Adapting to the Menopause (also known as the Climacteric)
WHAT IS THE MENOPAUSE?
‘Menopause’ is also known as the ‘climacteric’—a word indicating a critical period or event, possibly having extreme and far-reaching implications. The term ‘climacteric’ refers more to the gradual changes of ovarian function that start before the menopause and continue thereafter for a while, whereas the term ‘menopause’ refers more to the specific event (i.e. the cessation of menses/monthly menstrual bleeding).
In fact, the word ‘menopause’ is from the Greek ‘men-’ (meaning ‘month’) and ‘pausis’ (meaning ‘cessation’) and is recognized to have occurred after 12 consecutive months of amenorrhea (no periods). The moment of menopause is, therefore, known with certainty only in retrospect—at least one year later and there are no adequate biological markers for the event of menopause.
The word ‘climacteric’, on the other hand, implies a period of time as the Greek word ‘klimater’ means ‘step’, indicating the process has stages. Although the word ‘menopause’ is the one favoured in most cultures, the word ‘climacteric’—which indicates a progressive phenomenon that takes place in an extended period of time—is, perhaps, better suited to this stage in a woman’s life. Although ‘climacteric’ is the better-fitting term, this article will use both words, interchangeably.
The transition of a fully functional ovary to a post-menopausal ovary is a physiological process that takes years and reflects the status of the hypothalamic-pituitary-ovarian function that occurs before and after the final menstrual period (FMP)—relating to changes of the rhythmical pattern of uterine bleeding, and changes in the ovarian hormone level which may precede these pattern changes. There are markers for these changes—in particular, levels of FSH (follicle stimulating hormone), (which start gradually rising 7 years before the FMP and have a steeper upward inclination 2 years before), and estradiol (which markedly decreases 2 years pre-FMP). These trends continue after FMP for 2 more years before stabilizing. Indeed, estradiol is the form of estrogen made mainly by the ovaries and whilst high amounts are produced during reproductive years, almost none is produced after menopause.
To summarize, although the word 'menopause' is applied to the middle-to-later years of a woman's life, the word 'climacteric' is a better word for descibing the changes that happen to a woman's body when her monthly periods change and eventually cease. This is because, in fact, 'menopause' indicates a particular moment and can only be known after the event, whereas the word 'climacteric' describes the process of change that occurs. It is the process of change that results in the symptoms of what we (inappropriately) call the menopause.
NOTE: the word 'menopause' will be used below, although technically the word 'climacteric' should be used.
WHAT ARE THE SYMPTOMS OF THE MENOPAUSE?
The end of ovarian function is a gradual process that takes years to evolve.
Various symptoms may occur, many of which deteriorate the quality of life. Symptoms may include:
- hot flushes,
- sweating, night sweats,
- sleeping problems/insomnia,
- fatigue, physical exhaustion,
- brain fog, difficulty concentrating,
- memory lapses,
- mood swings, irritability,
- emotional strain,
- panic disorders,
- joint stiffness,
- osteo-muscular pain/tension,
- sore/tender breasts,
- vaginal dryness/tenderness,
- recurrent urinary infections,
- urinary incontinence/bladder weakness,
- weight gain,
- digestive problems,
- bloating/water retention,
- sagging breasts/change in breast size,
- tingling in extremities,
- feeling cold,
- heart palpitations,
- breathing difficulties,
- dry eyes,
- altered skin (texture, acne, itching),
- thinning hair,
- brittle nails,
- burning mouth, dry mouth,
- tooth decay/gum bleeding,
- altered sense of taste/smell,
- body odour,
- loss of bone density,
- dyspareunia (painful intercourse),
- low libido,
- and loss of motivation/confidence.
Additionally to experiencing any of the symptoms mentioned above, women in menopausal years may have increased risk of chronic diseases; these increased disease risks may be the influence of increased age or may associate with ovarian function declination including metabolic syndrome (atherosclerosis risk may be impacted by deficit of ovarian steroids), genitourinary atrophy (vaginal mucosa status is dependent on estrogenic levels) and osteoporosis (as increased bone turnover is influenced by ovarian function and clearly associates with menopause).
The menopause is a period of change—physically, mentally and emotionally. A woman’s experience of menopause will reflect her chosen responses to these changes as well as her existing state of health and her life circumstances.
SUPPORT DURING THE MENOPAUSE
In addition to experiencing the menopausal body changes, women aged in their 40’s and 50’s may also be experiencing personal life changes—children growing/moving out, becoming grandparents, suffering illness/bereavement of parents/relatives—that may contribute to stress levels. The ability to adapt to these changes—internal and external—will largely affect her experience during this life stage.
Menopausal symptoms are numerous and varied—often impacting more than one body system simultaneously. It is clear that menopausal symptomology impacts quality of life very early and for an extended period of time.
Adaptogens, by helping the body to adapt to its environmental (internal and external) changes, can help ensure that this period in a woman’s life—which is a developmental event/phase—is less stressful, less strained, less difficult. And increases opportunity for resilience, health, and fulfilment during this important mid-life transition.
USING ADAPTOGENS TO ADJUST TO CHANGE DURING MENOPAUSE
As well as having a healthy nutritive diet and a suitable lifestyle and exercise regime, women, during this period of immense change may benefit from use of adaptogenic herbs. Adaptogens are non-addictive and support energy, resilience to stress, and hormonal balance. Adaptogens can modulate the body’s response to environmental (internal and external) changes and increase the body’s resistance to physical, biological and chemical stress.
Adaptogens can be especially helpful during the menopause.
The superfood Maca is an example of an adaptogen. Maca grows high in the Peruvian Andes where the rich soil and harsh conditions help to create this amazing plant also referred to as ‘Peruvian Ginseng’.
Suma (Pfaffia) root is prized throughout Latin America for its restorative properties. Commonly referred to as ‘Brazilian Ginseng’, Suma is considered a ‘ginseng’ for women mainly, but supports all those who have stressful lives.
Use adaptogens to increase opportunity for resilience, health, and fulfilment during this important mid-life transition commonly referred to as the menopause.
Author: Rose Holmes, Registered Nutritionist, mBANT, BSc, Dip.ION, PGCE
The above is based on text originally published as 'Managing the Menopause Transition' by Rose Holmes, Registered Nutritional Therapist, in 'Inside: Menopause' in association with Natural Lifestyle magazine published by Target Publishing, October 2023 edition