What are the most common symptoms of menopause? And which can hormone therapy treat?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers.
Adding to the uncertainty, a recent series in the Lancet medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate.
So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says.
Remind me, what exactly is menopause?
Menopause, simply put, is complete loss of female fertility.
Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause).
Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months.
Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder).
What are the most common symptoms of menopause?
Our study of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are:
- hot flushes and night sweats (known as vasomotor symptoms)
- disturbed sleep
- musculoskeletal pain
- decreased sexual function or desire
- vaginal dryness and irritation
- mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.
However, none of these symptoms are menopause-specific, meaning they could have other causes.
In our study of Australian women, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats.
But the severity of these symptoms varies greatly. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55.
So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are similarly affected.
Maridav/Shutterstock
Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span.
The most robust guidelines do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of menopausal hormonal changes.
The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. Some studies suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) have not been shown to change.
Who might benefit from hormone therapy?
The Lancet papers suggest menopause hormone therapy alleviates hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats).
In contrast, the highest quality clinical guidelines consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy.
Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency).
Monkey Business Images/Shutterstock
However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”.
Despite musculoskeletal pain being the most common menopausal symptom in some populations, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied.
Some guidelines, such as an Australian endorsed guideline, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease.
What are the risks?
The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot.
Oestrogen-only menopause hormone therapy is consistently considered to cause little or no change in breast cancer risk.
Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, has been associated with a small increase in the risk of breast cancer, although any risk appears to vary according to the type of therapy used, the dose and duration of use.
Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels prescribed at standard doses
What if I don’t want hormone therapy?
If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats.
In Australia, most of these options are “off-label”, although the new medication fezolinetant has just been approved in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat).
Unfortunately, most over-the-counter treatments promoted for menopause are either ineffective or unproven. However, cognitive behaviour therapy and hypnosis may provide symptom relief.
The Australasian Menopause Society has useful menopause fact sheets and a find-a-doctor page. The Practitioner Toolkit for Managing Menopause is also freely available.
Susan Davis, Chair of Women’s Health, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
What you need to know about xylazine
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Xylazine is a non-opioid tranquilizer designed for veterinary use in animals. The sedative is not approved for use in people, yet it’s becoming more prevalent in the illicit drug supply.
Sometimes called “tranq,” it’s often mixed with other drugs, such as fentanyl, a potent opioid responsible for a growing number of overdose deaths. Last year, the White House Office of National Drug Control Policy declared fentanyl mixed with xylazine an “emerging threat.”
Read on to learn more about xylazine: what happens when people take it, what to do if an overdose is suspected, and how harm reduction tools can prevent overdose deaths.
How are people who use drugs exposed to xylazine?
Studies show people are exposed to xylazine—knowingly or unknowingly—when it’s mixed with other drugs like heroin, cocaine, meth, and, most frequently, fentanyl. When combined with opioids or other drugs, it increases the risk of a drug overdose.
What happens if someone takes xylazine?
Taking xylazine can cause drowsiness, amnesia, slow breathing, slow heart rate, dangerously low blood pressure, wounds that can become infected, and death, especially when taken in combination with other drugs.
Why does xylazine increase the risk of overdose?
Xylazine is a central nervous system depressant, which means that it slows down the body’s heart rate and breathing. It can also enhance the effects of other depressants, such as opioids, which may lead to suffocation.
What are the signs of a xylazine-related overdose?
Xylazine-related overdoses look like opioid overdoses. A person who has overdosed may exhibit a slow pulse, slow breathing, blurry vision, disorientation, drowsiness, confusion, blue skin, and loss of consciousness.
How many people die from xylazine-related overdoses in the U.S.?
Xylazine-related overdose deaths in the U.S. rose from 102 deaths in 2018 to 3,468 deaths in 2021. Most occurred in Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia. Fentanyl was the most frequently co-occurring drug involved in those deaths.
What should I do if an overdose is suspected?
If you suspect that a person has overdosed on any drug, call 911 and give them naloxone—sometimes sold under the brand name Narcan—a medication that can reverse an opioid overdose. You should also stay with the person who has overdosed until first responders arrive. Most states have Good Samaritan laws, which protect people who have overdosed and those assisting them from certain criminal penalties.
While naloxone cannot reverse the effects of xylazine alone, experts recommend administering naloxone if an overdose is suspected because it’s often mixed with opioids.
You can get naloxone for free from some nonprofit organizations and government-run programs. You can also purchase over-the-counter naloxone at pharmacies, grocery and convenience stores, and other retailers.
Learn how to use naloxone in this short training video from the American Medical Association, or sign up for a free online training.
How can people prevent xylazine-related overdoses?
Harm reduction programs are community programs that prevent drug overdoses, reduce the spread of infectious diseases, and connect people to medical care. These programs provide lifesaving tools like naloxone, as well as fentanyl and xylazine test strips, which can detect the presence of these drugs in a substance and prevent overdoses. Drug test strips can also be ordered online.
However, test strips are considered “drug paraphernalia” in some states and are not legal everywhere. Learn more about state laws around drug checking equipment from the Network for Public Health Law.
Learn more about harm reduction from the CDC.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
Share This Post
-
5 Ways To Beat Afternoon Energy Slumps
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This is Nisha Vora, of Rainbow Plant Life fame. After graduating from Harvard Law School, she realized she hated being a lawyer, and pivoted completely to become what she now is 12 years later, a chef and health coach.
Here are her tips for boosting energy through the day:
Caffeine timing
If you don’t do caffeine at all, no need to change that, but if you do, Vora advises that midday is the best time for it, with a very good rationale:
- of course it should not be too late in the day, because the elimination half-life of caffeine (4–8 hours to eliminate just half of the caffeine, depending on genes, call it 6 hours as an average though honestly for most people it will either be 4 or 8, not 6) is such that it can easily interfere with sleep for most people
- because caffeine is an adenosine blocker, not an adenosine inhibitor, taking caffeine in the morning means either there’s no adenosine to block, or it’ll just “save” that adenosine for later, i.e. when the caffeine is eliminated, then the adenosine will kick in, meaning that your morning sleepiness has now been deferred to the afternoon, rather than eliminated.
Another reminder that caffeine is the “payday loan” of energy. So, midday it is. No morning sleepiness to defer, and yet also not so late as to interfere with sleep.
See also: Calculate (And Enjoy) The Perfect Night’s Sleep
Simplify what can be simplified
This one’s not from a physiological basis, but rather, that a lot of the time most of us have much of our energy being taken by constant task-switching (what gets called multitasking, but as our brain is a single processor, it really means switching rapidly between different kinds of cognition, which is not efficient). In order to avoid that energy drain, try to streamline things and make a particular effort to not only single-task, but to do so without distractions.
Counterpoint: if you have unmedicated ADHD, then chances are you’ll do better with a single small distraction chosen by you, than trying to go without distractions, because your brain will find distractions anyway, so you might as well choose one (for many people it is background music, or a podcast or TV show that one doesn’t may attention to but it’s there) as a matter of harm reduction, and that way you’ll do better at focusing on your primary task than if your brain were reaching out for every and any possible distraction.
Manage your blood sugars
In particular, she advocates for avoiding sugary breakfasts, opting instead for protein, fat, and fiber-rich options. For more in this regard, see:
10 Ways To Balance Your Blood Sugars
Walk after meals
You don’t have to don hiking boots and “I am just going outside and may be some time“; rather, even a 2–5 minute walk after a meal helps regulate digestion and glucose levels, avoiding postprandial energy slumps.
So,
- if you have a treadmill, after eating is a great time to use it for a few minutes
- if you have stairs, now’s a great time to go up and down them a few times
One last technique for when everything else fails
We’ll quote her directly on this one:
❝Despite my best efforts, soemtimes I just have one of those days. Maybe I didn’t sleep well or I’m distracted by my never ending thoughts. If I need to be productive or energized on those days, I will do something that I absolutely hate:
I will take a cold shower.
And I hate it because I’m already always cold all the time, so why would I want to get a cold shower?
Well, it’s because cold water immersion has been shown to dramatically boost your dopamine levels, which gives you more energy and motivation.
In the moment though, it’s mostly painful and I hate everything and everyone around me.
But I know that if I can suffer through two minutes of a cold shower, I will feel so refreshed.❞
There are more benefits than just that, though, see:
A Cold Shower A Day Keeps The Doctor Away?
Want more from Nisha Vora?
We reviewed one of her books a while back:
The Vegan Instant Pot Cookbook – by Nisha Vora
Enjoy!
Share This Post
-
Kidney Beans or Black Beans – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing kidney beans to black beans, we picked the black beans.
Why?
First, do note that black beans are also known as turtle beans, or if one wants to hedge one’s bets, black turtle beans. It’s all the same bean. As a small linguistic note, kidney beans are known as “red beans” in many languages, so we could have called this “red beans vs black beans”, but that wouldn’t have landed so well with our largely anglophone readership. So, kidney beans vs black beans it is!
They’re certainly both great, and this is a close one today…
In terms of macros, they’re equal on protein and black beans have more carbs and/but also more fiber. So far, so equal—or rather, if one pulls ahead of the other here, it’s a matter of subjective priorities.
In the category of vitamins, they’re equal on vitamins B2, B3, and choline, while kidney beans have more of vitamins B6, B9, C, and K, and black beans have more of vitamins A, B1, B5, and E. In other words, the two beans are still tied with a 4:4 split, unless we want to take into account that that vitamin E difference is that black beans have 29x more vitamin E, in which case, black beans move ahead.
When it comes to minerals, finally the winner becomes apparent; while kidney beans have a little more manganese and zinc, on the other hand black beans have more calcium, copper, iron, magnesium, phosphorus, potassium, and selenium. However, it should be noted that honestly, the margins aren’t huge here and kidney beans are almost as good for all of these minerals.
In short, black beans win the day, but kidney beans are very close behind, so enjoy whichever you prefer, or better yet, both! They go great together in tacos, burritos, or similar, by the way.
Want to learn more?
You might like to read:
- Kidney Beans vs Fava Beans – Which is Healthier?
- Chickpeas vs Black Beans – Which is Healthier?
- Bold Beans – by Amelia Christie-Miller ← this is a recipe book; if you’re looking to incorporate more beans into your diet and want to make it good, this cookbook can lead the way!
Take care!
Share This Post
Related Posts
-
Paulina Porizkova (Former Supermodel) Talks Menopause, Aging, & Appearances
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Are supermodels destined to all eventually become “Grizabella the Glamor Cat”, a washed-up shell of their former glory? Is it true that “men grow cold as girls grow old, and we all lose our charms in the end”? And what—if anything—can we do about it?
Insights from a retired professional
Paulina Porizkova is 56, and she looks like she’s… 56, maybe? Perhaps a little younger or a bit older depending on the camera and lighting and such.
It’s usually the case, on glossy magazine covers and YouTube thumbnails, that there’s a 20-year difference between appearance and reality, but not here. Why’s that?
Porizkova noted that many celebrities of a similar age look younger, and felt bad. But then she noted that they’d all had various cosmetic work done, and looked for images of “real” women in their mid-50s, and didn’t find them.
Note: we at 10almonds do disagree with one thing here: we say that someone who has had cosmetic work done is no less real for it; it’s a simple matter of personal choice and bodily autonomy. She is, in our opinion, making the same mistake as people make when they say such things as “real people, rather than models”, as though models are not also real people.
Porizkova found modelling highly lucrative but dehumanizing, and did not enjoy the objectification involved—and she enjoyed even less, when she reached a certain age, negative comments about aging, and people being visibly wrong-footed when meeting her, as they had misconceptions based on past images.
As a child and younger adult through her modelling career, she felt very much “seen and not heard”, and these days, she realizes she’s more interesting now but feels less seen. Menopause coincided with her marriage ending, and she felt unattractive and ignored by her husband; she questioned her self-worth, and felt very bad about it. Then her husband (they had separated, but had not divorced) died, and she felt even more isolated—but it heightened her sensitivity to life.
In her pain and longing for recognition, she reached out through her Instagram, crying, and received positive feedback—but still she struggles with expressing needs and feeling worthy.
And yet, when it comes to looks, she embraces her wrinkles as a form of expression, and values her natural appearance over cosmetic alterations.
She describes herself as a work in progress—still broken, still needing cleansing and healing, but proud of how far she’s come so far, and optimistic with regard to the future.
For all this and more in her own words, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Many Faces Of Cosmetic Surgery
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Get Ahead (Healthwise) This Winter
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Tomorrow will be December the first.
A month later, it’ll be January the first, and very many people will be quite briefly making a concerted effort to get healthier.
So, let’s get a head start, so that we can hit January already in great health!
December’s traps to plan around
In North America at least, common calendar-specific health problems associated with December are:
- Infectious diseases (seasonal flu and similar unpleasantries)
- Inactivity (seasonal weather)
- Slower metabolism (seasonal eating and drinking, plus seasonal weather)
- Alcohol (seasonal drinking)
- Stress (seasonal burdens)
So, let’s plan around those!
But first, sleep
Nothing will go well if we are not well-rested. There are six dimensions of sleep, but the ones that matter the most are regularity and duration, so plan for those and the rest should fall into place:
Calculate (And Enjoy) The Perfect Night’s Sleep
Skip those viruses
If you’re doing the rest of what we advise, your immune system will probably be in good shape, unless you have some chronic disease that means you are immunocompromised, in which case the next things will be extra important:
- Avoid enclosed spaces with lots of people where possible
- Ventilation is your friend (as is air filtration)
- Masks don’t protect against everything, but they do protect against a lot
- Wash your hands more often than you think is necessary (invest in luxurious soap, to make it a more pleasant experience, then you’re more likely to do it often!)
- Breathe through your nose, not your mouth (nostril hairs attract floating particles by static charge, and then dispose of intruders via mucus)
See also: The Pathogens That Came In From The Cold
Plan your movement
But, realistically. Let’s face it, unless you already have such a habit, you’re not going to be hitting the gym at 6am every day, or be out pounding pavement.
The weather often makes us more reluctant to exercise, so if that sound like you, plan something low-key but sustainable that will set you in good stead ready for the new year. Here are two approaches; you can do both if you like, but picking at least one is a good idea:
- Commit to just a few minutes of high-intensity exercise each day. If you don’t have equipment, then bodyweight squats are a great option.
- Commit to gentle exercises each day—pick some stretches and mobility drills you like, and focus on getting supple for the new year.
See also: How To Keep On Keeping On, When Motivation Isn’t High ← this isn’t a motivational pep talk; it’s tricks and hacks to make life easier while still getting good results!
Fuel in the tank
It’s fine if you eat more in winter. We even evolved to put on a few pounds around this time of year. However, to avoid sabotaging your health, it’s good to do things mindfully. Pick one main dietary consideration to focus on, for example “anti-inflammatory” or “antidiabetic” or “nutrient-dense”.
Those focused ways of eating will, by the way, have a huge amount of overlap. But by picking one specific factor to focus on, it simplifies food choices at a time of year when supermarkets are deliberately overwhelming us with choices.
If you’re having a hard time picking just one thing to focus on, then we recommend:
What Matters Most For Your Heart?
About that festive spirit…
Alcohol consumption goes up around this time of year, partly for social reasons, partly for “it’s cold and the marketing says alcohol warms us up” reasons, and partly for stress-related reasons. We’re sure you know it sabotages your health, so choose your path:
How To Reduce Or Quit Alcohol, or
How To Reduce The Harm Of Festive Drinking (Without Abstaining)
Relax and unwind, often
There’s a lot going on in December: consumerism is running high, everyone wants to sell you something, finances can be stressful, social/familial obligations can be challenging sometimes too, and Seasonal Affective Disorder is at its worst.
Make sure to regularly take some time out to take care of yourself, and make sure you’re doing the things you want to do or really have to do, not just things you feel you’re expected to do.
Different people can have very different challenges at this time of year, so it’s hard to give a “one size fits all” solution here (and we don’t have the room to cover every possible thing today). You know your life best, so think what you’re most likely to want/need for you this month, and make sure you get it.
At the very least, most of us will benefit from taking a few minutes to consciously relax, and often, so something that is almost always a good idea for that is:
No-Frills, Evidence Based Mindfulness
…but if you’re feeling in a more playful mood, consider:
Meditation Games You’ll Actually Enjoy!
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Meningitis Outbreak
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Don’t Let Your Guard Down
In the US, meningitis is currently enjoying a 10-year high, with its highest levels of infection since 2014.
This is a big deal, given the 10–15% fatality rate of meningitis, even with appropriate medical treatment.
But of course, not everyone gets appropriate medical treatment, especially because symptoms can become life-threatening in a matter of hours.
Most recent stats gave an 18% fatality rate for the cases with known outcomes in the last year:
CDC Emergency | Increase in Invasive Serogroup Y Meningococcal Disease in the United States
The quick facts:
❝Meningococcal disease most often presents as meningitis, with symptoms that may include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status.
[It can also present] as meningococcal bloodstream infection, with symptoms that may include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a dark purple rash.
While initial symptoms of meningococcal disease can at first be non-specific, they worsen rapidly, and the disease can become life-threatening within hours. Immediate antibiotic treatment for meningococcal disease is critical.
Survivors may experience long-term effects such as deafness or amputations of the extremities.❞
~ Ibid.
The good news (but still don’t let your guard down)
Meningococcal bacteria are, happily, not spread as easily as cold and flu viruses.
The greatest risks come from:
- Close and enduring proximity (e.g. living together)
- Oral, or close-to-oral, contact (e.g. kissing, or coughing nearby)
Read more:
CDC | Meningococcal Disease: Causes & How It Spreads
Is there a vaccine?
There is, but it’s usually only offered to those most at risk, which is usually:
- Children
- Immunocompromised people, especially if HIV+
- People taking certain medications (e.g. Solaris or Ultomiris)
Read more:
CDC | Meningococcal Vaccine Recommendations
Will taking immune-boosting supplements help?
Honestly, probably not, but they won’t harm either. The most important thing is: don’t rely on them—too many people pop a vitamin C supplement and then assume they are immune to everything, and it doesn’t work like that.
On a tangential note, for more general immune health, you might also want to check out:
Beyond Supplements: The Real Immune-Boosters!
The short version:
If you or someone you know experiences the above-mentioned symptoms, even if it does not seem too bad, get thee/them to a doctor, and quickly, because the (very short) clock may be ticking already.
Better safe than sorry.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
