Menopause is a completely natural biological process, and therefore not a problem to solve! And although it concludes the time in a woman’s life for fertility, women can stay healthy, vital and sexual through their 50s and well beyond. That said, declining levels of oestrogen and general hormonal shift that occurs during menopause might lead to mood swings, hot flashes, insomnia, vaginal dryness and other symptoms that impact quality of life. After all, there are oestrogen receptors throughout the brain and body, so when oestrogen levels change, the repercussions are experienced all over affecting physical and psychological health.
Insulin, adrenaline and cortisol also impact oestrogen levels during the menopause; cortisol and adrenaline is produced by the adrenal glands in response to normal daily bio-rhythms, as well as contributing to the body’s stress response; insulin helps to control blood sugar levels. Imbalances in these hormones can contribute to many perimenopausal symptoms; raised adrenaline levels contribute to hot flushes and chronic exposure to cortisol impacts many areas throughout the body including the sleep-wake cycle, bone health and brain function. In fact, loss of bone density and osteoporosis can be one of the most debilitating symptoms of the menopause. Oestrogen production in the body is inhibited by insulin resistance, which is becoming a widespread phenomenon throughout the population associated with high sugar and processed food diets, obesity and Type II diabetes. A poor diet and insulin resistance may therefore further exacerbate the symptoms induced by naturally declining levels of oestrogen during the menopause. The adrenal glands also take over some of the production of oestrogen once ovarian perimenopausal oestrogen levels begin to decline so adrenal health is paramount to maintaining equilibrium during this time of a “perfect storm” of hormone imbalances.
Is supplying extra oestrogen through Hormone Replacement Therapy (HRT) the answer?
In 2002, the Women’s Health Initiative (WHI) conducted the largest, most rigorous study to date on hormone therapy following 16,000 women over 5 years, and found that HRT can increase the risk of both breast cancer and heart disease in healthy postmenopausal women. WHI investigators looked at risk three years after stopping HRT, and found that although cardiovascular risk returned to normal, there was still a greater incidence of malignancies.
So is bio-identical hormone replacement therapy safer than HRT? It makes sense logically to use a hormone with the same molecular structure as a hormone that is endogenously produced, versus one that is completely synthetic. But these bio-identical hormones are still made in a laboratory in the same way that conventional HRT is made and from the same sources. Also, the menopause is a time of naturally declining hormone levels so replacing hormones may disrupt the body’s natural rhythm.
So what can be done to master the menopause?
Natural approaches address the diet and lifestyle as a way of literally diminishing perimenopause symptoms and coping with this natural life transition. A low refined sugar, high fibre diet is an important factor in balancing hormones and may help reduce hot flashes and other menopause symptoms, including reduction in bone density. Typical dietary approaches include avoiding high sugar foods and drinks, as well as caffeine and alcohol, which can also raise adrenaline levels and impact on adrenal function. Increasing daily intake of vegetables and other plant matter like seeds and nuts provides beneficial fibre and essential fats, vitamins and minerals. Important nutrients include Vitamin K2, Vitamin D3, calcium, magnesium, boron and folic acid for heart and bone health; Vitamin E has been shown to reduce the severity of hot flashes, as well as Vitamin C to support collagen and skin elasticity. These can be obtained in the diet as well as through menopause-targeted multivitamin and mineral supplements.
It’s well known that Japanese women do not experience so many of the menopausal symptoms – in part due to the high level of natural soya consumed. Soya beans contain substances called phytoestrogens, which exert weak but definite oestrogenic effects in the human body. Obviously, such substances have the potential to give significant physiological support to menopausal women whose symptoms arise from relative oestrogen deficiency. This helps support cardiovascular health, bone health and even cognitive function. Phytoestrogens include soya (fermented not processed is best to concentrate the isoflavones – a type of phytoestrogen), hops, dandelion, red clover, sage, alfalfa, flaxseeds. Ground flaxseeds provide good levels of phytoestrogens, as well as other nutrients including essential fatty acids and fibre. Mindfulness and mediation practice, as well as exercise, are also compelling in the ability to manage and reduce perimenopause symptoms.
For a full set of references and more information please see the Nutrigold Education Article “Nutritional Support for the Menopause”.
Doshi et al (2013) The role of oxidative stress in menopause. J Midlife Health 140-146
Rossouw JE, Anderson GL, Prentice RL, et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From principal results From the Women’s Health Initiative randomized controlled trial. JAMA 288(3):321-33 Full article
Epperson CN(2013) Menopause effects on verbal memory: findings from a longitudinal community cohort. J Clin Endocrinol Metab. Sep;98(9):3829-38. doi: 10.1210/jc.2013-1808. Epub 2013 Jul 8. View abstract
Greendale GA(2009) Neurology. Effects of the menopause transition and hormone use on cognitive performance in midlife women. May 26;72(21):1850-7. doi: 10.1212/WNL.0b013e3181a71193. View abstract