Understand the link between adrenal health, menopause
By Dr. Martin Gleixner, MSc, ND
Many hormonal changes occur as women come closer to or find themselves in menopause. Does this relate mainly to changes in sex hormones such as estrogen and progesterone, or are there other important factors to consider?
In today's column, I will explain why assessing for and treating adrenal dysfunction is paramount in helping women reduce or eliminate menopausal symptoms.
The menopausal transition usually occurs between the ages of 42 and 58. It is recognized that menopause is not a disease, but many women face many health challenges during this life transition. The only sign that all women universally have by the end of the menopausal transition is the cessation of menses. For many, symptoms can also include hot flashes, insomnia, vaginal dryness, low sex drive, memory and mood changes, and fatigue. The bumpy road prior to menopause can also include irregular and abundant menses.
After menopause, many women also face an increased risk of osteoporosis and heart disease. Others are challenged with conditions such as chronic fatigue syndrome.
How it is then that some women can coast through the menopausal transition, while others are plagued with unpleasant symptoms?
The prevailing myth in conventional medicine is that menopausal symptoms are caused by a deficiency in estrogen. In reality, as mentioned by Dr. John Lee, MD in his book 'What Your Doctor May Not Tell You About Menopause,' estrogen levels "decrease by only 40-50 per cent at menopause, while progesterone levels can drop to nearly zero." Although estrogen deficiency can be an important factor, it falls short in providing a complete understanding of hormonal changes during menopause.
Too often, treatments in the form of birth control pills, hormone-based IUDs, hormone replacement therapy, or bio-identical hormones are used to treat menopausal symptoms. Although these can be effective in decreasing certain symptoms in the short-term, they do not address the underlying cause(s).
What is the missing explanation?
Low adrenal function is one of the most important underlying causes of menopausal symptoms. Let's find out why...
During the menopausal transition, the ovaries stop ovulating and decrease their production of progesterone and estrogen. For some women, this decline in hormones can occur abruptly or slowly over time. To make up for this lack of sex hormones, a women's adrenal glands (also known as the 'stress' gland) at this stage in life, are designed to pick-up the slack for the ovaries.
More specifically, the adrenals (like the ovaries) are also able to secrete progesterone as well as other hormones such as androstenedione (a precursor hormone for estrogen and testosterone). Until menopause, the adrenal's role to produce female sex hormones is minimal.
Throughout our lives, the adrenal glands are also responsible for the production of cortisol, aldosterone and adrenaline, among other hormones. The adrenals allow humans to respond to changing life situations by regulating sugar levels, adjusting metabolism, moving blood to where it's needed in the body, controlling electrolyte concentrations and regulating blood volume, etc. In doing so, they affect energy levels, our sleep/wake cycle, our blood pressure, and our ability to do things we need to do day-to-day.
But many women have lived with a tremendous amount of stress and responsibility. Women are raising children (often later in life - in their 30s and 40s), while juggling their careers at the same time.
In the Western world, we have lost touch with certain cultural practices that help decrease our stress levels. In other cultures, community and extended families more commonly help each other during times of increased stress. A Japanese tradition, for example, holds that after a woman delivers her baby, she does not conduct any household duties and is even prevented from driving. Recuperation from labor, the challenges of breastfeeding and caring for the newborn take priority instead. Without such help, women are forced into 'survival' mode and do whatever it takes to get things done. This can go on for months, and even years.
By the time women reach the menopausal transition, the adrenal glands are so depleted that they are unable to produce healthy levels of hormones. In whatever capacity they can, the adrenal glands focus on the production of baseline levels of cortisol rather than the production of progesterone and other sex hormone precursors. The result is clear: increased menopausal symptoms and related adrenal deficiency symptoms such as fatigue, insomnia, and cravings. To better understand, read the following articles about stress. It's important to recognize symptoms that may indicate that stress is taking its toll.
As usual prevention is best; keeping the adrenals healthy is an important factor in enjoying a smoother menopausal transition. Addressing the root cause of the stress and learning adaptation techniques that suit each individual is paramount. Adopting practices such as taking naps or taking small breaks during the day, getting outside for fresh air and sunshine, taking up yoga, spending more time with friends and family, are only a few great ways of reducing the effects of stress.
As I've often mentioned before, chronic health conditions and related hormonal imbalances are complicated and should be evaluated based on the greater context of your care. Work with your medical doctor or naturopathic doctor to assess the effect of hormones on your health.
When menopausal symptoms are affecting your day-to-day quality of life, it is important to assess for adrenal imbalances. This can be done by a review of one's symptoms and medical history, a physical examination, and by conducting a salivary cortisol test to assess for adrenal function. This information will enable your naturopathic doctor to recommend a personalized treatment protocol to restore hormone balance.
In conjunction with lifestyle changes, specific vitamins and herbal remedies in medicinal doses can be administered to address the underlying causes and provide relief of menopausal symptoms.
An approach that addresses all factors (causes), including adrenal dysfunction can provide better therapeutic outcomes in treating menopausal symptoms. Improved treatment outcomes can allow menopausal women to enjoy the transition for what it was intended...a new stage of life.
Published by Dr. Gleixner on Wednesday June 8th, 2011 in Times & Transcript.
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