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Menopause and PMS The Menstrual Cycle The monthly menstrual cycle is for reproduction. It is an amazing process of hormonal changes that ultimately brings the release of a healthy egg ready for fertilising. The average cycle last 28 days but this can differ from woman to woman. This cycle continues for a woman’s reproductive years (usually around 40 years) and is normally only interrupted by pregnancy. Other factors can change the cycle e.g. extreme dieting and exercise Menstruation to ovulation – Days 1-14. Day one is the first day of your period. At the beginning of the cycle the levels of oestrogen and progesterone are low. This is where the lining of the womb is shed and you get the monthly bleed. The purpose of this lining is to support a fertilised egg (oocyte), if the egg has not been fertilised the lining is shed. When the hypothalamus gland senses the drop in levels of oestrogen and progesterone it releases gonadotrophin releasing hormone. This hormone then sends a message to the pituitary gland to release FSH – Follicle Stimulation Hormone. FSH stimulates the follicle to grow and to release an egg for fertilisation at around day 14. FSH also stimulates the ovary to produce more oestrogen. Oestrogen levels rise and the lining of the womb begins to thicken in preparation of the possible fertilised egg. This stage can last up to ten days. Oestrogen levels peak at about day 12 of the cycle which is when LH –luteinising hormones signals for the release of a mature egg from the ovary. The egg then starts its journey down the fallopian tube to the uterus. Ovulation to menstruation – Days 14-28 When the egg has been released it leaves a space on the ovary that fills with blood and cells into a mass called the corpus luteum. The Corpus Luteum becomes the manufacturing site for oestrogen (in a lower amount) and progesterone (a higher amount) during the second half of the cycle. The body temperature rises slightly at this time. If the egg is not fertilised the Corpus Luteum breaks down. This stops the release of oestrogen and progesterone which signals for the lining of the womb to fall away. This is removed from the body through menstruation. The low levels of these hormones also stimulate the hypothalamus to release gonadotrophin releasing hormone. And so the cycle happens again. PMS – Pre-menstrual syndrome What causes PMS? It is thought that PMS is caused by the sharp drop in oestrogen and progesterone before a period. Two major brain chemicals (neurotransmitters) are affected by this change, serotonin and gamma-amino butyric acid (GABA). Serotonin is often referred to as the feel good hormone. Low serotonin levels can lead to carbohydrate cravings and depression. Oestrogen can help keep the levels of serotonin levels up which will increase mood levels. Similarly a form of progesterone helps the production of GABBA. This neurotransmitter is calming and switches off adrenaline which helps reduce irritability and anxiety levels. Ways to reduce PMS and menopause symptoms Remove any toxins from your diet especially 10 days before your period. Caffeine, alcohol, processed foods, sugar, dairy and wheat are all toxins to the body. Eat plenty and a variety of fresh vegetables including potassium rich foods (bananas, green leafy vegetable, millet, buckwheat) iron rich foods (liver, sesame seeds, dark green leafy vegetables( kale, watercress, spinach, rocket etc) Eat lean protein at every ‘feed’. Ensure you eat good fats. Organic cold pressed coconut oil, pharmaceutical grade fish oils, good quality olive oils Zinc and B6 have been shown to reduce PMS symptoms 5 HTP helps in the formation of serotonin the feel good hormone Herbs like dong quai can help regulate hormone levels (can help menopausal hot flushes), ginger helps reduce inflammation, black cohosh helps with anxiety and tension (hot flushes, sweats in menopause) , agnus castus is another hormone balancing herb. Always consult a professional for the correct herbal doses Milk thistle to aid you liver functionality which will help remove excess female hormones from the body Reducing stress by finding some space in your day to breath, use relaxations techniques, yoga/Pilates Exercise will increase endorphins, the feel good hormones. Do any exercise that you enjoy. Walking is great for stress relief and it has the added bonus of being outside which will increase vitamin D levels and help lift the mood Be asleep by 10.30pm at least 5 nights per week. This will help keep you cortisol levels down. You also need to let your body repair and rest. The menopause is when a woman has her last period. This occurs because the follicles in the ovary stop working. When the follicles and eggs die the ovary no longer secretes the hormones oestrogen and progesterone which regulates the cycle. This low level of progesterone causes the body to send a message to the pituitary gland to release increased levels of FSH and LH. In blood tests performed by your GP these high levels can be an indicator of menopause. For a few years before the menopause the menstrual cycle can become irregular and changes occur in the flow. This time frame is called the peri-menopause . Sometimes eggs are not released in the cycle and this is called anovulatory cycles. It usually starts aged 4547 but can start earlier or later. The actual menopause, when the periods cease, starts at around the age of 53. This age differs in individuals. If a women goes into menopause before the age of 40 it is considered an early menopause and is called premature ovarian failure. It is not known why the ovaries decide to stop working. Maybe it’s a predisposed genetic programming? Removal of ovaries in a hysterectomy can cause a sudden menopause. How do you know you are menopausal? Here are some of the symptoms of menopause. These are not exclusive to menopause and can be indicators of other issues e.g. Thyroid problems. The menopause is a naturally occurring event and not a medical condition. Many women breeze through it with minimal disruption to their lives. Others can suffer terribly. Menopause can affect women physically, mentally and spiritually. It can cause a sense of mourning for the loss of ‘youth’ and of the reproductive years. It can be a time when children fly the nest. Physically a women may suffer with the hot flushes, break in sleeping patterns and other uncomfortable symptoms. Spiritually a woman can feel as though she has lost her way or maybe feel that life has a lack of meaning. Menopause can also be a truly liberating experience It can make the age of wisdom and self-confidence. It’s a stage in a women’s life where she can have more free time and freedom to pursue her own desires instead of those of her family’s. Hot Flushes and sweats These are caused by an increased activity in the hypothalamus gland in the brain. The hypothalamus is often referred to as the body’s thermostat. It is responsible for controlling your appetite, sex hormones, sleep cycles and body temperature. During the menopause the gland somehow turns up the thermostat. The body responds to this by wanting to cool down by making the heart pump faster, the blood vessels in the skin dilate to circulate more blood and your sweat glands release sweat to cool you off. This gland makes FSH and LH. In menopause the levels of these two hormones are very high as they are trying to stimulate the ovaries to produce eggs. At the same time oestrogen and progesterone levels fall. Some research has shown that foods containing phytoestrogens, which are similar to our body’s oestrogen, can reduce symptoms in some women. Try Edamame beans, fermented soya products like miso. Soya milk and yogurts tend to be highly processed so are best avoided. Weight Gain Estrogen is the name of a group of hormones that we produce in the ovaries until menopause. These hormones are estrodial which is the strongest and the main source of estrogen until menopause, estrone which is less potent and estriol which is weak and which we have in abundance particulary in pregnancy. So we know Estradiol is the primary source of estrogen until menopause, then what happens? The body switches to Estrone as its source. Estrone is produced in the adrenal glands and your FAT cells. Your body will produce more fat cells to produce more Estrone. Your body will also protect these fat cells as it needs them to produce Estrone. So when you hit menopause you tend to gain fat. You are fighting against your body’s own physiology when you try to lose this fat. Your body will even break down protein tissue i.e. muscle rather than use its fat for energy. We need to keep and gain lean muscle tissue in menopause to keep the metabolism fired up. This means resistance training. We need this for three reasons. 1. you need to keep using up your glycogen stores in your muscles so when you eat you don’t lay down fat. 2. The more lean muscle you have the higher your metabolism will run. 3. you look better!! Insulin also rises when Estrone rises. Too much insulin in the system leads to insulin sensitivity and potentially type 2 diabetes and all the associated health risks. Insulin resistance means your body cannot deal with excess sugars in your blood (carbohydrates). The body will store the excess sugars as fat. The more fat you have the more Estrone you produce and so the cycle continues. Stress causes cortisol levels to rise in the body. Your body perceives any stress on the body as a stressor not just the ‘I feel stressed at work’ stress. For example your body sees the reaction caused by irritants to the body, like processed food, as a stress. High cortisol levels will also add to the fat bank as high cortisol levels will affect your digestive system and ultimately your body will lay down more fat. If you are peri menopause and want to lose weight do it NOW!! Do not put if off because it is so much harder when you hit the menopause. It is not impossible to lose weight but it will be much harder. Remember that early menopause is much more common than it used to be. You may think you have lots of time but do you really know that? There are no guarantees. Even if weight loss isn’t a goal follow the suggestions below for you own health and vitality. What do I do? This is dependent on your symptoms. If you are only experiencing slight symptoms then the best course of action is to let your body do what it is designed to do. Support your body through this change by changing lifestyle through nutrition and exercise. Simple changes can have a big impact; you really are what you eat. If you are suffering with symptoms start by changing your lifestyle as above. Try the herbal supplements, remember they are not a quick fix but supplement your existing good nutrition. Get moving and exercise, this will help lift your mood and make you feels better. Weight bearing exercise is important for bone strength and aerobic exercise will keep you cardiovascular system healthy. Add some resistance type training to your exercise plan. This will stop any muscle from being lost and will help keep your figure toned. The more toned muscle mass you have the higher your metabolism will run. Find a class or a trainer to help you. Keep your body fat down as excess weight causes many known health issues as well as sending your hormone system into disarray. Discuss your options with your GP. Find a Bio-identical Hormones therapy practitioner. How long does it last? The main concern of many women is the feeling of the unknown. Many women are fearful because they are not sure what to expect, how long it will last or what to do about it. Do not suffer in silence. Simple changes can make a huge difference. The more women talk about the menopause the more we will realise that it is a natural phase of our life and we need to support each other. Talk to your husband and family! Talk to your partner/ husband and family. Women can change a lot during the lead up to menopause and this can have a huge impact on your relationship with those close to you. Make sure you communicate what you are feeling. Divorce rates are Explain to them about the changes in your mood, feelings, sleep problems etc. Men can find this change very difficult to deal with and it is important to be honest with them. In menopause you may find that your libido takes a dive and you start to experience changes to your genitals. These are very common symptoms and can be remedied. Using a estrogen cream on your genitals can help with dryness. When your hormones balance out you may find that your libido returns. Menopause and Me online survey In a survey I carried out the main concerns are mood swings, flushes/sweats and weight gain. These unwanted symptoms can be reduced through nutrition changes and supplementation. There is no ‘text book’ menopause; we are in the hands of our hormones! What we can do is take responsibility for our lifestyle. Who doesn’t want to be full of energy, sleep well, feel relaxed and to be full of vitality? I know I do!! Complete the ‘menopause and me’ survey here. http://www.smart-survey.co.uk/v.asp?i=44044bhfkg Wishing you love and light Tanith x [email protected] @tanithleefitnes www.facebook.com/TLChangeFitness Recommend reading and my references http://www.simplyhormones.com Balance your hormones by Patrick Holford Natural solutions to menopause by Marilyn Glenville Women’s bodies, women’s wisdom by Christiane Northrup