menopause affects a woman Many societies still view menopause as the end of a woman’s vitality and even identity, which causes many women to remain silent when they face this stage and not talk about their symptoms for fear of being harshly judged by others. Sometimes, due to a lack of awareness and education, a large number of women do not realize that there is a relationship between their symptoms and menopause.
Despite the prevalence of symptoms of this stage and their consequences, which can sometimes be dangerous for women’s health, research in this area is not sufficiently funded and is often overlooked. Menopause affects not only a woman’s body, but her brain as well.
What are these effects?
How do they occur?
Are there ways to mitigate them and improve women’s health during this stage?
“Women’s Hell” and “The Death of Sex”
Interest menopause increased in the twentieth century, but it took a long time to realize the extent of its impact on women’s health. Menopause has long been viewed in medical circles and popular culture as a period of deterioration in a woman’s health and “female worthlessness” and loss of the ability to bear children – it has been described as “women’s hell” and “the death of the sex.” The term menopause was generally absent from medicine until the 19th century.
The French physician Charles Pierre Louis Dugardin first coined the term menopause, which he derived from the Greek word men, meaning “month,” and pausis, meaning “stoppage or cessation.” In 19th-century Victorian Britain, doctors considered women going through this phase to be “mentally unstable.” In his best-selling 1966 book Feminine Forever, American gynecologist Robert A.
Wilson described women who had gone through menopause as “castrated.” With the discovery of the link between menopause and estrogen in the 1960s, menopause came to be described as “estrogen deficiency. ”Estrogen has become a magic and profitable drug, and pharmaceutical companies have rushed to produce an alternative version of it by creating what is known as hormone replacement therapy.
Estrogen and the menopausal brain. There is a small percentage of “lucky” women – estimated by researchers at 10-15 percent – who do not suffer from any symptoms due to menopause. But the vast majority suffer from a range of physical and even neurological symptoms that affect the brain, the variations of which vary from one woman to another. Many women find it difficult to deal with some of the symptoms due to their severity, to the point that they may feel as if they are on the verge of losing their minds.
The ways in which estrogen affects the brain were not discovered until the late 1990s, when scientists concluded that the so-called sex hormones (especially estrogen) in women are of great importance not only for reproduction and fertility, but for brain function as well.
Professor Lisa Mosconi, assistant professor of neurology and radiology, director of the Women’s Brain Initiative and the Alzheimer’s Prevention Program at Weill Cornell Medicine in New York, and author of The Menopause Brain, published earlier this year, was one of the first researchers to study how a woman’s brain changes during menopause.
Mosconi told that “menopause brain” is “a non-medical term that describes the neurological symptoms that many women experience during this period… symptoms such as hot flushes, night sweats, insomnia, poor memory, brain fog, difficulty concentrating, and mood disorders such as anxiety and sadness. Symptoms of depression have nothing to do with the ovaries, but are rooted in the neurological changes that accompany menopause.
More than 80 percent of women who are going through perimenopause or postmenopause report experiencing at least one of these symptoms.” According to Professor Mosconi, “estrogen plays a critical role in the structure and function of the brain. It supports vital areas of the brain that control memory, learning, and cognitive flexibility.
When levels begin to decline during menopause, these areas can be negatively affected, leading to cognitive challenges that many refer to as menopausal brain.” In her book, Mosconi discusses the benefits of estrogen, which boosts metabolism and protects against weight gain, insulin resistance, and type 2 diabetes. It also helps support bone, cardiovascular, and immune system health, provides brain cells with the ability to fight damage and aging, and helps produce new brain cells.
“Historically,” Mosconi says, “women were told that when they talked about their cognitive health during menopause, it was just a fantasy, but now we have real data to support their experiences… Estrogen is a neuroprotective hormone that helps regulate the neurotransmitter, energy, blood flow, and communication between neurons and the immune system in the brain.
When levels of estrogen drop during menopause, these systems can get messy, contributing to symptoms like forgetfulness, brain fog, and mood swings.” Fortunately, most symptoms lessen or go away over time, and most women don’t experience long-term problems. Menopause and the risk of nervous system disorders.
Several studies suggest that women are more likely than men to develop a number of nervous system disorders, including migraines, stress, depression, brain tumors, Alzheimer’s, and multiple sclerosis, an autoimmune disease that attacks the brain. In her book, Mosconi says that the prevalence of these brain conditions changes from being almost the same in men and women before menopause to increasing in women after menopause.
The neuroscientist stresses that this does not mean that menopause is a disease or causes these diseases, but the hormonal changes that occur during this stage burden many organs of the body, including the brain, especially when ignored, which makes them vulnerable to these conditions.
Hormone Replacement Therapy (HRT)
In the early 1940s, the United States approved the use of the first drug containing an estrogen replacement, which gained great popularity that reached its peak in the 1970s, especially after the publication of the book “Forever Female” that promoted this treatment, in which its author wrote that when a woman takes this treatment, “her breasts and genitals will not wither.
Life will become happier (with a woman) and she will not become gloomy and unattractive.” However, it was later discovered that the drug increases the risk of endometrial cancer. Later, researchers found that reducing the dose and adding a synthetic progesterone substitute protects the uterine lining.
However, concerns about taking hormone replacement therapy increased again after the announcement in 2002 that a study on these hormones, which had begun in the late 1990s in the United States and included about 160,000 postmenopausal women, had been stopped three years before its scheduled end, after concerns that the treatment increased the risk of breast cancer.
The results of this study still raise concerns among many women about resorting to this treatment to relieve the symptoms of menopause. However, it should be noted that the method of manufacturing this treatment has become different now, as it uses natural sources that make the composition of the hormones identical to their composition in the human body.
It has also become possible to take the estrogen substitute through the skin (in the form of a cream, gel or patch), and this method does not increase the risk of blood clots, and it is safer than pills for women who have problems related to the liver or cholesterol.
Recent studies on hormone replacement therapy have shown that the timing of its use is crucial to achieving maximum benefit (helping to alleviate many of the symptoms of menopause and preventing osteoporosis as you age, as well as heart disease): the best time to start treatment is shortly before or immediately after menopause. It is also most effective in the ten years following menopause (one of the drawbacks of the American study mentioned above is that it was conducted on a large number of women in their sixties and seventies).
Several medical institutions in the West have recently changed their assessment of this treatment, stating that the risk of breast cancer associated with it is very small, and now consider it safe to use – except if the woman has had the disease in the past.
Does hormone replacement therapy prevent cognitive decline?
Oestrogen produced by the ovaries (and the brain) plays a role in protecting brain health, says Professor Mosconi, “but the talk about hormone replacement therapy is multi-dimensional. The effects of [synthetic] oestrogen on the brain are less well understood than natural oestrogen.” She adds that “some studies suggest that hormone replacement therapy, particularly oestrogen-only hormone therapy, may reduce the risk of dementia if women start taking it early after the menopause.
However, other studies do not show any positive effects, and research is ongoing.” At present, hormone replacement therapy is only recommended for the prevention of dementia in cases of early menopause (before the age of 45).
“The decision to seek hormone replacement therapy should be based on a comprehensive assessment by a qualified physician, taking into account personal and family history, overall health, and potential risks,” says Mosconi. “Hormonal replacement therapy is not a universal preventative measure against Alzheimer’s, and other factors such as genetics, medical history, and lifestyle also play a role in the risk of developing the disease.”
Can lifestyle improvements help alleviate symptoms?
There is no doubt that following a healthy lifestyle is beneficial at all ages and protects against many diseases, but it is especially important as we approach menopause, as it can increase women’s risk of developing conditions such as osteoporosis, heart disease, and cognitive decline.
Many experts now recommend following a diet similar to the Mediterranean diet, eating a variety of vegetables and fruits, avoiding or reducing refined sugar, avoiding or reducing ultra-processed foods, avoiding hydrogenated fats, eating foods that contain healthy fats such as nuts and avocados, and eating more foods that contain fiber and those that are beneficial to gut microbes such as yogurt and sauerkraut, and eating enough protein to maintain muscle health.
Mosconi says that there is no single diet or type of exercise to eliminate menopausal symptoms, but “eating a balanced diet rich in antioxidants, healthy fats, fiber, and low-fat proteins can help reduce hot flashes and mood swings.” She adds that “consistent exercise, especially weight-bearing exercise, helps maintain bone density, while cardiovascular exercise is good for brain and heart health.” Mosconi also recommends practicing stress management techniques, such as yoga and mindful meditation, to improve overall mental health, as well as ensuring that you get enough sleep.
Positive outlook
It may be difficult for women to look at menopause with optimism, but there are some positive things that come with it. For example, the pain that precedes or accompanies menstruation stops. Many women also talk about feeling more confident, happy, and satisfied in the post-menopausal period. Mosconi points out in her book that research has shown that women who look at this stage positively usually have less severe symptoms, and vice versa. Society should also play a positive role by respecting and appreciating women who are going through this stage.
The cessation of the ability to reproduce should not be equivalent to the cessation of a woman’s ability to give, whether in the field of work, the family environment, or her community as a whole.