The female life cycle is made up of hormonal milestones - menarche, pregnancy and menopause.
Most women need courage to face menopause - the cessation of menstrual bleeding. It's a turning point for many women, both psychologically as well as physically. You lose calcium in your bones during menopause, making it more likely for a fracture. Bone loss can also cause osteoporosis. Low estrogen also raises LDL-C cholesterol and this contributes to atherosclerosis.
There are, however, many women who have sailed through menopause without any problems. Lifestyle changes are important at this time as well as a shift in attitude towards these changes.
However, you go through menopause, there will be a drop in hormones. Estrogen levels also fall because of extreme exercise, pregnancy failure, anorexia nervosa or polycystic ovarian syndrome.
Metabolism, Mood and Brain Chemistry is Disturbed
Most people, even those in the medical profession, have the entrenched idea that menopause is all about a decrease in the sex hormones - estrogen and progesterone. While hormones are clearly involved, you can't blame menopausal symptoms solely because of a drop in these hormone levels.
Estrogen isn't a single hormone, but rather 3 hormones with different functions. Estrogen is made up of related hormones. The 3 hormones are known as -
● estradiol, a powerful female hormone in childbearing women. This hormone is responsible for female characteristics and is important to bone health in women. It's also the hormone which contributes to most gynecologic problems, of which endometriosis is one.
● estrone - a hormone in the post-menopausal women which is produced in the ovaries and fat cells
● estriol - secreted by the placenta. This hormone is produced during pregnancy.
The decline in estrogen levels leading up to menopause can disturb a woman's metabolism as well as bone strength, blood sugar levels, thyroid function and mood.
Unpleasant symptoms can occur -
● Swing in moods - it has been shown that estrogen can certainly improve mood. In fact, estrogen has a wide range of effects on the body and brain. A decline in estrogen levels can lead to anxiety or depressive disorders. It is also believed that about 95% of women have recurrent psychosis according to fluctuations in endogenous estrogen levels. It is therefore important to understand the relationship between estrogen level changes and cyclical mood disorders. Clinicians recognize estrogen's therapeutic potential for mood change. Estrogen replacement therapy is used in post-menopausal women to improve mood and general well-being. However, the impact of estrogen on emotion varies and depends on other factors too.
● Hot flushes - hot flushes occur in peri-menopause- as well as in menopause. The hot flushes are caused by dropping estrogen levels when the brain has been used to higher levels. Hot flushes in peri-menopause occur because of swings in estrogen while in menopause the estrogen levels have become low. While it has always been thought that too little estrogen caused hot flushes, today it is understood that too much estrogen and too little progesterone as well as other hormone imbalances can cause them.
● Depression - there is plenty of evidence that the high incidence of depression in women is exacerbated by the presence of the ovarian hormones estrogen and progesterone. Peri-menopause is the period preceding menopause, characterized by decreased estrogen production. Higher rates of depressive symptoms occur in peri-menopausal women, and it has been suggested that mood disturbances associated with peri-menopause can bring on hot flushes, fatigue and depression.
● Headaches - the main trigger of menstrually-related migraine is the withdrawal of estrogen. Changes in the increased estrogen levels with pregnancy and decreased levels in menopause appear to affect headaches. Hormonal replacement with estrogen can worsen migraine and oral contraceptives can change its frequency and character. Women often notice a relationship between headaches and hormonal changes. Headaches result because of a hormone imbalance. The frequency of headaches is linked to fluctuations in hormone levels. These fluctuating hormone levels can influence headache patterns but your doctor can help you prevent them.
Other symptoms of declining estrogen levels include -
●back- and joint pain
●vaginal dryness, loss of libido, urinary urgency
●a general feeling of unenthusiastic lethargy
Managing Menopausal Symptoms
The truth is, estrogen is a chain of biochemical events and all chemical processes in the body depend on a range of co-factors. With respect to clinical studies, the decline of estrogen in women needs to be addressed. Questions need to be answered. Do all women find relief from their symptoms by getting hormone replacement therapy? How many women are experiencing negative neurological symptoms? Which of these symptoms such as depression and hot flushes are the most debilitating? What are estrogen creams? Do they help with vaginal dryness and pain during intercourse? Which women will react- and respond well to hormone- or estrogen therapy? Are there those that won't benefit at all?
Doctors may prescribe natural bio-identical progesterone to improve the ratio between estrogen and progesterone, there are herbal formulas that are safe to try, while lifestyle changes, diet and exercise are essential.
Menopause doesn't signify the beginning of the end for you, but a time where you have to adjust to changing hormone levels to prevent some of the symptoms and diseases associated with this particular stage of your life.
Rev Neurol (Paris). 2000;156 Suppl 4:4S30-41. Sex hormones and headache. Available at https://www.ncbi.nlm.nih.gov/pubmed/11139745
EurekAlert. Public Release: 22-Jan-2012. The influence of estrogen on female mood changes. Available at https://www.eurekalert.org/pub_releases/2012-01/sicp-tio010912.php
ScienceDaily. May 26, 2014. May 26, 2014. Hot flashes/night sweats solutions: Estrogen therapy vs. Venlafaxine. Available at https://www.sciencedaily.com/releases/2014/05/140526182751.htm
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