Women in their mid-life years often discover that menopause is the ‘game-changer’ when it comes to their health and fitness levels. Not only does menopause have implications for the metabolic and cardiovascular health of women during this time, but for some, severe symptoms may impact hugely on their quality of life. Wendy Sweet explains why menopause matters in mid-life including its relevance to healthy ageing.
I call menopause the ‘game-changer’. Not only for me, but also for the thousands of women experiencing symptoms that impact on their quality of life. Some women sail through menopause, others don’t. And for the latter, no matter how active or ‘healthy’ they may have been earlier in life, menopause arrives, navigating its own path, causing havoc on what was in the past, probably relatively ‘good health’.
For these women, the transition into and through menopause can be fraught with physiological and psychological challenges, including hot flushes, high risk abdominal fat and a cocktail of internal chemical changes contributing to listless days and sleepless nights. It can be the start of the slippery slope towards poor health, post-menopause. It can be the ‘game-changer’ towards healthy ageing, or not.
While menopause is a natural process that occurs in women’s lives as part of normal ageing, since the mass production of hormone replacement therapies by pharmaceutical companies, it has also become highly medicalised.
Although medication is generally warranted for those women with severe symptoms, what may also help is a mid-life revamp of lifestyle, including exercise and nutrition.
This article is the first of three. Each aims to demystify menopause and assist women to make the lifestyle changes that are required to send them towards their healthy and active ‘third-age’, i.e. their post-menopause years.
Understanding the menopause transition
Defined by the World Health Organisation (WHO) as the permanent cessation of menstrual periods occurring naturally or induced by surgery, the Greek derivative is men (month) and pausis (cessation). The years preceding menopause that encompass the transition from normal menstruation to cessation are termed the peri-menopausal years and are generally characterised by irregular periods.
On average, in non-surgical menopause, peri-menopause begins around the late forties and may last up to four years but it is well known that smokers begin to transition into menopause about three to four years earlier than non-smokers. Based on the Massachusetts Women’s Health Study of more than two and a half thousand women, the mean age of menopause was 51.3 years and this hasn’t changed since ancient times.
Post-menopause begins at the time of the final menstrual period, although it is often not recognised until 12 months after periods have ceased. This cessation of menses is known medically as the climacteric, the end of a woman’s reproductive potential.
A decrease in oestrogen levels occurs at this time, and for some, the spin-off is endocrine (hormonal), psychological and somatic (bodily) havoc.
This first article helps women to navigate the changes that occur during the menopause transition and in further articles I will introduce some of the lifestyle changes that will help them transition through this critical time.
It’s all about the hormonal cascade
Hormones are very powerful substances. They are potent chemicals that are made by the body and are needed for a huge number of actions to sustain internal health. As a woman’s body comes to the natural end of its reproductive years, (in peri-menopause), there is a change in the production of the two fertility hormones, oestrogen and progesterone by the ovaries. This is because it is a time in a woman’s life when there is a loss of ovarian follicles. It’s a process which can take from two to eight years.
The human endocrine system is the name of the system which controls the body’s hormones or ‘chemical messengers’. It’s a complex system and importantly, for menopausal women to understand, it operates as a negative-feedback loop. This means when any single hormone production is decreased or increased, it changes other hormone production in the body.
As a woman naturally ages, so too do the ovaries. They start to lose the oestrogen-producing follicles. This usually begins to occur in the early fifties with fewer and fewer follicles responding.
Oestrogen production diminishes and the ovaries begin to lose their responsiveness to other reproductive hormones, follicle-stimulating hormone (FSH) and Luteinising hormone (LH). These are released by the pituitary gland in the brain and in peri-menopause when oestrogen production drops, they get confused and more FSH is secreted than usual. It’s an attempt to ‘bribe’ the ovaries into responding.
Consequently, high FSH can often herald the start of the chaos that some women experience at this time, both physically and psychologically.
After menopause the ovaries don’t just cease functioning. Unfortunately for some women, they continue to secrete different hormones and this is where the complex link between menopause and hormones secreted by both the thyroid and adrenal glands, might cause further health chaos.
A post-menopausal woman experiencing a busy lifestyle, increased stress, poor nutrition, inadequate sleep and low exercise levels can experience a range of symptoms which she sees as defining her menopause experience. Symptoms range from mood swings, weight gain around the midriff, to poor sleep patterns, sore joints and the exhausting hot flushes and night sweats.
Remember, all hormones interact in the body so they can’t be looked at it isolation. For example, hot flushes are officially seen as being caused by low oestrogen production, but the ‘flush’ is just the body’s normal response to getting rid of heat.
What precedes the ‘flush’ matters and this may be perceived stress (the adrenal glands control your stress levels), poor thyroid function and of course, the wrong nutrition for menopause which can ‘trigger’ the heat production and regulation of the body.
Nutrition, stress management, as well as the right amount and type of exercise needs to change in mid-life otherwise metabolic chaos, including cardiovascular disease and insulin sensitivity leading to Type 2 diabetes can be the by-product for so many women post-menopause.
Success comes when mid-life women manage their lifestyle.
In our next article, we will take a look at some of the main symptoms in menopause, including the high-risk weight-gain occurring under the diaphragm and stomach (central obesity). More importantly though, I will provide tips for women on how to manage their lifestyle to reduce their symptoms and take back control of their health during these critical mid-life years.
Wendy Sweet (RGN/ M.SpLS/ PhD Student, Waikato University)
An award-winning fitness and wellness educator in New Zealand and Australia, Wendy brings her personal experience as well as her research interest in women’s mid-life ageing and lifestyle behaviour-change to the relatively unspoken topic of ‘menopause’. Coming in early 2016, is ‘My Menopause Transformation’ (MyMT™) – an evidenced 12-Step Program of Lifestyle Change, just for women transitioning into and through menopause.