Menopause is more than hot flashes!
The time of perimenopause can throw a woman’s life into chaos. You may not know what is happening, feeling off, not like yourself. We tend to think of menopause as hot flashes, but there is so much more. During the transition to menopause, there is a sharp decrease in estrogen levels that alters many processes in our bodies. Studies have shown that visceral fat (belly fat) can increase from about 5-9% of total body fat to 15-20% of total body fat. Many women can anywhere from 20-50 lbs. This can be distressing for women who must deal with sudden changes in their appearance, health and well-being. While gaining fat, women also lose skeletal muscle mass. These changes can lead to increased insulin resistance and rates of metabolic syndrome, increased hypertension, development of cardiovascular disease, and fatty liver. There can be increased inflammation and immune disorders as well. Some women may experience gastrointestinal problems as well, including worsening acid reflux, gallstones and more. With decreased estrogen levels, many women experience joint pain, as well as increased risk of osteoporosis (low bone density) with increased risk of fractures.
The hormonal changes of menopause also impact our mental well-being. Women can experience cognitive changes, often describing “brain fog”. There can be sleep disorders, increased anxiety and mood changes as well.
So, is it all a lost cause? Absolutely not! There are treatment options. A good doctor can help guide you through proper nutrition planning, focusing on well balanced meals that are high in protein and fiber, and moderating carbs. Strength training can help to build back muscle mass. But most importantly, menopausal hormone therapy. Menopausal disorders are woefully undertreated.
The Women's Health Initiative (WHI), a major research program launched in the 1990s, conducted one of the largest studies on hormone therapy (HT) for postmenopausal women. The WHI study investigated the effects of combined estrogen-progestin therapy (EPT) and estrogen-alone therapy (ET) on chronic disease prevention, including cardiovascular health, osteoporosis, and cancer.
When the initial results of the WHI were published in 2002, they raised significant concerns about the risks of hormone therapy, particularly with respect to breast cancer. These findings led to a dramatic drop in hormone therapy use worldwide. However, subsequent re-analyses and follow-up studies have clarified several points, suggesting the risks may have been overstated or misunderstood in specific contexts.
More recent research has shown that menopausal hormone therapy is safe. There are many potential benefits, including decreased hot flashes, improved metabolic health, quality of life and decreased risk of cardiovascular disease and osteoporosis, among other benefits. There are options to feel better, if you think that menopause is impacting your quality of life, speak to your doctor to see what treatment options are available to you.