The timing of natural menopause is variable. In the United States and Europe, the average age for the start of menopause is now 51. However, natural menopause can begin while a woman is in her 30s or in her 60s. Factors influencing the start of menopause include heredity (genetics) and cigarette smoking. Smokers (and ex-smokers) tend to reach menopause an average of at least two years before women who have never smoked. It may be important to note that race, height, the number of children, or the use of oral contraceptives does not influence the age at which a woman begins menopause.
WHAT CAUSES MENOPAUSE?
Menopause is frequently best understood as the process opposite to “menarche”, which is the start of the monthly periods. However, the explanation that describes a “permanent stopping of the monthly periods” is actually too simplistic. What is really happening during menopause isn’t just about what happens in the uterus, but more importantly, it is about what happens in the ovaries. What we are actually talking about here is the process of the ovaries shutting down.
Most women recognize the onset of menopause, when her monthly menstruation periods begin to shut down, and stop for a period of at least one year. If at some point in her life, the woman had her uterus removed (hysterectomy), then menopause can still be detected by a laboratory test that signals a really high FSH level.
When a woman has a hysterectomy, she will be technically infertile, but menopause will not begin until her ovaries actually stop functioning. Even without the uterus, a woman’s ovulation and the systematic release of reproductive hormones will continue until menopause actually begins.
While the ovaries will continue to function after a hysterectomy, if the ovaries are removed by way of an oophorectomy, the woman would immediately enter what is called “surgical menopause”.
CAUSE AND SYMPTOMS OF MENAPAUSE
Menopause is a process that begins the actual shutting down process (or surgical removal of) the ovaries. Since the ovaries are a part of the body’s endocrine system (small organs that involve the release of extracellular signaling molecules known as hormones), the process of the ovaries shutting down, also known as perimenopause, launches a cascade of physiological changes in a woman’s body. The endocrine system produces the hormones that make the reproductive process possible and it also influences sexual behavior. The physiological changes can begin as many as six years in advance of menopause, and some of those changes display like this:
- A change in periods – shorter or longer, lighter or heavier, with more or less time in between
- Vaginal dryness
- Hot flashes and/or night sweats
- Trouble sleeping
- Mood swings
- Trouble focusing
- Less hair on head, more on face
Since menopause is not actually a disease or disorder, some women will require no treatments during the perimenopausal phase of their lives.
Having a hormone test can determine your levels of Estrogen, Progesterone, Testosterone, and FSH. Saliva tests can be collected in the privacy of your home, or you can check hormones with a blood test or finger stick. These hormone tests are valuable in determining what hormone replacement you need or to monitor the levels of your current regimen.
HORMONE REPLACEMENT THERAPY
Some menopausal symptoms may require medical treatment, as defined by your practitioner. Do be advised that if you have bleeding after menopause, call your doctor, as it may an indication of a more serious problem.
Hormone replacement therapy (HRT) was long the standard medical treatment for menopause, however, it has been learned that traditional HRT using synthetic estrogen and progestins actually increases the risk of breast cancer and heart disease. As a result, women and healthcare providers no longer seek traditional estrogen replacement therapy.
DIET AND NUTRITION
Diet is an important tool that can be used to help control menopausal symptoms. Foods to avoid include:
- High amounts of caffeine in any foods
- Carbonated beverages (contains phosphorous that can increase bone loss)
- Commercially raised meats including beef, pork, and chicken (decreases the body’s ability to metabolize estrogen)
- Foods with excessive sugar (limits the liver’s ability to metabolize estrogen and impairs the immune system)
Increase the intake of foods such as:
- Soy, which contains phytoestrogens
- Grains: such as oats, wheat, brown rice
- Nuts: such as almonds and cashews
- Fresh fruits
Some of the symptoms may be addressed and treated with nutritional menopause supplements and herbal remedies, such as those listed here:
- Red clover isoflavone supplements have been shown to provide a significant positive effect on the rate of bone loss, improve cardiovascular health, and it may offer some protection against breast and endometrial cancer. Evidence also suggests that red clover isoflavones may decrease the incidence of hot flashes.
- Lactobacillus acidophilus and Bifidus (the “good” bacteria that is in our intestines) cultures help with metabolism and the best utilization of estrogen. Many suggest that these “good” bacteria may help reduce the occurrence of yeast infections. These bacteria can be found in various nutritional formulas on the market.
- Vitamin E, microcrystalline calcium hydroxyapatite calcium (MCHC) or calcium citrate, Magnesium and Vitamin C.
- Black Cohosh – a phytoestrogen that helps many women manage menopause symptoms. There are a number of products that contain Black Cohosh, including Remifemin.
- Natural bio-identical hormones are available over the counter or in compounds available by prescription from a pharmacy. These types of hormones are bio-identical – chemically equal to the estrogen, progesterone, and testosterone produced naturally in the body.
Since menopause is natural process that cannot be considered a disease or illness, some will be able to navigate the process without the aid of medicines and supplements. But, for those women who find their personal experience a bit more daunting than what it should be, there are a number of treatments that can be considered, with the help of a healthcare practitioner or without.