What is menopause?

Menopause, or the cessation of menses or monthly ovulation, generally occurs between the ages of 45 and 55 though this can be earlier or later. It is normally triggered by the depletion of the one million or so eggs or ova that are stored in the ovaries from birth. The number of eggs is said to drop to around 300,000 or 400,000 at puberty though it is believed only about 400 will ever mature.

Contrary to popular belief promoted by pharmaceutical advertising, oestrogen levels do not slump at menopause but only drop about 3 per cent a year over the average 5 year menopausal period. There are many natural approaches to menopause that avoid the need for HRT.

Menopausal symptoms are often due to relatively low levels of the other female sex hormone progesterone. Women who have undergone the removal of their ovaries are more likely to need oestrogen supplementation to compensate for the sudden loss in hormone production

Menopause can last from two to five years or more when the monthly cycle becomes more and more irregular until it ceases entirely. After one year of cessation of menses a women is said to have undergone menopause.

Typical symptoms of the menopause are hot flushes and night sweats, forgetfulness, skin dryness and joint pains, though these can also be due to other causes.

Menopause has commonly been described as an oestrogen deficiency disease which has led to the widespread promotion of HRT drugs and the belief that these will protect against heart disease and osteoporosis, or brittle bone disease. But it is clear that oestrogen only plays a small part in menopausal symptoms and there is no substantial research which proves that the oestrogen’s or the synthetic progestogens in HRT prevent these diseases. In some cases they do the opposite.

Research has also shown that women in other parts of the world who have healthy diets and take plenty of exercise do not suffer the menopausal symptoms, heart disease and osteoporosis of western women The importance of a healthy diet and proper exercise during this stage cannot be overstated and can eliminate many symptoms of hormonal imbalance as well as helping to protect the heart and the bones.

Vitamin E has been shown to help relieve hot flushes and headaches, relieve itching and inflammation and normalise blood sugar levels, the Soya based Lecithin can aid memory loss and research has shown that St John’s Wort can relieve anxiety and depression as well as insomnia

The B vitamins as well as vitamin C are also vital during this time to help the adrenal glands which regulate stress. When women are stressed during the menopause they can produce more androgens or male hormones and this can lead to an increase in hair loss and the growth of facial hair.

The plant Dong Quai can help restore hormone balance as well as reducing symptoms like swollen breasts and hormonal acne caused by excessive oestrogen. In addition to helping to reduce oestrogen levels when they are too high or increase them when they are too low, this herb also has anti-fungal and anti-bacterial properties.
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In the years preceding menopause many women suffer similar symptoms to PMS such as water retention and breast swelling, irregular cycle and mood swings as well as heavy bleeding and hot flushes and sweats and sometimes cravings for sweet food. These can be signals of hormonal imbalance where oestrogen levels are disproportionately high. HRT drugs containing even more oestrogen will only worsen the problem. As in PMS the symptoms can be alleviated by natural progesterone therapy. Nutritional supplements and a well balanced diet and exercise can also help rectify hormonal imbalance.

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Women start losing bone density well before menopause when oestrogen levels are high but do not generally suffer osteoporosis or brittle bone disease until they are in their 70’s unless they have undergone removal of the ovaries.

Since there are no obvious symptoms for this disease many women can be diagnosed with osteoporosis but still appear to live healthy lives. It is only when the skeletal frame becomes so fragile that falls or even knocks lead to fractures.

While the hormone oestrogen can prevent loss it does not build new bone and any beneficial effect gained from HRT drugs is lost as soon as these drugs are stopped when bone density falls to previous levels. The other female sex hormone progesterone in its natural form can help build new bones.

Minerals like calcium and magnesium are vital for healthy bones as is vitamin D which is activated in the skin by sunshine and helps the kidneys to reabsorb calcium from the urine. Certain B vitamins are also believed to be important in maintaining bone structure. Red meat, soft drinks, caffeine, alcohol. Sugar and fried foods as well as smoking can be detrimental for healthy bones.

Adequate weight bearing exercise also protects against this disease which has been shown to have a hereditary link

An overactive thyroid can increase bone loss by producing too much hormone as can thyroid medication. Steroid drugs also increase bone loss.

What starts menopause?

Hereditary factors influence the start of menopause as well as surgical removal of the ovaries (ophorectomy). The removal of the uterus (hysterectomy) and smoking can also cause an earlier menopause. It is less certain why some women have a very early menopause or cease ovulating after sudden shock but it is clear that the hypothalamus at the base of the brain is the controlling centre for menstruation The hypothalamus acts by releasing a hormone called GnRH (gonadotrophin releasing hormone) to the nearby pituitary gland.

During the reproductive years the pituitary, triggered by GnRR, produces two hormones, follicle stimulating hormone (FSH) and luteinising hormone (LH) which determine the amount of oestrogen and progesterone hormones being prepared by the ovaries for reproduction Whatever the reasons for the menopausal state, high FSH and LH levels indicate that the ovaries are no longer producing eggs as the body continually increases these hormones to try to promote egg production

These high FSH and LH levels are signals to the adrenal glands near the kidneys to supplement the body’s supply of oestrogen and progesterone hormones. While the ovaries continue to produce some hormones after menopause, the body’s fat cells can also be a source of oestrogen.