From: hubermanlab
Perimenopause and menopause are significant phases in a woman’s life, involving profound physiological and psychological changes. This article dives into these topics, providing insights based on a discussion with Dr. Mary Clare Haver, a board-certified OBGYN and an expert in perimenopause and menopause.
Defining Menopause and Perimenopause
Menopause
Medically, menopause is traditionally defined as the time when a woman has gone one year without a menstrual period. However, Dr. Haver highlights a problem with this definition, since not all women have menstrual periods due to various reasons like hysterectomy, IUDs, or other medical conditions. Therefore, she suggests menopause should be understood as the end of ovarian function, marked by a significant decline in hormones like estradiol, progesterone, and testosterone, which significantly impacts women’s health ([00:07:00]).
Perimenopause
Perimenopause is the transitional period leading up to menopause, usually starting around 7 to 10 years before the complete cessation of periods ([00:09:45]). During this time, women experience hormonal fluctuations leading to various symptoms including irregular menstrual cycles, hot flashes, and mental health changes like increased anxiety and depression mental health considerations during menopause ([00:17:00]).
Symptoms and Challenges
Common Symptoms
- Hormonal Fluctuations: Perimenopause is characterized by irregular and intense hormonal changes. The hormonal volatility often termed “the zone of chaos,” leads to irregular menstrual cycles and extreme variations in hormone levels ([00:11:18]).
- Mental Health: There is a noted increase in mental health challenges, including anxiety, cognitive disruptions, and mood changes, during perimenopause and menopause due to hormonal impacts on neurotransmitter systems ([00:16:26]).
Health Risks
- Cardiovascular Health: The loss of estrogen during menopause increases the risk of cardiovascular issues. Hormone Replacement Therapy (HRT) has been shown to help reduce these risks if initiated around the menopause transition ([01:14:01]).
Navigating Perimenopause and Menopause
Lifestyle Adjustments
- Diet and Nutrition: Emphasizing an anti-inflammatory diet rich in fiber, nutrients, and colorful fruits and vegetables can benefit women during this transition. Additionally, increasing protein intake supports muscle mass retention and overall health (importance of dietary protein for muscle health) ([00:45:20]).
- Exercise: Regular exercise, especially resistance training, is crucial for maintaining muscle mass, bone density, muscle longevity, and overall health. It is also an essential part of managing weight and improving mood during menopause ([01:03:03]).
Hormone Replacement Therapy (HRT)
- Dr. Haver argues for the benefits of HRT, focusing on its role in mitigating symptoms, protecting cardiovascular health, and maintaining overall quality of life. She highlights that the benefits of initiating HRT are greater when started around the time of menopause ([01:08:01]).
Addressing Misconceptions
Dr. Haver emphasizes the necessity to challenge misconceptions surrounding menopause and HRT, particularly relating to outdated studies that incorrectly associated HRT with increased cancer risks. Recent data show that timely and appropriate use of HRT can benefit women significantly without the risks previously believed ([01:10:00]).
Conclusion
Perimenopause and menopause are critical stages in a woman’s life, affecting physical and emotional health profoundly. Understanding these changes and employing science-based strategies, including lifestyle adjustments and medical therapies like HRT, can aid women in navigating these stages with greater ease and health benefits. For further reading, Dr. Haver’s book and resources offer more detailed guidance on these topics.