When looking at a post-menopausal woman related to hormones, what is ideal both in terms of choice of markers to run, as well as reference ranges pls?

Answer:

Decreased	Increased
Adiponectin AMH Estradiol Ghrelin HDL-cholesterol Inhibin A and B Progesterone	Apolipoprotein B Cholesterol, total and LDL FSH Leptin LH Resistin Triglyceride

Please refer to our blog entries and White Paper on Menopause for more information and ranges.

Here you'll find optimal takeaways that can help optimize the transition from premenopause to postmenopause.

The ODX Menopause Series

Although the phenomenon of menopause is inevitable, the symptoms and increased risk of chronic disease that accompany it may not be. A healthy lifestyle and diet, along with targeted supplementation, may not only help alleviate symptoms but also help reduce the risk of preventable disease going forward.

The following optimal takeaways can help the clinician manage menopause safely and effectively.

Menopause occurs in phases and usually begins between ages 45 and 52
Alterations in menstrual cycles can be the first noticeable sign of menopause, followed by symptoms and biomarker changes
Estrogen and progesterone regulate mitochondrial, cardiometabolic, neurological, skeletal, and reproductive functions
Estrogen specifically
- Reduces oxidative stress, promotes nitric oxide production, has anti-inflammatory actions, and regulates metabolic, anti-inflammatory, mitochondrial, and apoptotic genes.
Physiological and biochemical changes associated with menopause increase risk of chronic disease and dysfunction including obesity, CVD, metabolic syndrome, depression, NAFLD, inflammation, and oxidative stress
Monitoring biomarkers associated with menopause and cardiometabolic comorbidities would be prudent and should include
- Estradiol, progesterone, testosterone, DHEA, SHBG, FSH, AMH, lipids, leptin, adiponectin, vitamin D, thyroid markers, inflammatory markers, homocysteine, oxidative stress markers, and bone markers
Natural medicine, nutrition therapy, and targeted supplementation may relieve symptoms without hormone replacement therapy
If utilized, HRT should be initiated at the lowest dose needed to resolve symptoms, especially vasomotor symptoms, and minimize systemic estrogen exposure
Most postmenopausal women will have a serum estradiol level of 9.3 pg/mL (34 pmol/L) or less without hormone replacement therapy
A clinical goal for estradiol of 60 pg/mL (220 pmol/L) would be required to reduce risk of osteoporosis and reduce hot flashes by 50%
Transdermal HRT may have a better safety profile than oral estrogen
A sustainable Mediterranean diet is recommended for reducing menopause symptoms, and reducing risk and severity of the chronic disorders that can increase during menopause
Targeted supplementation may be needed to address micronutrient insufficiencies or increased requirements
A trial of natural products can be implemented including black cohosh, chasteberry, evening primrose oil, isoflavones, and traditional Chinese Medicine
Mind-body techniques may help relieve symptoms and can include cognitive behavioral therapy, hypnosis, deep-breathing, relaxation, yoga, and mindfulness-based stress management.