Perimenopause means “around menopause”. This refers to the 2-12 year period prior to menopause occurring. This is a time of fluctuating oestrogen levels, where your period begins to change. It is not uncommon for many women to experience a wide range of symptoms and mental disturbances during this time including hot flushes, sleep disruption and night sweats. The normal age range for menopause is between 45 to 55 years of age, with the average age being 50 years. You have officially entered menopause when you have not had a period for one year. After this time, you are in postmenopause.
Is it getting hot in here or is it just me? Despite popular belief, if a woman is experiencing a hot flush, she is not actually hotter than an unaffected woman, it is simply the brain perceiving itself to be hotter and is performing a cooling response.
The hypothalamus sets a temperature range that allows variations in temperature without executing a shiver or cooling response to warm or cool the body, known as the thermoneutral zone. In menopause, there is a narrowing of this zone. This means that a slight variation in temperature may induce a flushing response, as the hypothalamus perceives the body to be too hot. This narrowing is partially due to the decline of oestrogen.
Cognitive function is a well-recognised part of ageing, and it is seen to differing degrees in postmenopausal women. This decline in function is thought to be driven by the decrease in sex hormone levels after menopause, as oestrogen has been shown to have neuroprotective effects. Changes in thyroid function have also been associated with a decline in cognitive function. At Nurtura Health, our dedicated Naturopaths will perform a comprehensive assessment for each individual person to assess any underlying causes along with the presenting symptoms.
There are numerous studies showing an association between thyroid function and an increased risk of bone fractures, depression, cardiovascular disease and earlier mortality. The link between menopause and thyroid function is not one directional. Menopause has been associated with coexistingchanges in thyroid function, particularly a higher incidence of autoimmune-related thyroid disease. Postmenopausal women actually have the highest rate of thyroid disease, including hypothyroidism, nodular goitre and cancer. Our Naturopaths will monitor and support your thyroid function during and after menopause.
Other factors to consider during menopause include the impact on gut microbiome, cardiometabolic health, weight loss to reduce hot flushes, and oestrogen lifting herbs. Low oestrogen states such as those during menopause, may have an impact on the gut microbiome and this may potentially be the cause of negative health outcomes such as increased weight gain, insulin resistance, type 2 diabetes, increased inflammatory states, autoimmunity, and reduced bone density. Hormonal and metabolic changes that occur in women as they age may easily lead to weight gain. Many women find it harder to lose weight as they get older. The increased weight gain in menopausal women also increases their risk for cardiovascular disease, along with the accumulation of abdominal fat linking to the above mentioned conditions. Recent studies have found that women with higher body fat tend to experience more hot flushes than lean women. In addition, gaining fat during the menopause transition is linked to an exacerbating of flushing. Women who lost weight experienced a greater reduction in flushes than those who didn’t lose weight. Although weight loss results in a reduction of oestrogen, it also improves the other factor that influences the thermoneutral zone – the sympathetic drive.
In order to assist women through the menopausal transition, we need to do more than simply raise oestrogen levels. For best clinical results, we need to consider intracrinology, Hypothalamic-Pituitary-Adrenal (HPA) function, along with the role of the nervous system in the narrowed thermoneutral zone. At Nurtura Health, we will assess you as a whole and take into consideration your diet and other lifestyle factors. Stress reduction techniques, exercise and fat loss may all play a role in managing menopausal symptoms.
Watch this space for future posts on Women’s Health including Fertility.Disclaimer: The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided. Nurtura Health actively discourages any self-diagnosis or self-medication. Please consult your health practitioner regarding these important health issues. All rights reserved.