The Hindu Business Line : Well without a pause

The oestrogen-progesterone cycle of menstrual periods gradually ends by about 50 years. It’s goodbye to reproduction, a certain loss of libido, and some women even go so far as to term it a cessation of womanhood. What’s the world of menopause really like?

Physiologically, a woman loses the ability to reproduce as release of eggs stops. As the oestrogen-progesterone balance slowly readjusts in the last phase, there are women who get hot flushes, the muffin-middle, weight gain, severe headaches, osteoporosis and increased susceptibility to heart attacks.

In an attempt to stimulate the ovaries to produce eggs, the pituitary produces greater amounts of Follicle Stimulating Hormone (FSH) and Luetinising Hormone (LH). And this is believed to cause the hot flushes.

Women who gain weight during menopause have less severe hot flushes and denser bones. Fat cells convert the androstenedione produced by the adrenals and ovaries into estrone, the primary postmenopausal estrogen.

Oestrogen replacement

Today oestrogen is considered a uber-hormone as it not only ensures the perfect 0.7 waist-hip ratio but also works as protection against heart attacks.

To relieve symptoms such as prolonged bleeding, irregular cycles, hot flushes, weight gain, frazzled nerves and to slow down ageing, hormone replacement therapy (HRT) is often advocated.

But the incidence of breast cancer, strokes, heart attacks, pulmonary embolisms and blood clots has led to a rethink on the usage of synthetic oestrogens.

Recently bio-identical hormones were in the news as an oestrogen replacement. They are natural phytoestrogens derived from plants as opposed to synthetic hormones manufactured from mare’s urine among other sources. Although more compatible with human hormones, it is too early to decide on their safety.

What is promised is a bouquet of hormone combinations suited to individual needs and condition. After a clinical evaluation, which includes testing for estradiol and prolactin levels, one is likely to be prescribed oestrogen-progesterone or testosterone in varying proportions either in an oral form or as a cream. Some women are even recommended a thyroid test at this time.

Diet

Antioxidants, lycopenes (tomatoes) beta-carotenes (yellow fruits such as mangoes, oranges and vegetables like carrot) and isoflavones (soya) are recommended for their beneficial effects.

Exercise

Menopause brings with it a surge in hunger for some. So each time you feel the pangs, trot out into the park and boost your endorphin quotient. Exercise will help whittle your muffin-middle, protect you against cardiovascular disease, regulate sugar spikes and tamp down blood pressure. Go for a walk at the same time every day as your body will actually look forward to those endorphins.

Calcium benefits

For unknown reasons, menopausal bones slow down the production of new cells and seem to ignore the presence of calcium. Women who exercise regularly and eat calcium-rich foods enter their menopausal years with better bone mass than sedentary women and those who consume calcium-leaching foods (including soymilk, tofu, coffee, soda, alcohol, white flour, processed meats, nutritional yeast and bran). Bone mass usually decreases during menopausal years. Your best insurance for fracture-free years is to build good bones before menopause.

YOGA

A balanced yoga programme including relaxation/ meditation techniques helps relieve disorders of the respiratory and digestive systems that may arise in midlife. Some of the useful practices include pawanmuktasana, surya namaskara, paschimottanasana, halasana, trikonasana, bhujangasana and spinal twists.

POSITIVE SELF-IMAGE

The most important thing — during the ‘pause’ — is to maintain a positive self-image. According to Dr Christiane Northrup, an expert in menopause studies, women can turn back menopause with sheer intent by releasing an important signalling molecule called nitric oxide (NO) that comes only when you are happy. Non-pharma NO supplements include L-arginine, black tea, cocoa, flavonoids vitamin C, vitamin E, red wine, Omega-3 and folic acid.

Do not unduly increase your intake of soy, calcium or any other food as it increases the load on the kidney and liver.

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