Menopause marks the end of the reproductive years of a woman’s life, occurring usually between 45 and 60 years of age, with an average age of 51 years. Menopause occurs as the number of oocytes a woman carries reaches their endpoint with a marked decrease in ovarian oestrogen and progesterone. The transition into menopause, called peri-menopause, commonly lasts for 2-3 years, with common signs of irregular menses, skin changes, mood changes, depression, memory loss, insomnia, fatigue, vaginal dryness and atrophy, changed libido, night sweats and hot flushes, which may be moderate to debilitating in their effects. During peri-menopause, ovarian sex steroid synthesis slows and ovulation becomes unpredictable, causing fluctuating monthly patterns until menses ceases completely. Menopause is confirmed with the cessation of periods for 12 months with consistently elevated serum FSH levels and low serum oestradiol.
Whilst there may be a decline in circulating levels of oestrogen and progesterone (and the ratio between them), this does not reflect the oestrogen and progesterone levels and activity in various tissues. For example, postmenopausal women may sustain relatively high serum oestrogen levels despite declining ovarian oestrogen, as adipocytes (fat cells) become a major source of oestrogen biosynthesis.
The most common reason women seek treatment in menopause is for hot flushes. The drop in oestrogen is a significant catalyst, but not the only cause. Essentially, hot flushes are a short term expansion of blood vessels near the skin to allow the blood to cool and lower core temperature. However menopausal women do not experience higher core temperatures, instead what happens is their sensitivity to changes in body temperature narrows. This loss of thermoregulation occurs with low DHEA as a result of chronic stress and accompanying neurotransmitter imbalances, including depleted GABA and serotonin with increased noradrenaline and corticotrophin-releasing hormone (CRH). Therefore, stress management and adrenal support during the peri- and post-menopause years is vital.
Factors that may hasten the timing of menopause and worsen the symptoms experienced include:
- Premature ovarian failure
- Hysterectomy retaining the ovaries (thought to advance menopause by approximately 2 years)
- Bilateral oophorectomy (immediate menopause)
- Smoking (hastens follicular depletion)
- Radiation and/or chemotherapy used to treat a malignancy
- Chronic or acute stress, leading to adrenal insufficiency
- Toxicity (pesticides, smoking, alcohol, heavy metals)
- Certain medications
Common signs and symptoms of menopause include the following:
- Absent menstruation for at least 12 months (Irregular periods occur throughout peri-menopause)
- Hot flushes; of the face, neck, and upper trunk, which may be accompanied by palpitations, dizziness, headaches
- Night sweats, which may contribute to depression and irritability from insomnia
- Cold hands and feet
- Vaginal atrophy and dryness may lead to painful intercourse and/or post-coital bleeding
- Vulvar pruritis (itching)
- Urinary tract atrophy, resulting in increased frequency, burning, nocturia, incontinence, and infection
- Sleep disturbances and insomnia
- Mood changes such as depression, irritability, tension
- Memory impairment and loss of ability to concentrate
- Skin changes including loss of skin tone/integrity leading to wrinkles
- Weight gain and increased central adiposity
- Breast tissue atrophy
- Increased sensitivity to stimulants such as alcohol and caffeine
Treatment for Menopause
As mentioned, stress exacerbates many of the symptoms of menopause (and perimenopause) and supporting the individual with appropriate nutrition and lifestyle adjustments to relieve stress is a priority. Herbal Medicines are invaluable for symptom relief and reducing neuroinflammation and Jodie prepares these based on the individuals’ specific symptoms.
Herbal Medicines, Specific Nutrients and LIfestyle factors play an important role:
- Herbal Medicines: Shatavari, Zizyphus, False Unicorn, Sage, Wild Yam, Turmeric, Gingko, Bacopa, Ladies Mantle, kava, St John’s Wort, Black Cohosh and others
- Diet: Anti-inflammatory diet, Identify food intolerances, low alcohol and caffeine, minimise processed foods and correct dysbiosis if present
- Nutrients: Zinc, Activated B Vitamins, Vitamin D3, Vitamin C, Magnesium, Iodine and others
- Lifestyle: Activities that help relieve stress e.g. bushwalking, yoga, tai chi, meditation, relaxing baths. Regular exercise is also important
- Probiotics (if dysbiosis present): Lactobacillus rhamnosus GG (LGG), L. Plantarum (299v) and others
This information is not intended to replace medical advice. Please do not self-treat with the above herbal medicines – seek professional advice specific to your condition.