What really happens to your body during menopause Body Stuff with Dr. Jen Gunter
Transcriber:
There’s a lot of mystery and confusion
surrounding menopause,
so I’m going to take the next few minutes
to tell you exactly what’s happening
in our bodies when we go through it.
You can almost think of menopause
as puberty in reverse.
[Body Stuff with Dr. Jen Gunter]
Hey, it’s your favorite ob-gyn,
and I’m here today to talk about a subject
that I find truly fascinating: menopause.
Chances are you probably don’t find it
quite as gripping as I do,
but I promise that if you can
get past the horror stories,
you’ll be riveted too.
Whether you’re going through
it or know someone who is,
you’ll recognize there’s nothing to fear.
So what exactly is menopause?
Technically, “menopause” is diagnosed
one year after the final period,
but most people use it
to refer to the entire span of time
when our menstrual cycle
is changing in length,
a process that lasts several years,
and then all the time afterwards.
So it’s best to think of menopause
as a continuum, starting years before,
during what is called
the menopause transition.
Just like puberty, the process
happens over many years.
The menopause transition
is one bookend of our reproductive cycle,
opposite puberty.
When we’re born, we actually have all
the eggs we’re ever going to make,
about one to two million of them,
unmatured and encased
in follicles in the ovaries.
Around the age of eight to 10,
the hypothalamus, a region in your brain,
starts releasing a hormone
that essentially wakes up
those dormant eggs,
beginning the monthly cycles of ovulation.
This is what increases
production of a class of hormones
you’ve probably heard about – estrogen.
Estrogen, along with other hormones,
begins a delicate hormonal dance
that, once a month,
results in the most mature egg
leaving its follicle
and traveling down a fallopian tube.
The body builds up the lining
in the uterus, the endometrium,
to house the egg,
and if the egg isn’t fertilized,
the lining sheds, and we have our period.
This cycle repeats
over and over and over, for decades.
On average, sometime in the mid-forties,
ovulation starts to get erratic.
We just don’t have as many eggs,
and the ones that remain
may not be as healthy anymore.
Estrogen can be lower some cycles,
and even higher during others.
This is the menopause transition –
hormonal chaos, like puberty,
only this time, when estrogen
levels stabilize,
they’ll be much lower
than they were before.
This very normal decrease in estrogen
and other hormonal changes
does come with medical concerns,
such as osteoporosis, heart disease,
diabetes and vaginal dryness.
Some of us are lucky and we will have
no or mild symptoms.
Others will experience
trouble sleeping, irritability,
depression or decreased sex drive.
And then there’s the most
classic symptom, hot flushes.
They’re a wave of heat
that makes it feel like the furnace
just got cranked up on the inside.
Scientists aren’t completely sure
why this happens,
but the resulting heat
makes you feel sweaty and off-kilter.
Some women even have symptoms
that overlap with anxiety,
like nausea and palpitations.
But for me, it feels
as if I’ve had too much to drink.
Those are some of the negatives,
but there are positives too.
After menopause, you don’t have to worry
about periods or cramps,
and people who partner with men
who make sperm
don’t have to be concerned
about unintended pregnancy.
You’re through all that.
To me, menopause is something
we go through, like puberty.
And like puberty,
there’s a range of experiences.
We continue to make vital contributions
to society after menopause.
It’s not your dotage.
Your worth has nothing
to do with your ovaries.
So let’s say you’re
in the menopause transition.
What are the best things you can do?
If you’re suffering,
there’s almost always some kind of help.
If you smoke, definitely try to quit.
It will reduce
your risk of heart disease,
it might also reduce some
symptoms of menopause.
Reducing stress and getting
enough sleep is also good.
Focus on eating a healthy, balanced diet
rich in calcium and vitamin D
for healthy bones,
and try to get at least 150 minutes
of moderate physical activity a week,
especially if it’s
weight-bearing exercises,
like hiking, dancing or jogging.
If you’re losing sleep
or having hot flushes,
or experiencing other symptoms
that affect your quality of life,
talk to your doctor.
Don’t rely on wearable magnets
or so-called compounded hormones.
These are unproven and have risks.
There are a variety of proven options,
from cognitive behavioral therapy
to FDA-approved estrogen,
and some nonhormonal medications
that can be very helpful.
There are so many permutations
and combinations of options
that safe therapy can be
customized for almost every woman.
One more idea, have a mantra ready.
When I get a hot flush,
sometimes I tell myself
I’m feeling this
because women have evolved
to drive humanity forward.
This is a sign of my strength.
And then, I can make it
until it goes away.