What is menopause?

Hormones such as oestrogen and progesterone have a direct effect on the brain and play important roles in many aspects of brain function, therefore, any imbalance of these hormones can impact the way the brain functions and lead to changes and alterations in brain chemistry and cognition that affect mood and cognitive abilities. Declining levels of oestrogen for example in women going through the menopause may cause memory problems and mood fluctuations.

Adequate sleep is essential for our health and hormone regulation but for women going through the menopause disrupted sleep can be a common complaint. Symptoms such as anxiety, hot flushes or night sweats which occur as a result of declining levels of oestrogen can be unsettling and may contribute to insomnia.

Oestrogen plays an important role in maintaining the integrity of the tissues of the vagina as it helps maintain lubrication, elasticity, and thickness of the vaginal walls. When oestrogen levels decline during and after menopause, the tissues of the vagina can become thin, dry and inflamed, causing irritation and discomfort.

Hot flushes or night sweats are the most common symptoms associated with menopause. They are often accompanied by an increased heart rate and occur in response to a spike in adrenaline triggered by the stress response and as a result of oestrogen imbalance. The triggered stress response and the activation of adrenaline interferes with the bodily system that controls body temperature, known as the Hypothalamus.

Studies show that menopause increases susceptibility to depression and anxiety due to fluctuating levels of oestrogen, which affect the production of the neurotransmitters serotonin and GABA, both of which are involved in regulation of mood.

Weight gain is common during menopause and occurs primarily as a result of the hormonal changes that take place throughout this transitional period. During menopause, the adrenal glands have to work a bit harder, and as a result of being overstimulated, they produce higher levels of stress hormones, namely Cortisol, which triggers the release of Glucose. Glucose that is not needed as fuel for energy, is then surplus in the body and deposited as visceral fat. Weight gain that is associated with hormonal changes typically leads to fat accumulation around the abdomen region (otherwise known as visceral body fat), resulting in changes to body composition and body shape and is associated with increased health risks.

Whilst cortisol is involved in several important functions in the body, too much cortisol in the body can cause blood sugar management issues, leading to increased appetite and cravings, particularly for sugary refined carbohydrates. It is therefore important for women going through the menopause to maintain normal cortisol levels and to minimise excess levels in order to avoid weight gain.

The body’s adrenal glands are under additional strain when a woman goes through the menopause since the adrenal glands compensate for the lack of oestrogen by producing an alternative form of oestrogen, known as oestrone. Since the main job of the adrenal glands is to produce stress hormones such as cortisol, the demand on the adrenal glands increases. This additional demand on the adrenal glands can lead to adrenal dysfunction and can result to ‘adrenal fatigue’. Adrenal fatigue is commonly associated with symptoms such as anxiety, irritability, sleep disorders, cravings, depression, headaches, blood sugar imbalances and fatigue.

Due to physiologic changes, which can include altered nerve function, vaginal secretions and painful intercourse, all of which affect sexual response and are regulated by oestrogen production. Other factors may include depression (oestrogen fluctuations interfere with serotonin production), marital status, body image.

Oestrogen plays an important role in water retention and keratin production. Since keratin is the main protein that makes up the nails and the hair, declining levels of oestrogen can lead to thinning and dryness of the hair and nails, leaving both brittle and weak, and susceptible to breakage.

Declining levels of oestrogen can impact the health and appearance of the skin. This is because low levels of oestrogen can cause drying of the skin and loss of collagen, elasticity and skin strength, which can lead to the appearance of fine lines and wrinkles.

Oestrogen plays an essential role in musculo-skeletal health, including the bones and joints. Declining levels of oestrogen can lead to increased inflammation and swelling of the joints which can result in pain and discomfort or ‘aching joints’ and an increased risk of inflammatory disorders such as osteoarthritis. Post-menopausal women are at an increased risk of bone fractures and of bone disorders due to low bone mass and structural deterioration of bone tissue.

Whilst it may not always be possible to completely avoid stress particularly as stress can come in many forms; whether it be physical or psychological, it is important to find ways to help you manage and protect yourself from the effects of stress on the body to avoid over burdening and overworking the adrenal glands.

Drinking sufficient amounts of water keeps us well hydrated and helps counteract stress by encouraging the circulation of nutrients. Water also helps to flush out old circulating hormones from the body which is important since hormones that are not excreted from the body through the correct pathways can be detrimental to our health, with the potential of leading to oestrogen dominant conditions. The recommended amount for water intake is 2 litres per day (equivalent to approximately 8 small glasses). Herbal and fruit teas count towards daily intake, but caffeinated drinks do not.

Getting adequate amounts of sleep helps us to feel revitalised, refreshed and energised, ready to take on the challenges of the day. Lack of sleep or interrupted sleep can have a profound effect on our day to day lives and can have a significant impact on our emotional wellbeing, stress levels and energy levels as well as our hormones. The recommended amount is a minimum of 7 hours per night for an adult.

Important for both mental and emotional wellbeing, exercise can increase feel good endorphins as well as improving resistance to stress. Exercise has been shown to help improve energy levels, sleep and mood and reduce stress and anxiety. Furthermore, physical exercise increases muscle mass, which in turn helps to speed up metabolism and aid weight management. Swimming, walking, yoga and tai chi are all gentle forms of exercise that many people find really help their stress levels. According to research, sedentary women are more likely to have moderate or severe hot flushes compared with women who exercise. Furthermore, one trial reported a reduction of menopause symptoms immediately after aerobic exercise.

Maintaining balanced blood sugar levels helps to maintain normal cortisol levels-supporting adrenal function and by doing so will also help to reduce cravings, control appetite, regulate mood and help to sustain energy levels. There are many ways in which you can support healthy blood sugar levels:

It is important to avoid going for long periods of time without eating as blood sugars will be low and hunger/cravings will be intensified. It is recommended not to go longer than 3 hours without food to help maintain balanced blood sugar levels.

It is important to take time out and relax in order to keep cortisol within normal ranges and maintain normal adrenal function. Listening to soothing music, reading a book or practising meditation may all help induce relaxation and maintain healthy cortisol levels. Epsom salt baths containing magnesium sulphate are thought to be particularly useful in aiding relaxation, as magnesium can be absorbed directly through the skin.

Protein helps slow down the release of glucose into the bloodstream, helping to balance blood sugar levels. It also helps you to keep fuller for longer and can be helpful in preventing cravings. Protein can also help with weight management as it helps to increase lean muscle mass by increasing basal metabolic rate which in turn helps to burn fat. Healthy sources of protein include lean white meat, fish, beans and pulses, nuts and seeds.

Low GI carbs help to slow down the release of sugar from foods into the bloodstream, helping to achieve a better overall metabolic balance of blood sugar and insulin. Examples of complex carbohydrates that are low GI include:

• Wholegrains such as oats, rice, quinoa, amaranth and teff grains, all of which are nutrient dense, fibre-rich, and provide a slower release of energy and since they are excellent sources of B vitamins these foods can help to balance hormones.

The body requires both Omega 3 and 6 fats for many metabolic functions including oestrogen production. Essential fats also slow down the rate at which the stomach empties, boosts metabolism, balances blood sugar levels, increases cell membrane responsiveness to insulin, reduces inflammation and reduces the stress response. Healthy fats also help lubricate the joints, skin and vagina. These ‘healthy fats’ are found in:

• Oily fish such as salmon, trout, tuna, mackerel, sardines and herring
• Nuts and seeds such as walnuts, pumpkin seeds, sunflower seeds and linseeds/flaxseeds. Flaxseed is also thought to help stimulate metabolism.
• Avocado, and cold-pressed, unrefined flaxseed oils.

Try to consume plenty of dietary fibre since fibre helps to remove toxins and old or excessive hormones from the body. Fibre also helps to slow down the release of sugar into the bloodstream, helping to balance blood sugar levels, manage cortisol production and consequently help support adrenal gland function. Good sources of fibre include wholegrains, fruits and vegetables which will also provide antioxidants and essential vitamins and minerals.