Menopause

Menopause is a natural part of aging.  Menopause affects each woman differently.  Some of the more common symptoms women experience include:

  • Sagging skin, weight gain, bloating
  • Sleepless nights, night sweats, depression
  • Fragile bones, joint pain
  • Hot flashes, tension, mood changes
  • Migraine/severe headaches, fatigue
  • Mental confusion, memory loss
  • A dry vagina, breast tenderness
  • Irritability and loss of sex drive
  • Increasing anxiety

For those who decide that these symptoms are unbearable, they often resort to synthetic pharmaceutical hormone replacement products.  There has been controversy regarding the risk-to-benefit ratio of these synthetics.  These synthetic hormones are the ones that the Women’s Health Initiative (WHI) utilized and were found to lead to increased cardiovascular and cancer risk.  Fortunately, Bio-Identical Hormone Replacement Therapy (BHRT) offers a more natural alternative to a synthetic hormone.  As with all hormone replacement therapies, there are certain risks and possible complications, but without question, the benefits far outweigh these risks.

Menopause is the permanent end of menstruation and fertility and is a natural biological process, not a medical illness.  It is a phase in life where the body begins to change, which puts you at risk for certain illnesses.

In my opinion, there are two aspects to menopause:

  • Quality of life changes can occur (hot flashes, night sweats, moodiness, anxiety, low or no sex drive, etc.)
  • Increased health risks (bone loss, heart disease, vaginal changes, etc.)

For those patients who want to combat either or both of these aspects that can occur during menopause, Bio-Identical Hormone Replacement Therapy (BHRT) is the way to go.  Pellet therapy is the most effective of all the therapies I have worked with and has been around for more than 30 years.  Study after study has reaffirmed the effectiveness of this form of therapy.  Each patient’s specific hormonal deficiencies determine dosing.    A compounding pharmacist acquires pure pharmaceutical grade hormone and compounds it into the dose that I order for you.          

Why do we gain weight at menopause?

We gain weight because we are less physically active than before: our muscle mass decreases and muscles turn to fat.  We may comfort eat as we adjust to changes taking place around us: signs of aging, inability to sleep, our changing roles in the lives of those close to us, illness, death of a loved one, divorce, or a combination of these things.

Our metabolism often changes at menopause and our bodies hold on to fat until we discover the secrets of burning fat through exercise and eating a healthy diet.

We may be stressed and produce excess cortisol which is associated with flight or fight responses. High cortisol levels often cause us to put on weight especially around our waists.

Stabilize blood sugar

When we eat too many refined carbohydrates such as white bread, mashed potatoes, sugary drinks, alcohol, cakes, and biscuits; we promote an immediate blood sugar rush. The pancreas is stimulated to secrete large amounts of insulin to regulate blood sugar. Excess blood sugar over long periods eventually leads to insulin resistance.

In general, insulin and blood sugar levels are better regulated through a diet of whole, unrefined foods that include long-acting carbohydrates such as fruits, vegetables, and whole grains.  Complex or unrefined carbohydrates are processed slowly over a more extended period of time and require a small amount of insulin for metabolism. A diet high in unrefined carbohydrates helps to balance hormones and alleviate many symptoms of menopause and perimenopause as follows:

  • Reduced fatigue, better quality sleep, and more energy
  • Better ability to sustain exercise
  • Clearing of brain fog
  • Better ability to build muscle
  • Less hunger – ability to control portion sizes and cravings
  • Fewer symptoms of Premenstrual Syndrome (PMS)
  • Clearer skin
  • Deeper, better quality sleep
  • Stable moods and more optimism

Urinary Leakage, Bladder Problems

Increased frequency of urination, urinary incontinence/leaking, painful urination, and nighttime urination are common symptoms of menopause. These can be brought on by laxity of muscles caused by changes in hormones especially the decrease of estrogen. Weakened pelvic muscles and the thinning of membranes are the most common causes of these difficulties. Bladder symptoms can be very distressing, but they are very treatable.  A weakening of the pelvic floor muscles is common during perimenopause – you may notice that you have a leakage of urine when you cough, sneeze or jump.

Hair Loss at Menopause

One very distressing and emotional symptom of menopause is hair loss which can lead to low confidence.  The usual cause for hair loss in women at midlife is due to shifting and reducing hormone levels at menopause. Falling estrogen and progesterone levels – the most significant hormone changes at menopause – can cause some women to notice that their hair becomes weaker and thinner and grows more slowly.

Hot Flashes and Menopause

Hot flashes are one of the most common symptoms of menopause. They affect approximately 80% of women.  Hot flashes are caused by fluctuating hormone levels, particularly estrogen and progesterone. These fluctuations impact the functioning of the hypothalamus, the part of the brain responsible for controlling body temperature, appetite, sex hormones, and sleep.

A hot flash is a vasomotor or blood vessel symptom that can vary in intensity and duration. A typical hot flash will last between 30 seconds and 10 minutes.  Women may experience an unannounced brief feeling of intense heat that makes their face and neck feel hot and possibly look blotchy.  Some women report what feels like a sudden rush of blood from their toes to the top of their head.  They may feel very hot and then chilly. The hot flash can sometimes cause a rapid or irregular heartbeat and pulse, including heart palpitations. The skin may feel sweaty, and they may also feel dizzy.

During and after a hot flush some women experience headaches, shaking and dizziness. These physical symptoms can compound psychological symptoms such as feelings of anxiety, depression, and lack of confidence.

Insomnia and Menopause

Insomnia is a common symptom of menopause but may not always be recognized or identified as such. Sleep changes include difficulty going to sleep or falling asleep quickly only to spring wide-awake several times a night or every hour on the hour.

Some of these waking can be linked to menopausal symptoms. Anxiety and worry can prevent women from getting to sleep.  When women finally fall asleep hot flashes can wake them again. Sleep may also be disturbed by having to get up during the night to urinate.  Women often say that they can put up with night sweats, but they can’t cope with the lack of sleep. This continuous lack of sleep can cause women to become depressed.

Osteoporosis and Menopause

The hormone estrogen plays an essential role in maintaining bone strength. After menopause, the levels drop.  This accelerates the process of bone resorption (breakdown). This breakdown happens faster than the body can rebuild new bone, and the result is a weaker skeleton making you prone to breaking a bone more easily.

Psychological Symptoms of Menopause – Anxiety and Panic Attacks

Listed below is a range of symptoms, which may be associated with menopause. You may find yourself experiencing some of these symptoms for the first time in your late 40s. Anxiety and general feelings of nervousness are some of the most common symptoms of menopause.  These symptoms are often exacerbated by insomnia and fatigue:

  • Mood swings
  • Irritability
  • Anxiety
  • Difficulty coping
  • Panic attacks
  • Sudden unexplained fears or phobias
  • Confusion
  • Feelings of helplessness
  • A lack of confidence
  • Feeling invisible
  • Depression

Fatigue and Menopause

During menopause and perimenopause, many women may experience an on-going and persistent lack of energy and feelings of tiredness and weakness. You may be surprised to find yourself feeling exhausted in an unexplainable way. The signs of menopausal fatigue include decreased wakefulness, lowered attention span, mental fuzziness, irritability, and memory lapses.

Low Libido and Menopause

During menopause and perimenopause, fluctuating levels of reproductive hormones can result in changes in libido or interest in sex.  Many women feel a drop in their sex drive.  Low libido may be the result of hormone imbalance and will often be associated with other symptoms of menopause such as night sweats, fatigue, insomnia, vaginal dryness, and anxiety.  Some women worry about their sudden drop in sexual interest.  However, when women get their hormones back in balance, they often find that there is an increase in sexual desire.  In fact, many menopausal women find they enjoy the best sex of their lives as they are free from the worry of pregnancy and no longer need to practice safe sex. They are also free from the bother of monthly periods and the roller coaster of the monthly hormone cycle.

Periods and Menopause

Irregular periods are often one of the first signs that our bodies are on the road to menopause.  When periods stop for over one year, women are usually in menopause.  Changes in menstruation affect each woman differently. For some women, periods become more regular and very heavy before they stop altogether.  For others, they are less consistent or intermittent. You may skip a period for 2-3 months – possibly causing you to think you are pregnant.  Periods may also have become more frequent – your menstrual cycle may shorten by up to a week.  For some, periods become heavier and last longer.  Some women have breakthrough bleeding at the time of ovulation. Others have stop-start bleeding or very scanty bleeding.  The most common symptom is that periods become less regular over time with occasional skipped periods until they finally stop altogether.