Women are born with all of their eggs in their ovaries; they don’t make more throughout their lifetime. Once these eggs run out (from monthly ovulation cycles), menopause occurs. Menopause is achieved after a year without menstruation, in the absence of any unnatural interference, and it generally takes place during the late 40s or early 50s (surgery or damage to ovaries can cause menopause to take place earlier).
Once menopause starts approaching, your body produces less of the hormone estrogen, which leads to a change in your menstrual cycle, which becomes more irregular and eventually stops all together. Progesterone production during/after menopause also drops. This differs significantly from your pre-menopausal hormonal fluctuations.
The Phases of Menopause
Perimenopause
This phase can start eight to ten years before menopause, when the ovaries start gradually producing less estrogen. During the last year or two of this phase, this decrease in estrogen accelerates. Menstrual cycles are still taking place during this phase, and pregnancy is still a possibility. Many women start experiencing menopause symptoms during perimenopause, as well as breast tenderness, worsened PMS, and menstrual period changes.
Menopause
During this phase, your menstrual cycle has ceased, your ovaries have stopped releasing eggs, and they release very little estrogen. As mentioned above, the diagnosis of menopause can only be made after 12 consecutive months without a menstrual period.
Postmenopause
This phase starts after you have reached menopause, and continues for the rest of your life. Menopausal symptoms will ease for most people, but some might still experience them for a few years.
With the low levels of estrogen in your body, you are more prone to conditions such as osteoporosis and heart disease in your postmenopausal phase.
Symptoms of Menopause
Body Systems
Reproductive System:
- Change in cervical mucous (less of the thick cervical mucous)
- Drop in libido
- Vaginal dryness
Endocrine System:
- Hot flashes and night sweats
- Weight gain (less productive fat burning mechanisms)
- Dry skin, eyes, or mouth
Nervous System:
- Mood swings and irritability
- Depression and anxiety
- Sleep problems due to hot flashes and night sweats
- Mild memory loss and difficulty concentrating
- Headaches
- Fatigue
Excretory System:
- Incontinence (bladder leakage)
- Frequent urination
Cardiovascular System:
- Increased risk of cardiovascular disease (estrogen plays a cardioprotective role in the body)
- Changes in cholesterol, which increases the risk of a heart attack or a stroke
- Heart palpitations
Skeletal and Muscular System:
- Decreased bone density
- Higher risk of osteoporosis
- Loss of muscle mass
- Stiff and achy joints
Lifestyle Changes to Ensure an Easy Transition Into Menopause
Nutrition
Nutrition is a part of our lives that can have a huge impact on our health, and it, unlike most things, is completely under our control. As such, it is important to look at your nutritional habits, and adapt them to suit where you are in life. If you would like to follow a specific diet, the Mediterranean diet is a good option, as it curbs inflammation and has many hormone health enhancing aspects to it. However, some people feel diets are too constricting, in which case, here are some general guidelines to follow:
Foods to Focus on:
Phytoestrogens: Phytoestrogens, also known as plant estrogens, can be found in foods such as soybeans, chickpeas, peanuts, flax seeds, barley, grapes, berries, plums, green and black tea. These compounds acts like estrogen inside the body, countering the effect of the drop in estrogen from menopause, and soothing the symptoms thereof.
Dairy: Dairy contains calcium, phosphorus, potassium, magnesium and vitamins D and K. All of these vitamins and minerals are essential for good bone health, and as such serve to counteract the decreased bone density that comes with menopause. Furthermore, dairy contains the amino acid glycine, which promotes better sleep. Finally, studies have found that dairy decreases the risk of early menopause. Pay attention to where the dairy comes from; dairy can be just as detrimental as it can be helpful. Aim for grass-fed or unpasteurized dairy.
Quality, lean protein: Protein further impacts bone health, decreasing your risk of bone injuries. Sticking to leaner meat will also help manage your weight.
Fruits and vegetables: This food group contains an abundance of vitamins, minerals, fiber and antioxidants. Cruciferous vegetables aid in a healthy estrogen balance and berries are rich in antioxidants. Fruits and vegetables are not only good for your general health, but also reduce menopausal symptoms. Spinach, turnips and collard greens are also a good source of calcium.
Healthy fats: These fats, especially omega-3 fats, combat menopausal symptoms such as hot flashes, and are generally key to healthy hormones.
Whole grains: These grains contain healthy nutrients (fiber, vitamin B, thiamine, niacin, riboflavin and pantothenic acid), which all play a role in decreasing the risk for heart disease.
Good Foods
- Ground flax
- Bee pollen
- Cacao
- Coconut
- Fennel
- Mocha
- Sweet potatoes
Foods That Add to the Menopausal Symptoms
- Refined sugar and processed carbs
- Alcohol and caffeine
- Saturated and trans fats
- Spicy foods (hot flashes and night sweats)
General Guidelines
- Switch from saturated to unsaturated fats
- Decrease your red meat intake and focus on fish and legumes instead (iron can be found in eggs, leafy green vegetables and nuts too)
- Eat a lot of nuts, seeds and legumes
- Reduce your intake of refined sugars
- Reduce your intake of processed foods
- Fruit and vegetables should take up half of every meal
- Higher fiber foods, such as wholegrain foods, are best
- Vitamin D helps with bone health, so expose your skin to some sunlight or eat oily fish
- Get enough calcium in (dairy)
- Use sugar and salt in moderation. Excess salt can lead to blood pressure problems.
- If you would like to take supplements, calcium and vitamin D are the two most important ones to focus on. Make sure to discuss this with your health professional first.
Most of these guidelines are similar to nutrition for healthy hormones, with some added, menopause-specific guidelines.
Lifestyle Changes to Improve Menopausal Symptoms
There are lifestyle changes that you can make that will not only improve your menopausal symptoms, but increase your overall health:
- Get plenty of rest
- Exercise regularly, including body-weight and cardio activities
- Decrease stressors
- Stay hydrated
- Practice relaxation techniques
- Get sunlight on your skin daily
- Stop smoking
- Keep up the social aspect of your life- talk to people who have also experienced these symptoms
- Maintain a healthy weight
Finally, don’t be scared to adapt to your symptoms. If you get hot flashes, wear light clothing and buy a fan, if you feel tired, take a nap. Menopause is a natural process that should not be a cause of shame or embarrassment. Embrace every stage of life, including this one.
The most important thing you can do is to be kind to yourself! Listen to what your body needs, and don’t be scared to ask for help. Meet your body where it’s at.
Hormone Therapy for Menopause
There are three types of hormones that can be used in hormone therapy:
- Synthetic hormones- these are man made hormones made to mimic the structure and function of our bodies’ naturally made hormones
- Body-identical hormones – these are more natural ingredients, however, they are unregulated and unlicenced. Furthermore, they come in one size fits all, with the same ratio of hormones for everybody and a set dosage
- Bioidentical hormones- these are the good stuff.they are sourced from natural sources that are identical in chemical and moleculare structure to our natural hormones. These can be individualised by changing up the ratio of e to p.
From that description, it is clear that the best way to go is the last option!
A very important step when looking into doing hormone replacement therapy is to test your hormone levels. Salivary or urinary tests work best for this.
After testing and understanding your own hormone levels, it is possible to take the right ratio of estrogen to progesterone for your body. You can then also continue testing to make sure you stay on the right dosages.
Some HRT tips:
- Progesterone can flip to estrogen in the body, which is known as aromatization. This is why its not necessarily a good idea to only take progesterone. There are natural aromatization inhibitors, like passionflower, or you can just chat to your doctor about it.
- Taking hormones orally means that the hormones have to go through your liver, which can cause problems for at risk patients. Therefore try to avoid taking them in this form.
While there are a vast amount of adjustments you can make to ease yourself into menopause, or even relieve some symptoms, there is no harm in seeking medical help. Reach out to your doctor before taking any supplements, or making drastic lifestyle changes, such as a drastic change in your exercising habits, to ensure these changes are cohesive with your health.
