The objective of this article is to describe the changes that come as women begin to lose estrogen-usually with age, as well as some suggestions for dealing with these changes.
By: Susan Adams M.Ed.
Summary: Estrogen has been said to be the “glue” that holds women together. As we age, our estrogen levels drop. This can result in mood changes and weight gain as well as bone loss, decreased sex drive, and genital dryness. It is just as important for the men in our lives to understand the changes in our bodies as it is for us to understand them. There are ways to help this situation besides hormone replacement therapy.
For years, hormone replacement therapy was considered routine. In recent years it has come into question. So, what else can women do who are losing estrogen with age or because of other factors?
First of all, what are the signs of estrogen loss, most commonly occurring in menopause? Negative moods effect a large number of women. They report feeling anxious, irritable, impatient and depressed. HRT has been reported to be helpful here. However, many women are reluctant to go this route.
A number of herbal and dietary remedies are touted for their effects on menopausal symptoms. These supplements may help with mood swings but are more linked to hot flashes. The most popular herbal supplement is black cohash.
No one knows why black cohash works, when it does. The long term risks of taking it are not known but, if it acts in the body like estrogen, it may be that long-term use would produce the same health risks as HRT. There are studies in progress to evaluate this.
In general, the problem with herbal remedies is that there is a lack of rigorous study to determine the effectiveness or risk of these herbs. Another problem, is that it is difficult to determine exactly what is in the supplements that consumers
buy. It has been shown that placebos can reduce hot flashes by 30% on average and up to 75% in some women. This would lead us to believe that calm has an effect on hot flashes–the relaxation that comes with taking a placebo and the expectation of improvement.
Other remedies for the hot flashes themselves would include staying cool and avoiding triggers. Spicy foods, hot beverages, caffeine, and alcohol are common triggers to hot flashes.
Relaxing and reducing stress helps. Twice-daily sessions of deep-breathing have been shown to reduce hot flashes by 40%. These sessions can be done morning and night and also when a hot flash is felt to be coming on.
One of the big issues, and disruptors of families, are the mood swings which can come with menopause. Women can become very unpredictable and emotional. The men in their lives often feel desperate with the behavoral changes. Some women get depressed and think that is the fault of their partner–and it may be. Or it may be the change of life that goes undiagnosed and or/untreated.
Anti-depressants may be called for at this time of life to raise mood but also to stabilize it. Of these drugs, Lexapro is thought to have the least side effects.
Bone loss accelerates when estrogen levels drop, particularly within the first five years after menopause. Bone loss can also increase for people who have been on HRT and stop. Therefore, it is important to aim for l500 milligrams of calcium and 400-800 international units of vitamin D per day. Accompany this with weight bearing exercises which include walking, jogging, and stair climbing. Talk to your doctor about a bone density test to determine the health of your bones and if osteoporosis is developing, he can advise you about appropriate medication
There is a relatively new medication on the market that is an injectable. It actually restores bone loss and can be justified if the oral bisphosphonates have not proven effective in retarding the bone loss. This is an important drug to explore as it is the ONLY one that restores the bone.
Genital dryness may be addressed with lubricants and moisturizers. There is an estrogen cream on the market-Estrace- which does contain estrogen but in a different delivery system than the pill and in smaller quantities.
Testosterone in small quantities is often given to women (and men) to increase sex drive. It also comes in a cream to be applies on the skin.
Muscle mass typically declines with age. It declines faster without regular exercise. Changes in hormone levels after menopause may accelerate this decline. The rate at which you burn calories (metabolism) may also slow after menopause. Therefore, your weight may increase.
You probably need to eat less–200-400 calories per day less, just to maintain your current weight. Regular exercise is important here. You want to train your muscles with exercises like resistance training. You exercise with an elastic band or weightlifting and tis increases bone strength and improves metabolism since muscle burns three times as many calories as fat.
Overall, maintain a healthy lifestyle. Avoid smoking, keep a healthy weight, eat a nutritious diet (low at, high fiber, and plenty of fresh fruits and vegetables), exercise regularly, and limit alcohol consumption.
I think that the most visible discomfort to menopause is the emotional change that happens to some women and leaves families baffled. It this happens to you, by all means seek help and consider an anti-depressant for your sake and for the sakes of the people who love you.