Thank you to Genya Fleischer, for sharing this blog on Menopause

All women will experience a transition called perimenopause either as a natural part of life or a consequence of chemotherapy, hysterectomy or genetic factors. During this stage women move gradually from their fertile phase to the non-fertile phase. 

Perimenopause, usually begins four years before last menses. This is a time of significant physical, hormonal and psychological changes and is characterized by irregular menstrual periods, mood changes, and hot flushes. Each woman will experience it in her unique way.  

Menopause is when a woman does not have a menstrual period for 12 months. The average age of menopause is 51 years. During this phase there is a decline in estrogen and progesterone levels. Estrogen is produced primarily in the ovaries but in lesser amounts in other tissues and is essential to the reproductive process. They also play a critical role in helping to regulate the function of the brain and central nervous system, bones, liver, and urinary tract. When estrogen levels drop, these systems are impacted.  

One in five women will  go through menopause without experiencing any symptoms. Another one in five will have symptoms so severe that they significantly interfere with their daily life. However, for three out of five women, the symptoms of menopause are mild to moderate.   

Common Symptoms of Menopause 

Menopause can bring about mild to severe symptoms, including: 

• Mood Swings, Irritability and Depression: Hormonal changes can cause fluctuations in mood, making some women feel unusually irritable or emotional. Over the menopause transition, around 10 per cent of women report an increase in symptoms such as low mood, feeling depressed,  tearfulness and irritability. 

Women who have previously experienced clinical depression may be at increased risk of recurrence over the menopause transition. Persistent disturbed sleep may also increase the risk of depression. However, most women do not experience depression at menopause. For those who do, treatment should be the same as at other life stages, this includes psychological treatments,  acupuncture hypnosis or antidepressant. 

• Hot Flushes and Night Sweats: Around 80 per cent of women experience hot flushes and night sweats during menopause.   

Hot flushes are described as a feeling of heat that usually starts in the chest and spreads upwards to the neck and head. Hot flushes come and go. They may last from a few seconds to minutes. Some women experience sweating at the same time or after hot flushes. Some women experience symptoms of racing or pounding heartbeats at the same time as a hot flush.  Some women have chills instead of or after a hot flush. Night sweats occur at night, they are hot flushes that happen while you’re asleep, often waking you up in a pool of sweat  

• Vaginal Dryness and Decreased Libido: Reduced estrogen can lead to vaginal dryness, making intimacy uncomfortable. Lubricants and vaginal estrogen creams can help. Most women continue to have an enjoyable sex life through the menopause and beyond. 

Many other factors can reduce women`s libido, including  the relationship with  the partner, medications, diet, general health and wellbeing, life style, body image. 

• Sleep Problems and Memory Issues: Menopause has not been shown to affect memory or thinking. However, some women do report that they feel their memory or concentration has been affected by menopause. Sleep disturbance from night sweats can affect memory and concentration in the day. These symptoms generally improve when the hot flushes have settled down;    

• Weight Gain and Heart Disease: Changes in estrogen production and glucose regulation during menopause may lead to weight gain as well as changes in how our bodies look. Estrogen plays an important role in young women, storing body fat in the hips, thighs, and buttocks in preparing for pregnancy and delivery. When estrogen levels  drop, the brain no longer sends the message to store fat in the lower body, and more fat is directed to the abdomen. This is where you start to see that shift in body shape, despite no change in your dietary habits.  Metabolism changes as women age and this aspect of menopause may have consequences on immune  system and weight. 

A little extra body fat during menopause may not be a bad thing, as body fat stores have a limited capacity to produce estrogen, which can help with protecting bone health as women age. But too much, particularly in the abdominal region, may have an impact on metabolic and cardiovascular health, and heart disease is the leading health concern for women over 50. 

Weight gain may increase risk of obesity, higher blood pressure, type 2 diabetes, fatty liver and higher (LDL) cholesterol levels, which are all factors for CVD. 

• Bone Health:  The body is building bone up until age 30. After that, we start to lose bone. Since you’re losing estrogen around menopause, there’s an accelerated decline of the bones hence predisposing us to Osteoporosis  

• Frequent  urinary tract infection: frequent urination, frequent urination at night (disturbing sleep) and incontinence are all caused by menopause.  

Stay Tuned for part 2, where Genya shares how to manage these symptoms through dietary changes