2. Osteoporosis

3. Dementia and Alzheimer’s Disease

4. Arthritis

6. Symptoms of Estrogen Decline Hot flashes Vaginal dryness Changes in skin tone Depression Poor concentration and memory Irregular periods Hair loss and thinning Pain and inflammation Weight gain Decreased memory and cognitive function Dysglycemia

7. Typical Management of Menopause

8. Changes in pro-inflammatory activity after menopause There is now a large body of evidence suggesting that the decline in ovarian function with menopause is associated with spontaneous increases in pro-inflammatory cytokines.

10. Osteoporosis

11. Dementia and Alzheimer’s Disease

12. Arthritis

14. What if the Adrenals are weak? There is no compensation for estrogen loss this will lead to hormone fluctuations in the body all the typical symptoms will occur.

15. Symptoms of Estrogen Decline Hot flashes Vaginal dryness Changes in skin tone Depression Poor concentration and memory Irregular periods Hair loss and thinning Pain and inflammation Weight gain Decreased memory and cognitive function Dysglycemia

16. In addition potentially devastating mechanisms are getting activated: There is six factors that cause systemic inflammation in Perimenopause Those factors potentiate each other and have devastating effects on cell aging and tissue breakdown Hormone replacement is not addressing those mechanisms since they stay active once triggered

17. First mechanism: If there is a decline in Estrogen levels (specifically estradiol) in a female patient in premenopause, the inflammatory cytokine system is up-regulated and may stay up-regulated EVEN AFTER ESTROGEN LEVELS ARE RESTORED. Depending pre-existing inflamed areas in the body this up-regulation will determine which systems are most impacted by this process.

18. Preixisting Activity? Immune activation (which can lead to autoimmune diseases) Neuro-inflammation (which can lead to dementia, and many other neurological conditions) Free Radicals (increased cancer risk) Higher stress response (individual loses ability to cope with stress) Body fat (produces inflammatory agents)

19. Second Mechanism