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October 13, 2021

Menopause Part 1: A Quick Overview of a Slow Process

Welcome to the ODX Menopause Series. In this series of posts, the ODX Research team dives into Menopause with an exploration of the biology and physiology, laboratory evaluation, diet and nutritional intervention, and a discussion on HRT and bioidentical hormone therapy.

The ODX Menopause Series

  1. Menopause Part 1: A Quick Overview of a Slow Process
  2. Menopause Part 2: Biology and Physiology of Menopause
  3. Menopause Part 3: Increased Risk of Disease Associated with Menopause
  4. Menopause Part 4: Identifying Menopause: Signs and Symptoms
  5. Menopause Part 5: Laboratory Evaluation of Menopause
  6. Menopause Part 6: Cardiovascular Risk in Menopause
  7. Menopause Part 7: Beyond Hormone Testing in Menopause
  8. Menopause Part 8: Natural Approaches to Menopause
  9. Menopause Part 9: Diet and Nutrition Intervention in Menopause
  10. Menopause Part 10: Characteristic of Herbal Derivatives used to Alleviate Menopause Symptoms
  11. Menopause Part 11: Lifestyle Approaches to Menopause
  12. Menopause Part 12: The National Institute on Aging Addresses Hot Flashes
  13. Menopause Part 13: Hormone Replacement Therapy (HRT) in Menopause
  14. Menopause Part 14: North American and European Guidelines for Hormonal Management of Menopause
  15. Menopause Part 15: Bioidentical Hormone Therapy
  16. Menopause Part 16: Optimal Takeaways for Menopause
  17. Optimal The Podcast - Episode 10

An expected 1.1 billion women will be considered postmenopausal by the year 2025.[1] The inevitable physiological phenomenon of menopause can be unpleasant and intolerable for some women. Fortunately, there are actions and interventions that can help minimize its adverse effects.

Alterations in hormone levels can contribute to disruptive symptoms including vasomotor changes, hot flashes, headaches, poor sleep, depression, and weight gain. Biochemical and physiological changes occur as well and can include dyslipidemia and impaired glucose tolerance.

Hormone levels can be monitored during the perimenopausal period to help identify the stages of menopause, including estrogen, progesterone, testosterone, AMH, FSH, LH, and DHEA.

Biomarkers of chronic disease should also be assessed in perimenopause due to an associated increased risk of cardiovascular and metabolic disorders. Trends toward dysfunction should be identified and addressed early in order to practice prevention instead of deflection.

Menopause is actually a full stop, not a pause.

It is the cessation of menstruation in women that can occur at 40 to 60 years of age, though it usually occurs between 45 and 52. More than 80% of women will experience disruptive symptoms that can last for 15 years or more.[2]

Menopause itself reflects a change in complex interactions involving the ovarian, pituitary, and hypothalamic hormones that regulate cyclic menstruation.[3] A women can no longer become pregnant once menopause has occurred.

Menstrual irregularities can begin within 2-10 years of menopause in a phase called perimenopause. Alterations in the cyclical nature of circulating hormones, releasing hormones, and peptides facilitate “the change.” The reduction in hormone production at this time may increase the ratio of estrogen to progesterone which can increase risk of uterine cancer.[4] Melatonin levels were also found to decline from premenopause to postmenopause.[5] [6]

Symptoms of menopause may be mild for some but intolerable for others. Lifestyle changes and natural approaches may resolve menopausal symptoms. However, for some women, hormone replacement therapy may be advised.

References

[1] Stute, Petra et al. “A model of care for healthy menopause and ageing: EMAS position statement.” Maturitas vol. 92 (2016): 1-6. doi:10.1016/j.maturitas.2016.06.018

[2] Johnson, Alisa et al. “Complementary and Alternative Medicine for Menopause.” Journal of evidence-based integrative medicine vol. 24 (2019): 2515690X19829380. doi:10.1177/2515690X19829380

[3] Hale, Georgina E et al. “The perimenopausal woman: endocrinology and management.” The Journal of steroid biochemistry and molecular biology vol. 142 (2014): 121-31. doi:10.1016/j.jsbmb.2013.08.015

[4] Honour, John W. “Biochemistry of the menopause.” Annals of clinical biochemistry vol. 55,1 (2018): 18-33. doi:10.1177/0004563217739930

[5] Greendale, Gail A et al. “Melatonin Patterns and Levels During the Human Menstrual Cycle and After Menopause.” Journal of the Endocrine Society vol. 4,11 bvaa115. 27 Aug. 2020, doi:10.1210/jendso/bvaa115

[6] Laudisio, Daniela et al. “A practical nutritional guide for the management of sleep disturbances in menopause.” International journal of food sciences and nutrition, 1-15. 30 Nov. 2020, doi:10.1080/09637486.2020.1851658

 

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