Menopause; what to expect (with Anne Digby, women’s health specialist)
Did you know that ‘Menopause’ is a relatively new concept and the word was only coined in the latter half of the 19th Century? This is because, in past centuries, women were much less likely to live beyond the age of menopause.
Around 80% of women experience symptoms associated with reduced oestrogen at the time of menopause, to a greater or lesser degree. These symptoms include:
- Vasomotor symptoms of hot flushes during the day, night sweats or a particularly unpleasant sensation like ants crawling under the skin. These symptoms generally last around 3 or 4 years and then resolve, although 10% of women experience these symptoms indefinitely.
- Urogenital symptoms such as dry vagina and change of pH, painful intercourse, urinary frequency and/or stress incontinence.
These symptoms generally occur around 3 to 4 years after the onset of menopause and, unlike vasomotor symptoms, they tend to get worse over time.
- Physical changes such as decreased fitness and flexibility, changes in body fat distribution and changes in sleep patterns.
- Reduced skin elasticity and increased skin dryness.
- Emotional and psychological changes such as anxiety, depression, insomnia and difficulty concentrating.
- Loss of libido.
- Bone effects such as osteopenia, osteoporosis and risk of fracture.
Interview with Anne Digby, women’s health specialist
As well as running her Naturopath and women’s health centre, Anne is also Founder and Chairperson of Journey Nepal Australia, an organisation that is assisting women in Nepal with fertility and birthing centres. Journey Nepal opened its first Women’s Educational Centre and refuge in November 2014 in Kathmandu valley. Visit www.journey-nepal.org for more information.
Lynda: Across all the women you see, is there a common complaint that seems to be the hardest adjustment during menopause?
Anne: Hot flushes and night sweats are the thing that make women come in for a consultation. We don’t have a good understanding of exactly why hot flushes occur but it’s definitely associated with reduced oestrogen levels. The flush coincides with a surge of LH and is triggered by a small elevation in core body temperature.
The prevalence of hot flushes and other vasomotor symptoms differs greatly depending on culture and ethnicity, and is worse in women who have a surgical menopause (hysterectomy with ovaries removed).
However, I would have to say that reduced or completely lost libido is the one thing that gets women by surprise and is the most difficult symptom to adjust to. I think maybe that’s because it’s not as commonly spoken about as hot flushes and is still a bit taboo.
Lynda: In general terms, what is it that a women should do differently in menopause or in preparation for menopause?
Anne: It becomes more and more important to have a good diet and lifestyle as a women approaches menopause. The older she gets the less she is able to get away with the ‘not-so-good things’ she once did – like too much alcohol or too many refined carbs. Also making sure she gets enough calcium is important. As is relaxation and getting enough sleep.
Lynda: Are there natural therapies that can or should become part of a women’s routine?
Anne: Natural therapies such as acupuncture can be helpful. In my opinion, self-hypnosis to access a really deep relaxation is the most beneficial. Meditation is very helpful but some people have difficulty being able to still the mind and it can take some time to learn. The other barrier to meditation for some is finding the time and quiet space to do it every day. Whereas self-hypnosis can usually be achieved very rapidly, and can be done in bed before you go to sleep.
Lynda: In addition to supplements, what else would you recommend for women struggling with some or all of the symptoms and impacts that we’ve outlined here?
Anne: A good quality multi vitamin is essential, one that has at least 150mcg iodine, 200mcg chromium and some calcium.
Also Coenzyme Q10 (Ubiquinol) 150mg per day, Fish oil 2000mg per day, vitamin D and Magnesium.
Lynda: Does never having been pregnant change anything with regards to menopause?
Anne: Never having been pregnant is associated with an earlier than average onset of menopause – as is cigarette smoking and living at high altitudes. Never having been pregnant is not associated with reduced bone mineral density though (the good news), so there is no increased risk of osteoporosis.
Lynda: And what about fertility treatment?
Anne: Fertility treatment can easily disrupt the hormone balance and, once it’s disrupted, it can take some work to get it back on track. Herbal medicine can be used to restore the balance.