By Rawya El Gammal
Our mothers never spoke to us about our body’s life changes, and their mothers were less informed and probably never did either. In all honesty, the lifespan of our grandmothers didn’t extend as it does today, and they may not have spent 40% of their lives in menopause as women do today.
Scroll through the internet, talk to doctors and healthcare providers, and they refer to it as a dysfunction, a diagnosis with symptoms, or pure aging. Meanwhile, other cultures refer to it as the end of the reproductive years and the beginning of the self-nourishment phase.
Perimenopause is the phase before the cessation of the menstrual cycle. It can begin as early as the mid 30’s to early 50’s, lasting 4–8 years, with hormonal fluctuations, a phase where women are often misdiagnosed by healthcare providers across the board.
Menopause comes with many overlapping symptoms. The most common are sleep disorders, bone density decline, changes in body composition, brain fog, cognitive stress, mood swings and depression among other things, very often going unnoticed in the heat of a stressful life. Then some start struggling with hot flashes, which are the clearest indicator to doctors and women that the body is in transition. Not all women experience hot flashes, but 80% do, and for those who do, it is often the most unbearable phase of all. Sensitivity to changes in climate, whether hot or cold, leads to sweat cycles lasting 5–10 minutes almost as if they were in a furnace. This disrupts sleep, which in turn disrupts daily life. Lack of sleep creates more stress, and the hormonal pendulum creates more anxiety, raising cortisol levels, increasing weight, and continuing the cycle.
Suddenly, women have less energy to exercise or do daily chores. Muscle mass, already in decline due to aging, decreases faster, creating joint and mobility issues. The more physical stressors they endure, the more the nervous system kicks into fight-or-flight mode. If the cycle of heightened stress doesn’t return to baseline, the body cannot recalibrate, and the baseline shift is at that stressed level.
Cortisol is a normal hormone that circulates the body, produced by the adrenals, and known as the stress hormone.
Too much stress from fluctuating hormones as well as external stressors such as empty nesters, work/career stress, or adjusting to aging or caring for ill family members increases the level of cortisol circulating the body, creating metabolic changes, increasing the risk of raised blood sugar and blood pressure, depression, cardiovascular disease, and early mortality.
Appetite changes during menopause leading to weight gain due to the decline in estrogen which increases ghrelin (the hunger-stimulating hormone) and decreases leptin (the satiety hormone). In a normal functioning body, estrogen mimics leptin and keeps hunger pangs in check. The reduction of estrogen also decreases gut bacteria, leaving women feeling more bloated, depressed, while poor sleep further affects gut health.
Women often complain of belly and hip weight gain. As estrogen requires fat, the body layers on fat is an attempt to make forms of estrogen by converting cholesterol into estrone(post menopause), a weaker form of estrogen. Some belly fat is necessary at this phase of life, but the quality and quantity can create health risks. If it weren’t necessary, women wouldn’t go through this process as a default.
As almost every woman in her 50’s (and some with premature menopause) go through this same cycle, perhaps there is a way to change the conversation. Why look at menopause as a diagnosis or a terrible phase, rather than embracing the change and preparing for it?
As menopause is a catabolic process (a breakdown process), it is important to welcome it with small changes and celebrate the freedom. I stress ‘small’, as changing your lifestyle is not going to happen overnight. One way is to tackle it with good nutrition, stress reduction and breathing exercises.
Meet those changes with a stimulating, varied diet, and start your day with protein. It doesn’t need to be animal protein if you are vegetarian or vegan. Do the necessary blood work, identify deficiencies, and address them slowly one at a time, not all at once. Menopause is gradual, and your changes should be, too.
We know menopause causes muscle mass and power loss, and that bone density is affected. If you have never exercised, a short walk is a good starting point. If you used to exercise, jumping back into high impact training is not the way to go as that raises the cortisol level. Remember, your body is already under stress. Walk for 40 minutes a day, add some weights for strength, work out with a trainer, or reach out to a menopause informed trainer to help you build muscle, calibrate your cardiovascular health, and adapt to both good and difficult days.
Then comes the most important adaptation: sleep. Apart from caffeine in daily drinks which can last up to 20 hours in the system look at any supplements or medications you take, as they may also contain caffeine. You may want to choose when to take them. And finally make your bedroom a sleep sanctuary.
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Rawya El Gammal is an Integrative Sports therapist, Rehabilitation, Menopause Health & Fitness Specialist, Lifestyle medicine, Sleep, Nutrition & Wellness
Sports & Complementary Therapy 