Every day, millions of women around the world experience significant physical, mental, and emotional changes attributed to midlife and the menopause transition. Some cultures readily accept this time in a woman’s life, encouraging positive associations with the change, and its many effects. Others treat menopause as a disease or condition requiring medical intervention. By far, one of the most difficult challenges surrounding menopause is the reluctance of many women to talk about specific symptoms and to share their very personal experiences with their physicians.
Women tend to look to other women including mothers, grandmothers, sisters or friends for answers in midlife. Checking with each other to determine what’s “normal” and what to expect in the upcoming years is common in nearly every society.
Weird Symptoms in Menopause
Most women know about the common vasomotor (relating to blood vessel constriction) symptoms of menopause such as hot flashes and night sweats and these are thoroughly understood by the medical community. Some women report a few very unusual symptoms however.
Burning Tongue—Women may experience a burning sensation on either the tip of their tongue, or at the back of the tongue. Burning inside the mouth, in general is associated with a hormone imbalance in this case. This can last several years throughout the menopause transition.
Electric Shocks—Some women feel strange sensations like tiny electric shocks, in the head, or deep within the layers of skin. These are sometimes followed by hot flashes. While no one knows for sure why shocks occur, theories implicate vitamin B deficiencies and fluctuating hormone levels.
Itchy Skin—Some women report the feeling of ‘ants crawling on their skin’. This can happen while lying down at night, or can come on for no apparent reason in the middle of the day. Thankfully, this sensation is rare, but is definitely linked to hormonal changes in the body around the time of menopause.
Balance Disturbances—Some women experience difficulty with balance during menopause. Missteps and falls become more common, as normal neurotransmitter activity may be interrupted.
Menopause occurs in the United States between the ages of 45 and 55. It may start earlier however in women who:
- Live at higher elevations
- Are malnourished
Some cultures view menopause as a positive time in a woman’s life, filled with great freedom and release from fears of pregnancy. Older women in general are seen as assets in society, having gained wisdom and experience to be passed on to a younger generation.
An entire industry has been created for menopausal women, making way for a number of inventions designed to keep women comfortable in the middle years. Innovations include cooling fan neck pillows, jewelry filled with non-toxic cooling gel, sheets and pajamas that wick away sweat, and temperature controlled cooling pads for the bed.
In the late 1800’s and early 1900’s, treatment for “the menopause” included among other things, electric therapy, opium dosing, and arsenic consumption to cure the disturbing malady.
Hormonal Balance—The Key to Understanding Menopause
Many women needlessly suffer with uncomfortable symptoms associated with hormonal balance, or a hormone-related medical condition. Throughout a woman’s life, hormone levels of estrogen, progesterone, and testosterone fluctuate in response to the body’s needs and natural aging process. During the reproductive years hormones are released in cycles to support fertility and the monthly menstrual process. Cortisol, DHEA, Thyroid (T3, T4), and FSH (follicle stimulating hormone) also play a role in overall female health or reproduction. When hormonal balance is affected, either by natural developmental processes and aging, or certain medical conditions, a female hormone imbalance test can yield important medical information.
Menopause and its Effects
When menopause occurs, the natural cycle of menstruation ends altogether. This is due to changing hormone levels of estrogen, progesterone, and testosterone. These changes, while generally natural can cause significant emotional and physical changes. Many women experience a sense of relief and freedom in menopause while others feel a sense of loss at the inability to bear children any longer. The period leading up to menopause, referred to, as “perimenopause” can be fraught with depression, mood swings, anxiety and sleeplessness for some women. Physical symptoms may also include fatigue, weight gain, irritability, hot flashes, and vaginal dryness.
Perimenopause—Navigating The Many Symptoms of Premenopause
Premenopause, or perimenopause, as it is technically known signifies an important time in a woman’s life. As she naturally transitions to the non- childbearing years, many physical and emotional changes occur.
What is Perimenopause?
Menopause is defined as the time when a woman has naturally ceased menstruation for 12 consecutive months. This usually occurs in middle age between the late 40’s and early 50’s. The period leading up to the actual event of menopause where menstrual periods become irregular, and symptoms of pre menopause occur, is known as perimenopause.
Signs and Symptoms of Perimenopause
Perimenopause is a time of great change, where many women report uncomfortable or distressing symptoms that seem to “sneak up” on them. Adding to the confusion about what’s happening within their bodies are changes in mood and memory that further complicate this period.
While symptoms of perimenopause vary widely among women, there are several common changes that may occur including:
Irregular Menstrual Periods—One of the first signs of perimenopause, that most women notice is a change in their regular menstrual cycle. Where once periods were predictable and on- schedule, the length of time between periods begins to vary.
Menstrual flow may become lighter at times, with heavy flow occasionally, as well.
Depending on the length of time between periods, women can also determine whether they are in the early, or later stages of perimenopause. The longer the interval between menstrual cycles, (60 days or more) the greater the likelihood they are in the late stages of perimenopause.
Hot Flashes and Night Sweats—Hot flashes can occur any time throughout the day or night and include a sudden hot flush in the body, which may travel up the torso, head and face. This may also be accompanied by a rapid heartbeat and reddening of the skin, and last up to five minutes. Night sweats often occur while sleeping and include profuse sweating and chills after hot flashes.
Sleep Disturbance—Perimenopausal women may have difficulty falling asleep at night, or staying asleep. This may be the result of uncomfortable night sweats, but not always. Some women suffer insomnia-like symptoms associated with perimenopause due to hormonal changes.
Changes in Mood—Some women experience increased irritability and depression in perimenopause. Lack of sleep may contribute to these symptoms, as well as changes in biochemical activity in the brain.
Memory Loss and Brain Fog—Because of the effect low estrogen may have on certain neurotransmitters within the brain, women in perimenopause may experience short-term memory loss, difficulty concentrating, and foggy thinking.
Loss of Vaginal Lubrication—Throughout the various stages of menopause as estrogen levels diminish, vaginal tissue may become dry and lose some of its elasticity.
Urinary Conditions—Loss of tissue tone within the vagina may contribute to urinary incontinence. Lower estrogen levels can put women at risk for urinary tract infections as well.
Decreased Fertility—The chances of becoming pregnant during perimenopause are reduced since ovulation is irregular, however it is still possible. A woman can still conceive if she has a menstrual period, though less likely.
Change in Libido—Sexual arousal and drive may decrease during perimenopause, though not always. Lower levels of estrogen, fatigue, and vaginal discomfort during intercourse may contribute to these changes.
Bone Loss—During the period of perimenopause women become at-risk for bone loss, due to the lack of estrogen. This can lead to osteoporosis, causing porous bones that break easily.
Changing Cholesterol Levels—An increase in low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol may occur as a result of low estrogen. High-density lipoprotein (HDL), or “good” cholesterol declines during perimenopause as well. These changes may contribute to heart disease in some women.
Treatment for Perimenopause
The period of perimenopause leading up to actual menopause and the cessation of menstruation is a natural life event for most women. With the exception of medical problems or conditions that interfere with the natural course of menopause, every woman will experience the slow down and eventual end of ovulation and menstruation.
While many women will go through the many physical and emotional changes associated with perimenopause with only minimal discomfort, others will require natural or medical intervention.
A gynecologist, or other healthcare practitioner may advise a combination of lifestyle changes, natural dietary supplements and/or prescription medications for the treatment of symptoms.
These may include:
- Modified Diet
- Cardio-vascular exercise
- Altered sleeping environment
- Vitamin/Mineral/Herbal Supplements
- Anti-anxiety medication
- Anti-depressant medication
- Sleep Aids
- Cholesterol medication
- Topical Lubricants
- Hormone Replacement Therapy
With increased awareness and attention to the many changes experienced in perimenopause, women can experience the natural process of female aging with lower levels of discomfort and fewer concerns.
Q & A
Question: How do I treat hair loss during Menopause?
If you’re over the age of 40, female, and rapidly losing hair on the sides, top, and front of the head, you’re not alone. In fact, 20–60% of women will experience thinning hair as a result of menopause before age 60. Here’s why.
Normal Hair Growth
Approximately five million hairs cover the human body. Most of these are small, “vellus hairs” spread across the surfaces of the skin, with the exception of the palms, soles, and lips. Much larger “terminal hairs” grow on the scalp, eyebrows, armpits, and genital regions. Genetics determine hair color, thickness, texture, and volume.
Hair growth starts from the live bulb that contains cells that multiply. As these mature, follicles grow through a process known as “keratinization”. Hair grows in cycles based on the life of the bulb, and follicles go dormant. During this phase hair is shed until a new bulb is formed in the remnants of the follicle.
Hair Loss and Menopause
Based on years of research scientists know that women begin to lose estrogen and progesterone as the body winds down its reproductive function. Ovaries produce less estrogen and progesterone throughout the perimenopausal phase, which can last years before the actual cessation of menstruation. This decrease in hormone levels is directly related to lack of hair growth and weak hair structure during this period of life. When estrogen and progesterone drop, hair becomes thinner and grows more slowly. Excess male androgens, also produced in menopause contribute to thinning hair by shrinking hair follicles as well.
Body Chemistry and Aging
As women age, the progesterone and estrogen that once offered protection from hair loss fail to produce the same results, instead triggering an increase in androgen production. Testosterone, now more abundant reacts with enzyme 5 alpha reductase, to create dihydrotestosterone (DHT). Some studies indicate this may be a factor in female pattern baldness. While scientists don’t know for sure, DHT appears to send hair follicles into a “resting” phase more quickly, causing hairs to become thinner over time with every growth cycle. Eventually follicles may diminish entirely.
Diet Supplementation for Thinning Hair
Nutrition plays a key role in restoring hair during the menopausal phase. The following vitamins, minerals and nutrients are recommended to support hair loss in middle-aged women:
- Vitamins A, D & E
- Fatty acids
Based on one six-month study, supplementation with 1.5g/day of L-lysine and 72mg/day of iron resulted in a 36% reduction in hair loss. Orthosilicic acid increased strength and thickness of hair in another six month controlled study. It also decreased hair brittleness after 20 weeks. Supplementation with L-cysteine, along with yeast, and pantothenic acid returned hair to a normal rate of growth after a six-month trial period.
Healthy women naturally shed upwards of 70–100 hairs each day from the scalp.
If you’re experiencing greater than average hair loss and have entered perimenopause or menopause, talk with your doctor about diet and possible supplementation with vitamins, minerals and other nutrients.