As our female bodies prepare for the transition of perimenopause to menopause (when the periods have stopped for more than 12 months), it’s important to be aware of many physical changes taking place.
Before menopause when women are fertile, oestrogen is produced mainly in the ovaries. Ovaries are grape-sized glands located by the uterus and are part of the endocrine system. After the cessation of the menstrual cycle, the body still makes small amounts of oestrogen by changing hormones called androgens into oestrogen. Androgens are produced by the adrenal glands, located above the kidneys. A hormone called aromatase changes androgens into oestrogen. Aromatase is produced mainly by fatty tissue.
Oestrogen is no longer important for reproduction as we mature, but it still plays a key role in other bodily functions:
- It maintains blood vessels and vascular health
- Supports skin function, skin texture and hydration
- Retains salt and water for hydration and fluid balance in the body
- Increases bone strength and calcium for bone health
- Decreases cortisol and stress responding mechanisms
- Manages gastro-intestinal tract by:
- Improving smooth muscle function of the intestines and the stomach
- Reducing bowel motility
- Increasing cholesterol in bile
- Promotes lung function by supporting alveoli
- Assists thyroid function
- Regulates immune function
- Increases platelet adhesion and coagulation
- Supports brain health
Inflammation and oxidative levels increase with age, making us more susceptible to a variety of age-related conditions. The drop of oestrogen at midlife will increase oxidative stress and inflammatory cytokines in the body. Cytokines are messengers in our bodies, creating certain reactions in our system and they play an important role in immunity. It’s vital to support all bodily functions with a clean, fresh and versatile diet. High acidity which promotes inflammation and vice versa can be targeted with an alkalizing diet, which means cutting out junk food or things that come out of a packet. It also means having fewer animal products, sugars, grains and alcohol.
Hot flushes and night sweats are experienced by 70% of women undergoing menopause. Fluctuating amounts of oestrogen upset the body temperature thermostat and the brain signals that the body is too hot. It’s similar to a stress response that is activated and hence the dread and anxiety that sometimes accompanies hot flushes.
A stress response involves the release of adrenaline and cortisol and these key hormones prepare our body for fight or flight which causes an increase in heart rate, blood pressure and a boost in energy supplies. This is important in a situation where there is threat but is unhealthy when it becomes our normal state of being. High levels of adrenaline and cortisol in the system will not only deplete the adrenals glands but also have an adverse effect on our health.
High stress levels in menopause reduces the body’s ability to make androgens which convert into oestrogen. Ongoing stress situations will also deplete serotonin levels and hence create depression and mood disorders.
Body weight gain
As these hormonal changes take place leading up to, during and after menopause, women lose their waist because we gain more fatty tissue around our abdomen. Its natural and acceptable to increase healthy body weight by around 5kg post menopause. Too much abdominal fat, however, will adversely affect our health and could result in a condition called ‘Metabolic syndrome’ which results from overweight and is associated with abdominal obesity, blood fat disorders, inflammation, insulin resistance, full-blown diabetes, and increased risk of developing cardiovascular disease. During menopause where our bodies are switching from a childbearing to a non-reproductive phase, to be under- or overweight can be an additional complication.
Migraines with or without aura
Headaches are more common in females because of their highly sensitive hormonal balance. Due to stronger fluctuation of oestrogen in menopause and particularly related to the ratio of progesterone and oestrogen, headaches might become more predominant during the transition of perimenopause to menopause.
Sleep disturbances are often a primary complaint in menopausal women. Staying asleep without waking is a bigger problem than falling asleep. Sleep problems are not necessarily a primary symptom of menopause but can be aggravated by:
- High levels of stress
- Poor health in general
- Mental illness
- Sleep disorders such as sleep apnoea, insomnia, restless leg syndrome
- Hormonal changes
A structured sleep routine is best to assist the chaos of perimenopause, so the brain can easily release the hormones needed at the right time. For instance, establishing a routine of going to bed and waking at the same time assist your body in balancing the circadian cycle.
The body must cool down for sleep so use layers of natural fibres in bed, rather than one big doona that might overheat you. Tire your body before going to bed, turn off the screens (TV, Phone, other electronic devices) and calm your brain with meditation, light reading or any other relaxation technique that works for you. If there are primary sleep disorders such as sleep apnoea, you will need to address these too.
One of oestrogen’s benefits is to protect your bones and help keep them strong and healthy. When oestrogen levels drop, many women lose bone density and a loss of bone strength and mineral density make women susceptible to fractures.
Many lifestyle factors are important to good bone health: Stop smoking (if you still are), lose weight (if you are too heavy), clean up your diet, get moving and have your prescription medication regularly assessed by your medical professional as some medication will affect bone density.
Vitamin D is a hormone and assists the absorption of calcium and is important for bone health and 15 minutes of sunshine on arm and legs can go a long way when it comes to good health. Eggs, tuna and salmon also contain a healthy dose of Vitamin D.
Exercise is important for our cardiovascular health as well as for bone density and weight bearing and resistance training is best for stronger bones. Walking, skipping or tennis and other forms of exercise improve our metabolism and help maintain good physical range and function.
In Australia, breast cancer rates are high but thankfully most women affected by breast cancer will not die from it. Breasts are loaded with oestrogen receptors and when oestrogen is in the blood stream, the receptors will soak it up. This will generate cell growth which is how our breasts grow initially during puberty but if there are excessive amounts of oestrogen, it can stimulate cancer growth. Excessive oestrogen levels may result from HRT (Hormone Replacement Therapy) or many years of taking the contraceptive pill. Another cause could also be starting periods at a younger age or finishing at an older age because the system would have a longer exposure to extra oestrogen.
HRT can be derived from bioidentical hormones (they are identical chemically to those our bodies produce naturally and are made from plant oestrogens) and these are different to the traditional HRT, which is composed of the urine of pregnant horses and other synthetic hormones.
Breasts are still important for post-menopausal hormone production. As women age, the fat cells in their breasts tend to produce greater amounts of an enzyme called aromatase. Aromatase promotes the production of oestrogen by changing androgens to oestrogen. We require a good balance of aromatase in breast tissue, so we have the right amount of oestrogen.
Oestrogen plays an important role in cardiovascular health:
- It dilates blood vessels to lower blood pressure
- It increases good cholesterol (HDL)
- It decreases platelet clotting
- It lowers fat deposits in arterial walls
- It triggers chemicals to keep the blood flowing
- It regulates insulin
Its assumed that overstimulation of the sympathetic nervous system resulting from lower levels of oestrogen after menopause can cause irregular heartbeats and palpitations.
Cardiovascular risk factors are higher post menopause and must be addressed early. Many cardiovascular factors are related to our body weight and the way we eat. The better you monitor your weight and ensure that it’s within the accepted dimensions, the better you will feel overall. It’s almost as simple as that.
Haziness, forgetfulness, brain fog, losing words are all part of the process of change when the body stops producing oestrogen in the ovaries and instead adopts to the post-fertile phase of womanhood.
Oestrogen, as you may have guessed already is an important ‘brain player’. It regulates neuronal biochemistry. The structure and function related to cognitive and emotional processes. Research is not quite able yet to pinpoint exactly to what extent oestrogen is involved. Oestrogen is so important to brain function that it has its own endocrine gland – the hypothalamus – to produce oestradiol which is a type of oestrogen to support brain function. This production buffers the supply of oestrogen in times of great female hormone fluctuations like puberty, pregnancy and menopause.
Oestrogen also impacts our cognitive function and hence the ‘symptoms’ that sometimes accompany the peri- menopausal and post-menopausal phase. Oestrogen is involved in memory, problem solving, information processing, reaction time, language and emotional regulation, so you start to see why we experience brain fog, forgetfulness, memory loss and similar cognitive functions. The good news is it doesn’t last!
Change of life means that our bodies are making changes to our chemistry that are no longer relying on oestrogen production in the ovaries. Oestrogen is such an important hormone and messenger and supports many functions, so it’s important that those ‘system changes’ are done properly and over time.
The onset of menopause is truly the start of a new era and there is nothing wrong with celebrating it with a healthy and balanced lifestyle. Having the right amount of oestrogen floating in our system is the key to a happy, healthy and vital life beyond menopause.
In Chinese medicine theory
From a Chinese medicine perspective, menopause is the onset of Yin deficiency. Yin embodies the principles of passivity, female, earth, dark, cold and more. So, when Yin is deficient it allows the rise of Yang which causes some symptoms like hot flushes, night sweats, irritability etc. So, for instance to address a Yin deficiency situation, we supplement the body with Yin-type nourishing herbs and acupuncture protocols to ultimately boost the potential lack of oestrogen in our bodies. Frequently there is a variety of patterns in menopausal women as everyone presents differently. Nevertheless, the changes that our bodies undergo with peri-menopause, menopause and post-menopause can be similar. It’s important to understand also that it’s not a condition, it’s simply a modification and adaptation to a new situation.
Chinese medicine includes several modalities such as acupuncture and Chinese herbs. We have a range of formulas that we use depending on your situation and the way we tailor those formulas to your need is based on a treatment strategy that we agree on in support of your situation. Most women respond positively to both acupuncture and or Chinese herbs.
What you eat every day is your responsibility, but we will certainly address dietary optimization and most importantly, we understand that menopause is an important (and exciting) phase in a woman’s life and we are here to support you. We have done so with many other women in the past, and we can confidently say that the results have been very positive.