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What Every Woman Ought to Know about the Menopause

by Penny Crowther(more info)

listed in women's health, originally published in issue 251 - January 2019

Not so long ago ‘The Change’ was a taboo subject. Your Doctor suggested that you put up with it and your family tolerated your erratic moods with a mixture of embarrassment and bewilderment. The menopause and its seemingly inevitable catalogue of unpleasant symptoms wasn’t something that you talked openly about with your friends either. Thankfully, these days there is a lot less secrecy and mystery surrounding the menopause.  But there is still quite a lot of information that you may not be aware of.

Menopause in its literal sense means the last menses or period. It is defined medically as not having had a period for a year. A woman will not actually know she has had the menopause until a year after her last period.  The medical term for what is commonly referred to as the menopause, is in actual fact the peri-menopause, a phase which can last 10 years or more, in which the hormones are fluctuating and symptoms are occurring.

 

Menopause

https://en.wikipedia.org/wiki/File:Symptoms_of_menopause_(vector).svg

 

Hormonal Mayhem

During the peri-menopause, oestrogen production decreases which produces a corresponding drop in progesterone. Periods can stop suddenly, become heavier or lighter or the cycle can shorten or lengthen. The levels of FSH will keep increasing in order to try and stimulate the ovaries to produce oestrogen.

The main symptoms that can be experienced are hot flushes, insomnia, weight gain, reduced libido, mood swings, loss of bone density, vaginal dryness, loss of skin elasticity and tone, dry eyes, headaches and fatigue.

The commonly promoted belief is that the above symptoms are the result of reduced oestrogen levels. If this were true, every woman going through the menopause would experience symptoms but this is not actually the case.

Is The Menopause An Illness?

No, it is definitely not an illness! There is however still a view adopted by some people that it is a disease rather than a natural event. Way back in 1966, Robert O. Wilson, MD published what became a best-selling book, Feminine Forever. He wrote, “Many physicians simply refuse to recognize menopause for what it is – a serious, painful, and often crippling disease.”

He was an ardent promoter of HRT (hormone replacement therapy now more often known as HT or hormone therapy) and his influential writing reinforced the idea that menopause is a disease that needs to be ‘cured’ by supplying hormones. Women were prescribed HRT in their millions. Then in the 90s HRT lost its reputation as a panacea for menopausal symptoms when trials had to be halted as it was found that the women taking the hormones were more likely to suffer strokes, heart disease and breast cancer. Other reported side effects are hair loss, depression and weight gain. Nowadays GPs are more reluctant to prescribe HT although there are still a large number of women currently taking it. Faced with uncomfortable symptoms it’s understandable that some women choose what seems like an easy option, hormone tablets, patches or gels.

What is the Alternative to HRT?

However, you may have weighed up the risks and decided you want an alternative.  A useful starting point is to look at the menopause as a natural transition rather than a deficiency disease. The hormonal flux of the menopause is inevitable but symptoms are not. The focus then shifts to strengthening the body both physically and mentally to build up resilience to the changes taking place in the body.

Diet and nutrition play a very important role in creating this resilience. Blood sugar balance, nutrient insufficiency, antioxidant status, gut health and food intolerances will all have an impact and are just some of the factors to consider and manage.

Crowther 251 The Menopause

Ways to Thrive through the Menopause

1. Eat whole soya foods once per day in the form of, for example, tofu, tempeh, soya beans (edamame) or soya milk made from whole beans (it will state this on the packaging or you can ask the manufacturer). Tamari sauce could also be used as an accompaniment to stir fries and salad dressings and miso (available in powder to make a soup or stock with) is also beneficial.

In Japan, menopausal hot flushes are so rare that there is no traditional word in the Japanese language to describe them. Asian women have a generally low incidence of hormone-related disorders and have one-sixth the rate of breast cancer that we do in the West. This is attributed at least in part to the high soya content of their diet. Soya is rich in plant chemicals called isoflavones which act as weak oestrogens.

In recent years, soya has had some bad press which has led to a lot of confusion about this food. Some of the negative studies used raw soya flour in high amounts for long periods of time, which does not reflect usual consumption of soya. Raw soya contains substances called protease inhibitors which block the digestion of protein but are destroyed by cooking and removed in the soaking fluid of fermented soya products such as tofu and during the making of soya milk. Other common vegetables, if eaten raw, also contain these substances e.g. potatoes.

In addition, confusion has arisen because of failure to distinguish clearly between traditional whole soya foods and processed fractions of soya e.g. concentrates, isolates or single soya isoflavones in large amounts. Many processed food such as TVP (textured vegetable protein used to make mock meat products) and some baby foods, contain the isolate and this is far removed from the original soya bean, the traditional food of China and Japan.

The following foods are also sources of phyto oestrogen, in lesser amounts than in soya; apples, cherries, plums, olives, tomatoes, coconuts, carrots, yams, celery, aubergines, peppers, wheat germ, brown rice, nuts, fennel and liquorice.

2. Milled flaxseeds should definitely be a daily addition to the diet as they contain lignans which are converted by gut microbes into substances similar in structure to oestrogen.

3. Take an oestrogen metabolism test
Oestrogen is broken down into different types of metabolites, some of which are beneficial (the 2 series) and others (the 16 series) are pro-breast cancer. Check to see that you are not making too much of the harmful oestrogen. If you are, there are things you can do to stop this.

4. Osteoporosis Prevention
Protect your bones. See my previous article on osteoporosis here

5. Stress Reduction
It is also very important to address causes of persistent stress in your life as stress has a known effect on hormone balance. For example, one of the stress hormones cortisol, produced by your adrenal glands interferes with the way progesterone is used by your body. So the more you can do to relax, the better whether, it be meditation or deep breathing, taking a stroll or listening to music. Exercise is also a good way of ridding the body of excess stress hormones. Yoga is particularly beneficial for relaxing both mind and body.

6. Keep Active!
Any activity which encourages sweating is very beneficial since this will allow toxins to be expelled and will also give your glands a workout. Exercise also increases flow of blood and oxygen which can boost energy levels and metabolism. Another benefit is that exercise is a good outlet for stress which unbalances the hormonal system.

7. Book a one to one hormone supporting, personalised nutrition, diet and supplement programme, with a registered nutritional therapist, tailored to your particular needs. There is no “one size fits all” diet, it will be unique to your individual requirements.

As with most major life turning points, ‘The Change’ can be a very positive event.  Women are recognising that this time of hormonal flux a can be an opportunity to re-evaluate their lives and re-define themselves as women. In the words of health guru, Leslie Kenton, the menopause is a “passage to power” when the more mature woman begins to value the strength and wisdom that comes in later life. With life expectancy now at an all-time high, many women have 30 or more years of living to do after the menopause. All the more reason to make it a positive experience!

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About Penny Crowther

Penny Crowther DN Med BANT NTCC qualified as a nutritional therapist in 1997 and has seen hundreds of clients at her practices in SW15. She has written for Positive Health, Families, Green Farm, Health Matters, The Health Times and contributed to articles for the Daily Telegraph, The Times Literary supplement, Pregnancy & Birth, Marie Claire, has been featured in the Daily Express, Daily Mirror and on local radio. She is a current member of the BANT (British Association for Applied Nutrition and Nutritional Therapy) and formerly sat on their ethics committee.

Experienced London nutritionist Penny Crowther has been in clinical practice for 20 years. Penny has been featured in the national press (including the Daily Express and the Daily Mirror) for her work with nutrition for fertility and is the author of many nutrition articles. The food you eat affects every cell and system in your body. It optimises how you look and feel. The right nutrition can make the difference between feeling just "okay" and feeling in top form, both mentally and physically. We are constantly being advised to eat a “balanced diet” and many people think they are following one. Most of us know the basics of healthy eating but very few people actually eat a truly healthy diet containing optimal levels of nutrients. The main problem is that the concept of a “balanced diet” is too vague and unspecific. In addition, there is the idea of a “therapeutic diet” which makes use of the latest scientific knowledge to support the management and prevention of various health problems. We are bombarded daily with an unprecedented amount of information on diet and nutrition from many different sources. Whilst useful in some respects, it can be overwhelming and lead to confusion. Would you try to fix your own car? No, most people would take it to a mechanic. Many people have found that the most effective approach is to receive an individually tailored wellness plan to fit their particular health picture

Penny’s approach to health is holistic, and takes into account emotional, mental and environmental factors as well as nutrition. She studied many complementary therapies before training as a nutritionist which provides a broad foundation of knowledge. She is dedicated to personal and professional development and frequently attends lectures and seminars to keep up to date with the latest scientific nutrition research. Penny may be contacted on Tel: 07761 768 754;   penny@nutritionistlondon.co.uk   www.nutritionistlondon.co.uk

Please note that nutritional advice is not a substitute for medical advice and treatment or visiting your GP or Health Professional.

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