To fully understand when menopause may hit us we first need to understand the three stages of menopause.
The Three Stages of Menopause
Perimenopause or “menopause transition.” Perimenopause can begin 8 to 10 years before menopause, when the ovaries gradually produce less estrogen. It usually starts in a woman’s 40s, but can start in the 30s as well. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1-2 years of perimenopause, the drop in estrogen accelerates. At this stage, many women can experience menopause symptoms. Women are still having menstrual cycles during this time, and can still get pregnant.
Menopause. Menopause is the point when a woman no longer has menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.
Postmenopause. These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, can ease for most women. But, as a result of a lower level of estrogen, postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease.
Poverty (experts hypothesize that women in poverty have poorer eating habits)
Smoking (this can increase your risk of early menopause by 30%!)
Alcohol, although it is noted that yes alcohol may contribute to entering the phases of menopause at an earlier age, it is not necessarily deemed as “early menopause” – not sure what the difference is myself.
Medical treatments, such as chemotherapy and radiation
Women who have had their ovaries surgically removed
Premature ovarian failure (POF)
An overload of heavy metals like lead, mercury and cadmium can also be a cause
When premature menopause is suspected, you can ask your doctor to order blood tests that look at the levels of follicle-stimulating hormone (FSH) and estradiol. This work-up should also include the thyroid and the adrenal glands because they can be affected too.
Relief for the Symptoms of Early Menopause
According to WomentoWomen.com:
“Our estrogen, progesterone, and testosterone levels are constantly shifting throughout our life, and that’s normal. But as we age, the fluctuations and ratios between these hormones can become more extreme. When the body cannot regulate these shifts in hormone levels, women can experience common symptoms of menopause, including night sweats, hot flashes, food cravings, and fatigue.”
We can balance these symptoms naturally with:
A healthy, whole food diet
Herbal remedies such as black cohosh, passionflower, chasteberry, wild yam and ashwagandha have been shown to help support our hormone production
Lifestyle changes such as removing environmental toxins, getting enough sleep
Reducing chronic stress
Getting more exercise
Health Concerns for Early Menopause
Our hormones (estrogen, progesterone and testosterone), are needed for the years leading up to menopause.
They offer protection against cardiovascular disease and osteoporosis.
If you have been found to be in early menopause chat with your doctor, or a naturopath who specializes in women’s health and get yourself on a health plan to protect your heart and your bone health.
Some things to look at are:
Vitamin D, to support your bones
Strength training, to help build new bone and strengthen the heart
Maintaining a healthy weight. Studies have shown that women who go through menopause before the age of 46 are twice as likely to suffer from coronary artery disease or have a stroke
Don’t smoke – or quit
Take a high-quality omega 3, daily
HRT (hormone replacement therapy)
Local Naturopaths Who Specialize in Women’s Health
I have been cold for most of my life (and I’m talking physically, not metaphorically).
I am always the one with a sweater on, even in the dead of summer. I am the last one to turn on a fan when working out, and I once wore a scarf – in Mexico.
I am probably the only woman on earth that couldn’t wait for menopause and hot flashes to start.
Fast forward to today and here I am kinda wishing I wasn’t so vocal to the hormone gods that I wanted some hot flashes.
What Exactly is a Hot Flash
Hot flashes are a common symptom of menopause. It’s a quick feeling of heat that is not caused by any external sources, leaving us sweating from our scalps all the way down to our toes.
They can range from mild and tolerable, to downright troublesome, and all the way to severe and debilitating.
Some women can have hot flashes for decades, while others for just a few years.
A few weeks ago I reached out to my community to ask them how a hot flash felt for them, and here are some of the responses I received:
“A heat that feels like it’s “radiating from your body” late at night or the early hours of the morning…often accompanied by a sweaty neck and restless sleep.”
“…my experience has been with night sweats which you wake up and find yourself very hot and sweaty, sometimes having to change because you have soaked your pj’s – not fun! I have experienced day ones too, which you don’t give you any warning. One minute you’re fine and then the next you are wanting to take your clothes off because you are so hot and uncomfortable. It can be very embarrassing depending where you are, thank goodness I don’t get those very often. I do find if I have had wine that night that I am more prone to having a night sweat.”
“Hot flashes are a very uncomfortable feeling as they come suddenly and leave suddenly. Nights are the hardest as I dress up, undress, dress up, undress, probably 20 times a night.”
“Before hormone replacement I was getting hot flashes that would make my head and face feel like a volcano had erupted on it.”
“…a hot flash feels like my blood is burning up from the inside of me and my face and neck area gets very red, my arms are really hot and a darker color. Thank god they don’t last too long. You can feel them coming on and then you feel normal again.”
Researchers believe that women with hot flashes have more sensitive thermostats in their brain, so they are only comfortable in a small range of temperatures (North American Menopause Society – NAMS).
Researchers also hypothesize that hot flashes may be because of a change in our circulation (WebMD).
Dr. Karen McGee, naturopathic physician in Fort Langley who specializes in women’s health, says that a drop in estrogen is one of the factors in a hot flash, however she says that it is a bit more complex than just low estrogen.
She explains that we are actually designed to fight off hot flashes, but lifestyle hinders that fight.
There is a layer of our adrenal glands that releases sex hormones, and these hormones can prevent hot flashes. But, throw in a busy lifestyle and chronic stress and our adrenal glands are left being busy dealing with day-to-day life stuff. They are unable to balance the thermoregulation needed to prevent a hot flash.
And so the hormone sh*t-storm begins.
Hot Flash Triggers
While you can’t escape hot flashes during menopause, there some triggers you can avoid to help with the intensity of them.
Stress (to keep your adrenal glands happy)
NAMS recommends if your hot flashes are mild or moderate you may find relief by simply changing your lifestyle.
But, if you have severe hot flashes, while you will still benefit from lifestyle changes, you may also choose to take a nonprescription therapy or a prescription medication, including hormones to help you manage your symptoms.
A big lifestyle change that can help produce a difference with hot flashes is to stay cool (both physically and metaphorically), and reduce your stress.
Other relief options can include:
Avoiding warm rooms (no more saunas or hot tubs), hot drinks and foods, alcohol, caffeine, excess stress, and cigarette smoking.
Wearing layers of clothing made from light, breathable fabrics. This way you can remove a layer or two when you’re hot and replace them when you’re cooler (this is a tactic I use).
Reducing stress and promoting a more restful sleep by exercising regularly.
Meditation, yoga, qigong, tai chi, biofeedback, acupuncture, or massage will also lower your stress levels.
When you feel a hot flash coming on:
Try “paced respiration” (NAMS). This is slow, deep, abdominal breathing where you breathe in through your nose and out through your mouth. You want to breathe like that for only 5 to 7 times per minute. So it is much slower than usual, and continue breathing like that until you feel the flash subside.
You can also try different strategies to stay cool while sleeping, such as dressing in light, breathable nightclothes. Or, wear workout wear, like a Nike dri-fit top.
Use layered bedding that can be easily removed during the night.
Cool down with a bedside fan.
Keep a frozen cold pack under your pillow, and turn the pillow often so that your head is always resting on a cool surface.
If you wake at night, sip cool water and to get back to sleep try meditation, paced respiration, or getting out of bed and reading until you become sleepy.
Women who are overweight tend to have more hot flashes, so maintaining a healthy weight and exercising regularly will help in both decreasing the hot flashes while also improving your overall health.
Many nonprescription therapies can help reduce hot flashes, but not because of how you would think.
Researchers claim that nonprescription therapies work because of the placebo effect.
When nonprescription treatments are studied scientifically (NAMS) it has been found that they are JUST as effective as the placebo.
But, even if relief is simply all in our heads it is still worth a shot to try, yes?
Yes, I think so too.
Some remedies you might want to consider for hot flash relief are:
Soy: eat one or two servings of foods daily (containing isoflavones). This can be tofu, tempeh, soymilk, or roasted soy nuts.
Supplements containing soy isoflavones.
Herb supplements: such as black cohosh, have also decreased hot flashes in some studies
Dr. McGee sees success with her patients using bio-identical hormone replacement therapy (replacing your estrogen and progesterone).
Estrogen, in a pill or a transdermal patch, is highly effective at reducing, and in some cases, eliminating symptoms.
However, there are risks with hormone therapy (HT).
Long term studies of women receiving oral preparations of combined hormone therapy of both estrogen and progesterones were halted when it was discovered that the women in the study had an increased risk for heart attack, stroke and breast cancer when compared with women who did not receive HT.
Later studies of women taking estrogen alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer.
So, the decision to start, or continue taking, HT is a hard one and a very individual choice. Talk to your health care provider to weigh the pros and cons.
Other prescription therapies include:
Low-dose depression drugs like fluoxetine (Prozac), paroxetine (Paxil), or venlafaxine (Effexor)
Clonidine, a blood pressure medication
Gabapentin, an anti-seizure drug
Brisdelle, a paroxetine formula specifically for hot flashes
Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes
You can also read what the North American Menopause Society recommends by clicking here.
TIRED OF TRYING TO FIGURE OUT WHAT WORKOUTS YOU SHOULD BE DOING?
GRAB MY 21-DAY FITNESS PROGRAM AND LET ME DO THE PROGRAMMING FOR YA.
I just recently came face-to-face with getting older and I didn’t like it one bit.
With every passing birthday I was aware that I was getting older; I just never felt or thought that I was. I mean, getting old was what happened to other people, like my husband and my sisters for example.
Of course there was that grey hair I found a while ago. But, that was easily sorted out with a good tug.
Then the wrinkles came, but hallelujah for high-definition makeup, retinol and really expensive eye creams.
I also ignored the aches that weren’t there in my body ten years ago, as well as the declining energy levels (I chalked this up to me learning how to relax, something that is recommended for us high-stung Type A’s).
But, something recently happened that I could no longer ignore, buy a cream to correct, or even drink my delusions away with.
I started menopause.
A Trainer’s Denial About Menopause
At first I was in complete denial. How much denial, you’re wondering? Epic levels, let me tell you.
One evening I internalized this change in my body when I couldn’t sleep – because we don’t really sleep do we? Instead, middle-aged women “drift” through the night.
Anyways, I got myself so worked up about my lack of a menstrual cycle for the past three months that I convinced myself that this absolutely could NOT be menopause.
It had to be something else.
I was far too young for menopause. This only happened to other women. Older women.
The thought of this not being menopause, and instead being the alternative, was frightening to the bone and I could not keep this to myself any longer. I had to wake up loving husband and let him in on my epiphany.
Now, ladies, I have a tip for you. If you want to FREAK your significant other out, wake them up in the middle of the night and tell them that you think you are pregnant. Works better than a bucket of cold water to the face.
Poor loving husband was up all night having waking nightmares of being in his 60’s with a teenager.
The next day I ended up in a local pharmacy, incognito, buying a home pregnancy test. When I got home sure enough I did test positive…for menopause.
Lucky for me, this past last year I have been designing fitness programs and plans specific for peri and menopausal women.
I have had the fortune of interviewing some of the industry’s best about how to handle menopause so I knew what I needed to do to help control my weight, my hot flashes, my sleeping problems, my brain fog and my turn-on-a-dime moods.
What none of these experts taught me, however, was how to handle this change emotionally. Because that was where menopause was really kicking me in the butt.
I did not want to age like my mother!
Could Menopause Be Just Like a Workout?
And then I got to thinking (again when I couldn’t sleep, because those are the best times to think, aren’t they?), menopause is just another cog in the wheel of this thing called my life.
I started relating to it in terms that I knew and could understand.
First, I thought of life as one big workout (cut me some slack, I’m a trainer), and came to the conclusion that menopause is just another rep in this one big workout of life.
And, just like any other rep that I do in the gym I have three choices:
I can perform it poorly and set myself up for injury
I can do the rep half-hearted and see little to no results
Or I can put all of my effort and focus on this one rep and grow
The only difference here was that I wasn’t growing physically; instead, I was focussing on growing emotionally and spiritually.
So, here I am putting all my energy into this one rep and finding out that I don’t mind the burn or the short-term pain of menopause. Because, in the end, I plan on coming out of this a better woman.
TIRED OF TRYING TO FIGURE OUT WHAT WORKOUTS YOU SHOULD BE DOING?
GRAB MY 21-DAY FITNESS PROGRAM AND LET ME DO THE PROGRAMMING FOR YA.
We cannot pretend menopause is not going to happen. We cannot wish it away, or hope that it won’t happen to us.
We also cannot think that it won’t affect us. It will, and it will affect those around us too.
So, instead of putting out the fires and the hot flashes as they happen, let’s start learning what changes to our lifestyle and mindset we need to make to give us the greatest impact.
What’s the difference, perimenopause and menopause?
Perimenopause happens 8 to 10 years before menopause, when the ovaries gradually produce less estrogen. It usually starts in a woman’s 40s, but it can start in her 30s as well.
Perimenopause lasts up until menopause, which is the point when the ovaries stop releasing eggs (ie. we stop having periods).
To be fully out of perimenopause and menopause (medically speaking), we need to be without a menstrual cycle for one full year.
How will I know when I am postmenopausal?
A woman is considered to be postmenopausal when she has not had her period for an entire year.
Measuring through a blood test called the follicle stimulating hormone (FSH) level is another way to determine if you are postmenopausal.
FSH is a hormone produced by the pituitary gland (located at the base of the brain). However, the routine use of the FSH test is not needed to help the vast majority of women. Sometimes, the levels can be misleading since the levels go up and down during the transition into menopause.
After the age of 30, women can expect to lose as much as 3% to 5% of their lean muscle mass per decade. Once we reach 75 years this loss accelerates (however for some women this can happen as early as 65 years).
How do you offset this? Not by walking and not by performing cardio. The only way to build your lean muscle mass is with a properly devised strength training program.
As our cells age they don’t function as well as they used to and eventually old cells must die as a normal part of the bodies functioning.
While this is a normal process of age, it does become a concern when the number of old cells in the ovaries, liver, and kidneys decrease.
When these cells become too low, an organ cannot function normally and this is why most organs function less than stellar as people age.
Great news, though, not all organs lose a large number of cells. The brain is one good example. Science has proven that women who are healthy do not lose as many brain cells as unhealthy women do.
Our bones, as we age
Bone mass and bone density decrease as we age and will begin to decline by approximately 1% (or so) with each passing year from 30 years old until menopause is reached – at which point we will then see a 2-3% loss each year.
The number of our muscle fibers are also decrease as we age. This means that our muscles can’t contract as easily as they used to, making us slower in general as well as slowing down our reaction time.
Our heart, as we age
Our heart muscle also slows down as we age. It becomes less able to propel large quantities of blood quickly which means that we are going to tire more easily and take longer to recover as we get older.
Body fat increases as we age and the distribution of body fat shifts from subcutaneous (under the skin, evenly over the body) to visceral (around the internal organs).
Visceral fat is deep within the body surrounding our internal organs and is also known to increase our chances of developing: heart disease, diabetes, high blood pressure, stroke, sleep apnea, various forms of cancer and other degenerative diseases.
Estrogen, how we miss thee
Most of the symptoms related to perismenopause and menopause are happening because we are producing less estrogen.
This production will continue to decrease until the ovaries eventually stop making it.
WTF is going on with my belly fat?
When estrogen declines cortisol and insulin production increase.
And guess what? Both of these hormones contribute to fat gain, especially around the midsection, and in particular as that dangerous visceral fat we learned about just above.
In addition, perimenopausal women may see more accumulation of fat around the belly – even if they are eating better and exercising correctly.
You see our bodies are pretty amazing machines and during times of hormone imbalances our body favours belly fat because its programmed to preserve fertility as long as possible. Thanks body.
Belly fat also produces estrogen! So, it’s of no surprise that when estrogen production from the ovaries slows, the body compensates by adding a spare tire around our mid-section.
This can either cause difficulty falling asleep, constant waking or full on insomnia – all of which will lead to lower energy levels and fatigue.
Chronic sleep deprivation is also linked to elevated cortisol levels and cortisol is that visceral belly fat loving hormone, in addition it is responsible to increasing our risk for a whole host of diseases, including cancer.