How Does Menopause Affect Your Body?
I’m always fascinated by how certain life events can effect people differently. Some people sail through without things affecting them others seem to suffer greatly. I recently noticed a shift in the type of clients I have been seeing. More and more of my clients are either entering peri-menopause, experiencing menopause or are transitioning to the post menopause phase of their life.
Being in my 40’s myself and starting to experience what might possibly be pre-menopause symptoms I thought it time I learnt more about this natural process. Afterall, forewarned is forearmed! My mother didn’t experience many menopausal symptoms and whilst there is a genetic component this doesn’t necessarily mean it will be the case for me. However, rather than approaching it as a negative experience I thought I would find out what POSITIVE things I could do to soften any unpleasant symptoms and therefore reinforce the POSITIVE BENEFITS of being a post menopausal woman.
I have more of an understanding of the body from a Chinese Medicine perspective so I thought I would start my search with getting to know the western medicine perspective. The following is a summary of a webinar I did with Professor Bruce Robinson who is a Medical Doctor and retired Professor passionate about integrating western medicine and oriental medicine and integrating traditional and natural medicines into main stream treatments.
The information covers the physiology and biochemistry of menopause, the main symptoms and their triggers, weight management, the treatment of menopause and HRT.
Menopause
Menopause is the final cessation of periods and fertility. A woman must not have had a period for 12 months to be considered menopausal. It is a necessary process of aging and the final process takes place over 2-3 years. It usually begins at age 48-49 and is, on average, complete by the age of 51. However, menopausal symptoms can begin 10 years earlier and even as young as 35. These symptoms are classed as pre-menopause and then peri-menopause in the last couple of years before the final period. Symptoms arising from menopause can last as long as 10 years.
Menopause can occur early if the ovaries have been removed. It rarely occurs naturally in the early 40’s and sometimes doesn’t occur till the late 50’s. This is something a client of mine experienced. Menopausal symptoms started in her early 50’s and carried on for many years. It was an awful time for her. Her periods became heavier and heavier. She experienced terrible flooding and had to have multiple iron infusions as she was experiencing fatigue from iron deficiency. Her final period did not happen till her late 50’s.
Physiology and Biochemistry
The balance of female reproductive hormones begins to change in a woman’s late 40’s. There is a reduction in estrogen and a greater reduction in progesterone. These are called steroid hormones. They are important for good health and are closely related to each other biochemically. Steroid hormones are organic chemicals that come from cholesterol.
Cholesterol is not the total baddie that it has been made out to be. It’s actually quite important. Every cell in the body, except red blood cells, manufactures cholesterol. A major percentage of the actual cholesterol that is used by the body is manufactured in the liver from ingested lipids (the building blocks of all cells), proteins and carbohydrates. We need an adequate intake of fats and triglycerides (the main component of natural fats and oils) for the liver to process. And, when the liver is functioning normally a proper balance of lipids (building blocks) is maintained throughout the body.
The flow of steroid hormones goes like this: From Cholesterol we get Pregnenolone which is used by the mitochondria (engine room) of all cells, except red blood cells. It is the precursor to all steroid hormones; From Pregnenlone we get Progesterone which is made primarily in the ovaries after ovulation. Progesterone is what preprares the uterine lining for a possible pregnancy; From pregnenelone we also get the steroid hormones cortisol, corticosterone, aldosterone and testosterone; Testosterone which is made in a females ovaries is the precursor to all Estrogens.
There are three types of estrogens - estradiol, estriol and estrone. They are made primarily in the ovaries but also in fat cells, muscle cells and skin. Estrone is the estrogen of menopause and has much weaker estrogenic effects than estradiol or estriol.
What are the symptoms of Menopause?
In Pre-menopause periods where no egg is released from the ovary can begin to occur. This causes estrogen dominance because without ovulation no progesterone is secreted so there is no balance to the estrogen being secreted by the ovaries and fat and muscle cells. Estrogen dominance can cause more breast swelling and tenderness, sudden and often unpredictable mood swings, sleep disturbances, a tendency to experience water retention and a newly increased likelihood of putting on weight more easily than before.
In perimenopause, which occurs in the year or two before menopause, there can be an onset of hot flushes, night sweats, vaginal dryness (women who are sexually active stop the vaginal mucusa from atrophying so report less dryness - use it or lose it is the lesson), increased body odour, depression, anxiety, thinning of head hair, increased facial hair, chronic fatigue, sleep disruption, loss of interest in sex or love life (many women report their libido increases after they get through the menopausal years).
Symptoms can begin in earnest and become more apparent in the late 40’s and continue through menopause (the average age of which is 51). Hot flushes and night sweats are the most common and occur in about 85% of women in industrialised countries.
“ I don’t really want to go through this menopause thing!”
Why are hot flushes so common? It all comes down to the control centre of the body, the Hypothalamus. Located in the brain it controls our appetite, body temperature and the finely tuned balance of our parasympathetic and sympathetic nervous system.
The hypothalamus also controls the endocrine system and stimulates the pituitary gland to secrete hormones that tell all the other glands when and how much hormone should be released. The thermoregulatory centre of the body is right next to the centre in the hypothalamus that controls the secretion of female hormones.
When estrogen levels fall during early menopause, the hypothalamus starts firing off more and more gonadotropin-releasing hormones to the pituitary gland putting pressure on it to ask the ovaries to release more estrogen. Which they don’t. This firing off also activates the thermoregulatory system to open up the blood vessels in preparation for a flood of estrogen to be sent around the body, which doesn’t happen. Instead the sudden increased blood flow through the blood vessels especially of the face, head and neck can feel like an intense heat.
Alcohol, nicotine, caffeine, spicey foods, exercise and chocolate can all trigger hot flushes. Too hot outside or too hot inside can also make it feel worse as can sleep deprivation, excessive stress and failure to drink enough water.
Osteopersosis is also common in menopausal women. So it is best to ensure you are getting 800mg of calcium daily through food such as non or low fat milk products, green leafy vegetables, canned sardine or salmon as well as possibly taking 1 gram of elemental calcium in supplement form. Sunlight plus daily moderate exercise is also important as is taking 1000-3000 iu/day of vitamin D if your blood tests show that your Vitamin D is low. Those most at risk of osteoperosis are cigarette smokers and those who exercise to extreme eg marathon runners, fitness instructors, ballet dancers.
How do you manage weight gain in Menopause?
It is normal in terms of the hormone changes to gain some weight in mid-life. However, many women find themselves overweight in their 50’s and 60’s. With a decrease in estrogen the hypothalamus stimulates the person to eat more and as a result to deposit increased body fat in the abdominal area. Remember, the body wants estrogen so is trying to get more released from fat, muscle and skin cells.
We are faced daily with temptations that may be worse than we think. Diet is super important during pre-menopause (your 40’s) in order to avoid too much abdominal fat. Truncal obesity sets off a chain reaction of poor health issues - hypertension, an increase in LDL cholesterol (the not so good cholesterol), insulin resistence (precurser to diabetes), vascular inflammation and heart disease.
To lose weight you need adequate moderate exercise daily and a balanced diet with less than 30% fat and limited sugar (5-10 teapoons at most per day). To work out how much sugar you’re consuming you need to substract the fibre grams from the carbohydrate grams and divide by 5. Eg 28 grams of carbohydrate minus 3 grams of fibre = 25 grams divided by 5 = 5 teaspoons of sugar. 2 slices of wholemeal bread can equal 5 teaspoons of sugar as an example.
It’s also wise to take a multivitamin with minerals daily as well as fish or krill oil capsules for omega 3 fatty acids and a calcium and magnesium supplement.
Women who follow this regime complete menopause and emerge on the other side in good health and good physical condition with a greatly increased chance of a long pleasant life ahead.
Help with Treating Menopause Naturally
It’s important to remember that Menopause is a natural process of aging. It’s not a disease so is not something that needs to be cured. It’s actually a major process of transformation in a woman’s life. There is the physical process of moving from being a fertile woman to a non-fertile woman as well as the mental and emotional (soul) process of transforming into the wise woman and for many finally being able to truly live their life purpose.
Treatments for menopause are more about alleviating unpleasant symptoms and ensuring good health, wellbeing and longevity. Some good tips for personal management of menopause symptoms are:
For reasons mentioned above, hot flushes and the likelihood of putting on extra weight, severely limit alcohol, caffeine, sugar and junk food.
If you’re a smoker this really is the time to STOP SMOKING.
Increase your exercise if possible to a regime of daily moderate exercise. When we exercise we release heat by opening up the pores and sweating so this should decrease the number of hot flushes. By including weights in your regime you’ll also be supporting your bones. If you haven’t heard of or tried rebounding I highly recommend it as a choice of exercise. It’s less stressful on your joints, great for moving the lymphatic system and for strenghtening the pelvic floor.
Develop some good stress management strategies such as breathing practices, yoga nidra, meditation, qi gong, take up a creative hobby, get a regular shiatsu massage. This is especially important if you have experiences of anxiety or depression. In particular, there is research to show that women who experienced post natal depression are more likely to experience depression around menopause.
Consume foods rich in Vitamins B and E.
Consume phytoestrogens. These are found in fermented soy products such as tempeh, miso and natto. Tofu is not well fermented so is not a good phytoestrogen source.
Get enough vitmain D from the sun or take Vitmain D3. Remember your belly and thighs are like solar panels and are the best parts of the body to absorb vitamin D from the sun so don’t be shy in exposing them especially on sunny autumn, winter and spring days.
Oriental medical treatments such as acupucture, shiatsu massage, cupping, moxa and chinese herbal therapy are very effective at managing menopause symptoms and creating better health and wellbeing so these should be used liberally.
Anecdotal studies have found certain western herbal remedies like Black Cohosh, Agnus Castus, Ginko Biloba, Red Sage, Cayenne Pepper and St John’s Wort to be good for symptoms such as depression, hot flushes, migraines, anxiety and heart palpitations. There are some retail remedies that contain these but it is best to work with a naturopath so as to ensure you’re getting what your body needs.
If you’re more inclined to take Western Medical drugs speak to your GP about HRT (Hormone Replacement Therapy). HRT is an estrogen plus a progestin taken every day or cyclically. It can be taken in pill form, as a transdermal patch, vaginal ring or a skin cream or gel. Estrogen can be given as a conjugated animal estrogen taken from pregnant mare urine or as a plant based esterified estrogen made in a compounding pharmacy. The dosage is administered based on a patients hormone levels.
HRT should not be taken to prevent menopausal symptoms or osteoperosis for more than 3-4 years. Studies have shown HRT does carry an increased risk of thrombatic cardiovascual disease, persistent or new fibroids, gallstones and an increased risk of developing breast or uterine cancer. There are also some contraindications to taking HRT so you’re GP should have taken a thorough medical history prior to prescribing.
All medicines carry a benefit and risk so it is important to weigh these up first before taking anything. However, it’s always better, where possible, to work with diet and lifestyle changes first.
So, what have we learned from all this?
The best time to start preparing yourself for menopause is in your 40’s!
Menopause is a natural part of the aging process due to a decline in the body’s ability to produce estrogen in the ovaries. It can come with some unpleasant symptoms and this will vary from woman to woman.
Post menopause can become a wonderful time of life for a woman as there is no longer the huge hormonal shifts that occur throughout the reproductive years and this allows women to more productively express who they truly are into the world.
A smooth transition from pre-menopause all the way through to post menopause can be achieved by ensuring there is plenty of moderate exercise, a healthy diet with limited alcohol, caffeine, junk food and sugar and by creating a more stress free and relaxed lifestyle.
Our golden years are to be enjoyed and are best enjoyed when we’re healthy and well in body, mind and soul.
As a Shiatsu Massage and Oriental Therapy practictioner I work with clients all the way from pre-menopause in their 40’s to post-menopause in their 60’s. It is a wonderful experience to observe their transition and see the transformation that results. Sessions can involve a combination of talking therapy, hands on body work and guidance with diet, exercise and lifestyle from a chinese medicine perspective.
Soul Body Shiatsu in Bayside Melbourne specialises in helping women ease the symptoms of menopause naturally. To book a Shiatsu Massage treatment for peri-menopause, menopause or post menopause please contact Marian on 0403 500 695.