I didn’t know where Yazd was until I read the research article. But smack in the middle of Iran lies Yzad province. Somewhere in this province is the Shahid Sadoughi University and over the past year or so, within the Faculty of Medicine and School of Public Health, there has been some wonderful research being undertaken by PhD students. The study arrived in my in-box this week. When I read the title, it got my attention – ‘The Association between Lifestyle and Severity of Menopausal Symptoms in Menopausal Women.
Over 300 Iranian women participated in this study – I would like to thank them. I hope they have been all doing OK as the world turned to chaos over the past year.
For too long, menopause has been invisible in the lifestyle research and the emergence of this study broadens our understanding of this life-stage.
With an average age of 49-50 years, this particular study labelled these women as post-menopausal. This is just a term used to signify the change towards not having menstrual periods as we age. You enter post-menopause, when your periods have stopped for a year or more.
I noted that entering post-menopause at 49-50 years for these Iranian women, is slightly earlier that the global average age that women enter their post-menopause years, which is 51-52 years. I was also intrigued that from all the various amounts of data collected in this study, the average age of marriage of the study participants was 19 years old. I had barely left home at that age.
Defining ‘lifestyle‘ is tricky, because as most of us would know, this differs between culture, socio-economic means and our geographical location. Furthermore, defining ‘healthy lifestyle‘ differs again. But wherever we live and whatever culture we follow, your ‘lifestyle’ refers to the range of activities that you undertake daily and those which make up your daily life.
Hence, within this context is whether or not we choose to pursue activities that are known to contribute to a ‘healthy lifestyle’ – you know the list – not smoking, following nutritional guidelines (which differ around the world), ensuring adequate exercise, avoiding drug use, protecting ourselves against accidents, preventing disease, maintaining emotional control and adapting to our environment. Yes, all those factors are determinants of your ‘lifestyle’.
When I began to understand that there are numerous women throughout the world who don’t report symptoms of menopause and don’t experience the lifestyle-related diseases attributed to older age in many western countries, I became curious about the choices that influence our lifestyle behaviours during menopause. Many of these women come from the group of countries known as the Blue Zone countries. You may have heard of these. Geographical locations where women and men live longer free of disease compared to other populations globally.
I talk about these in my Masterclass on Menopause (now available online for you as well) and refer to women in their 50’s and early 60’s as the ‘Guinea Pig Generation’ for an explosion of lifestyle changes that have influenced our health over our life-time.
Lifestyle research has been gathering momentum over the past decade. An ageing population globally and the rise in diseases attributed to how we choose to live our life, has lead researchers down this path. Nowadays it is thought that 70% of diseases as we age are associated with an individual’s lifestyle.
Women in menopause, please take note because with the research that has emerged from the Study of Women’s Health Across the Nation, it makes sense that the life we’ve lived contributes to the severity of our symptoms in menopause and weight gain as well. This is due to the build up of cellular inflammation.
I’ve said numerous times that one of the realisations I personally took out of my own doctoral research, which explored women’s health as they age, was that because menopause is the biological gateway to the next phase of our lives, it becomes a vulnerable time for our health as we age. If you are putting on weight or experiencing poor sleep, depression, high cholesterol, sore joints, worsening hot flushes, symptoms of fibromyalgia or other health changes and you are only in your 50’s, then I know how you feel. It’s a confusing and frustrating time.
But back to the wonderful women of Iran and the relationship between their lifestyle practices and the severity of their symptoms. The results were ‘significant’ concluded the study authors.
“Our study found a significant relationship between lifestyle factors and the severity of menopausal symptoms; whereby those with a healthier lifestyle had less severity of symptoms.” [Yoshany et al, 2020, p. 4]
So, what constituted a ‘healthy lifestyle’ in those with less severe symptoms?
For most, engaging in some physical activity was important, although the amount and type wasn’t defined in this particular study however, I’ve written about this HERE for you.
This is important to note for those of you feeling depressed and ‘hopeless’. Some women are doing too much exercise when they aren’t sleeping – I see this a lot. What this does is to increase a stress hormone called cortisol and this prevents healing and repairing of tissues overnight. High-end exercisers might then find that they experience worsening hot flushes, sore joints and emotional changes. Then there are those of you who have no energy for exercise, because your motivation is low and/or you are feeling depressed.
As we lose oestrogen, our lovely mood hormone called serotonin declines too. This decline is more rapid for those who aren’t sleeping and have gut inflammation from IBS or other gut health changes. The link between our gut health and depression is well known in metabolic research. So for those of you, who don’t feel like doing much exercise, then it’s important that not only do you deal with any underlying health concerns, but that you make the time to do some moderate aerobic exercise. Julie in BC, Canada was the same. There were days when she struggled to get through her day and as she said, “It seems as if all my joy had been sucked out of me.” She shares her remarkable story about her journey HERE.
The women in the Iranian study who reported the least menopause symptoms didn’t smoke and followed healthy nutritional choices. Following on from other similar studies, the authors noted that overweight status also correlated with more severe hot flushes.
A lot of women in the MyMT™ community, myself included, can attest to this connection between being overweight and experiencing more severe hot flushes and night sweats.
Part of the reason for this, is because as we move into post-menopause, there are numerous changes around our body that are a result of our biological ageing. This includes the loss of elasticity in our blood vessels and structural changes to our liver and gallbladder. This means that we need to reduce the load on our liver and gallbladder as we age by changing our diet to the Mediterranean Diet. This is my approach in the programmes, whether weight loss is required or not.
Managing oestrogen load on our liver is also important. If you are in peri-menopause, then you are still producing oestrogen and in post-menopause, oestogen and progesterone levels decline to their lowest.
Having oestrogenic compounds in your diet or from supplements therefore differs for each stage of menopause you are in. This is often not being addressed in many menopause discussions. For those of you who are overweight, then managing liver regulation of fats, environmental oestrogens, and reducing inflammatory changes that occur due to our ageing, is important. Otherwise hot flushes and night sweats can last for years.
Our menopause transition is a natural part of a woman’s life-course. It’s a powerful reminder that we are transitioning through a normal life-stage that heralds in the next phase of our life – our biological ageing. Understanding this was a game-changer for me personally.
With my studies on women’s healthy ageing, I was able to position menopause as a normal life-stage in ageing research. And when it comes to women’s ageing, there are numerous changes that occur in our body because oestrogen and progesterone are powerful hormones that affect the entire body.
As such, the emphasis I have in the MyMT™ programmes follows the scientific research for maintaining our health as we age. Post-menopause heart disease is the number 1 concern for us as we age, globally.
We already know from the health of the first cohort of Baby-boomers to reach their older-age, that many diseases of older age are due to the accumulation of inflammation in cells and tissues. To get back to having a body that is free from inflammation, there are changes we need to make now, in our late 40’s and 50’s and even into our 60’s and older. These changes include lifestyle changes that are situated around:
- Anti-inflammatory nutrition
- Exercise for promoting cardio-vascular health, strength, flexibility and balance.
- Stress management.
Both of the MyMT™ programmes follow my 7-pillars for women’s health as they age. This is because our menopause transition is our biological gateway into our ageing. And with these hormonal changes, come numerous physiological changes that occur in our body and throughout our organs when both oestrogen and progesterone are declining.
If you would like to come on board with me, then please use the promo code ATHOME22 and apply this in any Buy Now button on the website. It would be my privilege to help you. Alternatively, listen to the Masterclass and take the MyMT™ Menopause Symptom Quiz too.
Abud, T., Kounidas, G., Martin, K.R. et al. Determinants of healthy ageing: a systematic review of contemporary literature. Aging Clin Exp Res 34, 1215–1223 (2022).
Blumel J., Fica, J., Chedraui, P., Mezones-Holguin E., Zuniga, M & Witis, S. (2016). Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause, 23(5), 488-93.
Egger, G., Binns, A., Rossner, S. & Sagner, M. (2017). Lifestyle Medicine: Lifestyle, the Environment and Preventive Medicine in Health and Disease. Elselvier Academic Press: London, United Kingdom.
Pettee-Gabriel, K., Sternfield, B., Colvin A. et al. (2017). Physical activity trajectories during midlife and subsequent risk of physical functioning decline in late mid-life: The Study of Women’s Health Across the Nation (SWAN). Preventive Medicine, 105, pp 287-294.
Yoshany, N., Mazloomy Mahmoodabad, S., Bahri, N., Moori, MK., & Hanna, F. (2020). Association between lifestyle and severity of menopausal symptoms in postmenopausal women. Electron J. Gen Med. 17(5): em22, 1-6.