Dealing with Menopause
We often write and talk about issues that affect the child-bearing years, but very seldom do we address the very special time of life known as the post-menopausal years. For some women, this is a time of freedom, enlightenment, travel, and finally getting to do what YOU would like to do. After dedicating your life to everyone else for 30 or 40 years, you finally have a chance to do something for yourself. For others, it is a time to enjoy family, a chance to spoil the grandchildren, crochet, make quilts, relax, work in the garden, enjoy the well-earned peace of a life well-lived. Unfortunately, for other women, this is a time of declining health, depression, loneliness, confusion, feeling lost, and feeling like the world has passed them by. What makes the difference? Are women really that different in how they view life or is there some chemistry involved here that makes their thoughts and outlooks different?
I think it’s both with, perhaps, an emphasis on chemistry. A woman is considered to have entered menopause when she has not had a period for twelve months. The average age of menopause is 51 years old. This is the time of life when the ovaries stop functioning. In other words, you no longer ovulate or have the ability to become pregnant.
Symptoms of menopause can include:
Abnormal vaginal bleeding. Some women have minimal problems with abnormal bleeding during the time before menopause whereas others have unpredictable, excessive bleeding. Menstrual periods may occur more frequently or they may get farther and farther apart before stopping. There is no normal pattern of bleeding during perimenopause, and patterns vary from woman to woman.
Hot flashes. A hot flash is a feeling of extreme warmth that spreads over the body and is often most pronounced in the head and chest. It is often associated with flushing and is sometimes followed by perspiration. They can last from 30 seconds to several minutes. They are thought to occur due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels.
Mood changes. Women in perimenopause and menopause are often concerned about the emotional and mental changes taking place. Things like memory problems, irritability, and rapid mood changes.
Fatigue. Night sweats (episodes of drenching sweats at night) sometimes accompany hot flashes. This may lead to restlessness, being awakened in the middle of the night, and difficulty falling asleep again. This can often result in feeling exhausted during the day.
Stress. During the time women are entering perimenopause and menopause, there may be other life-changing events taking place such as children leaving home, becoming an empty-nester, losing a spouse, down-sizing to a smaller home or apartment, dealing with chronic illness in themselves or their spouse, retirement, etc. As we will discuss later in this article, the release of cortisol due to stress adding to the hormonal cocktail can make life even more challenging. Your metabolism is very much like a stress barometer and it measures more than just what you eat or how you exercise. One of the most important aspects of keeping your metabolism up is giving your body enough rest and recovery time. By doing this, you give your hypothalamus and pituitary (the command and control center of your metabolism) the ability to rest and reboot your hormonal software.
Vaginal dryness and itching. As estrogen levels start to fall, the tissues lining the vagina become thinner, drier, and less elastic. This can cause irritation, and be uncomfortable or painful during intimacy.
Urinary symptoms. The urethra (the tube which goes from the bladder to outside) can change due to declining levels of estrogen. This can lead to an increased chance of urinary infections, feeling the need to urinate more frequently, or leakage of urine. This can happen when laughing, sneezing, coughing, or lifting heavy objects.
Weight Gain. Many women put on extra weight around the middle of the body.
Hair Growth. Since testosterone levels may be high compared to progesterone and estrogen levels, women may experience some hair growth on the chin, upper lip, chest, or abdomen.
Let’s take a look at how our hormones shift and change throughout our lives and what we can do to help stabilize all of these fluctuations. Dr. Jade Teta tells us in “Metabolic Renewal Roadmap”:
Hormones all play together like a symphony. When one part of the symphony overwhelms another part, it impacts the harmony of the whole thing. And like in a symphony, the instruments (in this case hormones) can have different effects. Sometimes they work one way, sometimes another, just like a violin can make you feel happy one moment and melancholy the next. The best symphonies play in tune together. They are balanced, and that is exactly what you want with your hormones. It’s what I call the Goldilocks effect. Not too little and not too much – but just right.
Estrogen and progesterone influence nearly every other hormone in your body, including those involved in the speed of your metabolism, your ability to regulate blood sugar, and more. Of course, your estrogen and progesterone levels are themselves influenced by many things, including whether or not you are menstruating, which stage of menopause you are in, and how you currently eat, exercise, and live.
Estrogen and Progesterone Levels In Every Stage
In our childbearing years, progesterone and estrogen each take turns being dominant.
During each of our menstrual cycles:
In the first 14 days, progesterone is relatively flat. In fact, it’s about the same as a man’s level. During this time, estrogen slowly rises and peaks right around ovulation. At this point, you have more estrogen in your body relative to progesterone. This is called the follicular phase of your cycle. The egg is released and the uterine lining begins to thicken under the influence of estrogen.
The next phase, known as the luteal phase, begins as progesterone begins to rise and estrogen levels decrease. Midway through the luteal phase, progesterone is higher than estrogen. If the egg is not fertilized, progesterone and estrogen levels fall and the uterine lining is sloughed. Throughout the cycle, there is a natural ebb and flow of progesterone and estrogen. A young woman who menstruates normally will be estrogen-dominant in the first half of her cycle and progesterone-dominant in the second half of her cycle.
During the perimenopausal years:
There will be times when ovulation does not occur due to decreasing viable eggs. If ovulation does not occur, there is no corpus luteum (follicle where the egg was released) to trigger the progesterone. This can lead to extended periods of estrogen exposure without progesterone to balance it out. Sometimes estrogen will be dominant. At other times, it will become completely wiped out since it is never getting any help from progesterone. This is one of the reasons perimenopause can feel so unstable, unpredictable, and sometimes even bipolar. Normally, estrogen and progesterone work together in harmony. But when progesterone is no longer exerting its influence, estrogen levels can rise and fall unpredictably.
This can leave you feeling motivated and clear one second, wired and anxious the next, and depressed the next moment. When no two days are the same, you can begin to start feeling a little crazy. One of the most impacted areas can be the brain. Fluctuating estrogen levels can create an unstable influence on serotonin and dopamine levels, leading to a lack of motivation (dopamine) and feelings of insecurity and depression (serotonin).
Once we officially enter menopause:
Once you move into menopause, ovulation stops altogether and estrogen levels begin to fall. Because progesterone and estrogen levels have dramatically fallen, testosterone, insulin, and cortisol begin to have a greater impact. This can make you more stress-reactive and more insulin-resistant. Your brain chemistry also changes as there are estrogen and progesterone receptors all through your body––including the brain.
In our post-menopausal years:
Post-menopausal women are more prone to bone loss (osteoporosis) and heart disease, so incorporating some type of resistance training with weights or exercise bands will help to increase bone density.
At this point, our metabolism can look more like a man’s––there is higher testosterone relative to estrogen and progesterone. This is the time that many women put on more weight around the middle, may become more flat-chested, and lose their hourglass shape.
As I am putting all of this together on paper, I realize how daunting it all sounds, but it doesn’t have to be. Like so many other challenges in life, it is up to each one of us to decide how we want to live in this season of our life. Let me get personal here for a minute and share some of my own experience.
Do you remember in the first paragraph of this article, I listed several different scenarios about how women feel and live in their post-menopausal years? Well, the truth is, I was sharing some of my own feelings and experiences. I cycled until I was sixty years old, so I went through menopause at the age of sixty and would have been considered post-menopausal sometime during my 61st year. Recently, I celebrated my 66th birthday.
At first, I thought it was wonderful not having to put up with periods anymore. I saw my life in three seasons:
The first season would have been the years I spent growing up.
The second season would have been the 45 years of my life that I took care of everyone else – my husband, my family, my midwife practice, my community, people in my church, etc.
The third was the season I was entering. I saw the next 30 or 40 years as a time to explore, discover, learn, travel, take tennis lessons, bike across Ireland, and a time to get to know myself again and what makes me happy.
As I moved into the post-menopausal years, I started becoming upset with myself for putting on so much weight and allowing myself to get out of shape. I began to get frustrated with many of the situations I found myself in. I loved spending time with family and grandchildren, but began to realize that I was experiencing a lot of ups and downs––one minute I was at peace and happy, the next minute I was sad and fighting back tears, and then the next minute I would be shocked at how angry I was––I seriously wanted to hurt someone. I ended up creating an office/sanctuary for myself where I could go to work, pray, study, and give myself space where I could ground myself.
Then my life radically changed. I’m not going to take the time or space to go into all of the details here of how this happened, but three young children who were 4, 5, and 6 years old came into my life and needed a home. During this time of transition, while they settled into a life with us, I realized I had created the perfect chemical storm for myself. I was estrogen dominant, out of shape, had extreme amounts of cortisol raging through my system with extreme side effects. I found myself unable to focus and be creative, easily agitated, and fighting off depression and despair.
This was not me––I wasn’t sure how to navigate these waters but knew I needed to do something to turn this around. One evening, I drove myself to the emergency room with extreme chest pain convinced I was having a heart attack. It turned out to be stress-related. It was a huge wake-up call! I realized it was time to stop and chart a new course for myself which was exactly what I did.
How To Make The Transition Better
For those of you who are in your post-menopausal years and are hurting physically, mentally, or emotionally–there is hope and there are things you can do to change how you feel. Here are a few of my suggestions:
Get to your ideal weight.
There are multiple reasons for this––your joints, your circulatory system, your heart, your bones, and every other system in your body will thank you. It will do wonders to help restore energy and reboot your metabolism. There are lots of ways to go about doing this, but the one thing I would emphasize is not to go on a fad diet which will only slow your metabolism more and put greater amounts of stress on your body. Incorporate something which has you eating lots of fresh salads, fruits, smoothies, and live food. You don’t need to go on a low-calorie diet––you just need to change what you are eating. Cut out the processed sugars, flours, foods, and start rebuilding a life with life!
Find something to help balance your hormones until your body is strong enough and healthy enough to do it on its own.
Some people have been able to successfully incorporate an herbal supplement specifically designed for this stage of life. I would stay away from traditional hormone replacement therapy due to the use of synthetic hormones. But if you can find a naturopathic doctor who does plant-based hormone replacement therapy, this can be extremely helpful.
Exercise.
Dr. Teta says, Research has shown that a component of metabolism called non-exercise associated thermogenesis (NEAT) makes up 15% of our changeable metabolism. Exercise is only 5%. That is why women who walk a lot remain so thin compared to women who don’t, whether they exercise or not. As a woman, walking, and other activities that are not exercise – gardening, walking, doing dishes, doing laundry, taking the stairs, etc. sensitize the body to your hormonal system and reduce cortisol.
Cacao.
This can be eaten or taken in shakes. It has tremendous health benefits. It is extremely high in antioxidants––40 times more than blueberries. It’s the highest plant-based source of iron known to man and one of the highest plant-based sources of magnesium which is important for a healthy heart and helps turn glucose into energy, enabling your brain to work with laser-sharp clarity and focus. It is also high in calcium which helps to counteract osteoporosis. Finally, it contains serotonin and dopamine mimickers along with other compounds that support feelings of well-being and happiness.
Rest and relax–literally!
Read a good book, take a leisurely walk, relax with family or friends, go to the spa, go swimming, soak in a hot tub, pray. When life gets to be too much––put yourself in time out, take a nap.
My dear sisters, you have earned this time in your life to pamper YOU! It is not necessary to prove anything to anyone anymore. Do what makes you happy. If you haven’t already––learn to enjoy life again by choosing to be as healthy, strong, and vibrant as you possibly can be. Getting old doesn’t have to mean losing capacities. It truly can be a time of joy, of discovery––whatever you want it to be.