Menopause is a natural biological process that occurs in women typically between the ages of 45-55 and marks the end of women’s reproductive years. Hormones are one-way different organs in our body communicate and coordinate functions in order to work as one system. Hormones travel in the bloodstream from their origin (usually endocrine glands) to their targets, working slowly in regulating every action and process in our body from blood sugar and blood pressure to reproduction and growth.
Sex hormones such as FSH (Follicle stimulation Hormone), AMH (Anti Mullerian Hormone) and Estradiol are produced mainly by the adrenal glands and the gonads (ovaries in women and testes in men). Estrogen is a sex steroid hormone which serves an important role in the regulation of a number of biological functions, including bone density, brain function, cholesterol mobilization, electrolyte balance, skin physiology, the cardiovascular system, the central nervous system and female reproductive organs. In addition, estrogen has an an important role in reducing inflammation.
During menopausal transition (MT, also referred to as perimenopause) the ovaries gradually stop producing eggs and the body experiences hormonal changes that can cause a range of physical and emotional symptoms such as insomnia, fatigue, irritability, gastrointestinal symptoms, weight gain, muscle mass reduction and hot flashes.
In this series of three blogs, I will address three groups of symptoms of MT that I often seen in my clinic.
The first part of the trilogy will discuss weight gain and gastrointestinal symptoms such as bloating, constipation, and diarrhea. The second part will focus on hot flashes, night sweats, insomnia, and fatigue, and the last blog will discuss the emotional aspects of menopause ( irritability, restlessness, and depression).
In each blog, I will briefly introduce traditional Chinese medicine views of these changes and discuss how acupuncture treatment can help manage and ameliorate MT-induced symptoms.
Digestion and weight gain during MT
Gastrointestinal symptoms are very common among people at all ages but can become more pronounced during certain periods of the menstrual cycle and during MT. Such symptoms can preoccupy your mind and leave your body at unease, negatively impacting concentration and performance.
Three standard sets of symptoms during MT are irritable bowel syndrome (IBS), acid reflux and weight gain..
Irritable bowel syndrome
IBS is characterized by abdominal pain and altered bowel habits. Pain is frequently described as a cramping sensation and can vary greatly in frequency, intensity and location. Patients also frequently describe bloating and an increase in flatulence or belching. Altered bowel habits include diarrhea, constipation and, sometimes, alternating diarrhea and constipation. Studies have demonstrated that estrogen regulates motor and sensory functions of the bowel. Lower levels of estrogen slow digestion, leading to food staying longer in the intestine, which may contribute to some of the IBS symptoms women in MT experience.
Estrogen also has a roll in balancing cortisol level, a stress hormone produce by our adrenal glands. Changes in estrogen levels can impact this delicate balance and lead to stressful situations having a greater impact on our digestive system. Importantly, it may also make us more sensitive to nervous stimuli originating in the gut, thereby exacerbating symptoms such as pain and bloating. Furthermore, estrogen and other sex hormones are likely to have an effect on our intestine’s flora (the bacteria and microorganisms that colonize our gut). The importance of the intestinal flora is still only partly understood and is the focus of contemporary research. It is safe to presume, though, that the dramatic hormonal changes during MT disrupt the equilibrium of the intestinal flora’s micro-ecosystem, contributing to IBS symptoms.
Gastroesophageal reflux disease (GERD), also known as “acid reflux” is a a chronic condition in which gastric content flows back into the esophageal, causing symptoms such as heartburn and nausea. Higher prevalence of GERD in men and rapidly increasing prevalence in women as they age suggests an association with levels of sex hormones. Estrogen, though, is thought to relax the sphincter between the esophagus and stomach, possibly indicating different mechanisms for GERD in menopausal women and possibly a role of other sex hormones.
Weight gain is common during MT. Many women will notice weight accumulating mainly around their waistline and belly areas. This may happen even without an actual increase in body weight because of concomitant loss of muscle mass. On top of aesthetic considerations, belly fat is very unhealthy.It usually means the accumulation of fat not only under the skin but also between our internal organs (visceral fat). Visceral fat is associated with a risk of high cholesterol, type 2 diabetes, high blood pressure, and subsequent higher risk of heart disease and stroke.
So why do we gain weight during the menopausal transition?
Reduction in estrogen levels and subsequent cortisol imbalance lead to increase in fat tissue and a decrease in muscle mass. Changes in hormones that impact hunger and satiety, such as leptin and ghrelin, during MT lead to an increase in hunger and craving for carbohydrates and fat. Furthermore, other symptoms during MT, such as insomnia (discussed separately in the following blog), contribute further to weight gain.
How can Acupuncture help?
According to TCM (Traditional Chinese Medicine), as we age, we can experience a decline in Kidney, Stomach, and Spleen* functions, all directly responsible for food processing and absorption. By stimulating specific points acupuncture strengthens and restores balance to these organ systems, mitigating associated MT symptoms. It also improves blood flow to internal organs, improves their function and health, and reduces levels of stress hormones such as cortisol. Importantly, during MT and menopause biological changes lead to an imbalance in multiple systems, creating a complex interplay of different symptoms. Acupuncture takes all of these into account, offering a holistic approach rather than targeting each set of symptoms separately.
I invite you to schedule an appointment with me, where we can discuss your symptoms and create a treatment plan that is tailored to your exact needs.
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