What is happening to the female body during peri-menopause and menopause?
Menopause literally means the ‘ceasing of menstruation’. This is the time in a woman’s life when the body no longer ovulates, and thus periods stop. The ‘peri menopause’ is the transition time which women experience preceding menopause - and this can last anywhere between a few months to a decade.
A woman is said to be ‘post menopausal’ when she hasn’t experienced a period for one year. On average, this happens to a women at age 51. In this day and age, a women is likely to experience a third of their life in post menopause.
Menopause has received a lot of press recently as a result of women speaking up about the symptoms and management options available. This is really positive given menopause, as you may know or may experience, can be very impactful on a woman’s life mentally and physically.
Although the transition is a natural one, it can be quite a change and sometimes a shock to our bodies; the transition is due to the fluctuating, and ultimately declining sex hormones circulating in the body, namely oestrogen, progesterone and testosterone.
Many of the symptoms associated with menopause (there are officially 34 but many medical professionals and women report more) are wide ranging. This is because oestrogen affects many systems and structures throughout the body, and often in a positive way - therefore a flux or decline in oestrogen can cause some unwelcome and surprise symptoms in some women.
Oestrogen influences the psychological, physical and vasomotor elements of our body. Hence fluctuations in this hormone can result in wide ranging symptoms in areas such as:
- cognitive health (mood, concentration, memory)
- immunity (via the health of the mucous membranes)
- cardiovascular system health, including blood vessel health
- bone health
- intimate health (bladder symptoms, vaginal symptoms)
- collagen and cognitive tissue health
- gut health
Progesterone is quite a calming hormone, as a result of the interaction it has with the neurotransmitter GABA which regulates mood. Testosterone in a female body has been linked with a positive libido, good mood and energy.
Fluctuating levels of these hormones is natural as we move through peri-menopause, and its common to feel positive and energetic one week, and low and fatigued the next.
What are the main symptoms of peri-menopause and menopause?
As mentioned, there are 34 main symptoms, all attributable to the fluctuating hormones. Some of the most commonly reported symptoms include:
- hot flushes
- night sweats
- body aches and pains
- poor mood or anxiety
- vaginal dryness and discomfort during sex
- difficulty sleeping
- weight gain
These may come and go at different times for different women, and some may only experience a few whilst others experience many. It is not always known why some women get it worse than others; there seems to be some family connection and general, wider health may also dictate how well your body deals with symptoms - but some factors are simply unknown and its hard to predict.
How can we best support ourselves through the menopause?
The main medication available to women via the NHS is HRT - hormone replacement therapy. This is primarily in the form of oestrogen, but progesterone and testosterone is also available to women depending on symptoms. These replacement hormones can be delivered into the body via patches, creams, gels or orally. The safety guidance for these is now a lot more positive, and many women can take these hormones (with the exception of women with a history or active hormone driven cancers or blood clots - your GP will advise).
HRT can lower a woman’s risk of osteoporosis and cardiovascular disease. However, HRT has been linked to a higher risk of breast cancer; this is a good article to read for an informed and researched view on this risk. The NHS site now states ‘there is little or no change in the risk of breast cancer if you take oestrogen-only HRT’. For all women, HRT should be considered carefully with a GP based on your individual circumstances.
HRT should be viewed though as only one piece of the puzzle when it comes to managing menopause symptoms. Our overall state of health can impact our journey through menopause too, for better or worse, so I believe a holistic approach to health is the best one to take at this time.
Here’s my advice to make sure your body is as optimal as possible to deal with the changes:
- Diet - oestrogen is naturally anti-inflammatory, so the declining levels of this mean our body is more at risk of chronic inflammation, which can drive disease. Follow an anti-inflammatory diet as much as possible to counteract these effects - lots of fresh fruit and veg, pulses, beans, nuts, seeds, oily fish (salmon, mackerel, sardines) and small amounts of organic dairy and red, meat. Use olive oil on foods and limit alcohol and caffeine intake (these latter ones can exacerbate hot flushes and impact sleep). Ideally eat 3 balanced meals a day too - and avoid snacking. This isn't a time to starve ourselves as this will exacerbate symptoms, but instead nourish the body at mealtimes to provide nutrients and energy we need to thrive.
- Exercise and movement - both aerobic and gentle strength training are great forms of exercise doing this period of life. This could include walking, running or swimming, and pilates, yoga or gentle weight training. Aerobic exercise supports the cardiovascular system and releases happy hormones (endorphins), and it’s also great for maintaining a healthy weight. Gentle strength training will keep the bones strong - bones need to be used for them to retain their function and density - so a ‘use it or lose it’ attitude is a good one to apply here!
- Sleep - granted, sleep may be tricker during this period of your life if night swears and hot flushes are getting in the way. But as much as you can, it’s important to prioritise sleep and rest time. Get a good bedtime routine, read a book, avoid screens, use a lavender pillow spray, avoid food a few hours before bed, and wear light clothes to support any fluctuations in temperature. If you can't sleep, don't stress, just try to relax the body for as long as possible.
- Stress - stress will only exacerbate the symptoms you are dealing with during this time - be kind to yourself! This may be a time to re-configure your pace of life and make new priorities. Put put yourself first and find new things like yoga, or spending more time prepping foods, that benefit you. It may be hard to start with, but your body will reap the benefits late on. We at Simba can support you in creating new healthy habits, so consider signing up for some coaching if you need that extra bit of guidance and motivation.
- Alcohol - unfortunately, alcohol impacts the vasomotor system and requires detoxification from our system - which can put a burden on our body. Alcohol in menopause has been found to exacerbate hot flushes, mood swings and insomnia in some people, along with increasing weight gain at a time when weight loss may be harder due to hormonal changes. Cutting down, quitting or having alcohol free nights may be beneficial at this time.
- A healthy gut - gut health can influence our overall health in so many ways, and during peri-menopause its especially important to keep it functioning well. During menopause the gut can regulate hormones (expelling them when we have a surge), our mood (via serotonin in the gut) and weight (the composition of bacteria can impact our weight and ability to lose weight). Lower oestrogen levels can also make the gut more ‘sluggish’ - so eating fibre, drinking lots of water, moving our bodies and supporting the gut bacteria is especially important at this time.
Here are some great resources to find out more about the menopause and support available:
- NHS website
- Menopause care - private medical menopause Doctors, and lots of information can be accessed from this site.
- Dr Louise Newson Health - menopause Doctor
- And follow @emma.bardwell for nutrition advice on instagram, and @owningyourmenopause for fitness advice.