While it is still a topic many women are uncomfortable discussing, menopause is a normal part of life’s journey, writes Paula Mee and Kate O’Brien
Paula Mee and Kate O’Brien
Growing old is inevitable – it’s how we deal with it that matters. For many women in our youth-obsessed western world, a few lines and fluctuations in hormonal levels denote the end of fertility, the end of life as we know it and the measured approach of old age and all that accompanies it.
Thankfully, attitudes are changing and women are no longer willing to be cast aside at the first signs of ageing. We know our bodies better than ever before. We are living longer and are proving that age is no barrier to a full, vibrant life. What’s more, given that scientists tell us we may actually live until we are well over 100, we have a lot of living to do. It’s time to take control of our bodies and our lives and embrace the next act – the possibilities are endless.
Menopause is a topic that many women are still not comfortable discussing openly in these supposedly evolved times. While most of us will happily share intimate information with our closest friends, we are often too proud or too shy to admit how hormonal change is affecting us – or maybe we are hoping that by ignoring its existence, it might all just go away!
Fillers
There are always fillers and numerous other high-tech therapies for our faces, but once our body clock signals oestrogen’s grand finale, change is imminent. In our parents’ generation, menopause was kept within tight lips and rarely, if ever, discussed. Back then, the choice was stark: age visibly or have a facelift. Today we have more control over how we age and science is now proving that with the right diet and lifestyle we can look, be and feel our very best.
Menopause is not a disease; it is a normal, natural event for women the world over. Many women suffer years of immeasurable pain and anguish because of the enormous changes taking place within their bodies during these years. Others suffer little. None of us, however, is fortunate enough to retain the face of our 30s. As we watch our faces slowly become maps of our colourful lives and notice the increasing depth and dimensions of our new-found creases, we know in our hearts that this is for real. Partner this with a declining libido, sleep disturbances and a host of emotional and physical changes and it’s hardly surprising that many women suffer greatly and quietly for many years.
Combination
The word ‘menopause’ is a combination of two Greek words that, when translated literally, means ‘the end of the monthlies’.
Menopause is a specific point in time marking the permanent end of fertility, which occurs when a woman’s ovaries stop producing eggs and the hormones oestrogen and progesterone decline. We define it as a year without periods. The average woman reaches menopause at about the age of 51, although it can vary from the 30s to the 50s. Menopause can also occur if a woman’s ovaries are surgically removed.
While life expectancy has increased significantly during the past decades and the onset of puberty now happens earlier, the typical age at which a woman reaches menopause has not changed for centuries. While the reason for this has not yet been clearly established, two factors have been found to influence the timing of natural menopause – smoking and genetics.
According to the Mayo Clinic in the US, smokers start menopause one to two years earlier than non-smokers, while the genetic link is supported by the fact that women often experience menopause around the same time as their mothers.
Change
The World Health Organisation (WHO) estimates that by the year 2025, there will be 1.1 billion women aged 50 and over. That’s a lot of women going through a great deal of change, right now. In the US, for instance, an estimated 45 million women are going through menopause at any given time.
Menopause not only alters hormonal balance but also the way the brain works and the way you look at the world. Over 40 symptoms are associated with your middle years, including: irregular menstrual periods, weight gain and body fat changes, hot flushes and night sweats, sleep disturbances and mood swings.
Each woman will experience menopause in a uniquely different way. This variation is evident in different parts of the world and between women from different ethnic groups, which suggests both cultural and genetic influences. Many Caucasian women, for instance, experience hot flushes, while studies from other cultures suggest far fewer occurences of this phenomenon. Many Indian women accept the menopause as a part of the process of ageing and are less inclined to seek medical help. In Japan, some of the most mesmerising geishas are those in their 70s and beyond, women overflowing with wisdom, strength and compassion who are revered by their families and communities.
Our need for energy or calories reduces as we age. The average active younger woman needs approximately 2,000 kcal per day. However, this is not the case when we reach our 50s. Our basic energy needs start to decline and drop as low as 1,800 kcal by age 75.
Although this means that if we want to prevent weight gain, we need to eat less, our requirement for vitamins and minerals remains largely the same. In fact, we need slightly more protein and the same amount of vitamins and minerals as we always did. Iron is an exception, as we need less of this nutrient once menstruation ceases. We need to eat fewer calories but to include more nutrient-dense foods in our meals.
Disease
Osteoporosis is probably the most serious debilitating disease associated with menopause. It weakens bones and increases the risk of unexpected fractures. We naturally begin to lose more bone than we can make in and around our mid-30s. Calcium is vital for bone health. Adult women are advised to eat enough calcium-rich foods to provide 700-800mg of this essential bone mineral each day. This is just three servings of calcium-rich dairy or the equivalent of fortified soya/nut/rice-based products.
Many of us tend to think of heart disease as a men’s issue, but it’s now the leading cause of death in women over 50. The risk of high blood pressure and high blood cholesterol increases after the menopause. A regular annual cholesterol and blood pressure test is a good idea, especially where there is a history of cardiovascular disease in the family.
It is now pretty much a given that regular exercise can make an enormous difference to our quality of life, for the rest of our lives. Numerous studies show that middle-aged women who exercise regularly report a higher quality of life and reduced symptoms of menopause than those who lead a more sedentary lifestyle. Fitness also makes us smarter by keeping our brains active.
With regular exercise, everything improves – our skin, our hair, our heart, our brain and memory – while the risk of many diseases reduces. The hardest part is getting started. Whether it is yoga, walking, weights, swimming, dancing or running – at home, in the gym or the great outdoors – once exercise becomes a part of your life, a strong, toned body and mind will be yours.
As every woman navigating the menopausal years will attest, the profound emotional turmoil taking place in her life can completely overwhelm. Few medical experts address this and when they do, they often prescribe anti-depressants. And while most women understand menopause to be a natural transition, many also question the prescription of hormone therapy at the first sign of fluctuating hormones. The best advice is to discuss your options with your doctor, who should be armed with the most up-to-date facts, before deciding what approach is best for you.
They say 50 is the new 40 and we know now that with age comes wisdom, contentedness and, most importantly, an understanding and acceptance that what we are going through is normal. It’s OK. No, we can’t stop the clock, but the dull haze can be lifted.
Paula Mee is a dietitian and Kate O’Brien is a lifestyle writer. This edited extract is taken from their new book Your Middle Years, published by Gill Books (€16.99), which offers practical advice to women going through the menopause.