What you need to know about menopause
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Menopause describes the time when a person with ovaries has gone one full year without a menstrual period. Reaching this phase is a natural aging process that marks the end of reproductive years.
Read on to learn more about the causes, stages, signs, and management of menopause.
What causes menopause?
As you age, your ovaries begin making less estrogen and progesterone—two of the hormones involved in menstruation—and your fertility declines, causing menopause.
Most people begin perimenopause, the transitional time that ends in menopause, in their late 40s, but it can start earlier. On average, people in the U.S. experience menopause in their early 50s.
Your body may reach early menopause for a variety of reasons, including having an oophorectomy, a surgery that removes the ovaries. In this case, the hormonal changes happen abruptly rather than gradually.
Chemotherapy and radiation therapy for cancer patients may also induce menopause, as these treatments may impact ovary function.
What are the stages of menopause?
There are three stages:
- Perimenopause typically occurs eight to 10 years before menopause happens. During this stage, estrogen production begins to decline and ovaries release eggs less frequently.
- Menopause marks the point when you have gone 12 consecutive months without a menstrual period. This means the ovaries have stopped releasing eggs and producing estrogen.
- Postmenopause describes the time after menopause. Once your body reaches this phase, it remains there for the rest of your life.
How do the stages of menopause affect fertility?
Your ovaries still produce eggs during perimenopause, so it is still possible to get pregnant during that stage. If you do not wish to become pregnant, continue using your preferred form of birth control throughout perimenopause.
Once you’ve reached menopause, you can no longer get pregnant naturally. People who would like to become pregnant after that may pursue in vitro fertilization (IVF) using eggs that were frozen earlier in life or donor eggs.
What are the signs of menopause?
Hormonal shifts result in a number of bodily changes. Signs you are approaching menopause may include:
- Hot flashes (a sudden feeling of warmth).
- Irregular menstrual periods, or unusually heavy or light menstrual periods.
- Night sweats and/or cold flashes.
- Insomnia.
- Slowed metabolism.
- Irritability, mood swings, and depression.
- Vaginal dryness.
- Changes in libido.
- Dry skin, eyes, and/or mouth.
- Worsening of premenstrual syndrome (PMS).
- Urinary urgency (a sudden need to urinate).
- Brain fog.
How can I manage the effects of menopause?
You may not need any treatment to manage the effects of menopause. However, if the effects are disrupting your life, your doctor may prescribe hormone therapy.
If you have had a hysterectomy, your doctor may prescribe estrogen therapy (ET), which may be administered via a pill, patch, cream, spray, or vaginal ring. If you still have a uterus, your doctor may prescribe estrogen progesterone/progestin hormone therapy (EPT), which is sometimes called “combination therapy.”
Both of these therapies work by replacing the hormones your body has stopped making, which can reduce the physical and mental effects of menopause.
Other treatment options may include antidepressants, which can help manage mood swings and hot flashes; prescription creams to alleviate vaginal dryness; or gabapentin, an anti-seizure medication that has been shown to reduce hot flashes.
Lifestyle changes may help alleviate the effects on their own or in combination with prescription medication. Those changes include:
- Incorporating movement into your daily life.
- Limiting caffeine and alcohol.
- Quitting smoking.
- Maintaining a regular sleep schedule.
- Practicing relaxation techniques, such as meditation.
- Consuming foods rich in plant estrogens, such as grains, beans, fruits, vegetables, and seeds.
- Seeking support from a therapist and from loved ones.
What health risks are associated with menopause?
Having lower levels of estrogen may put you at greater risk of certain health complications, including osteoporosis and coronary artery disease.
Osteoporosis occurs when bones lose their density, increasing the risk of fractures. A 2022 study found that the prevalence of osteoporotic fractures in postmenopausal women was 82.2 percent.
Coronary artery disease occurs when the arteries that send blood to your heart become narrow or blocked with fatty plaque.
Estrogen therapy can reduce your risk of osteoporosis and coronary artery disease by preserving bone mass and maintaining cardiovascular function.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Stop Sabotaging Your Weight Loss – by Jennifer Powter, MSc
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This is not a dieting book, and it’s not a motivational pep talk.
The book starts with the assumption that you do want to lose weight (it also assumes you’re a woman, and probably over 40… that’s just the book’s target market, but the same advice is good even if that’s not you), and that you’ve probably been trying, on and off, for a while. Her position is simple:
❝I don’t believe that you have a weight loss problem. I believe that you have a self-sabotage problem❞
As to how this sabotage may be occurring, Powter talks about fears that may be holding you back, including but not limited to:
- Fear of failure
- Fear of the unknown
- Fear of loss
- Fear of embarrassment
- Fear of your weight not being the reason your life sucks
Far from putting the reader down, though, Powter approaches everything with compassion. To this end, her prescription starts with encouraging self-love. Not when you’re down to a certain size, not when you’re conforming perfectly to a certain diet, but now. You don’t have to be perfect to be worthy of love.
On the topic of perfection: a recurring theme in the book is the danger of perfectionism. In her view, perfectionism is nothing more nor less than the most justifiable way to hold yourself back in life.
Lastly, she covers mental reframes, with useful questions to ask oneself on a daily basis, to ensure progressing step by step into your best life.
In short: if you’d like to lose weight and have been trying for a while, maybe on and off, this book could get you out of that cycle and into a much better state of being.
Get your copy of “Stop Sabotaging Your Weight Loss” from Amazon today!
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The Myth of Normal – by Dr. Gabor Maté and Daniel Maté
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A lot of popular beliefs (and books!) start with the assumption that everyone is, broadly speaking, “normal”. That major diversions from “normal” happen only to other people… And that minor diversions from “normal” are just something to suck up and get over—magically effecting a return to “normalcy”.
Dr. Maté, however, will have none of these unhelpful brush-offs, and observes that in fact most if not all of us have been battered by the fates one way or another. We just:
- note that we have more similarities than differences, and
- tend to hide our own differences (to be accepted) or overlook other people’s (to make them more acceptable).
How is this more helpful? Well, the above approach isn’t always, but Mate has an improvement to offer:
We must see flawed humans (including ourselves) as the product of our environments… and/but see this a reason to look at improving those environments!
Beyond that…
The final nine chapters of the books he devotes to “pathways to wholeness” and, in a nutshell, recovery. Recovery from whatever it was for you. And if you’ve had a life free from anything that needs recovering from, then congratulations! You doubtlessly have at least one loved one who wasn’t so lucky, though, so this book still makes for excellent reading.
Dr. Maté was awarded the Order of Canada for his medical work and writing. His work has mostly been about addiction, trauma, stress, and childhood development. He co-wrote this book with his son, Daniel.
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Figs vs Banana – Which is Healthier?
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Our Verdict
When comparing figs to banana, we picked the banana.
Why?
Both of these fruits have a reputation for being carb-heavy (though their glycemic index is low in both cases because of the fiber), and they both have approximately the same macros across the board. So a tie on macros.
When it comes to vitamins, figs have more of vitamins A, B1, E, and K, while banana has more of vitamins B2, B3, B5, B6, B9, C, and choline. So, a win for banana there.
In the category of minerals, figs have more calcium and iron, while banana has more copper, magnesium, manganese, phosphorus, potassium, and selenium. Another win for banana.
Adding up the section makes for a win for bananas, but by all means, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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How Not to Diet – by Dr. Michael Greger
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We’ve talked before about Dr. Greger’s famous “How Not To Die” book, and we love it and recommend it… But… It is, primarily, a large, dry textbook. Full of incredibly good science and information about what is statistically most likely to kill us and how to avoid that… but it’s not the most accessible.
“How Not To Diet“, on the other hand, is a diet book, is very readable, and assumes the reader would simply like to know how to healthily lose weight.
By focussing on this one problem, rather than the many (admittedly important) mortality risks, the reading is a lot easier and lighter. And, because it’s still Dr. Greger advocating for the same diet, you’ll still get to reduce all those all-cause mortality risks. You won’t be reading about them in this book; it will now just be a happy side effect.
While in “How Not To Die”, Dr. Greger looked at what was killing people and then tackled those problems, here he’s taken the same approach to just one problem… Obesity.
So, he looks at what is causing people to be overweight, and methodically tackles those problems.
We’ll not list them all here—there are many, and this is a book review, not a book summary. But suffice it to say, the work is comprehensive.
Bottom line: this book methodically and clinically (lots of science!) looks at what makes us overweight… And tackles those problems one by one, giving us a diet optimized for good health and weight loss. If you’d like to shed a few pounds in a healthy, sustainable way (that just happens to significantly reduce mortality risk from other causes too) then this is a great book for you!
Click here to check out “How Not To Diet” on Amazon and get healthy for life!
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Policosanol: A Rival To Statins, Without The Side Effects?
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Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:
2001: it works!
After a lot of research in the 1990s, it came out of the gate strong in 2001, with:
❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞
This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.
Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women
Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:
2006–2010: we do not trust the Cubans!
After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):
Heart Beat: Policosanol: A sweet nothing for high cholesterol
And furthermore, US-based labs were unable to replicate the results:
Policosanols as Nutraceuticals: Fact or Fiction
The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.
Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.
Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.
2012: never mind, it does work after all!
An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:
❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞
Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.
Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol
2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba
A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:
- Consumption of Cuban Policosanol Improves Blood Pressure and Lipid Profile via Enhancement of HDL Functionality in Healthy Women Subjects: Randomized, Double-Blinded, and Placebo-Controlled Study
- Long-Term Consumption of Cuban Policosanol Lowers Central and Brachial Blood Pressure and Improves Lipid Profile With Enhancement of Lipoprotein Properties in Healthy Korean Participants
Mystery resolved!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.
Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎
Enjoy!
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Are GMOs Good Or Bad For Us?
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Unzipping Our Food’s Genes
In yesterday’s newsletter, we asked you for your (health-related) views on GMOs.
But what does the science say?
First, a note on terms
Technically, we (humans) have been (g)enetically (m)odifying (o)rganisms for thousands of years.
If you eat a banana, you are enjoying the product of many generations of artificial selection, to change its genes to produce a fruit that is soft, sweet, high in nutrients, and digestible without cooking. The original banana plant would be barely recognizable to many people now (and also, barely edible). We’ve done similarly with countless other food products.
So in this article, we’re going to be talking exclusively about modern genetic modification of organisms, using exciting new (ish, new as in “in the last century”) techniques to modify the genes directly, in a copy-paste fashion.
For more details on the different kinds of genetic modification of organisms, and how they’re each done (including the modern kinds), check out this great article from Sciencing, who explain it in more words than we have room for here:
Sciencing | How Are GMOs Made?
(the above also offers tl;dr section summaries, which are great too)
GMOS are outright dangerous (cancer risks, unknown risks, etc): True or False?
False, so far as we know, in any direct* fashion. Obviously “unknown risks” is quite a factor, since those are, well, unknown. But GMOs on the market undergo a lot of safety testing, and have invariably passed happily.
*However! Glyphosate (the herbicide), on the other hand, has a terrible safety profile and is internationally banned in very many countries for this reason.
Why is this important? Because…
- in the US (and two out of ten Canadian provinces), glyphosate is not banned
- In the US (and we may hypothesize, those two Canadian provinces) one of the major uses of genetic modification of foodstuffs is to make it resistant to glyphosate
- Consequently, GMO foodstuffs grown in those places have generally been liberally doused in glyphosate
So… It’s not that the genetic modification itself makes the food dangerous and potentially carcinogenic (it doesn’t), but it is that the genetic modification makes it possible to use a lot more glyphosate without losing crops to glyphosate’s highly destructive properties.
Which results in the end-consumer eating glyphosate. Which is not good. For example:
❝Following the landmark case against Monsanto, which saw them being found liable for a former groundskeeper, 46 year old Dewayne Johnson’s cancer, 32 countries have to date banned the use of Glyphosate, the key ingredient in Monsanto’s Roundup weed killer. The court awarded Johnson R4.2 billion in damages finding Monsanto “acted with malice or oppression”.❞
Source: see below!
You can read more about where glyphosate is and isn’t banned, here:
33 countries ban the use of Glyphosate—the key ingredient in Roundup
For the science of this (and especially the GMO → glyphosate use → cancer pipeline), see:
Use of Genetically Modified Organism (GMO)-Containing Food Products in Children
GMOs are extra healthy because of the modifications (they were designed for that, right?): True or False?
True or False depending on who made them and why! As we’ve seen above, not all companies seem to have the best interests of consumer health in mind.
However, they can be! Here are a couple of great examples:
❝Recently, two genome-edited crops targeted for nutritional improvement, high GABA tomatoes and high oleic acid soybeans, have been released to the market.
Nutritional improvement in cultivated crops has been a major target of conventional genetic modification technologies as well as classical breeding methods❞
Source: Drs. Nagamine & Ezura
Read in full: Genome Editing for Improving Crop Nutrition
(note, they draw a distinction of meaning between genome editing and genetic modification, according to which of two techniques is used, but for the purposes of our article today, this is under the same umbrella)
Want to know more?
If you’d like to read more about this than we have room for here, here’s a great review in the Journal of Food Science & Nutrition:
Should we still worry about the safety of GMO foods? Why and why not? A review
Take care!
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