Four Articles on Hormones and Menopause

#1   (600 words)

IT’S YOUR HORMONES…

Everything you ever wanted to know about Progesterone

Womens’ ovaries make two hormones – estrogen and progesterone.  An easy way to remember what progesterone does is to break the word down.  Pro (for) gesterone (pregnancy/gestation) – it supports pregnancy.

Progesterone is a progestogen.  Progestogens are a group of hormones which work in a similar way to progesterone – but only progesterone itself is natural.  All the others in this group are synthetic.  If progesterone is taken in the form of a medication by mouth, the liver quickly breaks it down.

In 1934 a synthetic form was created to get round this problem.  There are now over 10 synthetic progesterones available.  The newest is a micronized version.  Micronized means that the progesterone has been broken down into microscopic particles and avoids breakdown by the liver.

What are progestogens used for?

If a woman has a condition which leads to her ovaries failing to work, natural progesterone won’t be made in sufficient quantities.  Progestogens can be given to take their place.  They can also help to treat abnormal bleeding from the uterus, PMS and in conjunction with HRT.  They are probably best known for their use in birth control pills.

The use of progestogens in HRT

Hormone Replacement Therapy (HRT) is recommended for women going through menopause or for those who have suffered damage to their ovaries.  However, it is a controversial issue.  The use of HRT implies that the fall in estrogen during menopause is a deficiency but menopause is a naturally occurring condition.  It may actually be helping to protect the body.

For instance, it is known that estrogen can help the growth of certain breast cancers.  Breast cancer is more prevalent in women around menopause age.  So having a lower amount of estrogen in the bloodstream could be the body’s own protection against breast cancer.

At one time, the media portrayed HRT as a necessary wonder-drug but evidence regarding its true benefits and safety is conflicting.  However, many women have flourished on it.

HRT contains estrogen and if you have not had a hysterectomy (removal of the uterus) it will also contain progesterone. This is because estrogen supplements given on their own can trigger uterine cancer but if a progestogen is given with it, that risk is virtually eliminated.

Estrogen is able to lower the risk of heart disease by increasing HDL (a ‘good’ cholesterol) but synthetic progestogens seem to lower this benefit – with the exception of the new, micronized form.

Progesterone and PMS

Pre Menstrual Syndrome (PMS) can make life a misery.  It is thought that PMS is caused either by a lack of progesterone, the actual drop of progesterone levels or by the fluctuating ratio of progesterone to estrogen.

Both natural and synthetic progesterones can be used in an effort to treat PMS.  Natural progesterone is chemically processed from yams.  It’s given by suppositories (vaginal or rectal) or in the form of an injection.  This is because it won’t absorb if taken by mouth – so avoid any ‘non-prescription’ remedies containing extracts of wild or Mexican yam.  It’s physically impossible for them to work if swallowed.

Progestogens have been regularly prescribed for the treatment of PMS for the last 35 years.  However, the British Medical Association still does not officially recommend them as the majority of studies have not found progesterone to have any meaningful affect.  Nevertheless, many women claim that it has helped them.

Side effects of progestogens

Don’t use if you have ever had blood clots in your legs or liver disease.

Don’t take in pregnancy unless continually monitored by a doctor.

It may also cause bloating, tender breasts, weight gain, headache, moodiness and irregular vaginal bleeding.


#2   (488 words)

THE TIME OF YOUR LIFE…

All About Menopause

In our grandmothers’ time, the menopause was looked on as a natural part of life and women just had to put up with it.  Some women sail through it and notice no symptoms at all and others suffer quite a lot.  Nowadays, there is a lot of help available in the form of hormones, to deal with symptoms that you may experience during perimenopause and menopause.

What’s perimenopause?

This is the time prior to menopause (anything up to several years) when a woman’s monthly cycle begins to become irregular.  She may experience hot flashes, sweats at night, dryness of the vagina and feel emotionally labile.

The perimenopause is what women are really enduring when they say they are going through the menopause.  The medical definition of menopause is when a woman has not had a period for a year.  It usually occurs when a woman is in her late forties or early fifties.  Women who have had their ovaries removed during surgery, for whatever reason, will go into a sudden menopause if hormone replacement is not offered.

At the beginning of perimenopause, some doctors prescribe birth control pills.  These can help to regulate or stop heavy, frequently occurring or unpredictable periods.  They can also help with the unpleasant symptoms and will prevent pregnancy.  Many women think that they won’t conceive as their periods are now so erratic and then find themselves with a new baby!

What is MHT?

Menopausal Hormone Therapy (MHT) is the new name for Hormone Replacement Therapy (HRT).  This is in the form of estrogen.  If you still have a uterus, it will be combined with progesterone.  Estrogen supplements alone can cause cancer of the uterus but the risk is virtually eliminated if a progestogen is given with it.

MHT may help to prevent your bones thinning (osteoporosis) and help with menopause symptoms but they may return if you stop taking it.

Controversy surround MHT as there are risks involved.  Some women may increase their risk of suffering blood clots, heart attacks, strokes, breast cancer and disease of the gall bladder.  If you are considering MHT, talk to your doctor who can help.  It’s recommended that hormones are given in the lowest dose that helps and taken for the shortest time that they are needed.

Five things you should know about MHT

1. It doesn’t prevent heart attacks or strokes.

2. It doesn’t prevent loss of memory or Alzheimer’s disease.

3. It has not been shown to prevent aging, wrinkles or sadly, to increase sex drive.

4. Risks and benefits of hormone pills, patches, creams, gels and rings may all be the same.

5. Herbs and other natural products should be used with caution.  Research the latest studies to see if they may benefit you.  If you are a breast cancer survivor and your tumor was estrogen positive, you mustn’t take anything containing estrogen and that includes plant estrogens.  Take care and read the small print!

 


 

 

#3   (596 words)

LIFE CAN BE SO UNFAIR

All About Early Menopause.

Early or premature menopause is one that occurs before a woman is 40, whether it is natural or induced.  The symptoms are similar to those of natural menopause – hot flashes, sleep problems, feeling emotionally upset, dryness of the vagina and often a loss of interest in sex.  They can range from hardly noticeable to debilitating. Women in premature menopause have an increased risk of bone breakage due to osteoporosis as their bones get start getting thinner earlier.

Let’s look at why premature menopause can happen:

Chromosome defects

Women with Turner’s syndrome have no second X chromosome or they may be born without a part of it.  This means that their ovaries don’t develop properly and the result is a premature menopause.

Genetics

If a percentage of the women in your family have stopped their monthly periods early in life, it’s possible that you may too.

Autoimmune diseases

In autoimmune diseases, like Hashimoto’s Thyroiditis or rheumatoid arthritis the body’s immune system goes haywire.  It’s there to protect the body and fight off disease but it can mistakenly attack instead.  If it attacks the reproductive system it may damage the ovaries and affect the correct production of female hormones.

Surgery

If a woman has surgery to remove both her ovaries (a bilateral oophorectomy) she will immediately go into a menopause.  Her periods will stop and hormone production will plummet.  She may start to experience menopausal symptoms right away.  These women are offered MHT – menopause hormone therapy.

If a woman has a hysterectomy but is left with one or both ovaries, she won’t have a premature menopause as the hormone production can continue.  As there is no longer a uterus, she will not have any more periods and cannot become pregnant.  Rarely, hot flashes may occur but this is due to the blood supply being disturbed during surgery and not to hormones.  These women may have their natural menopause brought forward by a year or two.

Cancer treatments

Some cancer treatments, including some forms of chemotherapy and radiotherapy to the pelvic area may damage the ovaries.  If damage occurs, the woman’s periods may stop, she may have problems with future fertility or become infertile altogether.  This can be immediate or may take several months to occur.

The risks of entering early menopause depend on which type of chemotherapy is given, how much of it was used and how old the woman is when she receives the treatment.  As a general rule, the younger a women is the less likely she is to go into a premature menopause.

How will I know if I’m in premature menopause?

If you’re under the age of 40 and suffering any menopausal symptoms, see your doctor.  In suspected early menopause, blood tests will be needed to make a true diagnosis.

You may be given a blood test that measures follicle-stimulating hormone or FSH.  This is the hormone that ovaries use to make estrogen, so when levels of FSH rise, it indicates that the ovaries are no longer making it.  A higher than normal level of FSH would show that you are in menopause – but as estrogen levels vary from day to day, you may need to have this test repeated more than once for a definite diagnosis.

You may also have blood tests for estradiol (a kind of estrogen) and luetinizing hormone (LH).  When the ovaries fail, estradiol levels go down so a lower than normal level would show that you are in menopause.  Luetinizing hormone triggers ovulation and if levels of it are higher than normal, the diagnosis will be that you’ve gone through menopause.


 

#4  (600 words)

IS IT HOT IN HERE OR IS IT ME?

Helping Menopause Symptoms with Diet

There are any number of supplements and treatments advertised as the answer to a menopausal woman’s prayers.  You could spend a lot of time and money trying them all.  Some do work but the best way to help menopausal symptoms is to eat a balanced diet. 

What Should I Eat?

Try and include something from each food group to get your diet balanced.  Aim to eat grains, carbohydrates, proteins (and protein alternatives), dairy products, fats and a lot of fruit and vegetables.  Try to take it easy on fats, carbohydrates and proteins.

Aim to eat three meals a day – especially if you have been in the habit of skipping breakfast.  Have a small, nutritious snack between meals, to keep your energy levels up.  To keep your weight at a healthy level, check your portion sizes – eat on a smaller plate if it helps!  Have an occasional treat – you’re only human and it will keep you focused on your new eating plan…but keep them occasional!

How you can use food to manage symptoms

You may be experiencing hot flashes, swings in your mood and be putting on weight.  These can all be helped by eating right.  Let’s look at what you can do to help these symptoms. 

Hot Flashes

Along with night sweats, these are probably the menopause symptoms that women hate most.  Waking up several times of night in a pool of sweat is not fun.  Hot flashes can make you feel unwell, be embarrassing at work, make it difficult to get to sleep and can drive you nuts!

Try and identify what triggers your hot flashes.  For many women, these are coffee, tea, alcohol and spicy food.  Try and reduce your intake of these.  Increasing the amount of water you drink can really help.  Aim for at least 8 glasses each day – it’s great for your skin too!

Try to eat foods containing phytoestrogens.  These are plant estrogens that can help a lot of your symptoms.  You’ll find them in beans, legumes, seaweed, yams, apples, potatoes and carrots.  Soy is a high source of them. 

CAUTION: if you are a breast cancer survivor and your tumor was estrogen positive, I’m afraid you’ll have to give the phytoestrogens a miss.  Ironically, tamoxifen given to estrogen positive breast cancer ladies can cause horrible hot flushes.  But anything containing estrogen must be avoided. 

Mood Swings

During menopause, hormones fluctuate and this can cause mood swings and even depression.  People who are depressed often have a low level of serotonin in their brain.  Eating carbohydrates can help to bring up your serotonin levels and ease the depression.  Go for bagels, whole grain breads and cereals.

Weight gain

As estrogen levels go down during the menopause, fat in the body redistributes itself, unfortunately settling around the stomach.  Muscle mass also decreases which slows down your metabolism and can result in your weight going up.  Cut down your fat intake and aim to avoid saturated fats.  Broil and grill food instead of frying and if you do fry, use a little olive oil.  If you are retaining water, drinking water will help to flush out your system and may help to increase your metabolism..

After menopause, women are more at risk from heart disease.  Eat oily fish, rich in Omega-3 to help your circulation.  Reduce saturated fats and swap processed flour for whole grain.

To guard against thinning bones, aim to have between 1200 and 1500mg of calcium each day.  Eat low fat yogurt, cheese, sardines and leafy green vegetables.  Go easy on caffeine as it can prevent the body from properly absorbing calcium.


 

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