Menopause. The event in every woman’s life that many of us dread due to the symptoms that, for some, can come along with it. Many of us find, as we approach midlife and begin to notice new (and often unwelcome) changes that may be associated with the menopause transition, there is also a lack of easily accessible information about menopause and how it may impact our bodies and our lives in coming years. Contrary to some of the medical and societal language and messaging around menopause, it is not a disease or a “failure” on the part of our bodies – it is a natural part of the ageing process for women and anyone with a uterus. If you are approaching or just starting to learn about menopause, this article will cover some of the basics of what is happening with your body and what you might experience through this natural phase of life.
What is Menopause?
Menopause is medically defined as the point in time 12 months after a woman’s last menstrual cycle. In the months—and sometimes years—leading up to and after that date, she may experience a variety of symptoms including hot flashes, changes in energy levels, difficulty sleeping, pain during intercourse due to vaginal dryness, brain fog, moodiness, depression and/or irritability. Menopause typically occurs when a woman is between the ages of 45-55 years old, and most likely between the ages of 50 – 52 (unless she has previously had a hysterectomy). The transitionary period can last for several years, but symptoms experienced during and around the transition can vary widely based on genetics, with other factors such as lifestyle, stress levels, traumatic life events and race also playing a role in the severity, type and duration of symptoms.
What Happens Before Menopause?
Most women experience a gradual decline in fertility as our hormones change as we age. Prior to peri-menopause, our ovaries may be releasing eggs regularly. During this time, our bodies are likely producing “normal” amounts of estrogen and progesterone throughout our cycle. Throughout each monthly cycle, there is a rise and fall of both hormones during the ovulatory and menstrual (bleeding) components of our cycle.
Peri-Menopause & Post Menopause:
It is important to note that, unlike menopause (the date 12 months after your last menstrual period), perimenopause and post-menopause are phases. Both of these phases are considered part of the menopause transition.
Perimenopause is when our body starts transitioning to menopause and our ovaries begin producing fewer hormones, causing our menstrual cycle to become erratic or irregular. This is normal! At first, some women may worry when their period is late or if they start menstruating more frequently and/or irregularly. However, this unpredictability can be a sign that a woman is entering perimenopause. This transitionary phase can begin as early as one’s mid-30s and last all the way until menstruation stops. The duration may last between 1-8 years. During the perimenopausal phase, although a woman’s fertility rate is declining, it is still possible to get pregnant. During perimenopause, women may begin to experience other symptoms, such as hot flashes, night sweats and others mentioned above.
Post-Menopause on the other hand, is the rest of our lives after that 1 year post-menstruation. While symptoms are often most intense in the year leading up to and soon after menopause, most women experience a gradual decline in symptoms, including hot flashes, night sweats and brain fog in the years after menopause. Other changes, like vaginal dryness, dry skin and urinary incontinence are more likely to be persistent. At this time, our ovaries are producing far less estrogen or progesterone and the number of hormone receptors are also declining.
All About Estrogen
Estrogen, one of the hormones produced by our ovaries, affects our reproductive system, urinary tract, digestive tract, bone development, hair, skin, nails, muscles and brain. One single hormone has the ability to affect musculoskeletal, cardiovascular and neurological systems in our body. A change in estrogen levels can produce the following:
– Breast tenderness
– Irregular or absent menstrual cycles
– Mood swings
– Hot flashes & night sweats
– Frequent urinary tract infections
Believe it or not, estrogen also plays a crucial role in brain function. Estrogen helps with the production of serotonin and the synthesis of dopamine – a lack of serotonin can contribute to mood swings and/or depression. “In postmenopausal women, the earliest change in the brain appears to be a fall in the amount of glucose used by the brain, indicating reduced brain activity. This is due to falling estrogen levels as this hormone being vital for brain glucose metabolism.” Recent studies have also shown that, “as estrogen levels fall, changes occur in the morphology, number, and interactions between nerve cells, their glucose metabolism, and gene expression. In female animal models, low estrogen has been linked to the accumulation of the abnormal protein amyloid-beta (Aβ), which is notorious for forming plaques within brain tissue, in people with Alzheimer’s disease (AD), though also sometimes in normal people.”
Estrogen levels can also be linked to changes in one’s gut biome. Changes to one’s gut health can directly affect the regulation of estrogen levels within the body. This then influences the risk of developing estrogen-related diseases including; endometriosis, polycystic ovary syndrome, breast cancer, and prostate cancer. Estrogen also plays an important role in regulating body fat deposition, cardiovascular health, bone turnover and cell replication.
Lastly, a decrease in estrogen, or the initiation of perimenopause, menopause or post-menopause, leads to an increased risk of cardiovascular disease. Scientists believe that estrogen exhibits positive effects on blood vessels, increasing the flexibility and elasticity within their inner linings. As estrogen levels decline, the blood vessels are impacted. “In fact, studies show that women who experience early menopause naturally, or have had their ovaries removed before age 40, were shown to be at a higher risk for heart disease. After menopause, other changes occur in many women, including a rise in blood pressure and cholesterol and triglyceride levels.”
What can I do to support my health and hormones through menopause?
All this may make the prospect of aging in a body with a uterus sound a little bleak! However, many women experience menopause as a wake-up call to deepen their commitment to taking care of their needs and their bodies, to learn more about the way their bodies work and to advocate for themselves and their health care needs as they age.
Every person’s experience of menopause is different and even for those who experience more intense symptoms, there are many treatment options and lifestyle adjustments that can mitigate them. Changes to diet can promote brain, heart and bone health and reduce the severity of hot flashes through the menopause transition. Frequent physical activity can help mitigate symptoms and support mental health, and a focus on strength training and plyometric exercise will support bone growth and muscle mass that naturally decrease with age.
Women experiencing hot flashes and night sweats who are at a low risk for blood clots and breast cancer may find relief from a variety of different menopausal hormone therapy treatments in the perimenopausal and early-postmenopausal phase. Those who prefer a natural option, are further away from the menopause transition, or have some genetic risk of blood clots or breast cancer may find relief from poor sleep, irritability, hot flashes and night sweats through a combination of lifestyle modifications and natural supplements like Harmony MySleep, Menopause, Menopause Day & Night or Menopause Max, which use a combination of Eastern and Western herbal medicine to address the symptoms that can result from a drop in estrogen and progesterone rather than altering hormonal levels.
Though many health care providers are still not well educated on the menopause transition, treatment options and how best to support women through this phase of our lives, there is now more authoritative, well-researched information on menopause and women’s health and hormones, and more research being done than ever before. Women are creating platforms and using them to support frank and open discussion and allow greater access to helpful, reliable and research-based information. All of these factors will support women in understanding what our choices are and in choosing the approach, treatments and lifestyle modifications that work best for our bodies, our health and our lives.
By Lindsay Mustard. Lindsay is a Holistic Nutritionist, Osteopathic Natural Practitioner and firefighter-in-training with a burning passion for health and fitness. In her osteopathic practice, Lindsay works with clients to craft a unique plan that is tailored to their specific health goals. Her nutritional practice was built around a whole food and supplement approach.
1 Thomas, Dr. Liji. “How Does Menopause Affect the Brain?” News, 27 Sept. 2021, https://www.news-medical.net/health/How-Does-Menopause-Affect-the-Brain.aspx#:~:text=Cognitive%20decline%20is%20common%20during,speed%2C%20and%20impaired%20verbal%20learning.
2 Kresser, Chris. “The Gut–Hormone Connection: How Gut Microbes Influence Estrogen Levels.” Kresser Institute, Kresser Institute, 10 Oct. 2019, https://kresserinstitute.com/gut-hormone-connection-gut-microbes-influence-estrogen-levels/.
3 “Link between Menopause and Heart Disease in Women.” Franciscan Health, Franciscan Health Alliance, 24 Mar. 2022, https://www.franciscanhealth.org/community/blog/link-between-menopause-and-heart-disease-in-women.
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