MENOPAUSE

WHAT IS MENOPAUSE?

Menopause occurs when there has been a cessation in menses for at least twelve consecutive months. Perimenopause is the transition time prior to menopause. The average age of menopause is between 50-52 years old and the average age of perimenopause is 47.5 years old.

During perimenopause and menopause many women experience symptoms, which typically last between four and seven years:

• Irregular Periods: In the initial stages of perimenopause menstrual cycles usually shorten up to 7 days. In late stages of perimenopause, missed periods occur making the cycle 60+ days or longer.
• Hot Flashes: Hot flashes occur in approximately 85% of menopausal women, and they are believed to be due to a drop in estrogen which triggers a downward resetting of the body’s temperature via the hypothalamus (an area of the brain that regulates body temperature). The alteration in the set point causes the sensation of heat and flushing.
• Sleep Problems: Sleep problems are also very common with approximately 60% of menopausal women experiencing frequent bouts of insomnia. Sleep problems may include difficulty falling asleep, staying asleep, having a restless sleep, and waking early. Sleep problems may or may not be in part due to hot flashes during the night and night sweats.
• Weight gain: Weight gain is common after menopause however it is uncertain why this occurs. In general, as one ages lean body mass, muscle mass and metabolism decreases. Additionally, hormonal changes could have an impact on insulin resistance therefore leading to weight gain.
• Mood Changes: This may include irritability, sadness and depression, or anxiety. Mood changes may be related by hormonal changes or lack of sleep.
• Painful Intercourse: Vaginal dryness and atrophy resulting from declining levels of estrogen may lead to painful intercourse. Declines in estrogen subsequently lead to a decline in collagen levels, water and fat retention in the vulva, a shortened and narrow vagina with thin pale vaginal walls, in addition to atrophy of the mucous glands leading to dryness. As a result of these changes, menopausal women are at increased risk of vaginal infection and injury.
• Urinary Tract Infections: Due to declines in estrogen, UTI’s are common in women after menopause. This is in part due to a reduction in lactobacillus (a good bacteria) in the vaginal tract and an increase in vaginal PH, which makes the genitourinary tract susceptible to infection.
• Bone Loss: With declining levels of estrogen, the rate of bone loss increases therefore making postmenopausal women more susceptible to osteoporosis.
• Decline in Fertility: This results from several factors including the aging of the ovaries and uterus in addition to the rise of the follicle stimulating hormone (FSH) due to fewer follicles in the ovary and lower quality follicles. In perimenopause, unplanned pregnancies still may occur therefore contraception is required until full menopause has been reached.

WOMEN CAN ENTER MENOPAUSE IN DIFFERENT WAYS:

• Premature Ovarian Failure: Occurs when a woman lacks a period, has menopausal symptoms, and high levels of follicle stimulating hormone before the age of 40.
• Temporary Menopause: Occurs when normal ovarian function is interrupted temporarily and menstruation stops for 12+ months.
• Induced Menopause: Occurs due to the surgical removal of both ovaries (an oophorectomy). This is a more dramatic entrance into menopause as its onset is immediate. Overwhelming menopausal symptoms follow due to the sudden drop in hormones (estrogen, progesterone, testosterone).

Why seek advice from a Naturopathic Doctor for menopause:

• An ND will customize your treatment plan to your individual needs, with a goal to ease the symptoms of menopause. Treatments may include supplements, acupuncture, and necessary dietary or lifestyle changes. An ND will check supplement interactions with current medications before prescribing to ensure there are no interactions.
• Relevant lab testing may be ordered if appropriate. FSH levels tested on day 3 of the menstrual cycle will determine if a woman is entering menopause.
• Prevention of cardiovascular disease, bone loss, and other diseases of aging is important at this time in a woman’s life and will also be addressed.