Menopause Monday: What is Menopause?

What is menopause?
Menopause is the day you've gone 12 consecutive months without having your period. It's a natural process, unless it is surgically or medically induced, such as due to a total hysterectomy (removal of uterus and both ovaries) or radiation. On average menopause happens at age 52.

Your ovaries produce the hormones estrogen and progesterone, which regulate your periods. 
Estrogen also influences how your body uses calcium and maintains cholesterol levels in your blood. This is why menopausal women are at an increase risk for osteoporosis, bone fractures and heart disease.

Three stages of menopause

• Perimenopause generally starts 8 to 10 years before menopause. This is a period when your ovaries gradually produce less and less estrogen. Perimenopause generally starts in your 40s, though women are reporting symptoms as early as their 30s. 
• Menopause is the point when your ovaries no longer release eggs, and estrogen levels drop significantly, and you've gone for 12 months without having your period. Average age is 52.
• Menopause/Postmenopause are often used interchangeably. Once you hit menopause you are in the menopause stage for the rest of your life, though some people refer to this as post-menopause.

Early and premature menopause
"Natural" menopause is a normal part of aging and generally happens between ages 45-55. Menopause that occurs between ages 41-45 is called early menopause. Menopause before 40 or younger is considered premature menopause, also referred to as primary ovarian insufficiency.

Hormone changes
​The two main hormones that drop in production during perimenopause into menopause are estrogen and progesterone. There are others as well. You can read more about all them here. 

Track your symptoms
It's a good idea to keep a journal of your symptoms and periods as you go through perimenopause into menopause.  Symptoms may include:

• Irregular periods or periods that are heavier or lighter than usual
• Hot flashes and/or night sweats
• Vaginal dryness
• Urinary urgency and/or incontinence 
• Sleep disturbances 
• Irritability, mood swings, anxiety, depression
• Dry skin, eyes or mouth
• Breast tenderness

Some people might also experience:

• Racing heart
• Headaches/migraines
• Joint and muscle pain/stiffness
• Changes in libido
• Brain fog, difficulty concentrating or memory lapses
• Weight gain
• Hair loss or thinning

Symptoms can last from 7 to 10 years. Some women report symptoms greatly subside or disappear completely after menopause.

What can I do for my symptoms?
Again, journal keeping can help you track what might trigger your symptoms. Some women find that alcohol causes hot flashes, night sweats and sleep disturbances. Others say spicy foods do. A Somatics practice, on the other hand, can help you downshift into the parasympathetic nervous system— the rest and recovery part of your nervous system — so you can relax and sleep better. The more you take note of what you do, how you sleep (or not), what you consume, the more information you'll have to help you through.
Other non-hormonal treatments your doctor might recommend include:

• Changes to your diet (up the protein and fiber, reduce the simple carbs)
• Regular exercise 
• Join a support group
• Cognitive behavioral therapy (CBT)
• Hypnotherapy
• Limit caffeine and sugar intake
• Stop or limit drinking alcohol 
• Stop smoking

Foods that may help include:

• Soybeans, tofu or tempeh
• probiotic foods (kim chi, real kraut*, kombucha, real yogurt*)
• Chickpeas
• Lentils
• Flaxseed
• Grains
• Beans
• Fruits
• Vegetables

Should you consider hormone replacement therapy?
Since no two women experience menopause the same way, it’s a good idea to talk to your health care provider if your symptoms are intense and limiting your quality of life. Most healthcare providers get a ridiculously limited amount of education on menopause during med-school. If you feel dismissed look for a qualified practitioner on the Menopause Society directory. 

There are two main types of hormone therapy:

• Estrogen therapy (ET): In this treatment, you take estrogen alone. Your provider prescribes it in a low dose. Estrogen comes in many forms, such as a patch, pill, cream, vaginal ring, gel or spray. Estrogen therapy can’t be used alone (without a progestogen) if you still have a uterus.
• Estrogen progestogen therapy (EPT): This treatment is also called combination therapy because it uses doses of estrogen and a hormone similar to progesterone. Progesterone is available in its natural form or also as a progestin (a synthetic form of progesterone). Progestogen is a general name for treatments that can include both natural progesterone and synthetic progestins. This type of hormone therapy is for those who still have their uteruses.

I hope this post addresses any questions you may have. Feel free to email me or drop a comment below if you have any thoughts or need more info.

​Gone are the hush hush days of menopause. Talk to your friends around your age. Talk to your elders. They may surprise you and share their experiences and be glad to talk now, even though they may have gone through menopause “alone”. Talk to your healthcare provider about the symptoms you’re experiencing and how they impact your quality of life. Again, if your GP is not up to speed on the latest science, find someone who is. 

peace,
Kristin

* real kraut is fermented, not cooked or with vinegar added. It will be in the refrigerator case at your store. Stuff on the shelf is not real kraut and doesn't offer the probiotic benefits. Real yogurt ideally is plain, no sugar added and has millions of healthy bacteria in it. The majority of yogurt on the market is just dessert. Too much sugar which negates the probiotic benefits.