If you are a woman, age 40 and above, you might have started going through what is also known as the “change of life”. If hot flushes, night sweats, and mood changes are apart of your life, keep reading because this one’s for you.
What is Menopause?
Menopause marks the end of your menstrual cycle. Your menses stop permanently and you can therefore no longer get pregnant. You have reached menopause only after you have gone through a whole year without having your menstruation. This includes spotting or any bleeding for at least 12 months in a row.
The term menopause is derived from meno (month, menses) plus pauses (pause, cessation); in other words, it is a pause in menstruation. Menopause can describe any of the changes a woman might go through either just before or after she stops menstruating.
Menopause is a natural biological process, although it may not always be an easy process to go through.
Causes of Menopause
A natural biological decline of reproductive hormones.
As a woman, you are born with a limited number of eggs which are stored in your ovaries. During a normal menstrual cycle, your ovaries produce the hormones oestrogen and progesterone to control ovulation and menstruation. As you approach your 40s, your ovaries start producing fewer hormones and you no longer release an egg every month, as they are slowly coming to an end. This results in a decline in fertility. During your 40s your menses may become longer or shorter, heavier or lighter and more or less frequent, until eventually (on average, by the age 51) your ovaries completely stop producing eggs and you no longer menstruate.
Hysterectomy.
If you have a hysterectomy that only removes your uterus and not your ovaries, you usually don’t have immediate menopause. Even though you no longer have your menses, you still have ovaries which release an egg and produces oestrogen and progesterone. If you remove both your uterus and ovaries, you immediately go through menopause. Your menses will stop and you are likely to experience menopausal symptoms. These symptoms may be severe as the hormonal changes occur abruptly instead of the natural processes over several years.
Chemotherapy and Radiation therapy.
Cancer therapies may induce menopause, causing menopausal symptoms to occur during or shortly after the course of treatment. This halt of menstruation and fertility is not always permanent.
Primary ovarian insufficiency.
Premature menopause (experience menopause before age 40) happens to about 1% of women. This may be a result of a primary ovarian insufficiency if they fail to produce natural hormones. It may also stem from genetic factors or autoimmune disease. Hormone therapy is usually recommended for these women until the natural age of menopause in order to protect her heart, brain, and bones.
Regardless of the cause any menopause that happens before the age of 40 is considered as premature menopause.
The stages of Menopause
During natural menopause the process is gradual with three stages:
- Peri-menopause: It typically begins several years before menopause, when the ovaries start to produce less oestrogen. This stage lasts until menopause when the ovaries completely stop releasing eggs. During the last one to two years of peri-menopause, the drop in oestrogen levels quickens. This is generally when many women have menopausal symptoms.
- Menopause: As mentioned above, this is when a woman has had no menstruation for at least 12 months. At this point, the ovaries have completely stopped releasing eggs and producing most of their oestrogen.
- Post-menopause: The golden years after menopause. During this stage, most of the symptoms ease for the majority of women. Unfortunately, the health risks related to the loss of oestrogen start to rise as a woman ages.
For most women, this transition lasts about four years. Only a very small number of women stop having their menses abruptly.
Symptoms of Menopause
During the months or years leading up to menopause (peri-menopause), you might start to experience menopausal symptoms. These symptoms may be very mild at first or begin suddenly and be very noticeable. Menopausal symptoms may happen every now and then, or they can be all the time. Each woman will have her own symptoms unique to her body. Some of the symptoms are similar to PMS symptoms while others may be completely new.
Symptoms include:
- Irregular menstrual cycle: Your days of menstruation and your cycle itself might become shorter or longer and you may start to skip some months.
- Lighter or heavier menstrual flow than usual.
- Low libido or it takes longer to get aroused.
- Vagina dryness, and uncomfortable or painful sex.
- Hot flashes
- Chills
- Night sweats
- Insomnia or sleep problems
- Mood swings or changes
- Memory loss and weak concentration
- Irritability
- Fatigue
- Depression and anxiety
- Increased heart rate
- Headaches
- Joint and muscle pains
- Weight gain and slowed metabolism
- Thinning hair or dry skin
- Loss of breast fullness
- Bladder control problems
Pregnancy is still possible during peri-menopause. If you’ve skipped a period and aren’t sure if it’s the menopause transition, consider a pregnancy test.
Diagnosis
It’s common for women to self-diagnose menopause as the signs and symptoms are usually enough to tell that they’ve started with the transition. It helps to keep track of your periods as they become irregular as this will be an added clue to a health practitioner.
Tests are not usually needed to diagnose menopause. However, under certain circumstances, your health practitioner may recommend blood tests to check the following hormone levels:
- Follicle-stimulating hormone (FSH) and oestrogen (estradiol), because FSH levels increase and oestrogen levels decrease during the transition
- Thyroid-stimulating hormone (TSH), an under-active thyroid (hypothyroidism) may cause similar symptoms to those of menopause.
Long term health risks related to Menopause
A number of health risks increase for menopausal women due to the decrease of oestrogen levels as they age. These risks include:
- Osteoporosis: Weak bones that break easily)
- Heart Disease
- Increase in cholesterol levels
- Stroke
- Bladder and bowel dysfunction
- Alzheimer’s disease or weakness of the brain
- Poor skin elasticity (increased wrinkling and dryness)
- Poor muscle tone and power
- Impaired vision due to cataracts (clouding over the eye lens), and macular degeneration (tiny spots that affect center vision)
Risk factors
There are certain factors which may influence the age and severity of the menopausal transition, these include:
- Smoking
- Family and genetic factors involving oestrogen receptors
- Overweight
- More than one pregnancy or no pregnancy at all
- Toxic chemical exposures
- Treatment of cancers with chemo and radiation
- Epilepsy
Treatment
The fundamental goals of a holistic approach to menopause include relief from symptoms as well as preventing and/or treating osteoporosis, heart disease and other diseases of ageing. An objective is to use methods that do not increase the risk of life-threatening diseases such as breast cancer, blood clots, and strokes.
The individual risk factors and medical history of each woman should be considered when planning a treatment plan.
Nutrition
The healthiest diet for most women, before, during, and after menopause is a whole food diet. If you eat healthy foods you provide your body with all the nutrients it needs to function correctly and combat diseases. A whole food diet supports heart health, as well as prevents diabetes, cardiovascular disease and nutrient deficiencies that become more common with age.
Healthy nutritional habits include:
- Eat smaller portions more frequently
- Eat plenty fresh fruit and vegetables, legumes (especially soy), nuts, seeds, and olive oil
- Drink one glass of water for every 10 kg body weight
- Limit dairy products
- Reduce or eliminate sugar
- Limit or avoid alcohol and caffeine intake
- Avoid processed (junk) food
- Eat good quality and mainly plant based or whole foods and grains
- Avoid artificial sweeteners and preservatives
- Avoid excessive salt and coffee as it increases the excretion of calcium
Important nutrients to manage menopausal symptoms:
- Bioflavonoids: are known for their antioxidant and anti-inflammatory properties and their ability to strengthen capillaries. Evidence has shown that combining bioflavonoids vitamin C may help to relieve menopausal hot flashes.
- Boron: increases eostrogen retention.
- Essential Fatty acids: Omega 3 and 6 help to maintain hormonal balance and relieve symptoms
- Vitamin B complex: may help to relieve depression, insomnia, and irritability related to menopause.
- Vitamin. C: helps to maintain the skin’s elasticity.
- Vitamin D: controls calcium absorption.
- Vitamin E: helps to reduce hot flashes.
- Calcium: maintains bone density
- Gamma-oryzanol: may help to relieve hot flashes.
- Iron: increases energy levels
- Magnesium: works with calcium to strengthen the bones
- Phosphorus: slows down the loss of bone mass
- Phytoestrogens: activate the oestrogen receptors and is capable of exerting weak oestrogenic effects in the central nervous system, blood vessels, bone, and skin without causing stimulation of the breast or uterus. For this reason, their benefits may be more for preventing osteoporosis, heart disease, and even breast cancer than for the relief of menopause symptoms.
- Selenium: reduces hot flashes
- Zinc: helps to regulate hormone levels
Important foods:
- Evening Primrose oil: may relieve hot flashes.
- Rice, wheat, barley, oats, tomatoes, asparagus, olives, berries, peas, and citrus fruits: contain Gamma-pryzanol.
- Soy (not concentrated soy isolate supplements): is high in phytoestrogens
- Flaxseeds: Another source of phytoestrogens.
Herbs
Black Cohosh
Black cohosh can be used to treat a number of symptoms suffered by women during menopause as it may:
- Help to reduce menopausal hot flushes
- Reduce mood swings
- Reduce night sweats
- Help sleep disorders
- Treat body aches
Herbal extracts with black cohosh continue to be one of the most reliable herbal approaches to treating a wide array of peri-menopausal and menopausal symptoms.
This uterine stimulant may help if your progesterone levels are too high and oestrogen too low.
In a study using black cohosh for menopausal complaints; as early as 4 weeks after beginning therapy, a clear improvement could be seen in approximately 80% of the women. After 6 – 8 weeks, the complete disappearance of symptoms occurred in approximately 50% of the women.
You should not use black cohosh for more than 6 months. Anyone with heart disease should not use black cohosh.
Motherwort
Herbalists consider motherwort as a uterine tonic, particularly valuable in improving uterine atony owing to pelvic congestion, improving circulation and relieving vascular congestion. It may also help to prevent and relieve vagina dryness.
Motherwort is a favourite ally of menopausal women. A dropper-full may stop hot flashes, relieve a rapid heartbeat, soothe frayed nerves and anxiety as well as calm emotional irritability related to hormonal changes. It also helps to protect the heart.
Valerian
This is a well-known sedative and nerve tonic. It is excellent for nervous tension, agitation, anxiety, panic attacks, irritability, insomnia, nervous or tension headaches and exhaustion. Its calming effects can especially help with sleep disorders.
Due to its phyto-oestrogenic components, it may be useful in treating oestrogen-related menopausal symptoms.
Schisandra
Schisandra has a normalising effect on the entire body. It will take you from any extreme back to a balanced state. It may open you up to physical and mental exercise and protect you from environmental stress.
This herb can increase your energy at a cellular level by stimulating the central nervous system without making you nervous. It is used for the depletion from stress, chronic fatigue, anxiety, depression, irritability, dizziness, and insomnia.
Schisandra raises body enzymes which help to detoxify the body in a way that improves mental clarity. It’s also protective of the liver and helps to maintain liver function and regeneration.
It is a popular herb among women for its ability to make the skin soft, smooth and beautiful by balancing fluids in the skin. Night sweats and low libido may be improved with this herb.
Avoid the triggers
Prevention is always better than cure. There are a few triggers which may affect the frequency as well as the severity of hot flashes in some women, these include:
- Hot or spicy foods
- Hot drinks
- Warm environments
- Caffeine intake
- Alcohol intake
- Stress
Stress Management
Not only does stress affect your hormone production, but it also plays a role in the severity and frequency of menopausal symptoms. By learning how to manage your stress levels, you may minimise menopausal symptoms such as anxiety, irritability, sleeping problems, heart palpitations, mood swings, depression and so on.
Stress is also a cause of premature ageing which may increase the risk of developing heart disease, increased blood pressure, and strokes.
Learn what you can do to help manage your stress here.
Exercise
Regular exercise is tremendously important as it helps to strengthen the body and promotes healthy hearts, healthy bones, and longevity in general. Not only does exercise strengthen the bones, but it also increases muscular flexibility as well as improve balance.
Plus, exercise improves heart function, counters depression and may even prevent breast cancer.
30 minutes a day of any type of exercise can be of benefit. Improve flexibility, balance as well as strengthen your body with yoga and pilates.
Lifestyle
Personal empowerment, time for reflection, and pursuing one’s dreams are also important for ease during this transition.
Something as simple as your attitude towards something may influence the outcome of it. Try to be optimistic about the transition your body is going through and appreciate yourself for being a woman.