The science of menopause: Beyond myths

Link to the Episode

Anshu Bahanda: So I went through menopause from hell. I put on a lot of weight, about five kilos. I had night sweats. I wasn’t able to sleep at night. Previously, I used to sleep like a baby. Suddenly it all went away. I got insomnia, I had joint pains. You name it and it happened to me. I wrote an article on menopause. We put the link in captions, do look at it. I did lots of different things. I did homoeopathy. I’ve had cupping. I’ve had acupuncture. I’ve just tried to increase, improve my whole lifestyle. I’m exercising more than I’ve ever done in my life. All these things have come together and I think I’m finally coming out the other end feeling a lot stronger and a lot healthier, probably stronger than I was in premenopause.

Welcome to Wellness Curated. This is your host, Anshu Bahanda. And as you know, in this series, we’re getting you the best of Wellness Curated. Today’s topic is something that every single woman goes through— menopause. But before I carry on, can I please request you to subscribe to our channel and to follow our podcast? If you do so, we can get you better and better speakers and keep providing you the service for free. So, back to menopause. Now, menopause is something which you hear a lot of whispers about. I think we need to start this conversation all over the world. Menopause is a natural shift in a woman’s life. It’s not a condition, it’s not a disease, it’s not an ailment. And the run up to menopause is called perimenopause. We did a podcast with Dr Isabelle Bond, who is an endocrinologist based in the UK. Here is a summary of what she says.

Dr Isabelle Bond: The term menopause is a time when a woman, after one year, never had or experienced a period, and that corresponds, biologically speaking, to the rise of the FSH, the follicle-stimulating hormone coming from the hypophysis. And it’s going to rise and achieve a plateau. When that FSH is at a plateau, that’s what we call the menopause.

AB: We have talked about menopause in many, many episodes. Today we’re going to discuss the science behind menopause and how it affects women. And here is a clip for you from one of our episodes. So now tell me what happens to women emotionally. You were talking about how it affects their brain. 

Dr IB: Women have receptors to oestrogen, to nearly every part of their body, but specifically in the brain, we have receptors to oestrogen in the hypophysis, hypothalamus, amygdala and hippocampus. There’s a place in the brain that has a big impact on emotion. And they’re also the place where you have the dopamine, the serotonin, and the GABA secretion. When they diminish, they’re going to have less of an impact on these cells, on the neurons, and these neurons are going to be less produced. So serotonin is related to happiness. So we are going to have a diminishing serotonin. So women are going to feel more depressed. The other neurotransmitter which is affected is dopamine. So the dopamine is the decision making neurotransmitter. It’s a working memory. The other neurotransmitter which is affected a little bit more specifically from the progesterone is GABA. If you have a diminution of GABA, the woman is going to start to have anxiety, palpitation and feel really unwell. 

AB: What about night sweats and sleeplessness?

Dr IB: Night sweats are part of the FSH rising progressively to a plateau. I’m not sure we understand what the system or the connection is. Lack of sleep or the difficulty sleeping is due to the diminution of the progesterone. So as it diminishes, for sure the sleep is going to be not as good, and you have the GABA diminishing. Waking up about 3:00-04:00 in the morning with anxiety, not sleeping, not able to return to sleep— that’s all related to the progesterone gently diminishing.

AB: Dr Isabelle also, talk to me about sexual desire in women when they’re going through menopause and after.

Dr IB: The hormones, the secretion of the oestrogen is diminishing, as I mentioned earlier, it creates dryness. So that is drying, because the steroid, the oestrogen and the progesterone are giving like a bed of nutrition for this biofilm to be very healthy and moist. So the vagina is going to start to dry and diminish also anatomically. So intercourse is going to become painful or sometimes not possible. 

AB: So the decline in oestrogen levels doesn’t just affect our reproductive system, it affects our brain as well. You know, when you hear about people saying, I’m going through brain fog, that’s actually a thing. Oestrogen is like a superhero in our bodies. It regulates body temperature, it regulates mood swings and also cognitive functions. So as oestrogen levels go down, many women experience things like memory lapse, difficulty concentrating, mood swings, etcetera. What can you actually do about it? Here is what the UK and US based osteopath Katrine Cakuls had to say about it. 

Katrine Cakuls: So let’s start with something that Professor Andrew Huberman speaks about. He’s another neuroscientist at Stanford and I like the way that he presented this. And this is a technique that will immediately take down the intensity of the stress response. And it’s called the physiological sigh. It’s a breathing technique. And the breathing here is that the exhalation phase is longer than the inhalation phase. So some people term it, rather than the physiological sigh, they call it exhalation dominant breathing. Right, so we’ll go through it now. So I’m going to show you and then we can practise really easy. Ready? [breathing technique]. So what I want to just point out here is it’s not two breaths, it’s sort of one long breath and then just a little extra breath and then a really long exhale. 

AB: It’s not just about forgetting your keys. Your body is actually going on a hormonal roller coaster. There’s a lot that is happening in your life. You’re saying goodbye to certain roles which have been very important to you. Life’s taking you through some huge changes. You could be stressing about getting older. You could be stressing about those lines in your face. You could be stressing about not being young and nubile anymore. You could be tossing and turning in bed. The physical symptoms of menopause, the night sweats can be debilitating. The hot flushes can be embarrassing, sometimes, when you’re in public. Having said all that, our brain is very adaptable. So what would we recommend that you do? Eat the right food, do the right kind of exercise, possibly with strength training to combat osteoporosis and less muscle mass; take supplements under the guidance of some sort of a medical professional, eating food that’s rich in vitamin D and in calcium. Then there is dealing with mindfulness and meditation and relaxation techniques which will help you sleep better at night and it’ll help your mood swings. We can approach menopause from a sensible point of view.

Tell me Katrine, do you have any other advice for the people listening into this chat?  

KC: Yes. Take time out for yourself. You know, menopause is a transition from a fertile time, to a time to turn inwards for your needs. Looking at what your body, your mind, your soul needs, where you’re at. So number one, take time for yourself. Whether it’s on the bus. Focusing on yourself instead of reading 20 million things. Take the time to get a treatment, to allow your body to relax, to hold up, to let go of those held up emotions and give yourself some time to practise. Things take time to practise, even if it’s twice a day for 30 seconds that you practise some of the techniques or maybe a time you feel stressed. Just choose one time during the day. And that’s what Joe Dispenza said, that you need to practise things and rewire your brain so that it becomes a habit. 

AB: Your body is going through a major transformation. You could potentially put on weight. 

Any advice on menopause, especially with weight gain?

Shakiba Rangoonwala: Absolutely. Menopause is something that I… Actually, the ideal thing would be to come to me before menopause. That’s called perimenopause, or even before. So then we. I will give you diet and lifestyle [changes] according to the right guidance. For example, I tell you to have flaxseeds. Flaxseeds are full of phytoestrogens. Phytoestrogens are plant based estrogens which take the place of the oestrogen. So the menopausal symptom comes because there’s no oestrogen. So if you have plant based oestrogen, they give, they take the place, and then you don’t face so many symptoms. 

AB: Some people explore HRT, which is hormone replacement therapy. Please do this in a personalised way with a physician. 

Dr Sepp B Fegerl: Menopause is a hormonal change and the hormonal change is not an illness and it is not a sign of a character weakness. If some women are suffering from more problems and symptoms than other women, it’s not a sign for vitality. If you experience no symptoms, it’s just life and luck. So the hormonal change is affecting your metabolism, it is affecting your hormones, of course, it’s affecting your libido, your stress resistance, it is affecting your ability to perform and your ability to also rest. If a change is immediately causing a stress reaction inside of you, please start to read a little bit. Inform yourself about the hormonal change, to relax a little bit. Because again, a hormonal change is not a disease. Secondly, if the symptoms are pushing you that far and that much out of your state of well being, please contact your physician, do a proper examination, also do a testing of your hormones. In my experience, best possible would be if you test your hormones at around day 23-24 of your menstrual cycle. After this examination you can discuss either herbal or also you can discuss bio identical hormone replacement therapy. The classic hormone replacement therapy with synthetic hormones, normally is not supported because a hormone is something that has an effect on the body, not only stimulating but also calming effect. It needs the hormone to have a negative feedback on the body at the same time, not only stimulation. Because with just simulation you suddenly experience the negative side effects of a hormonal treatment. The bioidentical hormones for example, or also hormones or hormones like foetal therapeutics, that means herbal remedies, are not only stimulating but also calming at the same time. So the chance that you experience the negative side effects of hormonal therapy is going almost down to zero. It is of course possible that you are not liking the way it is affecting you. This is why I would really recommend the consultation and the guidance to find you the right remedy.

AB: Let’s talk about the power of community. The power of talking about it. A number of celebrities like Sharon Stone, Gillian Anderson, and Angelina Jolie have come and talked about it. Menopause is not an end. It is a beginning. Dr Kristen Hawkes, who’s an anthropologist, has done a TED talk about it and she’s come up with a groundbreaking concept. She calls it the grandmother hypothesis. And she talks about how once you’ve gone through menopause, you can actually support the entire community through your time tested wisdom. Menopause should not just be looked at through a lens of loss, it should be looked at as a beginning. It’s something that every human being has to go through. So let’s look at menopause as something powerful and positive. Let’s break the silence and share our stories, not just hide away and suffer alone. I hope you enjoyed this. Until next time, stay empowered.