How to get rid of all the fatalistic predictions about menopause to squeeze this stage of personal reaffirmation to the fullest

At this point, there are things that should already be basic. Things like menopause is not a disease; That its arrival does not make women wither, go 'crazy' or lose, all at once, all our attractiveness or desire to enjoy it in style (in all areas). "Menopause only means 12 months without a period. Everything negative that we think of this stage, pejorative, degrading, limiting connotations and fatal predictions are usually beliefs that come from what we have heard and read; of our education and the stories they have told us", says Mar Añó Torres, doctor of the Medical Department of Palasiet Thalasso Clinic & Hotel (Benicàssim, Castellón) and one of the members of the multidisciplinary team that integrates the Women's Balance Program.

Unpredictable and changing, "no two menopauses are the same, because we are all different and the way we live it depends on our upbringing, our education, our experiences, our spirituality or, simply, how we are at the moment it comes to us."

What is certain, continues Añó Torres, is that, in general, "when we enter this phase, we can feel fear, or uncertainty, or curiosity, or suffering, or sadness, or liberation, hope... The really important thing is to understand what is happening in our body, be well informed and be aware of what is going to happen, to take the reins. And, of course, knowing what we can do to feel better, to avoid risks and take care of ourselves, because health has to be our priority."

Although it sounds so obvious that saying it may seem like a real stupidity, the first thing to emphasize is that "menopause is a physiological stage of women, it is not a disease".

To better understand why this moment is reached, this doctor explains that "we are born with a certain number of oocytes in our ovaries. It is our ovarian reserve and not only will it not increase during our life, but, on the contrary, we lose it with ovulations. What's more, it begins to diminish even before the first period. Although the biological clock of our ovaries is different in each woman, the average age at which they stop working is between 45 and 55 years, which makes us one of the few mammals that lives so many years after finishing their reproductive stage. "

In all this inner revolution, hormones play a fundamental role. "Estrogens are responsible for many of the major functions of a woman's body and almost every organ has receptors for it. They are responsible for most of the characteristics of the female body, such as the distribution of fat, more predominant in hips, thighs and buttocks; our tone of voice; collagen production; the appearance of our skin: the growth of our breasts: the density of our bones; the lubrication of our vagina. We even have estrogen receptors in our brain."

But, beware, there is still more. "When the ovaries no longer respond, because the egg reserve has been exhausted, FSH (follicle-stimulating hormone) increases a lot to try to stimulate them (without success). Therefore, during menopause, FSH rises and estradiol levels in the blood decrease. And that drop in estradiol explains the changes that occur in our body during this stage."

MOST COMMON PHYSICAL SYMPTOMS

What are we going to notice at this stage and why? This doctor takes us out of doubts:

-Hot flashes. "It affects 80% of women. Normally, they are mild, but 25% of those who suffer from them see their quality of life reduced. They are vasomotor symptoms that manifest as a sudden sensation of sudden heat, which starts from the center of the chest and goes up to the head and arms. It causes redness, flushing, and a feeling of loss of control. Hot flashes can wake us up at night, preventing us from sleeping well and therefore limiting our performance the next day. They usually last between two and seven years and are becoming less intense."

They occur, he says, because "the thermoregulatory center stops noticing the effect produced by estrogen and narrows. This makes us sensitive to any temperature."

And, yes, there are factors that exacerbate its effects such as "stress, hot, spicy foods or with additives (such as monosodium glutamate), alcohol (especially sulfites in wine) and processed meats."

Passing the drink with resignation is not the option. "It is important to emphasize that you do not have to put up with it; Hot flashes can be resolved. We deserve to live well, sleep well, perform at work, enjoy life and feel good."

They are solved, he continues, "with MHT (menopausal hormone therapy). Also, with phytotherapy (phytoestrogens). The most effective are those containing genistein which, in addition, have an antioxidant effect; help reduce the process of inflammation that may be in our body; They improve bone quality and lower cholesterol."

Lifestyle, as often happens in everything related to our health, is key. "No tobacco, no alcohol. Our diet should be based on natural products and be rich in vegetables, fruits, legumes, fish, good fats -such as olive oil- nuts and seeds. It is essential to be well hydrated with water or infusions and domoderate exercise, focusing on strength training and disciplines such as yoga. Vital for the body to reduce inflammation, repair damage (glymphatic system) and balance hormones, rest, as well as good management of stress and emotions, is another of the basic pillars of our well-being in this cycle. "

-Dryness of mucous membranes and skin. "It translates, among other things, into vaginal dryness that can produce dyspareunia (pain during sexual intercourse). This issue is very important, since it can even make you stop having sex, which can deteriorate relationships, the concept of fulfillment as a woman and self-esteem. Orgasms are therapeutic!"

This specialist points out that, "in addition to itching, urine or skin infections can occur, it can even bother even the rubbing of clothing, a pathology known as genitourinary syndrome of menopause."

The good news is that "all of this can be solved with different vaginal lubricants and moisturizers."

-Loss of muscle massr. "This phenomenon begins to occur before reaching menopause and is one of the main reasons why our metabolism slows down. It can get worse if we don't take enough protein and improve if we take care of our diet and do strength routines that, in addition to helping us prevent diseases such as diabetes, protect our bones, help maintain our body structure and improve our quality of life, thus helping us to have a better old age. "

-Change in fat distribution. "At this stage, instead of in the area of the holsters or buttocks, it accumulates in the abdominal area, which increases the likelihood of cardiovascular disease. Therefore, I insist again on the importance of the lifestyle you have at this time, because if we avoid a sedentary lifestyle, we move, we do strength routines, we eat healthily, we rest well, we manage our emotions and we take care of our intestinal health, our weight and our contours will not change so much during menopause ".

-Change in the appearance of our skin and hair: "It occurs by decreasing collagen production. Although, in this section, it should be noted that what most deteriorates our skin is exposure to the sun without adequate protection. "

-Joint pain. "The increase in oxidative stress in our cells, also due to the decrease in estrogen, and the loss of collagen are responsible. Here, too, lifestyle influences a lot. Not stopping moving is essential, even if it hurts. Also, it can be useful to take collagen supplements, although you have to know how to choose the type very well. "

-Osteoporosis. "When estrogen decreases, bones lose density and become more fragile and susceptible to fractures. In this chapter, genetics plays a very important role but, to have strong bones it is essential to alternate strength and cardiovascular training. In addition, if our diet is poor in calcium, we must take supplements, because if we lack this mineral, the blood will steal it from the bones and worsen its density. It's also important to maintain adequate vitamin D levels."

EMOTIONAL CHANGES

So far, the physical changes, but what about our emotions? Why do we feel 'so weird' when we get to that moment? Lourdes Ramón Segarra, counselor at Palasiet Talaso Clínica, helps us understand it. "The climacteric is accompanied by changes at all levels – physical, mental, emotional and spiritual – that each woman will experience in a unique and different way. We need to know and identify what happens to us; what happens in our body; What happens to our emotions and what are the reasons for those ups and downs or mood swings that we experience and that we cannot control. And, above all, we have to understand that we are facing an evolutionary change that will require certain adjustments, as well as a comprehensive and loving look at ourselves and our own processes of evolution."

Ramón Segarra quotes Marianna-Doña Lola, founder of the Grove of Gaia, to emphasize that "menopause is, neither more nor less, an evolutionary advance privilege of the people of women and, from this perspective, it must be celebrated and honored".

Not surprisingly, "traditional Chinese medicine calls this stage 'second spring', something like a 'second adolescence', because of the similarities that exist between menarche and menopause."

Because if adolescents, when they have their first menstruation, "experience a hormonal revolution and a very profound change of identity, crossing the bridge between the girl they were and the woman they will be, starting in sexuality and, later, in motherhood", when they reach menopause, we are facing a very similar reality. "Our biological transformation will lead us, again, to another profound identity shift that will lead us from the woman-mother to the wise and complete woman. And all this inner revolution, again, will require a certain time to complete and involves a whole series of intense changes in the emotional body: changes in mood, mood swings, feeling of lack of energy, anxiety, irritability ... And in the spiritual; life dissatisfaction, need to balance life; of search for new purposes and meaning of life".

Here hormones come into play again. "All the hormonal change that manifests in our physical body is going to be the bridge to our emotional and spiritual development. Estrogen, one of the two main hormones (along with progesterone) that has accompanied us during our fertile life, are closely related to two of the neurotransmitters that most affect our mood: serotonin (associated with happiness) and dopamine (linked to the search for pleasure and reward). The more estrogen, the greater the production of serotonin and dopamine. Well, during menopause there is a drop in estrogen and the activity of these neurotransmitters decreases, so we can feel that it is harder for us to connect with joy, pleasure and enjoyment. "

For all this, precisely, "we feel so strange, because, really, there are changes at the physiological level that produce an alteration in our internal functioning and are expressed in the emotional body as alterations in our mood".

The mood swings, in the background, "what they ask us is to observe our life with a magnifying glass to know what we want to recover from everything we have left aside, what is not attended to and what we leave in our unconscious, in the shadow. So we are facing a great stage of personal growth."

What does menopause 'invite' us to? "The first thing he invites us to is a remodeling of our time: it is a priority to stop the frenetic pace in which we are usually immersed and create moments of silence and inner listening to be able to connect with our needs, desires and our soul."

This should allow us to begin "to develop the art of self-care and a more leisurely lifestyle consistent with our authentic needs."

If we let ourselves be felt, surely, "we will realize that the body asks us for more rest and rest; more moments of pause to live our mood swings and more pampering in the form of massages for our bones and muscles."

How do we encourage this to happen? "Perhaps, it is enough with small 'gestures' such as, for example, getting up half an hour before others. We could set aside a quiet time for ourselves that will undoubtedly bring about significant change during the day."

The idea is that "this is a magical and silent moment during which we can practice a little meditation or conscious breathing and then have breakfast calmly, enjoying the aroma and taste of food."

It is also important that "we do not overload our day; That we prioritize tasks by asking ourselves: what is important today? What do I want to do? We are facing a huge and magical biological change; Let us be guided by the principle of pleasure and enjoyment."

Recharging your batteries in nature, says this psychologist, "is the best natural anxiolytic because it connects us with a much slower pace and a calm in the heart. Its green color generates endorphins, serotonin and dopamine. So let's inhabit natural spaces assiduously in our lives. Whether it's in the mountains or on the beach."

Moving our body with the physical activity that makes us enjoy the most, "in addition to producing a great sense of well-being, will help us synthesize calcium, which will be phenomenal to our bones."

Diet, as you know, is also key. "Let's nourish ourselves with rich and fresh food in a sensory way. A diet rich in serotonin precursors such as tryptophan – an amino acid found in pure cocoa, bananas, nuts, etc. – will be our best ally to 'relieve' mood swings. Thanks to their anti-inflammatory and antioxidant properties, they help us protect our brain. In this sense, it should be remembered that inflammation directly affects our mood. Think about the gut-brain axis: all inflammation in our gut will alter our brain functions. The inflammation will ask us to stop and tell us: 'Better, stay home. Don't move.' Which will generate more sadness."

It is also advisable to "take foods rich in Omega-3, present in seeds, nuts, quality oils, fish ... All of them are foods for good mood!".

'Human warmth' is pure medicine. "It's very important to share special moments with the people we love. Hugs with our vitamin people produce an increase in the production of dopamine and oxytocin."

And so is inner silence. "It only takes 10 minutes a day – morning or evening – to be alone and intimate with ourselves and let the troubled waters calm down."

Surely, in those moments of reunion with what we are, we will be able to discover, says this specialist paraphrasing Germana Martín, counselor, creator and facilitator of Workshops Self-knowledge and Feminine Creativity in Women in Circle, "new or denied potentialities to continue growing, daring to be ourselves without waiting for anyone's approval or being subject to the demands of the outside".

• HBPR
• Articles Gema García Marcos

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