A hot topic at the memoment is the Menopuase, for a long time though. women were hesitant to talk about it and reluctant to ask for advice. Today for our wellness feature we speak to Dr. Fiona Barry PhD, about the menopause. She also shares with us her tips for making symptoms more manageable.
What is menopause and what happens during it?
In medical terms, menopause is the one year anniversary of a woman’s last menstrual cycle, so theoretically it only lasts one day. However, menopause has become the umbrella term for the transitioning of a woman’s body from her reproductive years to her non-reproductive years. Like puberty, this transition occurs over a period of time, and the process is divided into phases, beginning with perimenopause and ending with post-menopause.
Menopause occurs because a woman’s ovaries begin to shut down and become unresponsive to the signals they are receiving from the brain. This means they cease to produce the sex hormones, oestrogen and progesterone. This has a systemic effect as our sex hormones have many physiological effects throughout the body. Unfortunately, the winding down of the ovaries isn’t a smooth, linear decline, it is more a ‘stop-start’ process, causing the levels of hormones to fluctuate wildly. This can lead to a variety of symptoms as our brain and body struggles to keep up. Perimenopause can be the most difficult time for women for this very reason. This is time that the hormones fluctuate the most. In early perimenopause a woman’s menstrual cycle is most likely still regular, however, she will not be ovulating every cycle. This leads to a decrease in progesterone and therefore a relative increase in oestrogen and testosterone, potentially giving rise to symptoms such as weight gain, anxiety, sleep disturbance, brain fog, loss of concentration, night sweats and hot flushes. Due to the higher relative levels of testosterone many women find their sex drive increases during this time. In late perimenopause the levels of all the sex hormones have decreased but they are still fluctuating. The original symptoms may still remain and new symptoms may arise, such as palpitations, urinary incontinence, low libido, thinning of hair and vaginal dryness. Once a woman reaches menopause and becomes post-menopausal everything starts to settle down as the hormone levels stabilise and the body adjusts to the new lower levels. Most women find their post-menopausal years the happiest years of their life.
What age does the menopause typically start?
The typical age for menopause is 51. However, 1 in 100 women go into menopause before the age of 40 and 1 in a 1000 before they are 30. This is a significant, and noteworthy, number and women need to be aware of it. It is also worth bearing in mind that perimenopause, the time leading up to menopause, is often the most difficult and symptomatic time for women. Therefore, when we think about menopause we should think in terms of the time taken to complete the whole process, much like we do with puberty, and that process starts for most women in her early 40s.
What are the first symptoms and do they escalate quickly?
Every woman is unique and therefore every woman’s menopausal journey will be unique to her; including her symptoms or lack thereof, when a symptom might occur, in what order and how long it might last. Contrary to what we have been told many women do not experience hot flushes or night sweats as their first symptoms, in fact some women never experience them. This has led to a lot of confusion as many women assume if they are not getting hot flushes or night sweats then they are not perimenopausal. In my experience in clinic, mental and emotional changes are the first symptoms that many women become aware of, presenting with issues like anxiety, loss of concentration, mood swings, brain fog and sleep disturbances.
As women we are used to feeling different at different times of the month because of the natural cyclic fluctuations in our hormones and we adapt accordingly. Therefore, we can be slow in recognising when things have become erratic and we usually have had a change in our health and wellbeing for quite a while before we acknowledge it and think to do anything about it.
What are the common mental effects of menopause on women?
The effects of menopause on our mental faculties are diverse, including our cognitive functioning and our emotions. Our brain contains receptors for a variety of hormones and it is through these receptors that our hormones elicit their effects. Oestrogen boosts the synthesis and enhances the effects of neurotransmitters (chemical messengers) in the brain. It is intimately linked to the neurotransmitter, serotonin, which is the main neurotransmitter implicated in anxiety and depression. When oestrogen levels drop, as in PMS, post partum or perimenopause, it’s common for moods to plummet as well. Although it’s more complicated than this, put very simply, when oestrogen levels are up so are serotonin levels and so is our mood; when oestrogen levels decrease, so do our serotonin levels and our mood goes down too.
Waxing and waning levels of oestrogen help us to be more emotional, allow us to cry more easily and even to break down when we’re overwhelmed. When our oestrogen and progesterone levels become erratic during our transition through menopause our brain struggles to cope with the fluctuating highs and lows. resulting in changes to our behaviour and our mood. Emotional changes may include mood swings, anxiety, irritability, feelings of dread and even depression. Changes in cognitive functioning may also be experienced by many women, including forgetfulness, loss of concentration, brain fog and disturbing memory lapses. In general terms, fatigue and a lack of motivation are also high on the lists of symptoms that many women notice.
What are the lifestyle changes women could introduce to help?
Like everything in life, preparation is key and there is no doubt that the more prepared a woman is and the healthier she is coming into this phase of her life, the easier it will be. Our body is designed to cope with menopause but we must support it, ideally commencing before we enter into it, in another words in our 30s. While the ovaries are the primary site of production of our sex hormones, other sites in the body also produce these hormones, such as our skin, our hair follicles, our fat cells, our muscles, our adrenal glands, and even our brain. If a woman enters perimenopause in good physical, nutritional and psychological health her adrenal glands can increase their production of sex hormones by up the three-fold over time. This adaptation will not occur if she enters menopause completely depleted, which unfortunately is the case for many women nowadays. A good starting point to help you prepare for this phase of your life is a healthy diet. A Mediterranean style diet, comprising of whole foods and rich in vegetables is the most supportive during menopause. Adequate sleep is also vital to stabilise hormones, as is regular exercise and an appropriate work/life balance. As our oestrogen levels decrease we become more sensitive to cortisol so managing stress levels is really important. Practises that help you relax, such as Yoga, mindfulness, meditation or even a massage, will increase your mood and sense of wellbeing. If a woman is still struggling with symptoms while on a healthy diet, getting regular exercise and employing stress reduction techniques then she may need additional help, such as supplements or herbal remedies or acupuncture. Every woman is unique so different treatments work for different people. It’s worth investigating what might work for you. For some women their symptoms may be so severe that natural remedies don’t give them adequate relief and for these women they may have no choice but to go the medical route.
Do women still need birth control while experiencing symptoms?
During perimenopause a woman will still be having periods but may also be symptomatic. As long as a woman is having a menstrual cycle there is a chance that she may become pregnant, therefore contraception is still a factor. Many women’s fertility increases during early perimenopause and that, combined with potential changes in the regularity of a woman’s menstrual cycle can significantly increase the chance of a ‘surprise’ pregnancy. This is something a woman and her partner should be aware of so that they can decide on the best form of contraception for them. This may be hormonal such as the contraceptive pill, a barrier method such as an IUD or condom or it may be the time for the man to get involved and consider a vasectomy.
What are the benefits of using Revive Meno Active? Can it be used during perimenopause?
Meno Active, the super supplement created by Revive Active, was created specifically for this phase of a woman’s life. It contains ingredients to support every system in a woman’s body that is impacted by menopause, from bones to hormonal activity. Not only does it contain 19 vitamins and minerals to support overall health, but it also contains digestive enzymes and live friendly bacteria. This is very important as our metabolism slows down during menopause and can cause us to gain weight. In addition, it contains a high quantity of omega 3, in the form of DHA, which contributes to the maintenance of normal brain function. The formulation team also added 4 plant extracts; namely Ashwagandha, Sage, Green Tea and Genistein, which is an isoflavone found in soya. These were chosen based on evidence-based scientific research and are present in the appropriate biologically active form and at the appropriate concentration. In an independent market research study over 65% of women that took Meno Active for 3 months noticed an improvement in their wellbeing. Meno Active is not only suitable to take in menopause but it’s also suitable to take if you are perimenopausal and are experiencing signs that your journey has commenced.
How long does menopause last?
Menopause is a natural part of ageing and is a gradual process that takes place over months to years. Symptoms can start months or even years before periods stop completely. This perimenopausal phase can last up to 10 years and symptoms can continue on, on average, for about 4 years after a woman’s last menstrual cycle. According to one scientific study menopause symptoms last an average of 4.5 years following a woman’s last period, and 7.4 years in total.
What are your top tips for staying well mentally during menopause?
My top tips for staying mentally well during menopause are as follows:
- Practise regular self care. Take time out to nourish yourself both mentally/emotionally and physically.
- Eat a Mediterranean style diet with plenty of fresh, whole foods. Just as important as what you eat is HOW you eat. Try not to eat on the run or while distracted by other things, such as your work or your phone etc. To digest our food properly we need to switch on the parasympathetic nervous system, which is the ‘rest and digest’ part of our nervous system. A quick way to switch this on is 1 minute of deep breathing before eating and then to focus your full attention on what you are eating, the flavours and textures of the food, eating slowly and chewing well.
- Get plenty of sleep and rest. At a time when your sleep may be disturbed due to hormonal fluctuations, it is important to incorporate plenty of time to rest. If time is of the essence, then 10 minutes meditation or mindful breathing, on a daily basis, can make a significant difference to your overall health and wellbeing.
- Look after your mental health by dealing with any issues you may have from your past or in your present. I cannot stress this enough! As women we are biologically hard wired to nurture and support. Often this is achieved at our own expense. As we enter perimenopause all the problems and resentments that we have squashed down and repressed rise to the surface and demand to be dealt with. This can be very difficult and, in my experience, significantly exacerbates the symptoms of menopause. Therefore, if there are issues within your life that you are aware of, deal with them. You may need help to do this and there are many different wonderful therapies and therapists out there that can support you with it. We cannot separate our mental/emotional health from our physical health so in addressing one we address the other.
Dr. Fiona Barry PhD
Owner of two female wellness clinics in Cork
Member of Meno Active formulation team
