Below is an article written by Dr Wilson for A Child After 40, a website dedicated to women who have had children later in life, or are on their fertility journey in their 40’s.  


Women who give birth after 40 face the often challenging reality of raising young children while transitioning through menopause.  Moms in their 40’s and 50’s are turning to bio-identical hormones for a safe and effective means of coping with these changes.


Am I peri-menopausal or am I just going crazy?

I get this question a lot, so don’t be afraid to ask it!  Labile emotions, memory decline, and physical changes can cause you to feel as though you are not yourself.  Peri-menopause symptoms are directly related to hormone imbalance and hormonal decline.  This transition occurs as the ovaries fail to ovulate, and cycles become irregular or absent.  Hormone levels fluctuate, causing a myriad of uncomfortable symptoms:

  • Hot flashes/night sweats
  • Fluid retention/weight gain
  • Headaches
  • Insomnia
  • Mood swings, irritability, depression, anxiety
  • Poor memory
  • Difficulty handling stress
  • Fatigue
  • Fibrocystic breasts, uterine fibroids
  • Low libido
  • Vaginal dryness


Will I feel better on estrogen?

Many peri-menopausal women are prescribed synthetic estrogen, or experiment with estrogenic supplements when in fact, their symptoms are not due to lack of estrogen.  Despite the belief that all menopausal symptoms are caused by low estrogen levels, other hormone imbalances are more common!

A vast majority of peri-menopausal symptoms are due to estrogen dominance or estrogen/progesterone imbalance.  When too much estrogen exists relative to progesterone, using estrogen would make symptoms worse.


What are bio-identical hormones and are they safe?

Bio-identical hormones are identical to those that your body produces.  They are not synthetic or derived from animal hormones.  When used properly, side effects are infrequent, and bio-identical hormones can reduce your risk of cardiovascular disease, cancer, and osteoporosis.

Progesterone is administered topically or orally.  Progesterone is used to balance estrogen dominance, resolve fibrocystic breasts, improve sleep, mood, libido, headaches, and memory.

Bi-Est is an estrogen cream containing a mix of 2 forms of estrogen: estriol and estradiol.

Estriol cream is typically administered as a vaginal cream, and it contains estriol.  Bi-Est and estriol are used when estrogen levels are low and symptoms such as depression, brain fog, vaginal dryness, and urinary incontinence exist.

Discussing your symptoms with a physician who is experienced in bio-identical hormone therapy, and performing appropriate hormone testing will help determine what therapy is needed.

Thorough testing can also determine whether thyroid or adrenal support is necessary, and if bio-identical androgens (testosterone or DHEA) are needed.  Bio-identical hormones should only be obtained from a compounding pharmacy via physician’s prescription.