Recently, the Magazine published my first article on menopause, my personal journey since my symptoms appeared at the age of 63. Since then, I stopped the Semaglutide shots for a month, gained two pounds (1 kg.), went back on a low dose for a month, and then went off again. So far, so good.
Since stopping again, I’ve only had a small increase in my weight, but it was probably because I began eating carbs, something my body isn’t used to.
For this article, I turned to my sister-in-law, Pam Shipley, who herself ran into the “wall” of menopause at 48. She gained weight while eating healthy and running her usual five miles (8 km.) a day. She experienced night sweats, hot flashes, and was up for hours every night – making her absolutely exhausted the next day at work.
When she went to her physician, she was prescribed antidepressants. Really? Well, being a smart, educated woman, Pam looked for better answers. Thus began her journey into the field of menopause and midlife – leading her to help dozens of women through her podcasts and blogs on her site wearemorethanmenopause.com.
Excited that I had access to someone with a huge amount of knowledge, she shared much of the following information with me.
The role of hormones in menopause
Many women are not even aware of their body changes with the onset of perimenopause. If we don’t have symptoms such as weight gain, which I experienced, in addition to incontinence, sleep disorders, anxiety, stress, depression, body aches, brain fog, skin changes, hair thinning, headaches, hot flashes, and more (what a mouthful!), then we often don’t know that there is anything wrong. Even though we have all heard of the “midlife crisis,” we don’t always know what that means, how it comes about, and what to do about it.
As it turns out, as I mentioned in my previous article, hormones are usually the culprit. Low estrogen levels can cause headaches, vaginal dryness and atrophy, lack of sex drive, and more. It can also cause a lack of bladder control, as well as urinary tract infections.
In addition, as we get older our bones begin to deteriorate. A fall can result in a broken hip, as I have seen in many women I know; and, of course, other issues. I only found out recently the importance of measuring my bone density. Unfortunately, the wait for an appointment can be long in Israel, but it’s absolutely worth the wait. Osteoporosis is far too common in women. Knowing our bone health gives us the information we need to avoid this daunting condition.
I also learned that estrogen benefits the heart and helps to prevent heart attacks. As Pam explained, “It acts like olive oil for your arteries” by allowing the blood vessels to relax and expand to improve blood flow and reduce blood pressure.
Next, we discussed testosterone. I’m embarrassed to say I knew virtually nothing about testosterone hormones in women, and that we had them at all! I’ve learned that it’s an essential hormone for both men and women, assisting in healthy libido, mood, muscle and bone health, and cognitive functioning. Testosterone in women is produced in the ovaries and adrenal glands and decreases naturally with the onset of menopause, also leading to fatigue, skin issues, and irregular periods.
Reading online, I found out that androgens are the hormones produced by the ovaries and adrenal glands, with the principal androgen being testosterone. Interestingly, enough testosterone is converted to estradiol (an active form of estrogen). I further read that testosterone levels in women usually peak during our twenties, and by the time we reach menopause our levels shrink to about one-quarter of what they were. It’s important to mention that if women have their ovaries removed, the levels drop significantly.
The final hormone we discussed is progesterone, found in both men and women. In addition to affecting our menstrual cycles, it affects our ability to conceive, often causing miscarriages, as well as mood swings, anxiety, depression, headaches, and sleep issues. Add to that bloating, weight gain, and vaginal dryness.
So now what? Well, whereas hormone replacement therapy (HRT) is not necessarily for everyone, it is up to us to research to see if it might assist us in a healthy lifestyle during perimenopause, menopause, and postmenopause. The biggest benefits from HRT aren’t just from the reduction of the symptoms we experience that disrupt our daily lives (hot flashes, dryness, weight gain, brain fog, and so on), but rather the benefits come in ways we cannot see.
It is in the protection of our brains, our hearts, and our bones. Each woman needs to discuss the benefits and risks and make decisions that are based on knowledge and education. We need to understand what we have to ask for. The blood tests we should ask for are FSH, LH, and estradiol to evaluate perimenopause or menopause status.
Also, Pam explained that thyroid disorders are common in midlife and can mimic menopausal symptoms. These symptoms may vary depending on whether the thyroid is overactive or underactive. An overactive thyroid (hyperthyroidism) may lead to a fast heart rate, anxiety, and heat intolerance, while an underactive thyroid (hypothyroidism) can cause a slower metabolism, weight gain, intolerance to cold, and depression. With this in mind, it’s important to request a thyroid panel if you think that your thyroid may be the culprit.
As I mentioned in my previous article, experts such as Dr. Mary Claire Haver have a lot to say on the subject. Others, such as Dr. Kelly Casperson, Dr. Vonda Wright, and Dr. Sharon Malone, provide up-to-date information, assisting us in making the right decisions.
While understanding what is happening within our body hormonally, there are obviously other things that we must do to improve our chances for longer, healthier lives. All of us know that exercise is essential for a healthier life. While aerobic exercise is always great, as we approach midlife we need to focus on resistance training, mainly lifting, and, according to some experts, jumping (I haven’t figured that one out yet!). Of course, a healthy diet is essential. We must eat ample amounts of protein, fiber, fruits, and vegetables.
I think it is important that we keep in mind that the average doctor spends 90% of his training learning about men’s issues, and as I mentioned in my last article, “Women are not little men”!
Pam added, “Midlife is a powerful turning point for women and a time to stop minimizing our needs and start advocating for them. Menopause invites us to tune in to our bodies and our lives with honesty and courage. Learning to speak up for what we need in our health, our relationships, and our daily rhythms isn’t selfish; it’s essential for our well-being.”