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The MenopauseClick Here for the PDF Version.What Happens During The Menopause?The menopause begins gradually when the ovaries start making less oestrogen and progesterone, the hormones that regulate menstruation. The process usually begins in a woman's late 30s. By that time, fewer potential eggs are found in the ovaries and periods may become less regular. Levels of progesterone, which prepares the body for pregnancy, drop and fertility declines. The ovaries slowly stop functioning altogether, a corresponding substantial fall in oestrogen and progesterone occurs resulting in a variety of symptoms such as hot flushes, vaginal dryness, bladder weakness, abdominal weight gain and emotional changes. In the period leading up to the menopause, called perimenopause, women begin to experience menopausal physical and emotional symptoms, such as hot flushes and depression, even though they are still menstruating. The average length of perimenopause is four years. Although fertility declines pregnancy is still possible during this time. Perimenopause ends when a woman has gone 12 months without a period, this stage is known as post-menopause. Symptoms such as hot flushes stabilise but, due to low levels of oestrogen, women are at an increased risk of osteoporosis. The Role Of OestrogenOestrogen is generally thought of as the female sex hormone, however its effects on female physiology is far wider; this is the reason why the menopause results in such marked changes. Bone: The continuous replacement of old bone with new is affected by oestrogen; the hormone slows the rate of bone breakdown, stimulates the absorption of calcium and decreases calcium excretion (calcium is the main constituent of bone). As a result postmenopausal women are at a high risk of developing osteoporosis (brittle bone disease). Mood: The production of β-amyloid, the protein responsible for the development of Alzheimer's disease, is held in check by oestrogen. Oestrogen also promotes blood flow to the brain. Numerous studies have implicated oestrogen in modulating brain function, low and fluctuating levels of oestrogen depress mood. Weight: Oestrogen also favourably affects the metabolism of glucose (sugar produced when carbohydrate food is digested) and the response of the body to the hormone insulin, which regulates the level of glucose in the blood; this is one reason why most women going through the menopause experience weight gain. Other effects: Falling oestrogen is the underlying cause of typical menopausal symptoms such as urinary incontinence and vaginal dryness. Hot flushes, for example, are triggered because oestrogen, among various other factors, has a role in the regulation of the body's thermostat. When oestrogen declines, the thermostat becomes unstable and repeatedly signals that the body is too warm, hot flushes and sweating are the body's attempt to cool itself. Hormone Replacement TherapyHormone replacement therapy (HRT) uses estrogens and progestin (synthetic progesterone) to ease the symptoms of menopause. HRT may help to prevent or delay the development of age associated diseases such as osteoporosis, Alzheimer's disease, degeneration of the eyes, urinary incontinence and skin aging. However HRT involves substantial risk and its use must be carefully considered. HRT substantially increases the risk of breast cancer, heart disease, stroke and deep vein thrombosis (DVT or blood clots). Using oestrogen alone is associated with an increased risk of developing endometrial cancer. Side effects include bloating, breast tenderness, cramping, irritability, depression, and menstrual bleeding for months or years following menopause. Key SupplementsDue to the risks associated with HRT many women are seeking a natural alternative to help manage menopausal symptoms and reduce the risk of osteoporosis. Calcium and vitamin D: Calcium is the main constituent of bone, adequate vitamin D consumption is essential to ensure the utilisation of calcium. Studies have shown that calcium, particularly in combination with vitamin D, can help prevent bone loss. Isoflavones: Isoflavones are phytoestrogens or plant compounds that weakly mimic the action of oestrogen, red clover is a rich source. Significantly isoflavones and other phytoestrogens can bind to estrogen receptors, mimicking the effects of estrogen in some tissues and antagonizing (blocking) the effects of estrogen in others. Micronutrient support:A broad spectrum multi-nutrient supplement can support optimal health in later years when calorie requirements are lower but nutrient needs may actually be higher due to physiological changes associated with aging. Water-soluble vitamins are lost rapidly though sweat. Excessive sweating is associated with hot flushes. Black cohosh: Black cohosh is popular as an alternative to hormonal therapy in the treatment of menopausal symptoms such as hot flushes, palpitations, and vaginal dryness. Several studies have reported black cohosh to improve menopausal symptoms for up to six months. Chasteberry (agnus castus): When taken, Apigenin a flavonoid, has been identified as an active phytoestrogen in chasteberry, the herb may increase plasma levels of estrogens and progesterone. And finally...Get moving!Getting active is one of the most important life-style changes menopausal women can make; exercise can help preserve bone density, manage weight and maintain mood. Just 30 minutes of moderate activity three times a week is enough to make a difference. The menopause is an entirely natural process; a few key supplements can help smooth the transition and ensure optimal health at this difficult period and beyond.Quest For Life Issue 7
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