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How to have a smooth transition through menopause

How to have a smooth transition through menopause
By Marta Anhelush 3 months ago 11649 Views

“Ageing is not ‘lost youth’ but a new stage of opportunity and strength” Betty Friedan

Is this how you see menopause? Or are you dreading it? If you are a woman in a perimenopausal age and already thinking about it, or perhaps you are currently going through it and struggling, read on and we’ll delve deeper into how to have an easy transition through menopause and avoid or minimise some of the most common symptoms.

What happens during menopause?

Menopause is the permanent cessation of menstruation, resulting from the loss of ovarian follicular activity and hence a significant drop in the primary female hormones – oestrogen and progesterone. In the UK, the average age for a woman to reach menopause is 51, although women can experience the menopause in their 30s or 40s.[i] Perimenopause is the period that precedes menopause that can start a few years before a woman’s period stops completely. In this phase, hormone levels are gradually starting to decrease and a number of symptoms can start to appear, including irregular menstrual cycles and hot flushes.

Biologically, the ovaries are retiring from their hard work of producing sex hormones. This baton is passed on to the adrenal glands and adipose tissue which take over the role of hormone production. Due to the widespread activity of oestrogen, menopause is associated with a range of physiological changes such as endothelial dysfunction, oxidative stress and increased risk of cardiovascular diseases[ii] and osteoporosis.[iii]

Medical treatment predominantly focuses on hormone replacement therapy (HRT), which relies on oestrogen and/or progesterone supplementation to compensate for the natural loss. However, this approach comes with multiple risks, such as cardiovascular disease (heart attacks and stroke),[iv] as well as oestrogen-related cancers of the breasts or ovaries.[v] Furthermore, it exaggerates the sole role of hormones in menopause-related symptoms, where a number of other, often pre-existing dysfunctions and imbalances can play a large part of why some women have an awful time going through menopause and others don’t.

What are the symptoms of menopause?

Our sex hormones regulate so many bodily functions, from cardiovascular function, energy production and immunity, to hair or bone growth, which is why menopause often brings on a lot of uncomfortable and debilitating symptoms. Factors such as weight, smoking, alcohol consumption, lack of exercise[vi], use of oral contraception[vii], history of PMS,[viii] and stress[ix] can increase risk of menopausal symptoms.

The main symptoms that can occur include:

  • Night sweats, hot flushes
  • Fatigue
  • Weight gain
  • Low mood, depression and anxiety
  • Digestive discomfort: constipation, bloating, reflux
  • Memory and cognitive problems
  • Loss of skin elasticity, excessive wrinkling and dryness
  • Vaginal dryness and increase in infections such as thrush

As common as these symptoms are, they are do not have to be our destiny. Let’s look a little further into what dietary and lifestyle factors can affect or support menopause.

The Stress Factor - Are stress and lack of sleep making your menopausal symptoms worse?

As mentioned, once our ovaries stop producing oestrogen, that responsibility goes to our adrenal glands, through the production of androstenedione, which is the converted to oestrogen in fatty tissue in the body, and also small amounts of progesterone. The adrenal glands also produce our stress hormones – cortisol and adrenaline. High and chronic stress may preferentially ‘steal’ another hormone - pregnenolone (a pre-cursor to androstenodione and cortisol) to make more cortisol, which may lead to reduced levels of oestrogen.[x],[xi] The stress response also increases body temperature, which may be an additional trigger to hot flushes.[xii],[xiii] Oestrogen also promotes the REM phase of sleep, which is a vital process for healing and repair. When oestrogen levels drop so does time spent in REM cycles which leads to less refreshing and restorative sleep.[xiv]

How to reduce stress and improve sleep:

  • Magnesium[xv] reduces tiredness, fatigue, hot flushes[xvi] and promotes relaxation. Magnesium taurate or glycinate may be the preferable forms for nervous support.
  • Turn your bedroom into a sleep sanctuary e.g. dark room, eye mask, technology free. Use blue-light blocking glasses to increase your sleep hormone-melatonin.[xvii]
  • L-theanine and lemon balm increase the calming neurotransmitter GABA,[xviii] promote relaxation[xix] and reduce anxiety[xx] and insomnia.[xxi]

The Gut Link - Are your gut bacteria responsible for weight-gain during menopause?

Oestrogen is known to have an influence on our gut bacteria, which means that the decrease in oestrogen may contribute to digestive symptoms such as bloating, reflux or constipation during menopause. On the other hand, certain bacteria help to metabolise oestrogen. This gut-hormone interaction has been suggested as an important factor in reducing the risk of oestrogen-dependent cancers.[xxii] Furthermore, good levels of beneficial bacteria in the genitourinary area is important to prevent vulvovaginal atrophy at menopause, and other complications such as thrush[xxiii] and urinary tract infections.[xxiv] Another, exciting role of these bugs is aiding metabolism of fats and carbohydrates as well as insulin levels. Hence why poor bacterial balance in the gut can actually increase menopause-associated weight gain.

How to improve digestion and lose weight during menopause?

    • Increase your intake of fibre from fruit and vegetables, flax and chia seeds.
    • Inulin[xxv] increases Bifidobacterium and Lactobacillus bacteria, which promote healthy digestion and excretion of oestrogen and is effective in promoting weight loss.[xxvi]
    • Resistant starch found in pulses, green bananas and plantains, cooked and cooled potatoes or rice increase production of satiety hormones, reducing overall food intake.[xxvii],[xxviii] It also improves insulin sensitivity[xxix] and blood glucose regulation.[xxx]

Supporting Oestrogen Metabolism

Despite the levels of oestrogen dropping after menopause, it is still important to support healthy breakdown of oestrogen in the body. This is because different oestrogen metabolites have different potencies and some of them can be more toxic that others,[xxxi] driving more inflammation, free radical production, tissue damage and increasing the risk of cancer and cardiovascular disease, for example.

Clinically, we often see that women who struggled with hormonal issues in their reproductive years often have a harder time going through menopause, which may indicate a link with poor oestrogen detoxification, either due to nutritional or genetic causes. A number of nutrients are important to support specific detoxification pathways, namely methylation, glucuronidation and sulphation. These include folate and vitamin B12 for methylation, and vitamins B3, B6 and iron for glucuronidation. Menopausal women are often deficient in folate, B12,[xxxii] zinc and copper.[xxxiii]

Different plant chemicals also have potent anti-inflammatory and anti-carcinogenic properties. This includes:

    • Sulphoraphane - a sulphur-containing compound found in cruciferous vegetables such as broccoli (particularly broccoli sprouts), cabbage, and cauliflower.[xxxiv],[xxxv],[xxxvi] It induces a potent antioxidant - glutathione S-transferase,[xxxvii] thus deactivating damaging metabolites of oestrogens. Sulphoraphane also increases the action of many enzymes that are involved in oestrogen and carcinogen metabolism.[xxxviii],[xxxix],[xl]
    • Indole-3-carbinol found in broccoli and broccoli sprouts actively promotes the breakdown of oestrogen,[xli] and has been shown to be protective against oestrogen driven cancers (e.g. breast, endometrial and cervical).[xlii],[xliii]

In addition, avoiding synthetic chemicals which have harmful oestrogen-like[xliv] effect in the body should be a priority too. Those chemicals are often found in plastic, cosmetics and make-up, and non-organic foods so switching to organic and natural foods and beauty products can significantly reduce our exposure.

The Japanese Paradox

Japanese women are well known around the world for their easy transition through menopause, with far fewer symptoms than women in the Western countries.

One proposed idea is their high intake of plant oestrogens or phytoestrogens (aka isoflavones), mostly in the form of soya (e.g. tofu, tempeh). These plant molecules structurally resemble body oestrogen but are much less potent, so by increasing your intake through diet, you may fill in the gap of low oestrogen production, and also help with healthy oestrogen metabolism, and even reduce weight gain.[xlv]

Red clover is also a good source of isoflavones and has been shown to reduce hot flushes, vaginal atrophy, insomnia, cognitive impairment and bone density loss in menopause,[xlvi],[xlvii] as well as improving insulin sensitivity.[xlviii] Interestingly, one paper suggested that the differences in severity of symptoms found in different women around the world may be due to cultural differences in how menopause is perceived and approached.[xlix]

A popular Japanese philosophy called ‘Wabi Sabi’ encourages the acceptance of transience and imperfection; perhaps we need to try to embrace the change and support our body and mind through the transition, rather than fighting and resenting it?

By improving your diet; increasing your vegetable and fibre intake (especially from cruciferous and allium vegetables), reducing stress and improving sleep, you can make menopause a much easier transition. If you are however experiencing severe symptoms, a good place to start is a good multivitamin containing methylfolate and methylcobalamin, alongside some isoflavones and extra detoxification support in form of antioxidants and sulphur molecules.

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