Menopause

 

Menopause is the normal biological process occurring in a woman’s life marking the end of the menstrual cycle. It is that phase which involves a change in her life style - physical, mental and social for the rest of her life.

 

A menopause transition phase or perimenopause begins around 40 years of age. The working efficiency of the ovaries to release hormones (FSH- Follicle Stimulating Hormone and LH-Luteinizing Hormone) decreases because of aging resulting in decreased synthesis and functioning of estrogen, progesterone and testosterone. This disrupted regulation and the decline of the estrogen levels triggers various physiological and psychological symptoms of varying degrees of severity along with the alteration in various metabolic functions in our body. Perimenopause lasts for about 10-15 years till the final menstrual period (FMP).

 

The characteristic symptoms are the “hot flushes”-  sudden sensation of the extreme heat around the face, neck and the chest. Women complain of flushing, chills, palpitations, night sweating lasting for about 1-5 minutes leading to sleep disruptions. These hot flushes occur because of the increased sensitivity of our thermo-regulatory center in our brain. Other symptoms and conditions often accompanying the menopause cycle are – headaches, depression, anxiety, metabolic syndrome, sexual dysfunction, increased risk of cardiovascular disease and osteoporosis.

 

The fat mass distribution also changes during the hormonal shift. Studies have shown that an increased testosterone to estrogen ratio leads to central adiposity (fat around the tummy). Not only that the LDL cholesterol levels also tends to increase because of decreasing estrogen. As a result, women should be adopting a regular exercise regime to decrease the cardio vascular risk as well as preserve the muscle mass.

 

Calcium loss also increases because of the decreasing estrogen levels making women prone to bone pain, fractures as well as osteoporosis. Thus, increased intake of calcium enriched products or supplements is recommended to maintain the bone health along with blood tests to check for calcium and Vitamin D levels. However, a word of caution that no more than 2500mg/day of calcium should be consumed.

 

The insulin resistance increases with aging and the decreasing estrogen levels as a result complex carbohydrates with low Glycemic index should be consumed to prevent the onset of type 2 diabetes.

 

 

Eating Tips to Beat the Hormonal Heat

1. Include a wide variety of complex carbohydrates in your diet for maintenance of weight as well as the blood sugar levels.

2. There should be adequate protein intake of about .8-1.2 gm/kg body weight per day.

3. A regular exercise regime consisting of weight bearing exercises to preserve the skeletal muscle mass along with yoga for improving the flexibility as well as calming the mind should be followed.

4. Decrease the excessive intake of saturated fats as well as trans-fat to avoid the increase in the LDL cholesterol levels.

5. Increased intake of Vitamin B-6 and oily fish in the diet can help in decreasing the severity of hot flushes.

6. A daily intake of 1000-1200 mg of elemental calcium along with 800 IU (international Units) of Vitamin D is advised to maintain the bone mass.

7. Women should also increase the intake of Vitamin B12 either by supplements or by consuming vitamin enriched products because of natural decreased absorption efficiency.

 

This phase requires the Amalgamation of Emotional support of family and friends in a positive manner for an extended period. A thorough understanding of the symptoms by the clinician along with health modifications can help the woman enjoy the coming years to the fullest.