Menopause is a time when your ovaries stop producing estrogen and your female hormones are completely depleted. Once you stop having your period for one year you are officially in menopause. The average age a woman enters menopause is 51yr but menopausal symptoms can start in your 40years as hormonal fluctuations begin. During this time there are hormonal, physical and psychological changes happening that are completely disruptive to your life that often need swift medical intervention.
Symptoms of Menopause
There are over 100 symptoms of menopause! The most common symptoms of menopause include irregular periods, hot flashes, sweating, insomnia, depression, anxiety, feeling apprehensive, weight gain or loss, fatigue, poor concentration, memory loss, vaginal dryness and heart palpitations. Other less discussed symptoms include heart palpitations, joint pain, frozen shoulder, itchy and sensitive skin, ringing in the ears, electric shock sensations, gum disease problems, acne, urinary tract infections, nipple discharge and burning mouth syndrome.
All of these disruptive symptoms affect your quality of life and can be improved with simple lifestyle modifications, medications specifically treating each symptom and hormone replacement therapy.
Menopause and Osteoporosis
Osteoporosis is a disease affecting the bones. The bones become brittle, weak and fragile causing a decrease in quality and strength leading to fractures and broken bones. Women are 5 times more likely to develop osteoporosis than men.
In the United States, although women only have twice the fracture rate of men, they sustain 80% of hip fractures because older women far outnumber older men.
Osteoporosis is a skeletal disorder characterized by loss of bone mass, deterioration of microarchitecture, and a decline in bone quality, all of which leads to an increased vulnerability to fracture.
Bone is live tissue, constantly being built and broken down. Estrogen, calcium and vitamin D are part of the building blocks important in keeping bone tissue healthy and strong. When women go through menopause and lose estrogen, the building material of bone is weakened and puts women at risk for osteoporosis. Deficiency in calcium and vitamin D also contribute in making bone prone to this silent disease.
Prevention is the perfect way to avoid weak bones which put you at risk for osteoporosis. Whether you are in your 20’s, 30’s or 40’s, making sure you have enough daily dietary calcium is an important step in building strong bones and preventing this disease that affects older women.
Taking calcium supplements is not needed for most healthy women and can have some serious health risks including kidney stones. Vitamin D can be essential in promoting bone health, calcium and phosphate absorption, muscle strength/function and maintaining healthy teeth.
Weight bearing and muscle strengthening exercises build bone. Weigh bearing exercises are those exercises where your feet and legs support your body weight. Low impact exercise such as fast walking, elliptical and stair stepping machines, not only build muscle and endurance but also build the amount and thickness of bone. High impact exercises include running/jogging, jumping rope and high intensity aerobics. Strong muscles increase blood flow and send key nutrients to help maintain healthy bone.
Osteoporosis cannot be cured but the process can be slowed down and improved with medication. Medications used to treat osteoporosis put the brakes on bone deterioration. Some medications can maintain bone density, strengthen bone and decrease the risk of fractures and breaking bone.
Menopause and Heart health
Heart disease is the most common cause of death among women throughout the world, affecting 1 in 4 women. Plus, it’s the leading cause of death in women.
Menopause does not cause heart disease but there are risk factors that occur around this same time that increase your risk. They include a high fat diet, smoking, obesity, diabetes and high blood pressure that catch up with you in your 50’s. It’s around this time in a woman’s life that you need to pay attention to your risk factors for heart disease. Estrogen has a positive effect on your heart prior to menopause. The American Heart Association does not recommend taking HRT to prevent heart disease.
Prior to going into menopause, the hormone estrogen has a positive and healthy effect on blood vessels and blood flow. Once you enter menopause, estrogen levels plummet and you experience hormonal and physical chaos happening at the same time. The decrease in estrogen levels during menopause may increase risk of heart disease but does not cause cardiovascular disease. Hormone replacement therapy is not recommended to treat or prevent heart disease but can be used to treat other disruptive symptoms of menopause including hot flashes, night sweats, insomnia and mood changes.
Menopause and Memory loss
We always hear about hot flashes, irregular periods and insomnia classically linked to menopause but there are other symptoms equally annoying but less talked about. Menopausal symptoms occur as a result of low estrogen levels which can also cause a drop in serotonin and dopamine levels leading to cognitive changes including memory loss, poor concentration and a short attention span.
Vyvanse and other ADHD medications can be helpful with menopausal symptoms related to staying focus, organized, managing time, improving concentration, forgetfulness and memory, also known as “foggy brain”. Even if you haven’t been officially diagnosed with ADHD in the past, menopause can throw you into an ADHD-like state.
The risks of taking Vyvanse for menopausal symptoms include addiction and abusing the stimulate effect of this group of medication. Weight loss, loss of appetite, feeling more energetic and euphoric makes these medications popular for these added benefits. Other side effects include trouble sleeping, nervousness, dizziness, skin numbness, irregular heartbeat, headaches, nausea, and vomiting.
Hormone therapy Pro’s and Con’s
Main indication for using oral hormonal replacement therapy (HRT) is best therapy in symptomatic women for relief of menopausal hot flashes that are bothersome, disrupt sleep or adversely affect a women’s quality of life. Treating the symptoms of menopause is individualized and often based on your philosophies for the various treatment options. Discuss the treatment choices with your health care provider to understand what is best for you.
In 2002, the famous Women’s Health Initiative study studies 27,347 women aged 50 to 79 who took Estrogen only or Estrogen/Progesterone. The WHI study was prematurely stopped three years ahead of schedule when researchers found a higher risk of breast cancer, blood clots, stroke and heart attack in women on hormone therapy. When this information was given to the public, I think doctors stopped prescribing HRT and all women who took HRT, stopped taking it!
More than 20 years later we now know HRT is safe and has many health benefits beyond symptoms related to menopause. Brain and heart health are being embarrassed as benefits to using HRT.
Further studies showed that when HRT was started within 10 years of menopause or <60year, the risks are few and generally were outweighed by the benefits. However, when HRT was started >60year, the reverse was true…the risks NOW outweighed the benefits. Dose and duration should be individualized and personal risk factors such as “the risk of venous thromboembolism, stroke, ischemic heart disease and breast cancer should guide use of HRT…you may not be a candidate if you have any of these risk factors.
Many symptomatic women are now staying on hormone therapy longer if they are low risk.
Quality of life is everything. Menopause and its disruptive symptoms can be manageable. The benefits of hormone replacement therapy often outweigh the risks when it comes to your quality of life.
Menopause and Weight Gain
Weight gain in women over 50y is a common complaint at the doctor’s office. The best ways to help prevent unwanted weight gain is to do the following:
- Exercise regularly and often-The best form of exercise is aerobic activity combined with strength training. The more muscle you build up the better your body burns calories. If you are doing moderate aerobic activity such as brisk walking, 150 minutes a week is optimal. For more strenuous aerobic activity such as jogging, 75 minutes a week is recommended.
- Eat 200-300 calories less a day to maintain your current weight. Be mindful of eating a colorful, healthy and well-balanced diet including fresh fruits, vegetables, whole grains and fish. If you have to cut calories chose those with less nutritional value, such as fats and alcohol. Eating a healthy diet will also have other health benefits such as reducing the risk of heart disease, stroke, diabetes, high blood pressure, high cholesterol and improve cognitive function.
- Create an over 50yr support team-I am sure your close friends are going through the same frustrating challenges regarding unwanted weight gain. Use your friends and family as a support team to make permanent healthy lifestyle and dietary choices that will promote healthy aging and defeat the battle of the budge.
Recent medical studies now support GLP-1 medication in treatment common female hormonal conditions including PCOS, perimenopause and menopause. It is also used for weight gain caused from pregnancy and normal aging.
Semaglutides (Ozempic or Wegovy) and Tirzepatides (Zepound or Mounjaro) are approved and formulated to treat obesity and diabetes
These medications naturally manage blood sugar, regulate appetite, helps you feel full and balance the hunger and fullness signals, turning off the “food noise”
Whether you have 10 pounds to lose or much more, GLP-1 medications, a healthy diet and regular physical exercise will give you the framework for success.