Menopause is the end of menstruation and hormonal activity, which happens to every woman as she ages. Women who do not menstruate for one year are considered to have entered menopause. The hormones estrogen and progesterone play an important role in women’s metabolism.
Menopausal changes usually begin a few years before menopause. The average age of menopause is 50. In most women, pre-menopausal changes begin around the forties.
What is estrogen dominance?
Estrogen dominance is the most important of the changes that start in the pre-menopausal period.
In the normal ovulation cycle, the estrogen hormone increases in the blood with menstruation, and the progestreon hormone secreted in the last 14 days with ovulation balances this estrogen.
Estrogen hormone has the effects of thickening the uterus, fat storage, weight gain and water retention, and it is the progesterone hormone that prevents these effects from being excessive.
From the age of 35, the quality of eggs decreases and sometimes even no ovulation begins. This is because the quality eggs have been spent at an earlier age. Thus, not enough progesterone is secreted. Estrogen hormone continues to be synthesized, especially in places such as adipose tissue. This prevents progesterone from balancing estrogen sufficiently. This mechanism underlies many of the premenopausal complaints.
The estrogen hormone fluctuates constantly during this period, which is why it is very difficult to make a decision based only on blood results.
So what are the symptoms of the period we call estrogen dominance:
- Headache
- Menstrual irregularities such as shorter or longer periods
- Breast tenderness and cysts
- Increased risk for uterine and breast cancer
- Fibromyalgic complaints
- Hypothyroidism
- Sweet cravings
- Temperament traits
- Irritability anxiety
- Myomas
- Weight gain – inability to lose weight (especially in the hip area)
- Deterioration of sleep quality frequent awakenings
One of the most important reasons why estrogen dominance is seen intensely in today’s women is too much exposure to some endocrine disrupting toxins called xenoestrogens (especially intensively taken with cosmetic products). These toxins increase the dominance by showing estrogen effect in the body. If the person is already overweight, the increased estrogen secretion here aggravates the situation even more. In addition, poor eating habits, fiber-poor nutrition, pro-inflammatory foods and excess insulin also cause more estrogenic effects.
Estrogen dominance continues for some time after menopause. Estrogen fluctuations during this period cause hot flashes and night sweats.
Especially in this period when estrogen is still present in the body, progesterone support is absolutely necessary. We prefer natural progesterone. Natural progesterone is a drug that is rarely used orally. When taken orally, it breaks down into metabolites in the liver and causes completely different effects. We prefer the oral route in patients with sleep problems during this period. However, the way to be given to protect the uterus and breast and prevent lubrication is the vaginal route, so it reaches the area it will directly affect. It balances the estrogen that needs to be balanced. The dose used here may vary according to the person. Blood tests do not help us much because there are very frequent fluctuations, most of the time we adjust the dose by trial and error.
What happens when no estrogen is secreted at the end of the period when estrogen is dominant, that is, when menopause begins:
CHANGES THAT COME WITH MENOPAUSE:
Changes in the skin:Estrogen hormone affects the elasticity of the skin and the rate of collagen. With its decrease, collagen is reduced in the skin, the skin loses its elasticity and wrinkles.
Changes in the urogenital area: With menopause, most women begin to complain of dryness that causes discomfort, especially during sexual intercourse.This often negatively affects sexual intercourse.As menopause progresses, urinary complaints are added to this. Urinary incontinence is among the most important complaints of older women.Sexual reluctance: Again, it is one of the most important consequences of hormonal decreases. It is associated with a decrease in the free circulating testosterone hormone in the body.
Mood changes: A tendency towards depression may begin to be seen with menopause. Depression can be exacerbated by sleep disturbances.
Brain health : Unfortunately, the risk of Alzheimer’s disease increases after menopause. Almost all women suffer from postmenopausal brain fog, which we call brain fog due to hormone deficiency and decreased memory and sharpness of thought.
Bone resorption: Both estrogen and progesterone play an important role in the destruction of bone and the increase in its production. In fact, bone loss starts at the age of 35. The reason for this is that quality ovulation decreases after this age and the hormone progesterone, which increases bone formation, is secreted less. When the effect of estrogen in reducing bone destruction disappears, problems related to osteoporosis increase rapidly after menopause.Cardiovascular system: Perhaps the most devastating effect of menopause is the damage it causes to the cardiovascular system. While the risk of dying from a heart attack is much higher in men in the pre-menopausal period, this risk is equalized with men after menopause. The reason for this is that the positive effect of the hormone estrogen, especially on the blood vessels, disappears. Estrogen has a direct vasodilating effect and prevents vascular plaques. It does this directly through its positive effect on blood lipids. The end of this hormone in the body negatively affects cardiovascular health.Bowel health: The incidence of bowel cancer decreases in women who use hormones after menopause.
Body metabolism: With menopause, most women start to get fat, especially around the belly.This is entirely related to the disappearance of the positive effects of female hormones on metabolism.
Sleep disturbances: Especially frequent awakenings and difficulties in falling asleep may occur.So what can we do personally as we enter the menopause?
There are many things we can do personally:
First of all, we should organize our lifestyle.
– Nutrition is at the forefront of this.We should have a diet consisting of healthy organic foods.Unnecessary carbohydrate intake should be reduced and foods with high glycemic index should be away from us.
-We need to remove the endocrine disruptors we call xenoestrogens from our lives.
-Breathing exercises, yoga and meditation can be very effective, especially to balance the disturbed mood and prevent anxiety and depression.-Sleeping arrangements are very important.
Stopping looking at screens (phone, computer, TV) 2 hours before bedtime, choosing a cool, lightless environment for sleep and meditations to calm down before sleep can be effective.
– Exercise: It is very effective in both controlling weight and supporting mental balance. It must become a part of our lives. Especially resistance and weight lifting exercises are very important for bone health.
Hormone Replacement Therapy:
The most important thing to be done for anti-aging, which has become very popular recently, is to replace the missing hormones.
Hormone replacement was applied to every woman who entered menopause before the 2000s. The WHI Study published in 2002 changed the whole course. In this study, it was found that the hormones given increased the risk of stroke and breast cancer in women. Without going into the details of this study, I should point out that it was conducted in older women and did not reflect the facts because synthetic hormones were used instead of natural hormones. After this study, it was not possible to start anyone on hormones. However, in recent years it has become clear that replacement therapy with natural hormones does not have such side effects.
On the contrary, studies have shown that with hormone replacement therapy:
Bone fractures, death from heart disease and colon cancer are halved in postmenopausal women. Alzheimer’s disease is reduced by 35%.
Recent studies have also shown that replacement therapy with natural hormones does NOT increase the risk of breast cancer.
