The Zimmerman File, September 2009, by Marcia Zimmerman, CN. Visit Marcia’s website at www.thenutritionsolution.com.

“The most creative force in the world is the post-menopausal woman with zest!” Margaret Mead

Menopause is a normal, natural event – defined as the “last” menstrual period. So how do you figure out which one is the last? Although hopeful each month that this is indeed the last period, women won’t know for sure until twelve months without periods have passed. This is assuming natural menopause as opposed to that induced by hysterectomy, chemotherapy, or reproductive pathology.1 Despite the seeming abruptness of menopause, it doesn’t happen overnight – just as the first period didn’t magically appear out of the blue. The first clue that things are about to change in a woman’s reproductive life is something called perimenopause.

The median age for the onset of perimenopause is 47.5 years, according to the North American Menopause Society (NAMS).2 Imagine that? There is a “society” just for menopause? Well, menopause is a big deal. This “change of life” period averages four years and by 2025, the World Health Organization (WHO) estimates that 1.1 billion women worldwide will be age 50 or over and menopausal. Forty-six million of this group will be American women who are menopausal either naturally or by surgical means.3,4 So prevalent will menopause be, Dr. Tori Hudson N.D. has called it “boomerpause.”5

Reproductive aging appears to occur rapidly after the third decade of life, proceeding to menopause within the next 10 years. The numbers of oocytes* that are available for release from the ovaries may be down to a few hundred from an estimated 1 to 2 million at birth.6 Thus periods may not be preceded by release of an ovum.

The average woman can expect to spend 1/3 to ½ half of her life post-menopausal. There are various complaints associated with menopause – some of them quite significant – and it is a field ripe with treatment options.

Menopausal Complaints
According to NAMS and the National Institutes of Health, menopausal complaints occur around the ages of 48 – 52 and include7:

• Hot flashes, usually presented as flushing of the face, neck, chest and back
• Insomnia
• Mild to moderate depression
• Joint pain and muscle pain
• Water retention (edema)
• Heart palpitations
• Headaches
• Vaginal dryness
• Increased sweating

Physical changes also accompany menopause:

• Breast size, shape and firmness may change
• Skin tone, thinning, and wrinkling occur due to loss of collagen
• Fat accumulates in the abdomen and hips
• Weight gain may result from slower metabolism
• Bone mass and strength may decrease
• Nervous system changes occur including emotional swings, tiredness, forgetfulness, fuzzy thinking, anxiety, crabbiness, crying, and irritability may occur
• Hair loss or thinning or more hair growth on face

Risk of aging conditions also increases and this includes

• Heart disease, hypertension, and stroke
• Genitourinary tract changes, included vaginal thinning and painful intercourse, lower sex drive, reduced bladder and rectum control, and increased urinary tract infections (UTI)
• Musculoskeletal changes such as osteopenia** and osteoporosis, joint, bone, jaw and muscle aches, increased risk of fracture and decreased height.

Treatment Options
For many years, medical wisdom over what to do with menopausal women included hormone replacement therapy. The view was that something was “lost” at menopause and needed to be replaced. The decision to replace lost estrogen with equine estrogen; (premarin: pregnant mare urine or in combination with synthetic conjugated progestins (progesterone) hinged on whether a woman still had an intact uterus. That’s because estrogen therapy alone was found to increase the risk of uterine cancer.

A bombshell fell in 2002 when it was found that over 160,000 healthy women enrolled in the Women’s Health Initiative (WHI) appeared to have an increased risk of cardiovascular disease, blood clots, stroke and breast cancer with synthetic hormone replacement therapy (HRT). This was particularly true for women who began therapy when they were several years post menopausal. Reducing risk of CVD was thought to be one of the biggest arguments HRT.8 The potential risks of synthetic hormones were known as early as 1976, while the safety and effectiveness of natural hormone therapy has been known sine the 1980s.9 Yet the idea that natural (bioidentical) and synthetic hormones have the same effects is still broadly contested.

Bioidentical hormone replacement therapy is an option for very severe menopausal symptoms. These hormones are exact molecular copies of those manufactured in the human body and they have few, if any, side effects.10 According to medical doctors Schwartz and Holtorf, they are the preferred type of hormone replacement therapy used in Europe. The FDA has approved several brands of bioidentical hormones and this means that they have passed the same evidence for safety and effectiveness as synthetic versions. Opponents would argue that bioidentical are only available through compounding pharmacists, in which case the quality and safety are unknown. This is of course false information.11

Acupuncture for Hot Flushes is an effective way to reduce hot flushes, according to a study published in the May/June 2009 issue of Menopause. Dr. Einar Borud and her colleagues found that hot flash frequency decreased by 5.8 percent per day in acupuncture treated women. They experienced significant improvements in flushing, sleep and other symptoms compared with a control group.12

The Zimmerman File for October: The Wise Woman Emerges: A Life in Balance, Lifestyle Changes will further explore life after menopause.

Be ahead of the game. Attend my webinar of the Rite of Passage and Emergence of the Wise Woman on September 21st; 9 PM EDT, 8 PM CDT, 7 PM MDT, and 6 PM PDT.
https://www.now-university.com/Webinars/index.htm.

*Oocytes are female gametocytes involved in reproduction. They are an immature ovum or egg cell and are part of the ovary development.

**Osteopenia is a condition where bone mineral density is lower than normal.

References:

1  Keshavarz, H.; et al.; “Hysterectomy Surveillance – United States, 1994-1999 MMWR CDC 2002;51:1-8.
2  North American Menopause Society, 2000. 2000-2009 NHIOnDemand, LLC www.nhiondemand.com.
3  Lobo, R.A.; “Menopause Management for the Millennium” Medscape; dec. 13, 2000.
4  U.S. Census Bureau 2000.
5  Hudson, T.; Women’s Encyclopedia of Natural Medicine Lincolnwood, IL Keats Publ. 1998. p. 135.
6  Jeff Busby, Ph.D., Children’s Hospital of Orange County, NEWTON AAS Division of Educational Programs Argonne National Laboratory
7  “Menopause and Menopause Treatments” NIH Office of Women’s Health http://www.womenshealth.gov.
8  Rossow, J.E.; et al.; “Writing Group for the Women’s Health Initiative. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women” JAMA 2002;288:321-33.
9  Schwartz, E.T.; Holtorf, K.; “Hormones in Wellness and Disease Prevention: Common Practices, Current State of the Evidence, and Questions for the Future” Prim Care Clin Office Pract 2008;669-705.
10  Ibid.
11  Ibid.
12  zBorud, E.K.; et al.; “The Acupuncture on Hot Flushes Amopng Menopausal Women (ACUFLASH) Study, a Randomized Controlled Trial” Menopause 2009;16:484-493.