07 Dec 2018

Menopause -- don't worry if your superpowers are fading, you're only becoming a human 

Estrogen endows women with certain superpowers -- superendurance, superhealth and superpatience -- but what happens during menopause, when all these benefits slowly fade?

Wysokie Obcasy
Irena Cieślińska Wysokie Obcasy, Global
Menopause -- don't worry if your superpowers are fading, you're only becoming a human  - NewsMavens
Woman in Groucho glasses, PixaBay

The following fragments from Irena Cieślińska's article first appeared in the Polish weekly "Wysokie Obcasy" in February 2018. 

Estrogen gives you superpowers

Our average life expectancy is 80 years. For about 25 of these years we are fertile -- somewhere between the age of 15 and 40. What’s normal and what’s only a transition remains a matter of discussion. I guess we could say that this relatively short period of fecundity should be treated as an anomaly in our long and diversified lifetime. And an anomaly - although pleasant and useful -- is also inevitably brief and in no way defining either us or our personality.

Self-sacrifice is not a female norm -- it’s not even a human norm. It’s a transitory state characteristic only found in women caught in the estrogen cloud.

In order to make them capable of facing all daily tasks, estrogen provides them with certain superpowers: superendurance, superhealth and superpatience. Other hormones - similar to estrogen – add a capability for superempathy and superattachment.

In the past, one whiff of your baby gave you power to move mountains, volunteer at school, never miss a day in the office and work overtime. Yesterday, the prospect of sorting out the electricity bill made you so depressed you couldn’t get out of bed. Your superpowers are disappearing: you’re becoming a human.

The price of normality

Usually between the age of 45 and 55 woman’s menstruation stops. At that point she’s no longer able to get naturally pregnant and the level of estrogen in her body slowly decreases. Since estrogen receptors can be found in nearly all tissues - from breasts, through bones to our belly - this lack of hormones brings a whole range of symptoms.

We usually associate menopause with hot flashes, excessive sweating and a gradual disappearance of our once impeccable patience -- regarded by those surrounding us people as an “increased irritability”. But that’s not all. This estrogen deficiency affects collagen and elastic fibers, which weakens our skin, bones and joints.

Our wrinkles deepen, our hair weaken and our skin starts to itch, break and exfoliate. We become more prone to osteoporosis and consequently, more vulnerable to bone fractures. We suffer from joint pains. Women who are physically active are at bigger risk of sports injuries caused by tendon overuse.

We struggle with insomnia, feel nauseous and often suffer from irritable bowel syndrome. Four out of ten of us get urinary incontinence. Our libido drops, while epithelium atrophy and vaginal dryness don’t make sex any easier. 

Depressed mood, injury proneness, reduced physical activity and slower metabolism lead to an inevitable weight gain and increase our  risk of getting diabetes. The decrease of estrogen reduces not only the flexibility of our skin but also of our blood vessels, which might result in increased pressure and cardiovascular diseases.

Some women complain about problems with concentration and memory. In fact, studies proved that during menopause women’s memory does deteriorate. But it only drops to the level of men’s powers of recall -- before this, women have an edge over their male counterparts when it comes to all memory functions. 

Hormone Replacement Therapy

A vaginal lubricant? Yes, please! Hot flash relief spray? I’ll take 40 bottles! I’ll also throw in some magnesium tablets for tiredness, vitamin D to improve bone strength, selective serotonin reuptake inhibitor that prevents depression, a whole root black cohosh for the hormonal imbalance and finally -- a good quality multivitamin.

How else can we reduce the estrogen deficiency symptoms?

Simple logic suggests adding what’s missing, in the same way as we treat hypothyroidism with thyroid hormones or diabetes with insulin injections. In brief, that’s how the HRT - hormone replacement therapy - works.

It’s been held in disrepute for a long time, mainly due to serious mistakes made during the large experiments conducted by Women’s Health Initiative (WHI) in USA and The Million Women Study in United Kingdom.

Both studies involved observation of women who started the hormone therapy considerably late, often even 10 years after their menstruation had stopped. During that period, their estrogen receptors had already ceased so the administration of hormones was not only completely pointless but it also caused a lot of damage. What’s more, the dose applied to all patients was exactly the same, whether they were 50 or 70-years-old.

A dosage appropriate for a woman in her 50’s can be (and has been) lethal for a 70-year-old. Today, nobody right in the head would sign off on such prescription.

And despite the fact that the average age of experiment participants didn’t extend past 63 - the analysts described their results as relevant to all women in menopause. The main concern about the menopause hormone therapy was that it could increase the risk of stroke and breast cancer.

After the results have been published, a great number of medical doctors stopped prescribing HRT and many women decided to quit their therapy immediately. They struggled with hot flashes, and sleeplessness but they preferred these symptoms to the risk of having cancer. Within 2 years the number of women using HRT dropped by 66%.

HRT exonerated

A thorough analysis of the WHI results and further research conducted on a vast number of patients in Denmark (and a few other studies) showed that for women who started  HRT immediately after menopause, the risk of cardiovascular diseases in the following 10 years was considerably lower.

What about cancer? In a group of 1 000 women who were taking HRT for 5 years after they’d reached the age of 50, analysts observed two more cases of breast cancer and one more case of ovarian cancer than in a group of women not receiving the therapy.

Studies showed that obesity increases the risk of cancer ten times more than taking HRT. Smoking - even thirty times more. At the same time, HRT reduces chance of other types of cancer, for example: colon cancer.

We’re mainly concerned about cancer while the cardiovascular diseases are far more dangerous and fatal -- they kill ten times more women than breast cancer.

Unfortunately, despite the fact that 15 years have passed since the unfavourable publication and that since then the quality and dosage of administered hormones have been considerably improved and a great number of therapy safety tests have been carried out successfully, the information didn’t send the same shock waves across the media, as the alarming news had in 2002.

The latest observations showed that if we start taking HRT before reaching 60, its benefits will exceed any potential risk.

Hormone replacement therapy allows you to control menopause symptoms, improves the quality of your life, keeps your genitourinary system healthy and is a number one weapon against osteoporosis. 

If not hormones, then what?

Noradrenaline and selective serotonin reuptake inhibitors can help with hot flashes. Vaginal dryness can be overcome with lubricants. When it comes to diet supplements containing  isoflavones (a substance found in certain plants that produces effects similar to estrogen) for example: black cohosh root extract - there is very little (if any) evidence for its effectiveness. Supplements and alternative therapies might ease the symptoms but they won’t have a positive effect on our bone density, blood vessels and on our heart.


Translated from Polish by Martyna Kardach


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