Midlife Solutions with Karen Martel

The Great Estrogen Decline

As menopause approaches, the ovaries start to downshift, producing less estrogen. This hormonal rollercoaster can bring on some familiar but frustrating symptoms: hot flashes, night sweats, mood swings, and vaginal dryness (North American Menopause Society, 2021). In premenopausal years, estradiol (E2) is the dominant form of estrogen. Post-menopause, estradiol steps aside, and estrone (E1) takes the lead—but it’s not quite as effective, which can cause ripple effects throughout the body (Fogle et al., 2007).

Health Risks Tied to Low Estrogen Levels

Cardiovascular Health
Estrogen has long been celebrated as the heart’s secret ally. It keeps blood vessels flexible and regulates cholesterol. But when estrogen levels drop, LDL (the “bad” cholesterol) starts climbing while HDL (the “good” cholesterol) takes a hit. This shift raises the risk of coronary artery disease, which catches up to men’s risk by age 70 (Mosca et al., 2011).

Bone Density
Estrogen is like scaffolding for your bones. Without it, bone density declines faster than you can say “osteoporosis.” Postmenopausal women face a higher risk of fractures, particularly those who experience severe menopausal symptoms (Cummings & Melton, 2002). Getting enough calcium and vitamin D can help, but it’s no substitute for addressing the root cause.

Mental Health
Let’s talk about mood. Estrogen fluctuations can wreak havoc on emotional well-being, causing mood swings and heightened anxiety during perimenopause. Interestingly, while depression may spike during this transitional phase, many women report feeling better emotionally once they’re past menopause (Schmidt et al., 2004).

Urinary and Vaginal Health
Low estrogen can lead to vaginal atrophy, making urinary tract infections (UTIs) and urinary incontinence more common. Suddenly, frequent bathroom trips or leakage during exercise may become part of daily life (Robinson et al., 2013).

Hormone Replacement Therapy (HRT): A Lifeline?

For many women, Hormone Replacement Therapy (HRT) offers relief from the relentless symptoms of menopause. HRT can help with hot flashes, night sweats, and even bolster bone density and heart health. However, it’s not one-size-fits-all. It’s essential to discuss your personal health history and risks with your healthcare provider to determine if HRT is the right fit (Manson et al., 2017).

Lifestyle Strategies to Thrive Through Menopause

While medical treatments can be game-changers, lifestyle tweaks also play a starring role in managing menopause:

• Diet: Fuel your body with a balanced diet rich in calcium, vitamin D, and healthy fats.
• Exercise: Regular workouts help maintain muscle mass, improve mood, and support heart health.
• Stress Management: Yoga, meditation, or even deep breathing can make a world of difference.

The Bottom Line

Menopause is a major life transition, but it doesn’t have to be a crisis. By understanding the role estrogen plays in your health, you can take proactive steps to feel your best. Whether you choose lifestyle changes, HRT, or a mix of both, knowledge is your most powerful tool. Menopause might mark the end of one chapter, but with the right approach, it’s the beginning of a vibrant, empowered new one.

Citations:

• Cummings, S. R., & Melton, L. J. (2002). Epidemiology and outcomes of osteoporotic fractures. The Lancet, 359(9319), 1761-1767.
• Fogle, R. H., Stanczyk, F. Z., Zhang, X., & Paulson, R. J. (2007). Ovarian androgen production in postmenopausal women. Journal of Clinical Endocrinology & Metabolism, 92(8), 3040-3043.
• Manson, J. E., Chlebowski, R. T., Stefanick, M. L., et al. (2017). Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative. JAMA, 318(10), 927-938.
• Mosca, L., Barrett-Connor, E., & Wenger, N. K. (2011). Sex/gender differences in cardiovascular disease prevention. Circulation, 124(19), 2145-2154.
• North American Menopause Society. (2021). The 2021 hormone therapy position statement of the North American Menopause Society. Menopause, 28(9), 973-997.
• Robinson, D., Cardozo, L., & Peschers, U. (2013). Postmenopausal urinary incontinence. Maturitas, 76(3), 240-244.
• Schmidt, P. J., Murphy, J. H., Haq, N., et al. (2004). Depression in women in the menopausal transition. American Journal of Psychiatry, 161(8), 1339-1346.