What the Change!?!? Pt Deux

What the Change Part 2

In part 1 of this blog series, we discovered that there are many symptoms that are commonly associated with the change that occurs as the body shifts from the menstrual phase of life to the post-menopause phase of life. With the wide range of hormonal changes that occur in the body, it makes sense that the changes that occur are so wide. In this post we are going to dive into the why behind the common changes that occur in the body.

The two culprits of these changes are the main cycle hormones; estrogen and progesterone. Throughout a menstrual cycle, this duo preforms a rhythmic dance. They cycle in a way that counterbalances each other. Once the peri-menopause phase begins, they start to lose rhythm and lack support for each other.

Let’s begin with Miss E – the drama queen! Estrogen circulates in the body in 3 types – estrone, estradiol, and estriol. The changes that occur in the body are mostly due to the middle sister, who is a little rebellious at times and likes to be well known with her potency; estradiol. Playing a key role in metabolic functions in the whole body, there are body wide effects with tapering levels of estradiol in the peri to post-menopause phase.

To tone down the drama queen, we have progesterone who counterbalances a lot of the effects estrogen has on the body throughout the normal menstrual cycle. As the ovaries release fewer eggs, the level of progesterone lowers. During the peri-post menopausal shift, the previously listed common symptoms arise due to the change in ratio of estrogen to progesterone. The levels of progesterone in the body will not dip as significantly as our drama queen estrogen, due to the brain also producing progesterone after the ovaries stop its production.

The following are the hormonally influenced physiological changes that occur in the peri to post-menopause phase of life.

Muscle and Tissue Composition

As estradiol levels taper off, the body is less responsive to building muscle. As we age past 30, for both males and females, there is a natural atrophy of skeletal muscles. For females there can be a significant reduction in the strong force and power of the muscles, leading to a weakness, lack of neuromuscular connection, and diminished muscle tone. Progesterone also plays a role in helping build connective tissues. As the circulating progesterone levels decrease this leads to more instability in the joints, specifically the shoulders. This is also a common cause of further pelvic floor dysfunction, as the muscles and tissues naturally decrease in strength, it is more common to experience incontinence as the body’s hormones shift and the body ages. 

Bone Health

Our dynamic hormone duo both plays a role in calcium absorption and retention in the body to help with bone formation. As they both decrease to lower levels than in the menstrual cycle, there is a decrease in bone strength and remineralization. This is the reason behind the increase in bone related injuries in life experienced women.

Inflammation

Inflammation in the body can increase for a variety of reasons, and under the right circumstances can be a helpful part of the healing process. In general, we want to avoid chronic inflammation that can lead to further damage in the body. Throughout the menstrual cycle, estrogen and progesterone help to minimize the inflammatory response in the body. Estrogen also plays a role in helping to mitigate the damage that comes along with inflammation. As these two hormones dwindle to lower levels, there is less inflammation management and it is common to experience an increase in body wide inflammation, including bloating, puffiness, and menopausal arthritis.

Stress

Cortisol is the body’s stress hormone; in times of stress this hormone rises. It can sometimes be a little thief and in times of high stress likes to use estrogen and progesterone to make more cortisol. As the body’s hormones shift into the post-menopausal state, the nervous system has a more difficult time controlling this stress effect. This leads the body to go into a state of fight-flight-flee more easily and frequently, with less time in a rest and digest state, even if you’re just sitting at home bingeing the latest hot show. Another tie in to why you may be experiencing increases in bladder leaks, especially if you haven’t before. Weakening pelvic floor muscles has over time, and symptoms can often present after a significant hormone shift. If stress goes unregulated, you may see those incontinence symptoms even if you’ve never experienced them before.  

Blood Pressure

As if all this heightened state of stress doesn’t make your blood pressure rise on it’s own, our hormones also play a role in regulating the body’s blood flow. As our drama queen decreases, the body’s blood vessels become less responsive commonly causing blood pressure issues and dizziness when moving from sitting to standing.

Brain Effects

Mood swings, memory gaps, fuzziness, headaches and brain fog can commonly be associated with hormonal shifts, even in our menstrual cycle. But as our progesterone levels dwindle, there is less of a neurosteriod calming effect in the brain. Throughout the menstrual cycle, progesterone cycles to help calm the drama queen and provide anti-anxiety and memory enhancing properties. It’s no wonder that almost half of women in the peri-post menopausal stage complain about forgetfulness. As for the mood swings, irritability, restlessness, and anger, changes in serotonin are to blame. Estrogen helps increase our feel-good chemical, serotonin. It helps to prevent its breakdown in the body, increase the activity and density of its brain receptors. As our estrogen levels lower, our feel-good serotonin lowers too.

Thermostat

As our dynamic duo cycle in the menstrual cycle phase of life, estrogen helps regulate body temperature with control mechanisms such as increasing blood flow to the skin for the sweat cooling effect. Progesterone helps to increase the body’s core temperature, maintaining a slightly warmer core temperature during the menstrual cycle phase. The effect that these hormones have on controlling body temperature diminish as the hormone levels lower. This is the reason behind hot flashes, night sweats, and the body’s core temperature lowers to the same as a males in the post-menopause phase.

Food Fueling

Our body uses food as fuel. Part of this process requires the body to use insulin to help glucose (sugars from all carbohydrate sources) to be transported into the cells to be used as fuel. Estrogen helps transport glucose into the cells without the use of insulin. This makes us females during our menstrual cycle phase of life more adept at using carbs as fuel than our estrogen-less males companions. As we enter the post-menopause phase of life, the body has a bit of a harder time using sugars and starches as fuel. Studies on this have shown that natural menopause is not a risk factor for developing diabetes. Our fueling habits also change during the post-menopause phase due to the influence that estrogen has on our hunger signals as well, causing less satiety and more hunger.

Pain Tolerance

Having a good level of pain tolerance is helpful throughout the menopause and childrearing years. Progesterone helps to mitigate the emotional connection that we have in relation to pain during those hormonal phases. Once the hormones shift into the post-menopause phase of life, there is a higher sensitivity to pain. This includes more pain experienced in the vagina, as a compound factor from the heightened sensitivity to pain, and the other changes that occur causing dryness and thinning of the tissues.

One thing is for sure; life is not stagnant. The hormonal changes that occur from the menstrual to peri to post-menopausal phases of life are one example of this. Now, not all the changes that occur sound like something anyone would sign up for, not every individual’s experience will include all the changes. There are many external and internal factors that will play a role in how an individual experiences this transitional phase of life. Stay tuned for part 3 that will share all the support we can give the body to help mitigate these changes.

References:

Menopause Athletes, Dr Stacy Sims [course]

Next Level, By Dr Stacy Sims