The human body changes over time, both externally and internally. Hormones are one of the body’s great regulators and both men and women experience hormonal fluctuations throughout their lives.
For women, the transition through perimenopause to menopause is a time of major hormonal fluctuation. The phases are often confused with each other, but true menopause is when a woman has not menstruated for a full year. Perimenopause is the phase leading to menopause and lasts an average of four years, although it can range from a few months to 10 years. A woman’s body typically begins to start the perimenopause process at age 35.
Perimenopause usually begins between the age of 35 and 50 when the ovaries begin to produce less estrogen. The imbalance of estrogen and progesterone often results in missed periods as well as side effects like hot flashes (the most common side effect of perimenopause), fatigue or low energy, difficulty sleeping, decreased libido and what some women call “PMS plus” —instances when pre-menstrual side effects worsen.
Like many transitions, perimenopause can be physically and emotionally challenging. There is no quick fix for troublesome side effects but many women find relief in lifestyle changes that improve overall health, including:
- Adding moderate exercise to your daily schedule
- Improving nutrition
- Avoiding smoking and alcohol
- Reducing stress
- Increasing water intake
- Practicing good sleep hygiene
Hormone replacement therapy (HRT) and bioidentical hormone therapy (BHT) provide side effect relief for some women. These therapies help balance hormone levels that vary throughout perimenopause. However, using hormones to control symptoms are NOT mandatory. The first question to ask is, “how much do my symptoms affect my daily life?” And if the answer is not at all, then no hormones are needed at that time. The fluctuations of the hormones are like the waves of the oceans. Symptoms are variable depending on lifestyle habits, stress during that particular period in your life, weight loss or weight gain, climate and weather changes and Mother Nature.
Even though menopause is the official ending of your menstrual periods, the hormone fluctuations that created side effects during perimenopause are still occurring, meaning that some perimenopause symptoms may remain (or return) and new side effects could appear during menopause.
Once women reach menopause they are at greater risk for developing osteoporosis, a disease that weakens bones. The post-menopausal drop in estrogen is directly related to loss of bone mass. Because there are no symptoms of bone loss, it’s often only after a bone-related injury that the presence of osteoporosis is discovered. Bone mineral density tests (BMD) are x-rays that measure bone density. Screening should begin if you have any of the following risk factors or at the cessation of the menstrual cycle. The following puts you at a higher risk of developing osteopenia or osteoporosis:
- Advanced age
- Your race – Caucasians and Asians have a higher prevalence of osteoporosis
- Family history of osteoporosis
- Body frame – people with petite frames can have a higher risk because they often have less bone mass to begin with.
Likewise, your doctor can offer osteoporosis treatment and prevention suggestions which may include:
- Eating foods high in calcium
- Calcium and vitamin D supplements
- Bone density medications
- Estrogen therapy
- Exercise, especially weight bearing exercise
- Medically Supervised Weight Management
- Avoiding smoking and alcohol
Health Care Options for Perimenopause and Menopause
Perhaps one of the most important things to know about perimenopause and menopause is that you aren’t alone. Approximately three million women transition to menopause every year and there are abundant health care options for both phases. Each woman will enter this phase in her life. During these transition years, remember that these symptoms are not forever. Your doctor can help get you through the storm, by teaching you to dance in the rain.
Certainly the scope of this topic is much more in depth and much more individualized than can be covered here. Knowing that the greatest years of your life don’t have to be the darkest days, lends hope for every woman to reclaim her body.
Dr. Raman’s Concierge Medical Practice is focused on caring for each person as a whole, not just a list of symptoms. Our office is committed to helping our patients stay well and maintain good health rather than treating patients only after they become ill.
Menopause, a women’s worst nightmare or is it? By simply understanding the basic science, we can clear the myths of this dreaded change and make it the most empowering years of a women’s life.
The two predominant hormones are Estrogen and Progesterone. Menopause is nothing more than a mirror image of menarche, or the start of menses.
In the pubertal years, the E2 (Estrogen) and P4 (Progesterone) begin to increase in quantity in preparation of future pregnancies. During this time, there is an imbalance of E2 and P4 which occurs that results in PMS, development of female habitus, acne, mood changes and so on.
During the 20’s and 30’s, E2 and P4 are in prime balance which allows the opportunity for the woman to conceive. When in equilibrium, a woman feels her best.
Around 35 years of age, the body begins to prepare to slow down. This is the time, the change STARTS.
E2 and P4 levels begin to biologically drop. Progesterone declines twice as fast as Estrogen. It is this imbalance between the lower Progesterone in relation to the higher Estrogen that causes menopausal symptoms.
Walking around with higher than needed Estrogen leads to higher risk of breast, uterine, or ovarian cancers, blood clots, and heart disease. Progesterone is there to keep Estrogen from over stimulating the cells. Progesterone also helps with sleep, balances your mood, acts as a diuretic, and gives an overall sense of calm.
When Progesterone declines in respect to Estrogen, it creates a phenomena known as Progesterone Deficiency or Estrogen Dominance.
This is when women experience acne, mood changes, sleep issues, cravings, slowed metabolism, weight gain around mid-section and hips. In essence, menopause is a mirror reflection of menarche.
The solution? That is the million dollar question. Pre-menopause, Peri-Menopause, Menopause, Post-Menopause-whatever phrase you choose to describe this phase is irrelevant because the concept is the same.
Crossing the turbulent rivers of menopause is much easier and simpler than we think because we now understand why the body is changing the way it is.
So how do we get through these years? Here are few things to remember:
- Breathe. This is not a permanent! The hormones are trying to find their balance and they eventually will. No one can predict how long this will take. And nothing can be done to speed up the process. The body is only trying to protect you. Allow it to do so. Don’t condemn the changes you are experiencing. The body is your armor, your voice and your friend. Understand what it is trying to tell you when it speaks to you in the form of symptoms.
- Stop worrying about the weight. The weight is a symptom like anything else. Weight gain occurs due to Estrogen Dominance/Progesterone Deficiency. There are alpha and beta receptors throughout our muscle and adipose layers in the body. Depending on how those receptors are activated in each person, is where the weight change will occur.
- Watch your diet and move your body. Our foods are coated with Estrogen and other chemicals which worsens Estrogen Dominance. It is imperative to cut out gluten, sugar, dairy. Eat clean and as unprocessed as possible. Additionally, without exercise don’t expect the body to change. Your body will not respond how it did was few years prior. And that’s ok. But it doesn’t mean that it won’t change. This will just become the new norm. One of the places Estrogen is converted is in adipose tissues. So the more fat you carry, the more estrogen it will convert, thereby again, worsening Estrogen Dominance. Striving towards optimal body fat will help keep Estrogen Dominance controlled. Focus on feeling balanced, not skinny.
- Make sleep a priority. Without sleep the adrenal glands cannot function at their best. The disruption to the cortisol results in further Progesterone depletion. Turn off the devices and sink yourself into restful slumber.
- Meditate. When the mind is silenced amongst the chaos of life, we are able to center and align to the root of our existence. Take 5-10 minutes a day, close your eyes and go to the places that feel off balance and listen for the guidance given.
- Use hormones. I am all for using hormones, IF AND WHEN IT IS NEEDED. Treating with hormones during menopause is certainly not mandatory. The fundamental question to ask is, “are my symptoms debilitating enough that it is affecting my quality of life?” If the answer is yes, use the smallest amount needed for optimal results. Hormones are like the waves of the ocean. Anything can affect them – sleep, weight, seasonal changes, stress levels, nutritional habits, exercise commitment. You may need hormones for a while and decide later they are not needed. And depending on what’s going on in life, may need them again. There is no one answer. The correct answer always is what your body tells you it needs. Hormones are not the magic solution to these symptoms. They are only a crutch to lean on while working on lifestyle modifications.
- Stop comparing. Don’t compare yourself to your past self. Menopause is a beautiful opportunity for growth and experience. Just keep remembering the symptoms we experience is the body protecting us. This cloud WILL pass! Learn to dance in the rain and embrace the glory of being a woman. This is a period of transformation, revitalization and rejuvenation.
Menopause is the process of shedding the layers of struggle. But just be patient my friends because the wings of healing are opening to reveal the vastness of all that is authentically you.
Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health, CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.