What is Menopause?

We do not fully understand all that happens during menopause. Most of what we ‘know’ about it is largely theory. We understand it to be characterized by when a woman runs out of eggs and ceases menstruating. But the true cause or causes is not fully understood.

One thing we do know is that not all women experience the dreaded symptoms of menopause.

Menopause  - Friend or Foe? 

Somewhere around the mid-20th century, the concept of ‘menopause as a disease’ entered our consciousness. This set the stage for the creation of a ‘solution’ to this problem. The pharmaceutical industry came to the rescue and devised a plan to prevent the dreaded effects of menopause with the introduction of estrogen replacement therapy (ERT). Over time, due to an increase in uterine cancer rates, many doctors became reluctant to prescribe, and women reluctant to take, ERT. 

Since the market changed, likewise did the pharmaceutical industry, with the introduction of a new and improved treatment for menopause. This new therapy added progestins (a synthetic form of progesterone) to the estrogen, and hormone replacement therapy (HRT) was born. In addition to suggesting that HRT reduces the incidence of uterine cancer, many sources have declared that HRT decreases a women’s risk of heart disease and even prevents osteoporosis. Beware of these claims. 

The purpose of this article is not to give a discourse on the validity of HRT as a method of treatment. However, I will suggest that if you are considering HRT, do your research and look at the sources of what you read. There are holes in the evidence to support its use, along with a general lack of research in this subject matter overall.

When do women experience menopause?

Most women experience menopause between the ages of 40 to 58 years old.  Some women experience several years of a transition period, while other women the change seems to happen in a matter of months.

Some changes (symptoms) that occur during the transition period into menopause are resolved once a woman has reached menopause. However, there are women who have persistent symptoms well into menopause. This and the fact that some women transition through menopause with no symptoms should give us pause.  Perhaps it suggests that the root cause of many, if not all symptoms, may have an origin in something other than just menopause.

What are common symptoms of menopause? 

• Hot flashes 
• Night sweats
• Sleeping difficulties
• Headaches
• Brain fog
• Memory problems
• Anxiety and/or depression
• Other changes in mood – such as irritability.
• Changes in libido
• Discomfort during sex
• Bladder weakness
• Recurrent UTIs
• Joint Pain
• Change in bone composition (osteopenia, osteoporosis) 
• Feelings of loss of self
• Changes in skin conditions, including dryness or increase in oiliness and onset of adult acne
  

Many of the above symptoms that seem to appear at the onset of menopause have their origins prior to menopause and were exacerbated by the hormonal changes that occur during the transition.

Let’s dive into some of the most asked questions (along with common misperceptions) about menopause…

Does menopause cause weight gain?

Many women find that they are gaining weight around the period in life when they are transitioning into menopause. Although there may be some correlation with menopause and weight gain, it would be far too simplistic to play the blame game here. There is often a combination of factors that contribute to this phenomenon. For example, the interplay of advancing age, poor eating habits, exercise, and other lifestyle factors along with fluctuating hormone levels contribute significantly to weight gain.

Does menopause lead to osteoporosis?

Osteoporosis is a disease of progressive bone loss. This creates an increased risk of fractures, including hip fractures, which can be debilitating, if not life threatening. Contrary to common belief, osteoporosis is not a direct result of menopause. There are many factors that may contribute to osteoporosis. There have been studies that link a reduction in female hormones to an increasing rate of osteoporosis. However, Smoking, lack of exercise, inadequate nutrition and unhealthy diet are among the major contributors. 

Menopause and (Migraine) Headaches

Migraines are serious headaches and are thought to be the result of overdilation of blood vessels in the brain.    

Changing hormone levels have been implicated as a cause in some migraine headaches. Other factors that contribute to migraines include stress, poor nutrition, disrupted or inadequate sleep and blood sugar imbalances, etc. It is important to uncover the underlying cause of the migraine and not just assume the cause is related to hormones. In addition, a woman with a history of menstrual migraines may have an increased risk of migraine incidence in menopause.                                                                

Menopause and Hair Loss

Hair loss and hair changes have many contributing factors and the hormone fluctuations associated with menopause are one of them. Keep in mind that it is important to assess the status of other hormones such as thyroid hormones, as these can affect hair loss as well. Other factors that can affect hair growth include undiagnosed autoimmunity, nutrient deficiencies, stress, recent illness, medications, environmental exposures, hair/skin products and more. 

Menopause and Joint Pain

Due to various mechanisms that are beyond the scope of this article, menopausal transition can be associated with a systemic (whole body) inflammatory state. To put this into context, there are protective effects of female hormones. When a woman enters menopause, she is at a disadvantage because the protective effect of estrogen (and progesterone) has been knocked off balance. This makes it even more critical that other contributory factors be addressed if joint pain (or any inflammation) is to be alleviated. 

Menopause and Anxiety

What does menopause do to a women’s brain? Estrogen is known to increase the release of the neurotransmitter, norepinephrine, in the brain. Also called noradrenaline, this hormone has an effect of mood enhancement.  Estrogen also plays a role in the function of other neurotransmitters that affect mood. These hormones have mood elevating effects and when levels are reduced, may result in anxiety. Estrogen is also helpful in brain function in its own merit as it is responsible, in part, for stimulating nerve growth and maintenance. Be careful not to assume that estrogen is the key to anxiety relief. Like with all symptoms listed above, there are varied factors that may contribute to anxiety, some of which are unrelated to estrogen.

Menopause and hot flashes           

There is a lot of misinformation out there about what is happening when a woman experiences hot flashes. Most sources blame hot flashes on a decrease in estrogen (hence the push for estrogen/hormone replacement discussed above). One problem with this theory is that estrogen therapy does not help all women with hot flashes. Another problem is that many women who have normal levels of estrogen also have hot flashes. So, there is more to this equation than estrogen. The answer to this symptom may very well have to do with hormone balance overall and not just estrogen.

Can Functional Medicine Help and the Transition to Menopause?

Many women wonder, what does a functional medicine provider do to help transition to menopause? Menopause is a period in life that brings upon numerous physical and emotional changes. Lifestyle habits established much earlier in life will impact how this transition will play out. Diet, stress and lifestyle factors do not typically change just before a woman enters menopause. For example, a significant number of menopausal women complain they are gaining weight even though they have not changed their diet. What is changing is how the body is responding to the diet. Using stress as another example, as a woman progresses into menopause her body may ‘deal’ with stress differently and can result in increased cortisol levels that, via multiple mechanisms can change body weight and its distribution. It is important to understand that menopause is not a disease, but it is a physiological shift that often requires a woman to make conscious and deliberate decisions to offset the changes that occur.

Schedule a Menopause Consultation In Naperville Today

How can functional medicine help ease the transition into menopause and beyond? At Naperville Integrated Wellness, our goal is to assist you in creating and maintaining health. We begin with a thorough patient history and an in-depth office visit. We obtain a detailed blood panel, along with specialized functional testing, and use this information to create a comprehensive treatment plan. The goal of this is to address the factors that are adversely impacting a person’s health. The plan will address diet and nutrition factors. We may also make recommendations relating to emotional health, lifestyle habits, and routines. If you would like to learn more about how functional medicine can help you in your health journey, reach out to us and schedule a menopause consultation today!