Menopause: The Fork in the Road
Ever since I went through menopause……. ’I’ve been unable to lose weight’, ‘My memory hasn’t been the same’, ‘I’ve got high blood pressure and the doctor says I’m pre-diabetic’, ‘I’ve never been able to sleep like I used to’. These are some of the things I hear from post-menopausal women.
Peri-menopause (the 2- 10 yrs before menopause) is a time of major metabolic upheaval that can have a significant impact on long term health. It is a bit like puberty in reverse, characterised by large swings in hormones as the body tries to push the ovaries into action for their last hurrah.
The withdrawal of oestrogen can cause up to 25% drop in brain energy leading to poor concentration and memory and brain fog. Low progesterone, which occurs when a woman stops ovulating can cause insomnia, anxiety, depression and a low stress threshold as progesterone has a stress buffering effect on the brain via its conversion to a calming brain chemical. Low oestrogen and progesterone can cause changes in the brain that can act as a tipping point for the development of dementia as a woman ages so it’s important to support brain health during this time.
While the end result of menopause is low oestrogen, during perimenopause, oestrogen can increase dramatically over the menstrual cycle, even causing breast growth and laying down of fat, which normally happens during puberty. High oestrogen can cause histamine release resulting in itching, hives, nasal congestion, fluid retention, tinnitus (ringing in the ears), irritability, insomnia, brain fog, and headaches or migraines. In turn high histamine can drive high oestrogen levels.
A woman going into menopause with any degree on insulin resistance, is in for a rougher ride, as insulin resistance (what happens when the body stops responding to insulin causing higher glucose levels in the blood) amps up during peri-menopause. If there is also higher testosterone exposure (due to low oestrogen) this causes women to put weight on around the middle (the spare tyre). It is this weight gain and insulin resistance that will increase the risk of heart disease, high blood pressure and stroke.
Officially Menopause occurs one year after the final menstruation…phew! Support through menopause with natural therapies, such as specific herbs, nutrients and foods, can lead to better health in the post-menopausal years and enjoyment of a kinder and calmer phase of life.
Peri-Menopause Versus Menopause
Although these terms are used interchangeably sometimes, they are two very clear-cut phases women experience in midlife.
Peri-menopause is the time before menopause happens and generally lasts from 4 – 10 years. The average age it occurs is from mid 40s to mid 50s, but can be earlier or less rarely, later.
I like to think of it as puberty in reverse – as it’s a time when women experience a lot of hormonal upheaval. Think of a hormonal teenager – only older and more tired! Hormones start to swing up and down as the body tries to whip the ovaries into one final push at reproduction.
This manifests as symptoms such as:
- Irregular menstrual cycles
- Insomnia and sleep disturbance
- Irritability, mood swings
- Changes to the monthly cycle – either longer or shorter
- Changes to periods – usually heavier, sometimes lighter
- The famous hot flushing and night sweats
- Changes to libido and vaginal dryness
- Fertility generally declines – but ‘change of life babies’ can happen.
- Contraception is still important.
- Brain fog, loss of memory and concentration
- Weight Gain, especially around the middle
For a certain percentage of women symptoms can be very severe and debilitating. If symptoms are affecting your life you don’t have to tough it out. There are nutrients and herbs that can be very effective in supporting women at this time in their life.
Menopause, by definition, occurs one year after the final period. For many women menopause is the calm after the storm, a kinder phase of life. But some women do continue to have hot flushes and other symptoms.
If women in peri-menopause are given the information and support they need studies show they are less likely to have more severe health problems in the decades that follow, particularly osteoporosis and cardiovascular disease.
Peri-menopause and menopause are two very distinct phases of a women’s life. Peri-menopause affects women in different ways depending on their health going into peri-menopause and their health history. It’s important to tailor treatment to suit a women’s individual health issues. Helping the symptoms, and transition of women in peri-menopause may also help prevent some of the health issues of women as they age.
The Silent Diseases of Menopause
We hear so much about peri-menopause and not a lot about menopause itself.
Menopause, by definition, occurs one year after the final period. The average age this occurs is 51yo, but can be five years either side of that. For many women menopause is the calm after the storm, a kinder phase of life. But some women do continue to have hot flushes and other symptoms.
Studies have shown the more severe symptoms women experience during peri-menopause (4-10 years before menopause), such as hot flushes, night sweats, brain fog, fatigue, mood swings, weight gain and poor sleep the more like they are to experience more significant health issues into their older years.
The two big silent diseases in menopause that affects women’s health in their older decades are:
- Osteoporosis: and peri-menopause is THE time to address this, not when bones mass has already declined. Bone declines more sharply in the year after the last period than at any other time. It is good to establish a baseline for bone density and develop strategies to protect bone mass.
- Cardiovascular disease: Blood vessel stiffness accelerates within one year of a women’s final menstrual period. This can lead to high blood pressure and more likelihood of a cardiovascular event such as stroke or heart attack. The year after periods cease is a great time to support arterial vessel health and may help prevent the onset of heart and vessel disease in older women.
Strategies to help support what’s known as “metabolic flexibility” into menopause and beyond may be very helpful in supporting women in the prevention of the silent diseases of osteoporosis and cardiovascular disease.
Because, speaking for myself, I want to enjoy my older years. Embrace the grey hair and freedom from worry about what others think! Have the energy to take up travel, to hike and cycle, or just enjoy the grandchildren more. And enjoy more books and gardening and maybe do something creative like pottery or painting. This can be a wonderful time in any woman’s life, especially if she has good health.
Navigating Menopause over Christmas and New Year.
As if Christmas wasn’t stressful enough…. along comes menopause. Your moody, irritable, weepy, tired, having erratic and sometimes heavy bleeding and you’re getting hot flushes and not enough sleep.
Your feeling physically and mentally drained and now you have to be superwoman and concoct a masterpiece in the kitchen on Christmas day – often the hottest day of the year which you know is going to just about set you on fire, and not the way you’d like.
Here are my top tips for coping with Christmas:
- Nominate someone else to have it at their place. Foist all that responsibility on an unsuspecting daughter / daughter in law / son / son in law / sister / friend etc etc.
- Self-care is not selfish – go on a holiday – preferably to a place with air-con and a pool. If that’s not possible – look to nurture yourself with some time out – have a bath with your favourite book, scents, candles, music; read a book; enjoy your garden; go out to your favourite restaurant / café; walk in nature.
- Book a restaurant for Christmas. A lot of restaurants cater for this and it takes the pressure of everyone.
If you do decide to host Christmas:
- Ask everyone to bring a plate. And delegate who brings what – ie salad, pavlova, potato bake etc. That can really lighten the load.
- Don’t try and do the whole box and dice roast meal – hot flushes and cooking a roast in the middle of an Australian summer are not a great mix.
Be aware hot flushes can be triggered by alcohol, spicy foods and caffeine. Alcohol can also make you more prone to mood swings and weepiness so it’s good not to over indulge – as tempting as it is!
And lastly remember to sit back and enjoy family and friends and good food!
Has the horse already bolted on your bone density?
How do we know how strong our bones are?
The truth is we usually don’t until it’s too late. We find out after a fall causes a broken wrist or ankle or worse, a broken hip.
By the time we get our complimentary bone check at 70 years old the osteoporosis horse could have already bolted.
I see a lot of women in their 60s who already have a diagnosis of osteoporosis. If they wait until 70 to get a bone density test, that’s up to 10 more years of bone loss.
It is especially important to get your bone density checked earlier if you have risk factors.
These include:
- Certain medications (such as antacids and steroids)
- Poor Gut Health causing poor absorption of nutrients
- Poor Diet (read typical Western Diet)
- Sedentary lifestyle
- Thyroid or parathyroid problems.
If you do get a diagnosis of osteopenia (weakening bones) or osteoporosis (weak bones) then it’s important to be taking the correct supplements.
The wrong supplements at best do nothing and at worst, may do harm to your cardiovascular health.
Gut health, diet and exercise also play a powerful role in bone health.
