Demystifying Menopause: Finding Facts and Ignoring Fiction

By the year 2025, there will be over one billion women in the world who are either menopausal or postmenopausal. These women are in the prime of their life, but some have been led to believe this natural stage of womanhood is a sign that their body is betraying them.

Menopause is one of the biggest biological shifts a woman endures. Hot flashes, night sweats, emotional ups and downs, periods are heavy and painful one month and non-existent the next…

These are indications that your body is transitioning into menopause, and how a woman’s body can respond during this change can vary from day to day. This constant state of change can be difficult and worrisome for a lot of women, but it’s possible to enter into menopause gracefully and healthfully. Part of that is a willingness to talk about it. In honor of those soon-to-be one billion women—menopause is not something to be feared. Think of it not as an end, but as a beginning.

What is Menopause?

In the United States, more than one million women a year experience menopause. The years leading up to menopause are referred to as perimenopause. This process generally begins between ages 45-55, and it can last, on average, around 7-10 years. Premature menopause is when this process begins before age 45. Menopause is, by definition, when menstruation has ceased for 12 months.

Menstruation cessation is triggered by hormone shifts as a woman’s ovaries stop making adequate amounts of estrogen and other hormones. These naturally declining hormones no longer signal the maturation and release of an egg in a monthly cycle. Without an egg being released, there is no need for menstruation.

Some women sail right through menopause without any symptoms, and others deal with a whole boatload of them. Women who have had a complete hysterectomy can experience these symptoms immediately after the surgery. Those who have had a partial hysterectomy (leaving the ovaries intact) can experience menopause years sooner or in a normal time frame depending on their body.

Symptoms of Menopause

There are a variety of symptoms that can occur during perimenopause and continue through menopause. Typically, symptoms will start to reduce after menopause, but this is not the experience for all women. Symptoms can include:

• Hot flashes - also known as vasomotor symptoms where a sudden feeling of heat/warmth can spread throughout your body
• Night sweats
• Sleeping difficulties
• Vaginal dryness - this can make sex difficult or painful
• Urinary urgency
• Weight gain
• Dryness - this can include your skin, eyes, or mouth
• Emotional changes - Mood changes can include being more irritable, depressed, or anxious
• Breast tenderness
• Irregular periods - menstrual cycles may be heavier or lighter and more or less frequent

Additionally, women can experience symptoms like headaches, racing heart, pain in their joints or muscles, memory or concentration difficulties, and hair thinning or loss. There are also a few important health concerns to keep in mind after menopause (referred to as postmenopause). Osteopenia/osteoporosis is more likely to occur with reduced estrogen levels. Estrogen helps mature bone in childhood, and it is key to maintaining bone density and strength in older years.

The risk of coronary artery disease also goes up roughly ten years after menopause. This is because estrogen is anti-inflammatory and protective of the small blood vessels in the body. Once estrogen production slows down, the risk goes up. Heart disease is the leading cause of death in women and men worldwide, so heart disease prevention should always be considered.

Conventional Approaches to Menopause

Hormone replacement therapy (HRT) is a popular conventional approach to perimenopausal symptoms. There are two main types including estrogen-only hormone therapy used by women who no longer have a uterus, and estrogen-and-progesterone hormone therapy used by women who still have their uterus. These therapies are typically dosed orally with pills or topically via creams depending on doctor/patient preference. Risks do exist with HRT including an increased risk of endometrial cancer (if you use estrogen therapy and still have your uterus), breast cancer, blood clots including deep vein thrombosis, gallstones, pulmonary embolism, and stroke. Risks are lower if you start HRT close to when you started perimenopause or went through menopause.

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have been used to help reduce menopause symptoms. Birth control pills may also be recommended to assist with hormone fluctuations during this time. Additionally, vaginal hormone creams can be used directly on vaginal tissues to reduce vaginal dryness. You can choose other non-medical interventions to supplement these options or medications as a first-line approach.

Ways to Support a Healthy Postmenopausal Lifestyle

During menopause, it’s very important to help support your liver and adrenal glands. The ovaries will produce far fewer hormones, including estrogen, after this transition. This means estrogen is going to come mainly from fat cells and the adrenal glands. Liver health is also critical during this time. The liver helps regulate sex hormone levels by breaking them down and supports detoxification.

Healthy Diet. An overall healthy diet will contribute to a reduction in symptoms. Research has shown a reduction in weight in women can lower symptoms. Even a reduction of 5-10 pounds has demonstrated positive effects on hot flashes. A whole foods diet with whole vegetables, a moderate amount of leaner meats, and fruits are great for supporting a healthy weight. Foods such as avocado, turkey, fatty fish, dark leafy greens, strawberries, and pumpkin seeds can also support healthy adrenal glands.

Fiber. Fiber is critical to dietary support through the menopause years. Research shows fiber lowers the risk of cardiovascular events, especially coronary artery disease. The best kind of fiber to consume comes from a whole-food diet. Vegetables, fruits, and whole grains are all great sources of fiber that can be added to your diet. The USDA’s Dietary Guidelines for Americans recommends at least 22-28 grams of fiber per day depending on your age. Additionally, fiber helps bind with broken-down hormones so they leave the body instead of being reabsorbed.

Protein. Menopause has been linked with a decline in bone mineral density and lower muscle mass and strength due to declining estrogen. Adding in good sources of protein and minerals can help with this. Eating adequate amounts of protein can help stimulate muscle formation, especially when paired with quality mineral intake. Experts recommend elderly adults consume between 1.2 and 2.0 grams per kilogram of weight per day. This means that an adult weighing 150 pounds, should be eating a minimum of roughly 80 grams of protein per day. This means eating protein with every meal and snacks can help people reach this goal for optimal health.

Other things to keep in mind include physical activity, drinking enough water, breathing fresh air, getting some sun when you can, and working to get plenty of rest at night can all improve the menopause experience. It’s also a good idea to limit sugar intake to smaller amounts as it has been linked to many diseases.

Natural Approaches to Menopause

Here are a few other ideas you can consider to support health and wellness through your menopausal years.

Emotional/Mental Support. Menopause is another life transition for women. From childhood to teen years, to focusing on your career and/or having a family (if you choose), to kids growing up and leaving the house… Life is full of shifts. Seeking out talk therapy can help support mental health and may even lower hot flashes. Cognitive Behavioral Therapy (CBT) can help improve sleep. Finally, reaching out to other women such as family members or friends for chats can also be helpful.

Alternative Therapies. Besides talk therapy, studies have shown reflexology sessions may be helpful though more research is needed. Acupuncture and traditional Chinese herbs may also be helpful with a wide variety of menopausal symptoms. Research is mixed, but acupuncture is very practitioner-dependent; seek a trained licensed professional near you if you’d like to give this a try.

Botanical Support. Herbs can be a great way to help support your body in menopause. Valerian (Valerian officinalis) and lemon balm (Melissa officinalis) can be helpful to support sleep. Black cohosh (Cimicifuga racemosa) and wild yam (Dioscorea villosa) may be helpful with many menopausal symptoms such as irritability, hot flashes, night sweats, etc. Red clover (Trifolium pratense) and soy (Glycine max) can be helpful in supporting bone health. As always, especially if you are taking medication, see advice from your health professional before adding new herbs and supplements.

Exercise. Getting movement helps you maintain your health and wellness throughout life, not just menopause. Research has shown yoga may help improve hot flashes, fatigue, and mood. Other evidence has found that high-intensity and high-impact exercise can help maintain, and possibly improve postmenopausal bone health. Weight-bearing exercise in general can be very supportive of bone health. Even going for walks daily with a water bottle in a backpack adds weight which can support healthy bones.

To Sum It Up…

Perimenopause, menopause, and postmenopause are natural stages of menopause. There are many different ways to ease yourself through this transition. Self-support during this change may be connecting with others going through the same experience. To connect to others online, Healthline has a great listing of online blogs offering connections to women. Their listing can be found here.

Most importantly, remember this is your body changing to support you through the coming decades. It’s a life event for women that’s been ongoing since the beginning of humankind. To read more about menopause and hear the voices of other women from around the world, visit Women First for your free copy. As always, remember to reach out to a trusted health professional for information and advice on menopause and other health concerns.

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