Many Mis-Conceptions
Yes, I Know I'm Crazy!
Like women don't already have enough to deal with throughout life?
My kids are grown up and not in jail...I did a good job...so what is my reward?
Menopause!
It's just not fair, I gave birth to the children and dealt with years of monthly cramps and PMS, only to be rewarded with...Mood Swings... Hot Flashes!... Night Sweats!... Memory Loss!...Weird Hair Growth!
It has become a medicalised condition & hormonal health issues are increasing at alarming rates and affecting the young (early puberty)
The two hormones that play an essential role in menopause – oestrogen & progesterone
Menstrual cycle hormones
A Complex System but the signs are there!
Our hormone system has many complexities influencing hormonal imbalances & a womens health
Hormonal havoc early signs! PCOD, endometriosis, PMS, breast lumps, infertility
It is possible to re-balance the system & effect positive solutions to many of the health issues and in particular the varying severity of menopausal symptoms
Looking for a single dominant approach or drug has little chance of success when the root cause is complex
Improving your overall health is the key to protecting yourself against many illnesses and underpins hormonal balance
Hormonal overload – hormone disrupting chemicals
Our modern world is very different from our ancestors
Thousands of synthetic chemicals – put directly into our food, added indirectly (pesticides residues) packaging, processing, medicines
Pesticides
Plastic compounds-soft plastics, lining of cans & cling film
Industrial compounds
Pharmaceutical drugs – synthetic oestrogens & progestogens
Oestrogens Effects
* Indicates that these effects are caused by oestrogen dominance, or an imbalance of oestrogen caused by too little progesterone.
** Indicates that these effects are caused by an excess of progesterone.
*** Indicates that these effects are caused by a deficiency of oestrogen
Creates proliferative endometrium
Breast cell stimulation (fibrocystic breasts*)
Increased body fat and weight gain*
Salt and fluid retention
Depression, anxiety, and headaches*
Cyclical migraines*
Poor sleep patterns*
Interferes with thyroid hormone function*
Impairs blood sugar control*
Increased risk of blood clots*
Little or no libido effect*
Reduced oxygen levels in all cells*
Loss of zinc and retention of copper*
Causes endometrial cancer*
Increased risk of breast cancer*
Increased risk of prostate cancer*
Restrains bone loss
Reduces vascular tone (dilates blood vessels)
Triggers autoimmune diseases*
Creates progesterone receptors
Relieves hot flashes***
Prevents vaginal dryness & mucosal atrophy***
Increases risk of gall bladder disease*
Improves memory***
Improves sleep disorders***
Improves health of urinary tract***
Relieves night sweats***
Progesterone Effects
Maintains secretary endometrium
Protects against breast fibrocysts
Helps use fat for energy
Natural diuretic
Natural anti-depressant & calms anxiety
Prevents cyclical migraines
Promotes normal sleep patterns
Facilitates thyroid hormone function
Helps normalize blood sugar levels
Normalizes blood clotting
Helps restores normal libido
Normalizes zinc and copper levels
Restores proper cell oxygen levels
Prevents endometrial cancer
Helps prevent breast cancer1
Stimulates new bone formation
Improves vascular tone
Prevents autoimmune diseases
Increases sensitivity of oestrogen receptors
Necessary for survival of embryo
Precursor of corticosteroid biosynthesis
Prevents coronary artery spasm & atherosclerotic plaque.
Sleepiness, depression**
Digestive problems**
Progesterone deficient?
Hormones need to be in balance to work well
Difficult to achieve in modern times
Competition from synthetic hormones (mainly oestrogens / xenoestrogens) leads to oestrogen dominance
When Progesterone decreases eg; annovulatory cycles / menopause
Body adapts by making more oestrogen (aromatisation)
Cholesterol converts to pregnenolone which makes progesterone or DHEA which can further convert to testosterone or oestrogen
If oestrogen is made this way is increased production of testosterone (esp if receptor sites for oestrogen are filled with synthetic or xenoestrogens)
Hair loss on scalp, unwanted hair on legs & face & obesity
At menopause production of oestrogen fall by only ½ to 1/3 of pre-menopausal levels.
Progesterone decreases to 120th of baseline levels yet it is oestrogen that is more widely prescribed to tx menoapusal symptoms and protect against oesteoporosis & CVD
What is Menopause & why does it occur?
Peri-menopause
Peri-menopause- can start years before your period stops
Symptoms of perimenopause can begin as early as age 30 or as late as age 50.
For some women the symptoms are mild and only last from 2-6 years, for other women the symptoms are severe and can last as long as 12 years.
Peri menopause is considered to be over once a woman has gone 12 months without menstruating. Severe perimenopause symptoms can include, breast tenderness, urinary problems, severe premenstrual problems, insomnia, sleep disorders, depression, menstrual issues, fatigue and severe mood swings.
Menopause process usually takes 10 years to complete 45-55 years
At menopause lower levels of oestrogen are made, no longer needed to prepare womb for pregnancy
As oestrogen falls menstruation is lighter & often irregular until it stops altogether
Menopause should occur gradually allowing body to adapt to its new condition with ease
With cessation of ovulation, progesterone is no longer produced
Body compensates to release FSH & LH
Menopause is often confirmed by a rise in the levels of these 2 hormones
Break
Signs, Symptoms & Risk Factors
Hot Flashing (HF)
(HF)
Minor annoyance to intense unpleasant sensation
Hypothalamus regulates temperature, moderated by oestrogen
Body dissipates heat by vasodilatation (opening up blood vessels) causing sensation of a HF
external stiumli – anxiety, stress, ambient high temperature, coffee, alcohol
Body composition, less fat mass increases intensity
Adrenaline often follows a HF
Weight Gain
Fat cells produce oestrogen – body works harder to convert calories to fat to increase oestrogen levels
Water weight & bloating from decreased progesterone
Decrease in testosterone – fewer calories converted to lean muscle mass therefore lowering metabolism
Fat conversion increases insulin resistance
Underactive thyroid
Weight Gain Management
Seriously....Reduce Your Stress!
Adrenaline & cortisol
Competition for progesterone binding sites
Calcium released – elevates heart rate
Blood sugar - hyperglycaemia
Elevated Insulin
Increased fat storage abdominally
Insulin resistance, hardening of the arteries, arthritis, osteoporosis, CVD
Memory loss ‘Brain Freeze’
Trouble remembering names
Fuzzy thinking
Forgetfulness
Difficult concentrating
It has now been determined that declining oestrogen is not the cause but the ‘symptoms’ of menopause are; stress, tension, sleeplessness, depression!
Poor sleep
Fluctuating hormones rather than depletion cause sleeplessness
Oestrogen enhances 2 brain neurotransmitters (GABA & Serotonin) – sleeping pills and prozac both effect these neurotransmitters
Heat (HF) – adrenaline
Anxiety & Depression
Neurotransmitter serotonin, boosts mood and reduces anxiety
Loss of libido
Psychological, physical, relational, hormonal?
Oestrogen, increases sensation, lubrication & health of vaginal tissue (vaginitis)
Reduced testosterone
Irregular periods, fatigue, vaginal dryness
Headaches
Oestrogen excess – suppresses enzyme which breaks down ‘amines (one amino acid)’ eg; serotonin & adrenaline
Amines are potent constrictors of blood vessels – causing headache & migraine
Avoid amine foods eg; cheese, wine, chocolate, dairy, soy sauce
Osteoporosis (the ‘silent’ disorder)
is not a calcium deficiency disorder
It is a disorder where calcium is lost from the bone
When oestrogen declines – menopausal bone loss occurs & can be accelerated
Progesterone is the bone builder
Cortisol chronically elevated contributes to bone loss
Thyroid hormone & testosterone also affect bone loss
Staying Hormonally Healthy
Adrenals, Thyroid, Gut
A healthy digestive tract essential for hormonal balance
Hormones are made from the food that you eat (protein!)
Gut produces many hormones that help you digest & absorb essential nutrients required to make other hormones
Straining digestive system reduces body’s ability to cleanse itself of toxins
Food allergies/intollerances
Fibre – increases SHBG & FOS
Adrenals, Thyroid, Gut
Oestrogen dominance affects thyroid function
Food allergies/intollerances
Thyroid hormones are made from:
Amino acid tyrosine, converted to thyroxine then into T3 & T4
This is dependent on enzymes requiring zinc (at least 10mg daily) & selenium (at least 35 mcg daily)
Iodine (eg; kelp)
Minimise stress & stimulants (caffeine & nicotine)
Chromium as stress hormones compete with thyroxine
Adrenals, thyroid, Gut
In menopause produce oestrogen & progesterone to correct imbalance
Vitamin C
B5 (pantothenic acid) – converts choline (found is fish & eggs) into neurotransmitter acetylcholine = sex drive & vaginal lubrication
Magnesium
chromium
Bio-identical hormone replacement
Derived from natural sources – soya or wild yam (phytoestrogens)
Converted in lab to exactly the same structure as the body would have made (natural or bio-identical)
Delivery method is important –pill (converted in the liver), patch, vaginal gels, creams (absorbed into the blood stream)
Liver involvement can increase proteins assoicated with CVD – CRP, clotting factors
HRT – synthetic hormones
Ratios of oestriol (90% weakest form & most abundant pre-menopause), oestradiol (7% most potent), oestrone (3%) – in HRT proportions are nothing as above
Oestrone most abundant, then oestradiol then horse oestrogens
Oestradiol acts more like testosterone
Soy based gels can assist with problems of vaginal dryness & sex drive by helping to top us testosterone
Patent’s & $$$$$
Natural substances cannot be patented
Natural substances slightly changed can be patented
Not profitable for a pharmaceutical company to produce eg; progestrone as cannot be patented
Side effects are produced from alterations to natural substances eg; herbal medicine
Medical Testing
Fasting Homocysteine
Hormonal assay (profile)
Fasting lipids (cholesterol)
HS CRP (inflammation CVD)
Thyroid function
Liver function
Balance your hormones naturally with diet & lifestyle
Basic Principles- second rate fuel gives a second rate performance!
Reduce the amount of diary foods & red meat.
This reduces saturated fat intake & keeps oestrogen lower
Eat foods not exposed to pesticide residues (peel or organic fruit & vegetables)
Include regular intake of white fish for essential fatty acids
Cook from fresh and choose simple, nutrient rich foods
Cook with minimal amts of butter, coconut oil or olive oil
Eat a variety of vegetables, nuts, seeds, berries, fresh fruit, pulses, root vegetables
Learn how to use protein rich vegetarian sources eg; quinoa, beans & lentils
Fibre! 20-30 grams daily
for hormonal balance
Avoid alcohol, smoking refined carbohydrates, sugar and confectionery
Limit caffeine and avoid after 3pm if possible
Expand your range of foods & cooking methods
Minimise intake of burned, fried or BBQ foods
Minimise or avoid where possible intake of hydrogenated fats
1-2 litres of fluid daily
Include herbs & spices to foods
Salt minimally
Eat low – mod GI foods
Adequate protein (1 gram per kg body weight)
Sample Menu-Bfast
Glass water with lemon or lime on rising
Bfast-1-2 eggs (poached or scrambled)
1 slice rye or wholemeal toast/nut butter
Portion fresh fruit
Or..
Protein shake on the run (power packed!)
Or..
Low GI cereal & low fat yoghurt, bircher muesli xtra flaxseeds
Sample Menu – snacks x 2
Handful nuts with pc of fruit or pc raw vegetable
Mug green tea, herbal tea or coffee alternative
25g cheese
Low fat pottle yoghurt
200ml smoothie
2 rice crackers with nut butter
Nut/seed bar or protein ball
Sample menu - lunch
Portion of lean meat & Salad or vegetables
Cottage cheese
Tuna Salad / wrap
Small portion ¼ c of rice (basmati or brown)
Mixed legume soup
Sample menu - dinner
Palm of hand lean meat portion ¼ plate
2-3 cups low GI vegetables ½ plate
Starch or higher GI portion ¼ plate eg; rice, pasta, root vegetables
Stirfry lean meat / tofu + vegetables
20ml oil daily on salad or vegetables
1 standard glass (10g alcohol) red wine
Sample menu - evening
Hot or cold cherry juice
Green tea
2 squares high cacao chocolate
Low fat yoghurt & protein powder
Fruit portion with nut cream (eg; cashew cream)
Specific Supplementation
Vitamins, Minerals & EFA’s
Zinc, B6, B12 & folic acid, magnesium – enzymes / hormone production
Essential fatty acids – fish oils, black currant oil, evening primrose oil – down regulates inflammation & looks after cellular health
Vitamin E – reduces intensity of HF
Digestive enzymes & gut support – digestive health fundamental for hormonal balance
Chromium – blood sugar balancing
Multi vitamin/mineral for women over 40 – nutritional gaps & bone health
Herbal medicine
Dong quai, Black cohosh, Wild yam, Fennel – all have progesterone enhancing effects
Black cohosh – reduces HF, sweating, insomnia, anxiety
Dong quai – reduces HF
St Johns wort – SSRI inhibitor for mood, anxiety & mild depression
Vitex agnus castus – elevates progesterone
Ginseng & liquorice – powerful adaptogens
Liquorice – phytoestrogen & adrenal support
Phytoestrogens – beans, lentils, soy, fennel, linseeds, peas, hops, red clover
Break
Exercise Prescription
Significant Benefits
Weight management
Mood
Concentration
Sleep
memory
Weight bearing (bones & muscles) & resistance exercise (body weight or objects to create resistance) – two main forms of exercise that boost health of bones – prevention is vital
Resistance 2 x per week
Cardiovascular 2 x per week
Stretching / yoga / pilates 1 x per week
Summary
Eat good sources of phytoestrogens every day incl; beans, soy products such as miso, tempeh, tamari.
Up intake of anti-aging antioxidants by eating lots of bright coloured fruits & vegetables
Balance blood sugar by eating low GL diet and supplementing with chromium 200mcg in the morning
Take a high strength multivitamin with additional vitamin C (1-2 grams) containing also berry extracts & EFA – omega 3 & 6
Check homocysteine levels
Consider natural or bio-identical hormones
Try herbs; Black cohosh, Dong quai, St johns wort if you are prone to depression / anxiety
Get fit with frequent weight bearing & resistant exercise
Learn ‘belly breathing’, learn yoga or pilates
Your hormonal profile is unique
menopause is not a disease that needs to be cured-it is a natural life stage, and every woman ought to choose her own mix of options for coping with symptoms.
Its not all about us!!!