Perimenopause, Menopause, and the Lindora Program
While menopause is one of life’s natural progressions, its onset can evoke a variety of emotions for women. For some, menopause is the welcomed, long-awaited freedom from menstruation. It can be a time of renewal, regeneration, and revival. For others, menopause can be physically and emotionally challenging. It is important that women understand how to take care of themselves during this transition.
Perimenopause is the period of gradual hormonal and physical changes (beginning to occur in women at about the age of 35) that leads to menopause. Menopause can be a gradual or abrupt process and occurs when the ovaries stop releasing eggs. The average age of menopause is 51, but varies with each person. Usually the diagnosis is based on reported symptoms. Blood tests to check hormone levels may be beneficial but difficult to evaluate due to fluctuations in the hormone state during the perimenopausal period. Your doctor may do several tests at different times to compare the results. A woman is said to be in menopause after one year of absent periods.
Symptoms of menopause may include:
- Irregular periods
- Achy joints
- Hot flashes
- Change in sexual desire
- Frequent urination
- Difficulty sleeping
- Early awakening
- Mood swings
- Increased premenstrual syndrome symptoms
- Vaginal dryness
Seventy percent of menopausal women have intermittent mild to moderate symptoms, which may or may not motivate them to seek treatment, with 15% having no symptoms, and 15% having symptoms that become physically and emotionally disabling. There is a variation with each woman in how many of the symptoms are experienced and at what intensity.
Issues Caused by Decreased Estrogen
Decreased estrogen means women are more likely to suffer from these health risks:
- Heart disease
- Poor bowel and bladder function
- Poor skin elasticity
- Poor muscle tone and power
- Deterioration in vision
- Increased risk for Alzheimer’s and dementia
- Increased risk for breast cancer
Steps to Improve Symptoms
General recommendations to help symptoms:
- Stop smoking
- Practice good sleep hygiene
- Decrease alcohol consumption
- Reach a healthy weight and stay there
- Take multivitamins and ingest enough calcium
- Regularly drink eight glasses of water a day
Menopause has been shown to contribute to a higher incidence of osteoporosis.
Osteoporosis is a disease that causes the loss of bone mass and is very serious because there are no symptoms in the early stages. The symptoms occur only in the late stages, causing back and abdominal pain with frequent non-impact fractures. Menopausal women should have bone density testing to determine the progression of the disease and should take 1200-1500 mg of calcium with vitamin D per day. Women should participate in 30-60 minutes of aerobic exercise, preferably weight bearing (such as walking), on more days than not-about 6-7 days per week.
Women who are at higher risk for osteoporosis may be:
- Caucasian or Asian
- Those with over active thyroid
- Those who lead a sedentary lifestyles
- Those with diets low in calcium and vitamin D
- Those with a family history of osteoporosis
- Those who experience early menopause
Hot flashes are sudden or mild waves of upper body heat that last from 30 seconds to 5 minutes. They are caused by rapid changes in hormonal levels in the blood, followed by increased heart rate and increased skin temperature, causing facial redness and sweating that may be severe enough to cause drenching.
Treatment for hot flashes include:
- Hormone replacement is a controversial option
- Different SSRIs are also presently being studied as treatment for hot flashes.
- Non-prescription treatments
- Eating foods with soy
- Regular exercise
- Cold showers, cooler rooms, and wearing thin natural fabrics
- Keeping a hot flash diary to identify triggers
- Managing stress levels
Breast Cancer Risk
By the age of 60, one out of every 28 women develops breast cancer. Research suggests that using hormone replacement therapy for 5 or more years slightly increases a woman’s risk of getting breast cancer. Early detection is the cornerstone to treatment success. Menstruating and non-menstruating women should have annual breast exams by their provider, along with a baseline mammogram at age 40, and annual mammograms after age 50. Monthly self-breast exams should be performed.
Heart Disease Risk
Before a woman turns 50, she has three times less risk of heart attack than a man. Ten years after menopause-or at about the age of 60-the risk of heart disease increases to equal that of a man. Women can protect themselves against heart disease by not smoking, maintaining a normal weight, and eating a healthy diet moderate in protein, low in fat, and moderate in carbohydrates. Exercising regularly is also beneficial in prevention of heart disease.
Can menopause cause weight gain?
One long-term ongoing study of women before, during, and after menopause (Rancho Bernardo Women’s Study) has shown that women tend to gain weight more rapidly during and after menopause. Menopause may not cause weight gain, but it certainly contributes to it. As we age, metabolism slows, hormone levels change, and vigorous activity can become more difficult. Behavioral changes-such as growth in wealth and free time-also seem to play a role.