Perimenopause is the initial change, a few years prior to menopause, where ovaries gradually make less oestrogen. We will find this time to be an indication that menopause is looming.
Eventually, menopause arrives and the ovaries no longer release eggs. And periods stop completely. This results in oestrogen production falling to a very low level and progesterone production ceasing after the final menstrual period.
We are said to be ‘postmenopausal’ when a year has passed without menstruation.
It is worth being prepared for the arrival of these stages as the decrease in oestrogen has several effects on the body.
In a nutshell, a lack of oestrogen may increase:
- dryness and thinning of the skin,
- irritability, depression, sweats and hot flushes,
- loss of bone mass,
- increased risk of CVD and weight gain.
Oh dear! That’s some list. Let’s look a little closer.
- As oestrogen helps to protect bone strength, a fall in oestrogen levels, accelerates the loss of bone
- Hot flushes occur from the lack of oestrogen
- Menopause compounds many CVD risk factors. With reduced oestrogen, HDL (good cholesterol) levels may fall and total cholesterol may rise – hence an increased risk of CVD
- Changes in body fat distribution i.e. increased abdominal fat, reduced glucose tolerance and increased blood pressure also increase the risk of CVD
- Lower levels of oestrogen are also associated with lower levels of serotonin, a chemical that regulates mood, emotions and sleep
- However, when it comes to weight gain, contrary to popular belief, this happens around menopause not as a specific result but as a coincidence from an aging lifestyle. Exercise may also drop off and muscle mass starts to decline, which lowers your resting metabolism, making it easier to gain weight
- Hormonal changes of menopause do, however, result in a change in body composition with increased fat and decreased muscle (thus no net change in weight) and can cause fat to settle in your abdomen rather than your hips, thighs and buttocks
- Lower oestrogen levels may also increase appetite, and lower metabolic rate leading to weight gain. Lack of oestrogen may also cause the body to use starches and blood sugar less effectively, which would increase fat storage and make it harder to lose weight
What can we do to reduce these risks of CVD, reduced bone density, weight gain and menopause symptoms?
These points are imortant to keep in mind.
- Keep our weight within a healthy range – starting from peri-menopause. A chance to re-asses your food and drink routines
- Keep active – including some weight-bearing exercises
- Ensure you are getting enough calcium (RDI 1300mg) and vitamin D
- Ensure you are getting enough protein (some at every meal)
- Avoiding caffeine and hot beverages may help with hot flushes
- Watch your alcohol intake
There is hope!! Let’s not use menopause as an excuse but a time for reassessment. Menopause is an opportunity to monitor health, manage weight and improve lifestyle to promote healthy ageing.
by: Brigid Chunn, BSc Registered Nutritionist