine where the best knowledge can take even decades to make it all the way into the mainstream. Impeccable practice has not quite made it to prime time.

I have worked with so many women whose lives have changed dramatically with this approach, which so many practitioners are now presenting. Angie is 53 and had her last period at the age of 40. She is a successful professional, an avid athlete, and married. She had been on a variety of hormones since the onset of menopause yet still had sleep difficulties. She also had a lot lower energy and libido than she was used to. In her treatment, after adequate assessment, we made adjustments in the types and methods of application regarding her hormones. She learned how to find her optimal doses. I did not see her for awhile after this. One day as I was leaving my office, she drove up and jumped out of her car. With great exuberance she exclaimed that she was doing just fabulously again and wanted me to know about her success! She hadnıt felt this alive and passionate about her life in a long time.

Each woman entering, or, in menopause, differs in

This is understandable when you look at how our society defines sexual attractiveness. Being sexually attractive infers that you look like what they display in the media. Women are mostly presented as objects of seduction, with limited, and always very young, body shapes.

In the process of trying to live up to, or even push up against, these constrained and limited views of what being attractive means, women have lost some of their truer meaning in life. If this truer meaning is lost, then to approach menopause can be a horror. It can feel like a horrendous loss.

This loss is felt so intensely when there is nothing of greater meaning to replace how you have identified yourself. There is so much more to life, than what size you are, or how many wrinkles you have, or how much you sag. There is more to life than raising children, even though this can be a fulfilling and rewarding era. What follows can be more, more than you expect or even hope for.

In order to transform this journey of menopause from a potential horror into an adventure that inspires you to transcend your very image and identity of who you are, you need to look beyond what society offers you.

It is possible to transmute and transform menopause into a time of miraculous growth. Hormones have sometimes driven your body, driven your mind, and even driven you mad. These hormones are slowing down. Your drives, your needs, and your desires are changing. Who are you now? Who are you becoming?

When you enter into menopause, so many identities that you have of yourself can come to the surface for re-examination. Your old identities may not seem to work as well for you any more.

Throughout your life you have become at least somewhat familiar with your creativity and with your nurturing capacities. It is more of the knowing and the wisdom that awaits you now. But before you will allow yourself to become more wise, you need to face where and who you are in your life now. This is necessary before you will allow the wisdom to guide you into a life that is abounding with the love you so want to know, with passion and a vibrancy, with creativity and imagination that fill your world.

If you are willing to face your self, and face what and who you are now, then you can begin to move beyond your current way of experiencing life, into a life that can express more of who you really are. And this life is going to be much more fulfilling than your current life, no matter how fulfilled you are now. From here, you can reach into an ancient knowing and wisdom that can illuminate through you, from seemingly out of nowhere.

Many women recoil here, because they think that if they focus on this potential knowing and wisdom, they will lose their creativity or their passion, or have to give up their nurturing. They are afraid that they will lose their sexual appeal. They are terrified of losing the love.

There are so many limited images and beliefs that separate wisdom and knowing from love, passion, and vibrancy. You see these images of old old men and women barely hobbling around with canes, with zero passion and dried up expressions. Well, these are the personifications of the bleached out views that try to wipe out the richness and depth of what living a life replete with knowing and wisdom is about!

Wisdom and knowing actually flow from a deep passion, a sensuousness, and a deep sensuality within life. Wisdom and knowing flow out of a romance, a romance at the deepest level, with life itself. Wisdom and knowing flow out of love, out of a loving that has no words.

You will not lose your connection with loving, passion, or romance, if you allow your wisdom and knowing to flow. You can actually access passion and romance in ways that you never knew existed. And this will not be written about in the media. You can find new ways of loving and being loved, ways that can lift you into a renewed peace and joy, into a beauty that changes your life. You can access power that will knock your socks off!

Some women who reach this stage of growing and changing, get confused. They can become misdirected because they are beginning to look deeper, yet they donıt have a solid artistry or mastery developed with being more wise and knowing. They may be courageous enough to begin to see more of the truth of what is not working in their relationships, for example. And as they first wake up to this, they can assess that the way to change is to throw out their current life. They may leave their partners or impulsively quit their jobs and leap out into the void with a re-found, but misdirected passion. They may think that by doing this, they can go find that love or passion, that is out in that world somewhere.

This is not a necessary or helpful direction, to make the changes you desire. The love and passion, the wisdom and knowing are actually within you. It is more about finding these within the more real that you are, and from here you allow more love, healing, and joy into your life. It all flows the opposite way that society portrays it.

There are times, when leaving a relationship or a work situation will support you in your life. But these decisions and choices are best made, outside of the heat that menopause can produce. This is not to infer that you should stay in a destructive relationship or work situation until you have gone through menopause, because, that will not work. Rather, it seems more productive, to do your work with yourself, then go back and look at the changes that you want to make. And make them from a place of empowerment within you. This way you can make these decisions and choices from a knowing inside of you, instead of an instantaneous heated reaction to a chronic situation.

You can develop a trust with yourself by following your heart and your mind. Along with this, you can open yourself up to your deeper feelings and emotions. Then, with compassion for yourself and your life, you can make your choices from the greater understanding and knowing that emerge from this self-discovery.

Becoming more of who you are capable of being, is not about blaming or punishing others for your upset. It is about taking responsibility for your life, as it is now, and from here, making choices and decisions that inspire you to become more of who you are capable of being.

And, who you are capable of being, is what is left, when you let go of who you are not.

Blaming yourself or another, is who you are not’. Negatively judging yourself or others, is also who you are not. Feeling sorry for yourself, is who you are not. Feeling burdened by life, or by othersı expectation of you, is who you are not. Feeling weak and trying to get others to be strong for you, is who you are not. Feeling like you can not change your life, and having a list of reasons about why this is true, is who you are not.

As you let go of these beliefs and ways of being, who you are becoming will begin to flow. Who you are becoming can not be defined in ways with which you are familiar. It is important to let this be a mystery to you. This mystery of you can then find its way into your life and into your very being’ within your life.

How Do You Currently Identify Yourself?
Are you a creative, nurturing, giving person? Do you consider yourself to be self-focused and less interested in the needs of others? Do you see your self to be achievement oriented? Do you consider yourself to be a good friend? Or are you a mediocre friend to others? Do you feel that you are a happy person or a sad or a disappointed or lonely person? Do you feel that you are being pulled from every direction? Do you feel that you are being ignored or put down? Or do you feel content in your life?

When you enter into menopause, all of these identities that you have of yourself, and so many more issues, may come to the surface for re-examination.

Now Is A Grand Time To Heal
You can move beyond the limited definitions and identities that you have used to make up your current image of yourself. This image may have gotten you what you thought you wanted, in the past, but it probably does not work well now! It is unlikely that you want the same things now. You need a new image. In fact, the old one will eventually take you down, if you donıt put it down.

You can begin to remember why you are alive at all. The knowing and wisdom can begin to take you forward into a new arena of living. Here you are empowered to bring more happiness and more fulfillment to your life.

How Do You Reach Into This Knowing And Wisdom?
You can begin this process, by facing where your life is now. What have you been avoiding about yourself or your life? Look into this from both the negative and positive perspectives.

What in your life has been hurting you that you havenıt wanted to see or admit? What or who have you been hurting in your life that you have been afraid to admit? What do you have rage about? What is really behind that chronic depression you have been feeling? What have you been secretly feeling, that you donıt feel like you have had permission to feel, or at least, to feel directly and openly?

In order to face and reveal some of the answers to these, and other, questions, you must let go of your automatic and harmful judgments of yourself. You may be making judgments about your body, or about how you are never good enough. You may be telling yourself that you are less than or better than others. You may be telling yourself that you donıt deserve to have what matters to you.

More than ever, you now need to have compassion for who you are, for all of your failures and mistakes, and for how you have failed yourself. Answering the questions above only becomes possible as you are willing to have compassion. If you hold on to those destructive judgments of yourself, you will use some of what you discover, to punish and hurt yourself more. And if you continue to do this, you will not be willing to change. And the cycle of self-destructive behaviors would keep going around and around.

As you face yourself, with compassion, while acknowledging and taking responsibility for the negative impact that you have had on others and for the negative impact that you have allowed others to have upon you, from here, you can forgive yourself. When you forgive, you open yourself to what is beyond your failures, your disappointments, and your suffering. You open yourself to that deeper knowing and wisdom that will then come to you.

When you are willing to forgive yourself, you can change your life. You will not be willing to truly change your life until you are willing to forgive.

At this point, all you have to do, to begin receiving more of the wisdom and knowing available to you, is to close your eyes and ask for greater understanding and knowing in your life:

Greater knowing and wisdom can also be available through the avenues of admitting the good, the true, and the beautiful about your self. This admitting is actually much harder than you might at first think! We recoil from seeing what we judge as negative about ourselves, yet the exquisite beauty of who we are, is even more threatening to us! It is so very important to look deeper into your life, to see the beauty of how you love, and of how you give.

You can look at how you have helped another feel happier or more confident. How have you helped others express more of their strengths and power? How have you loved so that others have felt more love in their life? How have you inspired others? How have you brought more beauty into the life of others? How have you helped another resolve something that felt impossible to them?

Some Things to Remember
Life is so very much more than we have known it to be. Life is a dream. As you begin to let the possibility of this affect you, everything in life begins to become more alive. You begin to live your life with grace.

Living your life with more grace can inspire you to change what drives you within your life. The greatest drive that exists, is to unveil or unravel the secrets and mysteries of life and of love. You can unravel the mysteries about who you are and about how you want to express yourself in this world. You can begin allowing yourself to be driven by unraveling the mysteries of what love is really about.

You can also begin to allow yourself fulfillment of your greatest need, that of being truly loving’ (instead of trying to get someone to love you). You can find fulfillment of your greatest desire: to be happy, to have more joy in your life.

You are so much more than you acknowledge and know. For the rest of your life, you could find out more and more about what that statement means. You could search forever and this would be only the beginning, a beginning with no end, an eternal discovery of who you are. A journey where every moment is filled more and more, with all that you are and all that you can be. Where every moment is eternal. Here you can brush across the knowing that you are eternal. As you begin to let this knowing change you, everything changes. Everything becomes more alive with the mystery, the mystical, and the magical of what life can be.

Lyn Marsh PhD.
www.DreamingMagic.com