Menopause, also known as -the change of life' or -the change' is a natural event in a woman's reproductive life. Usually occurring between the ages of 45-55 years, in Australia the average age a woman reaches menopause is 51-52.
Menopause marks the end of ovulation and monthly menstrual periods, which can be either a liberating experience or a cause of sadness, depending on your viewpoint. Some women can experience early menopause naturally, due to surgery, primary ovarian insufficiency (POI), or after certain treatments for cancer. The physical and emotional symptoms experienced during menopause are caused by a reduction in oestrogen, one of the main hormones produced by the ovaries. Hormones are chemical messengers that control many bodily functions, such as temperature, digestion, telling your body when to heal, to grow or to reproduce.
Menopause is categorised into three stages.
Perimenopause: During this time hormonal changes occur, with levels of oestrogen and progesterone fluctuating due to a decrease in the number of healthy, fertile eggs produced by the ovary. Menstrual periods may become irregular, heavier or more painful, though an estimated 20% of women have no symptoms whatsoever. Perimenopause may last for up to 10 years and it's worth remembering you can still become pregnant during this time.
You may experience a wide range of physical and emotional symptoms. Among the most commonly reported are hot flushes, mood swings, itchy, crawling skin sensations, vaginal dryness, insomnia and sore breasts.
Menopause: Menopause is actually the final period a woman ever has but as periods become very erratic and irregular before menopause, it is defined to have absolutely occurred after 12 months of no periods.
Postmenopause: The time from 12 months after your final period.
Menopause often means midlife spread
Midlife spread is the common name for the extra roll of abdominal fat many women develop around menopause, thought to be due to reduced oestrogen levels encouraging a change in fat storage. It is estimated that, between the ages of 45 and 55 years, the average woman will gain at least half a kilo each year. Research suggests that women who don't gain weight around the time of menopause exercise for an average of 60 minutes per day.
Jean Hailes endocrinologist Dr Sonia Davison says, 'Weight gain is common around menopause and perimenopause, when ovarian hormone secretion becomes erratic. The weight gain tends to be distributed around the tummy region, and research shows this to be a risk factor for the development of heart disease. If women find themselves gaining weight despite eating the same amounts and doing the same amount of exercise as in younger years, then it's time for action! Speak with your doctor, dietitian or other health professional about how to adjust your diet and exercise patterns such that you avoid weight gain, or aim for weight loss if you are not in the healthy weight range for your height."
There are different types of fat, with some types being more of a worry than others.
Abdominal fat is subcutaneous, meaning you can grab it with your hand.
Visceral fat is the type that surrounds your internal organs and cannot be seen or grabbed by hand. It has long been linked to a range of health conditions; in particular, visceral fat has been linked to a higher risk of type 2 diabetes, cardiovascular disease (the name for a range of diseases affecting your heart and circulation system, such as heart disease or stroke) and breast cancer.
Fat that surrounds the heart muscle is called cardio fat and is linked to a higher risk of cardiovascular disease (CVD). CVD is the single-biggest killer of women in Australia, with one woman dying every hour due to heart disease. Menopause brings an elevated risk of developing CVD, so researchers are encouraging women approaching menopause to keep an eye on weight gain and to eat a heart healthy diet. 'Speaking with your doctor about your risks for heart disease and how to maintain a 'healthy heart' is a great start in terms of minimising your individual heart disease risk," says Dr Davison.
The message for women of all ages is to get up, get moving and look towards midlife with excitement, not worry. You don't have to go crazy – 30 minutes a day is enough to reduce your risk of CVD, improve your mood and attack that extra fat. Try dancing or skipping for 10 minutes, three times a day – just enough to get your heart racing. Try to be gentle on yourself though; visit your GP for a general check-up first. It's also worth asking for a referral to see a dietitian if you need advice on what to eat.
Read more information on menopause, preventing cardiovascular disease and eating for good health.
Published with the permission of Jean Hailes for Women's Health
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