Don’t Know Much About Menopause? You’re Not Alone

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
May 3, 2021
Don’t Know Much About Menopause? You’re Not Alone

Many women chalk up menopause to be simply being the end of their monthly cycles. And while this is true, there’s a lot more involved.

For example, most women don’t know that starting their period at a young age can lead to an earlier menopause, according to MDVIP’s Women’s Health Study. The average age of menopause is only 51 – many women experience it in their 40s. Being a smoker or having a chronic illness can speed up the timeline.

Read on to answer your questions about menopause.

What is menopause?

Menopause is the ending of a monthly period. It’s defined as going at least 12 months without a cycle and is the result of the ovaries no longer producing estrogen. Although you can no longer get pregnant, you can still contract a sexually transmitted infection. If you’re sexually active, but not in a monogamous relationship, protect yourself by wearing a female condom or having your partner wear a male condom.

When should menopause occur?

Typically, menopause occurs in your 40s and 50s, with the average age in the United States being 51. But underlying health conditions and poor lifestyle habits can cause a menopause to occur at an earlier age. One percent of American women experience premature menopause, defined as menopause before age 40. 

Here are some of the common causes of premature menopause, according to Cleveland Clinic:

  • Having surgery to remove ovaries or uterus
  • Having cancer treatments, i.e., chemotherapy or radiation to the gynecological area
  • Having a family history of premature menopause
  • Having a personal history of autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease
  • Having a personal history of viral infections such as HIV and mumps
  • Smoking
  • Having a chromosomal abnormality such as Fragile X or Turner’s syndrome 

Although only a small percentage of middle age women struggle with an eating disorder, it’s also worth mentioning that anorexia nervosa, bulimia nervosa can lead to irregular periods, even amenorrhea – the absence of a menstrual cycle for three or more months during childbearing years. These disorders seem to affect the hormones involved in menstrual cycles.

What is perimenopause?

It takes years for your body to transition to menopause. This phase referred to as perimenopause and it usually begins in your early forties, although some women report changes such as irregular menstrual cycles as early as mid-thirties. 

During perimenopause, ovarian estrogen production begins to wane, causing estrogen levels to fluctuate and variances in monthly menstrual cycle. For example, you may find your cycles longer or shorter than usual. Or maybe you don’t ovulate every month. You also can experience symptoms such as painful intercourse, increased urinary tract infections, irregular menstrual cycles, mood swings, insomnia, hair thinning, weight gain, irritability, headaches, depression, fatigue, difficulty focusing and of course, hot flashes.

Remember, you can still get pregnant during perimenopause. If you’re sexually active, continue using birth control to prevent unwanted pregnancies. 

Which health conditions am I at higher risk for now that I’m postmenopausal?

Estrogen provides women with protection from a handful of diseases. As estrogen levels lower, your risks for the following conditions can rise.

Cardiovascular disease – becomes more of a risk because as estrogen drops, blood vessels lose their flexibility, potentially raising blood pressure. It’s also common for heart rate to increase, leading to an atrial fibrillation. Good cholesterol often lowers and bad cholesterol and triglycerides rise. Any one of these factors – hypertension, atrial fibrillation and high cholesterol raise for a heart attack or stroke.

Type 2 Diabetes – can be an issue for women going through perimenopause. Estrogen enhances insulin activity, so when estrogen levels drop, many women notice they’ve become insulin resistant. Insulin is a hormone that escorts blood sugar into cells to be used as energy. When cells, muscles, fat and liver don’t respond to insulin, the blood sugar remains in the blood. When blood sugar levels rise higher than normal range, but not high enough to be considered, it’s prediabetes. If blood sugar continues rising, it can reach the diabetic range. Type 2 diabetes is a serious condition that can lead to poor wound healing, nerve damage, vision problems, kidney disease and cardiovascular disease.

Weight gain – is usually experienced by women going through perimenopause. Genetics, aging, metabolism drops, hormonal shifts and lifestyle all play a role in how much weight is gained. Most women also notice that once they hit middle age, their weight settles in their belly as opposed to their hips. That’s a surefire sign that estrogen levels have dropped. During reproductive years, estrogen directs fat to hips and upper thighs. Once estrogen drops, fat is stored in the belly. Meanwhile, belly fat increases the risk for insulin resistance. This means this weight gain, particularly in the belly, raises the risk for type 2 diabetes and cardiovascular disease.  

Osteoporosis – should be a concern for women as they age. Bone mass peaks around age 30 and then slowly declines. Additionally, there’s a link between low estrogen levels and the development of osteoporosis. 

Is hormone therapy to control perimenopause and post menopause symptoms good idea?
Talk to your doctor about hormones if you’re experiencing extreme hot flashes, night sweats, vaginal dryness, mood swings or hair loss. It also should be considered if you’re high risk for cardiovascular disease, osteoporosis or type 2 diabetes. 

If you’ve had your uterus surgically removed, you could be a candidate for estrogen therapy, which is available in pill, patch, cream, vaginal rings, gel or spray. If you still have your uterus, your doctor may prescribe estrogen progesterone/progestin hormone therapy. Keep in mind that hormonal therapy can raise the risk for certain types of cancer, gallstones and blood clots.

How can I control symptoms of low estrogen naturally?

Some lifestyle changes can help, such as:

Diet – consume food high in plant estrogens such as chickpeas, lentils, flaxseeds and certain fruits and vegetables. For hot flashes, the Cleveland Clinic advises women to avoid caffeine, smoking, spicy foods, alcohol and stress. Wearing tight clothes and spending time outside in hot weather also have been known for triggering hot flashes.  

Exercise – engage in relaxing activities like walking and yoga to ease mood swings without raising cortisol levels. Cortisol is a stress hormone that can interfere with your sleep cycles, intensify insulin resistance and exacerbate belly fat.  

For more information on menopause, consult your primary care physician. Don’t have a doctor? Consider partnering with MDVIP. Find a physician near you and begin your partnership in health »  

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Researchers Link Early-Onset Menopause to a Higher Risk of Type 2 Diabetes / Janet Tiberian, MA, MPH, CHES / September 22, 2017

About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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