## ALLERGIES

Without rhythmic hormones, immune response can soar, activating mucous membranes, causing an increase in allergies. Adolescents, for example, are more allergic than children are because their hormones are in flux. Once adolescence is over, allergies often stabilize.

## BLEEDING OUT OF RHYTHM We have no “bleeders” on WP. We have attained formidable results in women previously diagnosed with hemorrhage by accelerating the amplitude of follicular curve, just as IV Premarin is the standard of care for emergency use. More estrogen always means less bleeding. Incompetent shedding effect is also due to fibroids. Should early bleeding occur, estrogen will need to be increased next cycle. Brown tinge is usually old blood never shed or an excess of testosterone. Periods should be red. ## BREAST TENDERNESS Until Progesterone receptors have assembled in full compliment, there will be edema (cortisol receptor driven) in the breast causing swelling, discomfort and nipple and breast tenderness. When progesterone is received at its own receptor by month 3, apoptosis and subsequent debris is cleaned up by the immune response. Breast tissue has thyroid receptors and iodine uptake portals. There is some early research that iodine influences estrogen metabolism. It has been cited to successfully treat fibrocystic breasts. Some options are to lower progesterone by 1-2 lines, soaking cabbage leaves in boiling water and then placing on the breasts. This is a localized transdermal di-indol 3methyl carbinol (DIM) effect that speeds up the cleavage of E1 (estrone) to E2 (estradiol) and the estradiol reversal back to its original precursor. Add 2 drops of Lugol’s solution in a rhythmic approach. ## CONFUSION (BRAIN FOG) Differentiate form memory loss - losing keys is memory loss; not being able to prioritize, getting lost, not knowing what to do with the keys is “confusion”. ## CONSTIPATION High serotonin controls gut mobility. As E2 goes up, serotonin goes up. Sleep to convert serotonin into melatonin to lower it. Progesterone slows down smooth muscle, slowing down gut motility. 500-100 mg magnesium may help. ## CRAMPS - Uterine Fibroids may exacerbate cramps, but cramps are usually just not enough estrogen to block prostaglandins. Non uniform shedding of endometrium and low pain tolerance is due to low estrogen in the previous follicular phase. Low progesterone receptor compliment is due to an inadequate peak on day 23. Raise the peak two lines twice a day on days 11 and 12. ## DIARRHEA #Diarrhea during menstrual cycle is normal in young women, because when you are not reproductive (low estrogen state), the symbiotic bacteria in the gut is looking for a new host. So more E2 or if progesterone is blocking too much E, bring it down 2 lines. The jello (sugar) feeds the bacteria and the pectin solidifies gut liquid. Cortef slows down the auto immune response in IBS/inflammation. Prostaglandin activity used to start the menstrual process (cramps) can also cause a secondary diarrheal response. ## EDEMA When there is not a full complement of progesterone receptors, the progesterone we put in fits into the cortisol receptors creating a “prednisone-like” response. During the luteal phase, the progesterone can cause joint swelling, painful breasts or abdominal distention. Once progesterone is properly received at the progesterone receptor site progesterone will act as a diuretic. ## EMOTIONAL ISSUES Weeping and depressive states can be addressed by raising the estrogen every time. If you see more of a bipolar picture, as about drinking. Low estrogen is characterized by irritability and lack of patience. ## FIBROIDS Leiomyomas over express both progesterone and estrogen receptors. Muscle-wall tumors that appear at a time in a woman’s life when she is dysrhythmic can, logically, be halted or regressed by restoring rhythmicity. Smaller fibroids can shrink, while larger ones either will stay stable or grow. Cortisol replacement may further re-model receptor E2 and P4 response with the 4 peak a day release of E2 at the cortisol pulses. Reducing stress (blood sugar) meaning insulin response at the muscle wall can help. Fibroids are a compensatory mechanism that occurs as hormones fluctuate and fall off in mid life. Many decrease when testosterone is added in a normal rhythm. ## HAIR LOSS could take 3-6 months to see a difference in hair growth. Hair loss is a common complaint of menopausal women because as estrogen decreases, acute hair loss can be the result of some physical or biological, stress or event 2-3 weeks earlier. TSH increases along with androgens. Hyperthyroidism in perimenopause culminates in frank hypothyroidism after menopause. Too much progesterone may also result in hair loss. ## HOT FLASHES/NIGHT SWEATS Fluctuating levels of estrogen in perimenopause precipitate vasomotor symptoms; however on the WP the dose of E2 is stable, so it is a receptor driven event. Neurotransmitter response controls capillary dilation and constriction both internally and in the skin, hence the difference between flushes and flashes. Flashes end in a sweat. Excessive sweating accompanies changes in skin color and temperature. Some women experience estrogen fluctuation only at the receptor level during sleep, when cortisol falls at night and estrogen is bound more thoroughly. Hence night sweats. Since night sweats and hot flashes are caused by fluctuating hormone at the receptor level, sometimes women beginning the WP have hot flashes when they haven’t before because the sudden surge of estrogen can deregulate receptors spreading out the daily dose for at least three days allows receptors to catch up. ## INCONTINENCE Incontinence is too-low estrogen or fluctuating receptors. Raising the Day 1-28 E2 dose is often all it takes. If it occurs in the luteal phase, the progesterone is blocking too much E2. Fluctuation is resolved by addressing 72-hour receptor rollover by spreading out the dose. ## JOINT PAIN Most joint pain is just the garden variety aging and sleep deprived “old tiner’s disease” not to be confused with Alzheimer’s. Estrogen will usually fix it. If the pain is worse in the morning with stiffness, higher estrogen is indicated. If it is worse at night, Cortef regimen may help. Rheumatoid or osteoarthritis is a different matter. More estrogen will not only block pain but increase progesterone reception to afford immuno-suppression of TNFa. In the autoimmune case of rheumatoid arthritis, progesterone’s ability to imuno-suppress is even more substantial. ## LIBIDO Libido is the brain’s response to rhythmic estrogen in both men and women. Libido is lost in low estrogen states because pulsitility and feedback of Day 12 estrogen peak in a mammal’s menstrual cycle feeds back to pituitary, creating the characteristic LH surge on Day 13 and 14 provoking theca cells to secrete testosterone in preparation for ovulation. Vaginal mucosa is engaged and lubricated when these pulsitile time points are made depending on the amplitude. Anorgasmic people usually have high serotonin, prolactin are prone to headaches, high blood pressure, and high blood sugar because in order to have high serotonin and prolactin insulin must be up. Headaches and high blood pressure often follow high insulin. # MEMORY LOSS The memory loss of dementia is classic in the aging process that is termed “senile” dementia. Memory loss is essentially the loss of D2 receptors made by E2. The same mechanism that leads to memory loss is evident in acute phase in extreme old age as Parkinson’s disease. Much of memory loss is centered on sleep deprivation. The lack of sleep means that serotonin can’t turn into melatonin. High serotonin inhibits short term memory storage. That’s why you can remember your past but not last week or two days ago. ## PALPITATIONS The TSH curve is in inverse proportion to the E2 curve. When estrogen loses its amplitude, the negative feedback on TSH is lost. Thyroid hormones pour into the negative space causing palpitations. Put back the E2 modulate receptor response and they stop. MElatonin blocks E2 receptors in the hours before midnight, so they will repopulate after midnight. Use it rhythmically. ## SLEEP DISTURBANCE Sleep is REM and N-REM. The REM is driven by melatonin phase; melatonin secretion also controls white cell immunity like macrophages, leucocytes, and lymphocytes. N-REM is driven by the prolactin phase provoked by the previous timing of melatonin and varies seasonally in duration. This prolactin phase controls NK and T-cells and auto immunity after midnight. A lack of sleep is characteristic of perimenopause and menopause, adolescence and pregnancy, and classically, at times of hormonal fluctuation. Melatonin blocks estrogen receptors, so teenagers tend to stay up all night to get, essentially, get “more bank for the buck” or to get more hormone response from what sex steroids they are secreting to get through puberty. Menopausal women as hormones fall off, find themselves back at the same strata hormonally as adolescents trying to keep melatonin from blocking estrogen by being awake all night. Interval waking is the biggest complaint of peri menopausal women usually at 1 & 3 am and 2 & 4 am. In those periods cortisol is down, estrogen levels drop, and receptors are empty. Sleep is the biggest issue - and if we can resolve it many other issues will resolve also, like brain fog, emotional issues, joint pain, etc. Exercise will also help a great deal. ## TINNITUS Tinnitus can also be caused by hypothyroidism. More than likely, it is caused by low estrogen and fluctating receptors. Thyroid hormones may be needed plus more estrogen.