How to better experience menopause?

What is menopause?

Menopause, which typically occurs around the age of 50, is defined as the cessation of ovulation, a decrease in the production of sex hormones, estrogen, and progesterone, and consequently, the cessation of menstruation, which can occur more or less gradually. Cycle variations, sometimes accompanied by discomfort such as mood swings, anxiety, hot flashes, or urinary problems due to decreased pelvic floor tone, are considered precursors of menopause and can last for several months to several years. This period, known as perimenopause, varies significantly from one woman to another and may go unnoticed for some women in whom menstruation ceases suddenly.

It's important to note that treatments for menopause are prescribed only when it is truly established and diagnosed and do not apply to the period preceding it.

Hormone therapy: for or against?

With proven effectiveness, hormone replacement therapy (HRT) was long considered a panacea until the famous controversy in 2002 triggered by two American and British studies associating it with an increased risk of breast cancer, leading to a significant reduction in its use in France. Several European and French studies have since supported these results overall. For example, a recent study of a group of women of average weight in Western countries found an increased risk of developing breast cancer, with one additional case for every 50 women taking hormone therapy regularly from the age of 50 for 5 years. This risk can persist for several years after the therapy has been discontinued. While these results may seem alarming, it is important to consider the type of treatment, with or without combined hormones, the medical and family history of each individual, and the extent of daily discomfort.

Regular estrogen therapy, for instance, could reduce the tendency to develop osteoporosis, slow down bone loss that occurs after menopause, and reduce the risk of fractures due to bone fragility, which affects one in two women from their fifties onwards. However, there are other ways to prevent osteoporosis, such as a diet rich in calcium and vitamin D.

According to the latest recommendations from health authorities, HRT is now subject to controlled prescription and personalized treatment, taking into account strict contraindications, studied on a case-by-case basis, and assessing the benefits and risks for each woman, who must be informed. It is generally considered when menopausal symptoms, such as hot flashes, mood changes, or vaginal dryness, significantly affect a woman's quality of life. In all cases, the goal is to use the minimum effective dose for the shortest duration possible.

Are there effective solutions without HRT?

To combat the discomfort associated with menopause, research is increasingly turning to dietary supplements and phytotherapy, specifically phytohormones, which are plant hormones produced by plants. These plants that mimic the action of hormones vary in effectiveness depending on the intensity and type of symptoms to be treated and the ability of the gut flora to transform the components of certain plants into active substances. These may include flaxseeds, hops, soy, or other plants like sage, which are generally combined in the form of dietary supplements. Additionally, black cohosh, a plant long used by Native Americans to relieve menstrual pain and during childbirth, has been recognized by the World Health Organization for its efficacy in reducing hot flashes, sleep disturbances, and irritability associated with menopause.

There are some contraindications for phytohormones in cases of breast, ovarian, or uterine cancer or a history of such cancers. In all cases, it is advisable to seek a doctor's opinion on the appropriate complex for each case and the recommended doses.

Other natural products have certain beneficial properties, such as saffron, known for its positive effects on mood, or fish-derived omega-3 fatty acids, which can be taken as a dietary supplement for a few months to reduce hot flashes and emotional instability associated with menopause. Furthermore, a certain type of food can impact these symptoms, and an adapted lifestyle can help women go through menopause with more serenity. Among other recommendations from dietitians, it is advisable to minimize the consumption of stimulants like tea or coffee, as well as alcohol. Concentrated sugars found in desserts, pastries, and other sweets cause rapid fluctuations in blood glucose levels, which promote hot flashes.

Can weight gain associated with menopause be prevented?

During menopause, some women may notice unwanted weight gain, particularly in the abdominal region. This is due to the decrease in estrogen levels, frequent changes in dietary habits during this period, and a decrease in basal metabolism, which is the energy expended at rest. However, a balanced and targeted diet can help counteract this natural tendency and maintain a slim figure, or close to it. To achieve this, it is recommended to favor a diet rich in nutrients, fiber, and high-quality proteins such as eggs, poultry, legumes, natural fish, seafood, low-fat cheese, or tofu. On the contrary, trans fats and saturated fats found in pastries, processed meats, fatty meats, or high-fat cheeses contribute to weight gain.

Does menopause influence sexual life?

A majority of women continue to have an active sex life after the age of 50, contrary to common misconceptions about the desire and sexuality of menopausal women. It has been observed that changes in behavior and any difficulties encountered are more often due to apprehension than to reality. It's important to note that some physiological phenomena, such as vaginal dryness or more frequent yeast infections after the age of 50, may require the use of lubricants or antifungal treatments, but the biological and hormonal changes that accompany menopause have absolutely no effect on sexual behavior or a woman's libido and do not hinder the possibility of a fulfilling sex life.

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