The ups and downs of menopause

November 18, 2022
/ Aging

They say death and taxes are two things you can be sure of in life. If you’re a female entering middle age, you most certainly will also hit menopause, a major new life phase when reproduction stops.

Typically kicking off between the ages of 45 and 55, the hormonal changes can be turbulent, affecting far more than reproduction. Impacting around 75% of women, symptoms include mood swings, anxiety, hot flushes, sleeping problems, heavy periods, low sex drive, cognitive problems, skin changes and increased risk of chronic diseases.

While most symptoms will calm down eventually, many women continue to experience some of them into their 60s; most commonly hot flushes, vaginal dryness and itching, urinary incontinence, weight gain and insomnia.

The impacts of falling hormone levels can be tough, which is not helped by the ignorance, stigma and silence surrounding menopause. The good news is that awareness is rising, and with it an opportunity to embrace this change of life as part of aging gracefully.

Indeed, a recent editorial in The Lancet flagged that it’s time for a change in attitudes towards this significant life event, which offers an opportunity to take stock of our goals, take charge of our health and enjoy longer, happier lives.

More than sex hormones

Oestrogen plays many important roles in the body, and its decrease accounts for many of the changes that occur, exacerbating natural impacts of aging.

It helps facilitate insulin sensitivity, for instance, so lower levels can contribute to insulin resistance and diabetes.

Lower levels can contribute to weight gain around the abdomen as well as increased LDL cholesterol (the bad one) and triglycerides – which can all increase risk of heart disease. As muscle mass naturally declines with age, muscle is replaced by fat if it’s not maintained, also contributing to lower metabolism and weight gain.

Oestrogen helps maintain bone density, so falling levels can cause bones to become weaker and more prone to fractures and osteoporosis. It can even impact the brain, contributing to brain fog, depression, memory loss and possibly dementia.

The other key hormones the ovaries produce less of as menopause sets in are progesterone and testosterone, which contribute to perimenopausal symptoms.

The opportunities

Challenging as it is, the transition to menopause and beyond doesn’t need to be so bad. While some women may benefit from hormone therapy to support them through the transition, there are also many lifestyle factors that can mitigate the short- and long-term effects.

Exercise is fundamental, especially weight bearing exercises and resistance training to strengthen bones – although a range of different activities are recommended; yoga and tai chi, for instance, can help with balance and falls prevention. Exercise can also have a significant impact on mood, weight and preventing cognitive decline.

A healthy diet is a no-brainer for overall health, including maintaining a healthy weight and keeping blood sugar levels down. Calcium, protein and vitamin D are important for bones and muscles and can help prevent falls and fractures. A Mediterranean-style diet, high in plant foods and low in sugar and processed foods, is rich in nutrients that support healthy aging and can even help stave off dementia.

It’s also a good time to address stress levels and take time out to nurture yourself and welcome the change. As The Lancet Editorial states, “this stage of life is an opportunity, a new beginning that can be lived richly, productively, fully, and in good overall health”.