Menopause-start Here

The dreaded ‘M’ word. Up until now, every life change has been a growth milestone where you gained something. You learned to walk, talk, drive, fall in love, communicate, have babies, work and more. Things we celebrated. Unfortunately this hormonal change can throw some spanners in the works, like fatigue, weight gain, fibroids and definitely no white pants for the first year, but no need to fret. There is also some great things! Your hormones aren’t constantly cycling so, we can help things normalise by giving your body what it needs. Aging isn’t the end of the world, it’s a privilege. Your body can still rock, like the 80’s music you like to blast! It’s not about losing something, it’s about change, and how you adapt to it. 

Overview

Menopause is another thing we women don’t know much about. For some It’s like Voldemort, the word that shall not be named. Others can’t wait for it to happen, in part this has to do with how our mothers experienced it. There is a good reason for this as the age we start to experience changes is quite strongly linked to what our mother experienced. There are still things like smoking, lack of exercise, poor diet and also hysterectomies that can induce menopause early. What ever stage of life you’re at, it’s best to understand what menopause is and the signs it’s started for you. This will help you know when to adapt your lifestyle around to facilitate your hormones into your golden years, or should we say ‘silver years’. When we do this we can help protect ourselves against; weak bones, alzheimers, hot flashes, slowed metabolism, migraines, weight gain and fatigue. Forget botox, let’s help your insides stop sagging too. 

Peri Menopause

Ahh yes, the first signs that your body is developing into a new era, congrats! You may experience; irregular cycles, heavier cycles, weight gain, cravings, mood swings, hot flashes and definitely resigning your white pants to the back of the cupboard. The main thing that happens in peri-menopause, is that we stop ovulating every month. For some of us this isn’t anything new… Hello Polycystic Ovarian Syndrome (PCOS), but for others it’s a whole new experience. 

Because we aren’t ovulating as frequently, progesterone is the first hormone to start to drop, this means that our Oestrogen starts to become un-opposed. Remembering that oestrogen is the hormone that builds up your uterine lining, and the growth of our egg, this means heavier periods, and because the brain is confused too, you become irregular too. The severity of the ups and downs, as well as the heaviness can be dependant on your thyroid and insulin levels. It’s a good idea to get these babies checked, particularly if you’re feeling cold, fatigued and backed up. 

This stage can go on for several years. Some of the first signs you may notice are, heavy irregular periods, fatigue, irritability and forgetfulness. Keeping in mind these symptoms can be explained by a number of other things, if you think you’re heading into menopause it’s a good idea to go and get your blood FSH levels checked by your doctor. This level has to be consistently up and increasing for peri-menopause to be established. If you have symptoms and want to know what to do about them, head over to the tabs above. 

MenoPause

So technically menopause is when you haven’t had a period or any spotting for 12 months (you can also go straight into this after having a full hysterectomy, aka uterus and both ovaries). This means that your ovaries have stopped producing hormones. This isn’t necessarily the end of the world because we can get oestrogen, testosterone and progesterone from other sources (stress glands, fatty tissue and food), it’s not as powerful but can really help keep your levels up and minimise things like; vaginal dryness (ouch, and yes this is common), sleep disturbances, weight gain, anxiety, depression, brain fog, dementia, decreased strength and risk of bone weakness… No wonder we’re all fearful of getting older, that doesn’t sound very fun. That doesn’t have to be you though, keep reading to find out what you can do to thrive through menopause.

Types of Menopause

Menopause is a marker you have reached your next developmental milestone of life. Marked by a drop in  production of hormones from your ovaries. 

  • Natural — This occurs generally at the same age as your mother, plus of minus 1-2 years. This only applies if your mother went through natural menopause. Generally this will occur around 52 years of age. Factors such as:
      •  Age of your first period (Menarche): the earlier your first period, the earlier you will go through menopause
      • Smoking status: Smoking often causes you to enter menopause 1-2 years prior to your genetics determine
      • Length of your menstrual cycles: If your cycles where generally short (ie. 21 days) than you will enter menopause earlier, if they were longer (ie. 35 days) than you will enter menopause later
      • Pregnancies: The more pregnancies equals later menopause.
  • Medical — Menopause can be brought on sooner through medications and therapies such as chemotherapy and radiation which cause damage to the ovaries. If you want children that are genetically part of you, doctors will suggest harvesting and freezing your eggs prior to commencing treatment. This decision needs to be made with your specialist.
  • Surgical– Menopause can also occur when your ovaries have been removed. Remembering that your ovaries house your underdeveloped eggs, and when they undergo development they produce hormones. If there are no eggs, there is no hormones, so we enter menopause. This occurs when you have both ovaries removed (Bilateral Oopherectomy) you may also have both fallopian tubes removed at the same time (Bilateral Salpingectomy) and often your uterus is removed at the same time (hysterectomy), this is determined by the reason you want/need them removed in the first place. 1 in 4 women in USA will enter menopause as a result of surgery.
No matter how you enter menopause, adjusting how you look after your body in this new developmental milestone is important for maintaining healthy function. Keep reading for more details.

Post Menopause

So if we keep it simple, our oestrogen and progesterone have decrease quite rapidly. This can feel like we have a shorter mental fuse, difficulty sleeping and slow metabolism. Around 10 years after our last period our testosterone levels have dropped substantially. This can lead us to feeling less motivated, drained and lacking in libido. Hormonal replacement therapy (HRT) does have a place here and can often be used to subside symptoms beginning in peri-menopause. There are possible risks that you should discuss with your doctor, but what the research shows that there is a golden window of time where HRT can be protective to your bone, brain and heart health, along with subsiding your unwanted symptoms. We can also help our hormones through the amount of food we eat that has natural oestrogens in it (phyto-oestrogens), our body loves these! Check out the girl powder recipe to easily add these into your diet. 

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PhD Neuroscience and Nuclear Medicine. Functional Nutritionist and holistic healthcare practitioner

Dr. Lisa Mosconi

(In relation to menopause) Doctors and scientists can help, but we also need to learn how to help ourselves

Fibroids

Also known by the fancy term ‘Uterine Leiomyomas’ or myomas. These are non-nasty (Benign) tumours that grow inside the uterus, inside the muscle of the uterus, or on the outside. They can often have no symptoms but just as easily cause uncomfortable symptoms too. It all depends on their location

Signs & Symptoms

The location of the growth determines the symptoms you may suffer. Clinically there are one to four main way women can present; 

  1. Abnormal pelvic bleeding — this means that your bleeding has become heavier, has an  altered frequency or the colour has changed
  2. Chronic pelvic pain — This is the most common reason, particularly pain with menstruation however non-menstrual pain and pain during sex can also indicate possible growth
  3. Subfertility — This is most common with submucous leiomyomas. They are the rarest form, however the most likely to produce symptoms as they project into the endometrial cavity. 
  4. Pressure effects — presenting mainly as bladder or bowel urgency/difficulty going or painful intercourse 
Myomas are the most common pelvic growth found in women with approximately 50% of women in the western world having at least one, at some stage in her life. 

Do I have One & What do i do about it?

These lumps and bumps are diagnosed via an internal vaginal ultrasound.  From a medical stand point, your decision about what to do about it is whether you want to preserve immediate or future fertility. This is because the medical management is excision of the lump, or depending on the number and size, a hysterectomy may be suggested. 

From a functional approach, the size and growth of endometrial tissue in your body is controlled by oestrogen. Based on this, incorporating different lifestyle changes and functional supplementation to balance your hormones may help.  You can do this by decreasing your emotional stress, decreasing inflammatory foods particularly wheat and dairy, incorporating phyto-oestrogens into your diet (check out this recipe) and possibly integrating a bio-identical progesterone cream (depending on where you live in the world, some of these creams can be purchased online, other countries require a GP referral). We would recommend speaking to a practitioner before introducing any external hormones.

Hystectomy

Don’t let the picture below fool you, a Hysterectomy is when the uterus has been removed. It’s called a hysterectomy because back in the old days, a doctor found that manually stimulating women to the point of orgasm helped them to relax, therefore the uterus was the source of all of the hysteria… No wonder this doctor didn’t own a uterus themselves…

What is a Hysterectomy?

1 in 8 menopausal women Hysterectomies can be partial or complete. 

DO I need hormonal replacement?

The answer to this question resembles more of a maze than a straight line. However there are some key 

Hormone
Replacement

Menopause happens when our ovaries ‘shut up shop’ after their years of tireless service are over and they’re due for retirement (or redundancy in terms of a hysterectomy). Your ovaries are the main producers of your sex hormones, so in menopause, it is only natural for these hormones to decrease. This is where your symptoms can arise. 

Is Hormonal Replacement Safe?

In 2004 a large scale study called the Women’s Health Initiative was abruptly stopped because of an increased relative risk of breast cancer in women taking combined hormone therapy. (Combined means oestrogen and progesterone). This lead to many women immediately halting their hormone therapy and a change in the referring practices of medical doctors. In the years since, the dramatic halting of the study has come under scrutiny and the media has been somewhat at fault. What the communication of the study results failed to state was that the increased risk was ‘relative’. This means that although, yes, combined hormone therapy may increase your risk of developing breast cancer, so too does, smoking, consuming over 2 std alcoholic drinks a day, lack of physical exercise, menopause after 55 yrs, your first period before 12 yrs and more. This is not to say that hormone replacement is completely safe, but it isn’t necessarily the boogey man we’ve all made it out to be. 

The data suggests that there is a ‘window of opportunity’ where hormone replacement can be beneficial for your health, in protecting your cardiovascular health, brain health and bone health, whilst after a certain time it can actually become detrimental. This window seems to be the first 5 years of menopause. 

Osteoporosis

This is a fancy word that describes the stage of bone health that is fragile and weak. Bone is a dynamic organ that is constantly changing. Overtime due to changes in our physiology (how our body works) our hormones and gut function change. This can result in weaker bones, but keeping in mind that bones are dynamic organs, you can always help yourself.

How do i know if I have osteoporosis?

According to the WHO criteria 22.8% of women and 5.9% of men over 50 have osteoporosis. These figures roughly double by 70 years of age. These is 1 fracture every 2.9 minutes in Australia as of 2022. About half of all women over 60 and a third of men, will be diagnosed with an osteoporotic fracture during their lifetime. Osteoporosis is diagnosed via what’s called a DEXA scan. This measures your strength of your bones. 

T- Score: This is where your levels are compared to the average levels of women at the age of 21. If you are -2.5 then you are deemed to have osteoporosis. 

Z- Score: This is where your levels are compared to the average levels of women the same age as you. If your score is -2.5 than you most likely have a secondary cause of osteoporosis.

Other signs that may be hinting you have weaker bones: 

  • Easily fracture bones
  • Cracking teeth
  • Pain when you press on your shin bone

I've been diagnosed with Osteoporosis
What do I do now?

This depends on your age and the cause of your osteoporosis. 

  • If you’re pre menopausal and have experienced a premature loss of menstruation due to over exercise and lack of appropriate nutrient intake, your main focus should be to regain your period. This can be done by ceasing strenuous exercise and increasing your calorie intake with nutrient rich foods. This can be mentally difficult for womxn with body dysmorphia and the help of a mental health professional should be sought.
  • Post menopausal womxn are naturally lower in oestrogen (remember one of the main building blocks of bone) so it is important to make sure that oestrogen levels are adequate for as long as they can be. This often means going on hormone replacement to add more oestrogen to supplement for the natural loss we experience. There is a golden window of time that lasts up to 5 years post menopausal, this window has been shown to be beneficial for not only bone health but also brain and heart health when womxn implement hormone therapy. You need to speak to your doctor about which combination of hormones is best for you, given your specific history. 
  • Often the medical management will be a class of drugs called biophosphonates. These drugs aim to decrease the rate of bone loss, rather than focusing on building bone. The can be beneficial in women who are 10 years + post menopausal, however it is always important to talk through the possible side effects of medication with your GP as Jaw necrosis can be side effect among others, for this particular type of medication. Read more to learn what you can do…

Factors that increase my Risk of osteoporosis...

In addition to getting older, there are a number of other factors that are associated with an increased risk of osteoporosis they include: 

  • Being female (Damn**)
  • Smoking
  • Low body weight
  • Chronic stress
  • More than 1 caffeinated drink per day (too much makes calcium leach from your body)
  • History of lost period due to over exercising and under eating
  • Excess alcohol consumption (More than 2 standard drinks per day)
  • Sex hormone deficiency (Oestrogen in women and testosterone in men)
  • Genetic risk
  • Endocrine disorders (Hyperthyroidism, Hyperparathyroidism, Cushings etc…)
  • Malabsorption syndromes (IBS, Crohns, Ulcerative colitis etc…)

Bone health Program

  1. Cut out or dramatically reduce the lifestyle factors that increase bone loss (Listed above) 
  2. Focus on maintaining bone health and try to rebuild as best you can. Do this by…
    • Exercise for 45 minutes at least twice a week (Avoid forward bending and twisting)… You will need weights, start light and work your way up. Asking a personal trainer for a program can be handy. (This has been shown to increase bone density as much as taking hormone replacement) Exercises like; walking, cycling, climbing, strength training and weight bearing aerobic exercise are a great place to start. (Remember to always work with your abilities)

    • Naturally boost your oestrogen with phyto-oestrogens in your diet. Pueraria Mirifica a plant from Thailand has been shown to help boost bone health. You can also incorporate ‘Girl Powder’ into your diet by having a tablespoon per day. Make your own at home!

    • No longer getting a period? – If it has been less than 5 years since your last period, talk to your doctor about your ability to take hormonal replacement of oestrogen and/or progesterone. 

    • Boost your critical nutrients which help to hold your bones together (like the cement in a brick wall). These included; Vitamin D, Calcium, Magnesium, Boron, Vitamin C, Vitamin A and Vitamin K2. In order to get these nutrient you can take a mixture of supplements (Ostelin VitCalD-K2), liquid magnesium 2-4ml per day and Basica once per day. With any supplements it is important to talk to your practitioner to get the best advice for your specific health history.

** Trial this protocol for 6 months and then repeat your bone density scan. If there is  still a decrease in bone density than Biophosphonates are needed, if you are over 70 years old, medical professionals usually  recommend these as the first port of call. **

Brain Symptoms

Section coming soon!

We’re humming away like busy bees, putting together all the important info you need to know. We thought about waiting for Queen B (yoncès) approval, but don’t have her number (if you do, send it through). 

Hormone changes Effect your weight

When we enter menopause our oestrogen, progesterone and testosterone all decrease (albeit at different rates)

Hot flashes

Section coming soon!

We’re humming away like busy bees, putting together all the important info you need to know. We thought about waiting for Queen B (yoncès) approval, but don’t have her number (if you do, send it through). 

Hormone changes Effect your weight

When we enter menopause our oestrogen, progesterone and testosterone all decrease (albeit at different rates)

Fatigue &
Insomnia

Section coming soon!

We’re humming away like busy bees, putting together all the important info you need to know. We thought about waiting for Queen B (yoncès) approval, but don’t have her number (if you do, send it through). 

Hormone changes Effect your weight

When we enter menopause our oestrogen, progesterone and testosterone all decrease (albeit at different rates)

Weight
Gain

Have you ever started a diet at the same time as your male partner, brother or friend? Did they see results a lot faster than you, even though you were diligent as hell? The same goes for when you start a diet at the same time as your daughter who is in her twenties and you in your 50’s. Even if we do the same things, how we respond compared to others is going to change, because you’re changing. 

Females and Males

From puberty through to menopause females, have always had a natural need to have a higher percentage body fat compared to males. With Females having a healthy 20-25% body fat and males 10-15%. Males also tend to be leaner because they usually have more muscle mass due to higher levels of testosterone, this also helps to boost metabolism. 

Females on the other hand have higher amounts of oestrogen, this causes higher sensitivity to insulin which moves sugar from the blood and stores it as fat. Even when eating a diet high in healthy carbs, women tend to burn through these extra carbs right away, where as men will store them in their muscles as glycogen. 

Menopause changes Effect your weight

When we enter menopause our oestrogen, progesterone and testosterone all decrease (albeit at different rates). This results in 2 main changes; your metabolism slows down and your insulin goes a little ‘wonky’. 

Oestrogen acts like a magnet for sugar and helps to produce energy in the brain. When oestrogen drops, so does the energy in the brain, this leads to a dis-regulation in how the body regulates and distributes adipose tissue, leading to more fat around the waist line. 

In peri-menopause and post menopause our brains and bodies demand an increase in calories and nutrients. This is why many females struggle to shed the additional weight. So what do you do?…

How do I Balance my weight?

The key to balancing your weight when your hormones and body are going through a major change is to focus on boosting your metabolism. You can do this by: 

  • Focus on muscle and bone health. Do this by increasing your protein intake to 50g per day and doing strength based exercise 45 minutes 3 times a week.
  • Eating for your metabolism means having 5 balanced meals a day (3 main + 2 snacks) and making sure to eat within 1 hour of waking and no longer than 3 hours between meals/snacks.
  • Decreasing your stress (We recommend taking a look at SD Protocol for an in-depth guide to conquering your stress)
  • Having your thyroid checked to ensure you aren’t lacking any appropriate function.
  • Talking to your doctor about the need for hormone replacement therapy. (This has been shown to have peak efficacy 5 years either side of menopause) or incorporate phyto-oestrogens into your diet. (Check out our Girl-powder recipe)

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.

Harlow, B. L., & Signorello, L. B. (2000). Factors associated with early menopause. Maturitas, 35(1), 3–9. https://doi.org/10.1016/s0378-5122(00)00092-x
 
Northrup, C. 2020. Women’s Bodies, Women’s Wisdom. 5th ed. Batman House, Penguin Random House Books.
 
Urasopon, N., Hamada, Y., Cherdshewasart, W., & Malaivijitnond, S. (2008). Preventive effects of Pueraria mirifica on bone loss in ovariectomized rats. Maturitas, 59(2), 137–148. https://doi.org/10.1016/j.maturitas.2008.01.001