What Exactly Is Menopause
Menopause is a natural process in women resulting in the cessation of menstruation and reproduction potential. Normally the whole menopause can last for around 7 years from beginning to end and can be divided up into stages. Peri-menopause typically begins around 45-50 years of age when hormonal changes start to occur and cycle fluctuations and symptoms start. Menopause happens around the ages of 50-55. With the actual cessation of periods confirmed to be 12 consecutive months after your last period. When no more periods occur and generally the worst of the hormonal symptoms have passed, women are in the post menopausal stage
Typically women go through the menopause with few symptoms (which is the biological norm) whilst others can experience multiple symptoms making life very difficult. Menopause is characterised by a decrease in estrogen. Which triggers the uncomfortable symptoms of hot flushes, night sweats, sleep disturbances and vaginal dryness. Women can experience weight gain, mood swings as well as feeling fatigued, dizzy and experiencing headaches. In addition, feeling irritiable, anxious, depressed, experience bladder issues and breast tenderness are other menopause symptoms. Decreased muscular strength, and increased risk of osteoporosis can also be a consequence of the hormonal changes.
What Foods Should you Avoid During Menopause?
High blood sugar, insulin resistance and metabolic syndrome have been linked to higher incidence of hot flashes in menopausal women (Lee et al 2012). Therefore avoiding processed foods and added sugars which cause spikes in blood sugars should help to reduce symptoms. Try to limit white bread, baked goods and added sugars to help stabilise your blood sugar levels. High salt diets have been linked to lower bone density in postmenopausal women (Kwon et al 2017). Avoid spicy foods is a common recommendation for women going through menopause. However research is varied, so it’s best to see whether there is a correlation for you.
What Drinks Should you Avoid During Menopause?
Caffeine use has been associated with increased hot flushes in menopausal women (Faubion 2015). Caffeine and alcohol will also disrupt your sleep patterns so if you are already struggling alcohol and caffeine will not help matters. In addition, excessive drinking during menopause can increase risk of heart disease, developing central obesity, affect you liver, brain and nervous system.
What is the Best Diet During Menopause?
Phytoestrogens are plant compounds with estrogen-like properties they are very useful for helping the body replace some of its naturally lost oestrogen levels. These foods include flax seeds, oats, chick peas, lentils and sage. It is thought Asian diets generally involve alot of phytoestrogens (in comparision to America or Europe) and these women typically experience less hot flushes during menopause. Therefore reduced phytoestrogen consumption could be a contributing factor. Chen et al (2015) suggested phytoestrogens appear to reduce the frequency of hot flushes in menopausal women, without serious side-effects.
What Vitamin is Good for the Menopause?
The decrease in estrogens function observed during menopause, results in increased bone metabolism, a decrease in bone mineral density and the related elevated fracture risk (Matyjaszek et al 2015). If you are peri-menopausal, dark skinned, overweight and/or have a gastrointestinal condition you have an increased risk of vitamin D deficiency. Vitamin D helps your body absorb and use calcium, which gives your bones their strength and hardness. Therefore making sure you include vitamin D rich foods as part of a well balanced diet like oily fish and eggs is important. It is a good idea to test your vitamin D levels either through your GP or a private healthcare practitioner. If you have sub-optimal levels, it would be worth consulting with a nutritionist. They would discuss your situation, diet, current medications and whether taking Vitamin D supplements to support you through menopause would be a good idea. (Source Eleonora Sansoni menopause nutritionist)
What is perimenopause?
Perimenopause refers to the time period that begins when the ovaries begin to decline in function and continues until menopause (defined as the total cessation of menstrual flow for one calendar year) has been reached. Perimenopause has been called the “change of life” or “transition period.” It usually begins in the 40s, but may start as early as the late 30s. During this time, a woman may exhibit a number of symptoms that are largely due to abnormal hormonal fluctuations.
Perimenopause has the potential to become a difficult period in a woman’s life, as the ovaries begin to become depleted in eggs and produce hormones in reduced amounts. It is important that each woman attempt to understand the alterations that her body is undergoing and attempt to proactively manage these physiological changes. Moreover, she should not attempt hide her feelings and symptoms from others involved in her life, as this may lead to misunderstanding and frustration. Professional help is available, and new products and technologies are constantly being developed to assist with the control of perimenopausal symptoms. With appropriate dialogue between a woman and her health-care professional, most women can navigate this potentially difficult period of their lives.
Postmenopause is defined as a point in time that is 12 or more months from a woman’s last period. It is a term that is more useful to clinicians than it is perhaps to women. If a woman has not had a period for one year, then the likelihood of her ever having a period is extremely small. She is now defined as being postmenopausal. This does not mean that all her other symptoms will cease at the same time. Some will improve, and some may deteriorate.
Period after Menopause
After menopause, i.e. 12 months after our last period, our ovaries have ceased production of the female hormones that bring on menstruation. Any bleeding or spotting, especially in the absence of Hormone Replacement Therapy, is considered a warning sign for investigating the womb for any abnormality.
If a woman experiences any bleeding from the vagina after 12 months of no periods, then she must inform her doctor who can then examine her and arrange for an ultrasound scan or any other tests that may be relevant.
The term ‘clinically’ is defined as post-menopausal bleeding and is an indication for investigation. Therefore, whether you are on Hormone Replacement Therapy or not, any unexpected bleeding after menopause must be reported. It may not turn out to be sinister, but is best investigated, which is so easy to do.
You may have none. You may be completely asymptomatic except that you are not having any periods. Other women may still be experiencing the symptoms that started in the perimenopause. These could be:
- Vaginal dryness
- Recurrent cystitis
- Frequent urination
- Painful sex
- Hot flushes
- Night sweats
- Low mood
- Mood swings
- Disturbed sleep
- Lack of libido
- Fatigue and tiredness
- Heartburn and sluggish bowels
- Dry skin and altered skin texture
- Hair thinning
Many of these symptoms may resolve spontaneously, such as hot flushes, night sweats or mood changes, but others will remain. Of course these are really the exact symptoms as when you are in actual menopause.
As the collagen and elastin structure alters due to lack of estrogen, the following will happen and is likely to get worse over time: bone thinning (osteopenia or osteoporosis), hair and skin changes, dryness of the vulva and vagina (affecting the bladder and causing discomfort during sex).
All women will experience bone thinning after menopause. They will lose on average 5 per cent of their bone mass in the first year of their menopause and 1 per cent every year after that. It is important to maintain a good calcium and Vitamin D3 intake, but also to undertake light weight-bearing exercise. HRT or BHRT can help further in maintaining healthy bones and tissues.
Should I be worried about late-onset menopause?
At what age do you expect menopause to occur? How does it affect your health and cancer risk?
Menopause occurs when a woman’s ovaries stop releasing hormones. Naturally, a woman’s production of estrogen and progesterone hormones decrease in her late forties, which may cause menstrual periods eventually stopping. The age where most women become menopausal is between 50 and 54 years. In this context menopause is defined as not having a menstrual cycle for 12 consecutive months. As the hormone levels decrease, this may come with symptoms such as hot flushes, headaches, insomnia, mood swings and depression. Some women don’t have symptoms at all. Others may have symptoms at varying severity for 5 to 10 years.
Age and menopause
There is no set age when menopause should start, but according to the Australasian Menopause Society the average age is 51. If a woman is 55 or older and still hasn’t begun menopause, it is considered late-onset menopause. Menopause that occurs before age 40 is called premature. Up to 8% of women may have early menopause. Removal of both ovaries (bilateral oophorectomy) before the normal menopause is called “surgical menopause”. Menopause can also be induced by chemotherapy or radiotherapy to a woman’s pelvis.
Cancer risk and age at menopause
According to the American Society of Clinical Oncology, women who experience late-onset menopause have an increased risk of uterine and breast cancer. This is due to having an increased exposure to hormones such as estrogen. As women menstruate longer, they have more ovulations which also increases the risk of ovarian cancer. Women with a long reproductive life, menarche (onset of periods) before the age of 12 years and menopause after age 55 years have an increased risk of these hormone-dependent cancers. A pooled analysis of data from more than 400,000 women found for every year older a woman was at menopause, breast cancer risk increased by approximately 3%.
Benefits of late-onset menopause
It’s not all bad news, research findings suggest that later age at menopause and longer reproductive lifespan may result in longer life expectancy. Even though women who reach menopause later are at a higher risk for breast, uterine and ovarian cancers, women who go through menopause late are at a lower risk for heart disease and stroke.
A study of 12,123 postmenopausal women followed for 17 years found that age-adjusted mortality was reduced 2% with each increasing year of age at menopause. Though the risk of dying from uterine or ovarian cancer was 5% higher, ischemic heart disease was 2% lower for those with later menopause, and the overall effect was an increased lifespan. Life expectancy in women with menopause after age 55 years was 2 years longer than those with menopause before the age of 40 years.
Another study indicated women with longer reproductive years are more likely to live to 90 years of age. The study collected data from 16,251 participants, starting between 1993 and 1998 and followed for 21 years. Women who menstruated for more than 40 years were 13% more likely to reach age 90 years than those who had less than 33 reproductive years. Women who were at least 50 years of age when their menstrual cycles stopped were about 20% more likely to reach age 90 years than women who entered menopause before the age of 40 years.
Women who experience late-onset menopause also suffer less from osteoporosis, have stronger bones, and develop fewer bone fractures.
How do I decrease my cancer risk after menopause?
Late-onset menopause usually occurs because of a genetic predisposition. If your mother went through menopause late, chances are you may also. A study found that late menopause is not uncommon among obese women because fat tissue produces estrogen. If you are worried about your age and menopause exercise, eat a healthy diet, don’t smoke, and maintain a healthy body weight which can have a plethora of health benefits. Regular mammograms and smears are also important for women experiencing late-onset menopause.