Let's Pause to Talk About Menopause
According to The National Institute on Aging, menopause, a pivotal moment marked by a 12-month woman's last menstrual cycle, ushers in a transformative journey known as the menopausal transition or perimenopause. During this time, women may experience changes in monthly cycles, hot flashes, and additional physical and emotional symptoms, signifying the body's natural transition has begun.
Though perimenopause marks one of the most crucial transitions in life, there is a huge knowledge gap among Americans as to when it begins, its symptoms, and its impact on women’s health. With 47 million people entering perimenopause annually, this knowledge gap leaves millions of women unprepared for the changes their bodies experience in midlife.
Recently, I had the privilege of delving deeper into the subject with Dr. Panta Rouhani Schaffer, MD, PhD, MPH, FAAD, a distinguished expert in menopause and a medical advisor at Evernow, a leading menopause care company.
The menopausal transition, she shared, typically unfolds between the ages of 45 and 55, spanning a duration of anywhere between seven to 14 years. Influencing demographic and lifestyle factors such as smoking, age, and race all contribute to varying experiences in length and severity among women. The perimenopausal stage, characterized by fluctuating estrogen and progesterone levels, can add complexity to this already challenging natural life transition.
Dr. Kara McElligott Park, an OBGYN specializing in menopause and a medical advisor at Mira Hormonal Health Company, said, “The challenge with perimenopause is that the changes are subtle, come from multiple directions, and often correlate with stress. So it can be hard to tell whether that trouble sleeping is a natural response to life stressors or a sign of perimenopause. The symptoms also wax and wane erratically, so the trend in symptoms, in the short term, is not very helpful for determining what is related to perimenopause.”
Supportive Strategies for Easing the Menopausal Transition
In our conversation, Dr. Schaffer shared valuable insights on managing common menopausal symptoms, emphasizing the role of nutrition. "We aren't consuming as much protein as our bodies require," she said, highlighting that as women age, the body's protein requirements increase. Adequate protein intake is crucial to counteract symptoms such as hot flashes, mood changes, and the aging-related issues of hair thinning and collagen loss affecting the skin and muscles.
As we spoke, exercise emerged as a critical component during menopause for cardiovascular health and maintaining muscle mass, particularly in the joints and ligaments. "[Exercise]," Dr. Schaffer said, "improves mood, with the mind-body connection, so there is less fatigue as women say they feel less tired and their brain will work better." The consensus among medical professionals seems to support this tip, including a 2016 study showcasing the positive impact of exercise on the physical and mental well-being of menopausal women.
Navigating the premenopausal stage requires a nuanced approach, and Dr. Schaffer suggests the use of supplements as a potential solution. She urged women to discuss their options with medical providers. "[Check] levels of vitamins B12 and D, magnesium, and zinc, as these can significantly influence menopausal symptoms. Hormone replacement therapy", she continued, "can be beneficial for some." However, Dr. Schaffer acknowledged this treatment can present potential side effects, underscoring the importance of informed decision-making.
Dr. McElligott Park added, “Limit alcohol intake and avoid smoking, as it can worsen symptoms and accelerate aging.”
For women who opt for surgical intervention such as hysterectomy (removal of the uterus), the menopausal symptoms can be more extreme. Dr. Schaffer shed light on the swift hormonal fluctuations experienced by women who undergo surgical removal of the uterus or ovaries, affecting sleep patterns, skin, and hair. The importance of understanding and managing these abrupt changes was emphasized because the physical and emotional changes happen suddenly, and one might need more attention during this time.
The Impact of Menopause on Physical Appearance
Moving beyond the physiological and mental aspects of menopause, our conversation explored its impact on physical appearance. Dr. Schaffer explained, "The decrease in estrogen is a crucial factor," likening it to the oil in a machine that produces collagen. "Less collagen results in drier, less firm skin, and the loss of volume, and even contribut[es] to hair thinning." To counteract these effects, she reiterated the significance of a higher protein diet and regular exercise to build lean muscle while reducing muscle mass loss.
Proactive skin care measures, including sunscreen use and a dedicated skincare regimen, were recommended to balance menopause's effects on the skin. Dr. Schaffer also noted medical interventions, like lasers and injectables, as available options to slow collagen loss and preserve skin appearance. Embracing intelligent skincare practices can facilitate a smoother transition to changing physical appearance during menopause.
Conclusion
Our discussion concluded by exploring how the menopause experience is influenced by whether or not a woman has had children. While there is no set rule, Dr. Schaffer noted that women without children may experience menopause earlier. However, when menopause occurs, it ultimately depends on many factors, such as a woman's age at the time of her first period, the number of pregnancies, breastfeeding choices, and the age at which her periods stop, among others.
Dr. McElligott Park wants to remind us by saying, “With the rise of ‘quick fix’ products targeting women in perimenopause, it’s crucial to be skeptical of any unproven remedies. Always research ingredients and consult with a healthcare provider before trying new treatments.”
Irrespective of when menopausal symptoms manifest, Dr. Schaffer advocated for regular medical check-ups. Because genetic and lifestyle factors can increase susceptibility to postmenopausal risks such as breast, ovarian, and uterine cancer, staying vigilant and prioritizing self-care are vital for women navigating this transformative phase. She continued to emphasize the importance of proactive health management beyond menopause.
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