Should The Menopause Definition Get Updated?
“Recognition that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms. Optimising health at menopause is the gateway to healthy aging for women.” Researcher Susan Davis, Monash University Women’s Health Research Program.
Woo! Preach. However the treatment looks (hormones or not), this transition needs addressing for our long term health.
In addition, their team are proposing a new definition of menopause that I personally love. They suggest instead of focusing everything around menstruation (or not), we instead focus on the ovaries and that menopause is the “final cessation of ovarian function.”
Of course, this is still different from surgical menopause when the ovaries have been removed. At that point, you’re considered immediately menopausal.
Historically, the act of going through menopause microscopically focuses on reproductive changes by defining it after your period stops for 12 consecutive months. However, by widening the lens and acknowledging that the ovaries are not functioning like they used to, thus not producing the hormones that go systemically throughout the body, we can focus on all the other systems perimenopause and menopause effects.
Which, shocker, is more than just the reproductive system.
All 12 systems are affected - everything from cardiovascular to immune to neurological, to musculoskeletal and more. While you might not have SYMPTOMS in each system, it’s important to know that estradiol and progesterone (2 big hormones from your ovaries) have receptors they can bind to in those systems.
This means when your hormone levels decline with age, there is less binding or activation at those receptors.
Here’s an example. You have estradiol receptors in parts of your brain that have to do with memory, mood, and executive thinking/function. When your estradiol drops, you may notice worse mood, trouble with quick recall, forgetting things, needing to make lists/reminders, and not feeling as sharp or “on it” like you used to feel.
Here’s another example. You have estradiol receptors in your joints. When your estradiol drops, you may notice more joint pain or overall achiness because of the new changes in mechanical function and lubrication as a result.
In fact, in some systems you may not FEEL any symptoms even if changes are happening. You may not feel your blood pressure rising. You may not feel that you’ve become pre-diabetic and your cholesterol is creeping up.
None of these examples has to do with reproduction. But they can be very real symptoms or bodily changes women like you experience in this transition. This is why I fully support changing the definition so that we can properly educate the WORLD on menopause. Plus, have more research that focuses on all the systems affected.
Remember that menopause is not only about hot flashes and night sweats. In fact, you may not ever get those symptoms! However, it doesn’t mean internally things aren’t changing. They are.
You can click here to download my helpful labs sheet if you haven’t had a workup in a while!
Citations:
1.Susan Ruth Davis, Pinkerton JV, Santoro N, Simoncini T. Menopause—Biology, consequences, supportive care, and therapeutic options. Cell. Published online September 1, 2023. doi:https://doi.org/10.1016/j.cell.2023.08.016