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Embracing Menopause: Understanding the Natural Transition

Explore the physical, social, and cultural aspects of menopause, the climacteric period, and associated health concerns like osteoporosis and heart disease. Learn about lifestyle factors, exercise benefits, and the impact of cultural beliefs on women's perception of aging.

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Embracing Menopause: Understanding the Natural Transition

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  1. MENOPAUSE • A natural, normal physiological change. • Permanent cessation of menstruation. • Not a disease or a medical problem. • From reproductive life to non-reproductive life. • Complex mix of areas: • physical • social • psychological • cultural • spiritual

  2. MENOPAUSE • Long transition period leading to menopause: • climacteric, a.k.a. perimenopause • Age: • 35-60 • Climacteric: • ovaries less and less responsive to FSH • decline of estrogen and progesterone production

  3. MENOPAUSE • Climacteric (Cont’d): • ovulation skips: anovulatory cycles • periods less blood, shorter, skips, irregular • less testosterone • Still capable of reproduction • Menopause: • 12 continuous months without a period

  4. MENOPAUSE • Some estrogen and progesterone produced by: • adrenal glands • skin • muscle • brain • pineal gland • hair follicles • These hormones stored in fatty tissue

  5. MENOPAUSE • Universal signs of menopause: • cessation of menses • cessation of ovulation • decreased hormonal output • vaginal dryness • skin changes

  6. MENOPAUSE • Non-universal changes • hot flashes • tachycardia • headaches • memory lapses • fatigue • irritability • depression • Cultural differences

  7. MENOPAUSE • “Associated” medical conditions: • Osteoporosis (brittle bones) • Heart Disease • Osteoporosis: • Bones lack calcium, become weak, easily broken. North American diet relatively high in calcium. No correlation between amount of Ca++ in diet and incidence of osteoporosis (Asia).

  8. MENOPAUSE • Osteoporosis (Cont’d): • But – excess of protein in the diet results in Ca++ loss during metabolism. • Prevention: • exercise (aerobic and weights) • good diet, phytoestrogens • no smoking

  9. MENOPAUSE • Osteoporosis (Cont’d): • Men also get osteoporosis after about age 50 yet they do not suffer “estrogen deprivation”. • Women 1 in 4, men 1 in 8 • Muscle mass helps to prevent osteoporosis. Men usually have more muscle due to testosterone. • Baseline bone density test, repeat 5 years

  10. MENOPAUSE • Heart Disease: • Uncommon until 20th century • Longevity: • women’s life expectancy from 48 to 84. • Genetics and Lifestyle

  11. MENOPAUSE • Heart Disease (Cont’d) • Factors that increase incidence: • excess weight • consumption of ‘bad’ fats • sedentary life • smoking (first and second hand) • contraceptive pill • These are cumulative: greater effects with increased age. • Same preventative measures as for osteoporosis. Baseline for blood pressure and stress test.

  12. MENOPAUSE • Hormone Replacement Therapy (HRT): • Completely discredited today. HRT can cause: • reproductive cancers • heart disease • dementias • asthma • hearing loss • memory loss • and other health problems

  13. MENOPAUSE • Exercise: • as essential as breathing and eating • Benefits: • healthy weight • energy • mental acuity • antidepressant • strengthens immune system, lower incidence of all morbidity • stress buster

  14. MENOPAUSE • Exercise (Cont’d): • Benefits: • improves sex life • sweating important for cleaning toxins, skin • cardiovascular health: lower incidence of heart attacks and strokes • lower incidence of osteoporosis • low incidence of menopausal symptoms • helps with balance in old age

  15. MENOPAUSE • Exercise (Cont’d): • Should be a life-long habit. Lifestyle coadjuvants: • no smoking • balanced diet • good sleep habits

  16. MENOPAUSE • Exercise (Cont’d): • Barriers: • urbanization • TV • computers • desk jobs • multiple demands on women, double shift • affluence, mechanization (cars, shopping, etc.) • pharmaceutical culture • no tangible cultural rewards • not a serious part of school curriculum • not part of traditional female role

  17. MENOPAUSE • Psycho-Socio-Cultural Aspects of Menopause: • In Western cultures menopause is associated with decline and with loss of status for women. • Aging seen as loss of value.

  18. MENOPAUSE • Fear of Aging Associated With Menopause Causes: • negative expectations • negative thoughts and emotions • defeatist behaviours • So menopausal symptoms are magnified.

  19. MENOPAUSE • Cultural Influences: • “Sex for procreation only” • “Sex is for the young” • “Old people who have sex are dirty and disgusting”

  20. MENOPAUSE • Culture and Menopause: • Androcentric Image of Women: • sexy • young • fertile • Post-Menopausal women: • dry • withered • unattractive • Advertising • Medicine

  21. MENOPAUSE • Importance of youth reinforced by: • cosmetic industry • fashion industry • cosmetic surgery fad • medical-pharmaceutical industry • Western illness model is very profitable.

  22. MENOPAUSE • Some Cultures Associate Menopause with: • power • wisdom • high social status • leadership roles • respect • In these cultures women have few complaints about menopause

  23. MENOPAUSE • Menopause and Sex: • 50% report more enjoyment: • no fear of pregnancy • partners slower • more self-assured • Use of artificial lubricants • Vagina: • use it or lose it (atrophy)

  24. ANDROPAUSE • Male Climacteric (Male Menopause or Andropause) • 40-55 • Some real physical changes – less obvious than women • Confounded with normal aging changes: • less energy • slower RT (reaction time) • less vigorous responses

  25. ANDROPAUSE • And With Disease effects: • diabetes • circulatory • depression • surgery • medications • hypercholesterolemia • kidney problems • prostate problems

  26. ANDROPAUSE • Testosterone Drops: • testosterone maintains muscle, stimulates bone health, so less testosterone leads to reduced muscle mass and weaker bones. • Sperm Count: • also affected (drops) due to testosterone drop.

  27. ANDROPAUSE • Sexual Performance Declines: • increased episodes of impotence • genitals shrink, prostate enlarges • more time to reach arousal • erections less hard • ejaculations less forceful, less quantity • increased refractory period

  28. ANDROPAUSE • Estrogen Drops: • estrogen helps cardiac health, prevents atherosclerosis, counteracts LDL cholesterol, so less estrogen increases probability of atherosclerosis (arterial plaque) and of “bad” cholesterol. • More and more men on HRT. • Sildenafil (Viagra) • Cialis • Levitra

  29. ANDROPAUSE • HRT for Men: • Testosterone • Can cause • prostate cancer • prostate enlargement • blood clots • lower HDL (the ‘good’ cholesterol) • heart disease • Same prevention: • lifestyle

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