To HRT or not to HRT
When you are suffering with hot flushes, night sweats, brain fog, irregular or horrible periods, low mood, weight gain and generally feel pretty rotten, and the doctor offers you HRT, antidepressants or perhaps recommends checking your thyroid function, it’s pretty easy to answer yes. I know, I’ve been there, and it started in my mid 40s!
Why do so many women suffer through menopause and why are more people entering perimenopause before the age of 51 which is the ‘norm’? Tricky menopause symptoms are not normal, and 10 years of perimenopause is not normal. So, what can you do, without turning to drugs, to avoid this time of life being so difficult and potentially having an impact on both home and work life?
Much of the problem is due to stress and the increased consumption of both coffee and alcohol, by women, socially and as a means of coping with the added pressure which holding down a job puts on us, as well as looking after the home and children, keeping up with the Jones and generally being superwoman!
We are expected to go out to work and contribute to the family purse. If we have children, they must go to after school clubs, play for sports teams and go on the school trips. We have to provide imaginative packed lunches, keep our house looking like a show home, meet our friends for drinks on the weekend looking glamourous and be a fabulous chef and seamstress, baking cakes for the school fete and making fancy dress costumes for book day… All this is exhausting! We need coffee in the morning just to get out of bed and get the kids to school, and when we get home having done tea, gone to football practice with one child and swimming lessons with another, is it any wonder we need a bottle of wine to relax before we can sleep?
This was certainly the case for me in my 40s. We had moved to a new town and were living in a mobile home while I project managed the building of the family home and worked part time. My two children were in different schools, we had two dogs, one blind and living on a building site which was constantly changing. The children’s father was 200 miles away and the drives to meet him for weekend visits were challenging to say the least. It was a nightly trip to the local shop for wine and chocolate and the hot sweats and migraines kicked in.
Women in their 30’s and 40’s are living constantly on their nerves, the fight or flight mechanism set off by the stress of each day putting our adrenals into overload. Under stress the adrenal glands produce adrenalin and cortisol. This is a primitive response to a physical threat and would have prepared our body to fight or run away from that threat, but now, in the 21st century, this response is triggered by our never-ending ‘to do’ list and the production of these hormones is almost constant.
Under stress, the body switches off all other metabolic systems. When you need to run away from a sabre-toothed tiger, the last thing your body needs to consider is reproduction, digestion or immunity, so these systems are compromised and consistently run at sub-optimal levels. When we then reach our 40s and the production of sex hormones by our ovaries is naturally reducing, problems arise. When adrenal function is normal, these glands also produce oestrogen, but tired adrenals, in a body constantly under stress, use all their raw materials to produce stress hormones and have no residual function to produce oestrogen. And so, the drop in oestrogen level is more pronounced and the symptoms caused are also more pronounced and the hot flushes, brain fog and low mood ensue.
Caffeine is a stimulant. It causes the fight or flight response and hence shifts the adrenals into stress hormone production. And one coffee (or tea) in the morning can cause this all day - the half life of caffeine (the length of time for its effects to drop by half) can be anything from 8 hours upwards. Unusually for a substance, caffeine’s half life is affected by your genetics and what you eat alongside it, so some people’s bodies are still feeling the effects of caffeine 12 or 18 hours later, although they may not be aware of it. On top of the daily stresses of 21st century life, this is the straw that breaks the camels back.
But there are two straws in this equation!
The alcohol which we drink to counter our buzzing head from the stresses of the day and the coffee we’ve been drinking to keep us going is that second straw. Alcohol is both a sedative and a toxin. It doesn’t actually bring on true sleep, but rather puts us into a stupor, and without deep, natural sleep, our body cannot bring our cortisol levels back down into normal range and the day begins earlier than it should when cortisol levels rise to wake us at 4am rather than 7am.
Toxins are cleared from the body by the liver. High concentrations of cortisol are toxic. In fact, high concentrations of any hormone become toxic. And so under constant stress, the liver is working overtime to clear these toxins out of the body. If we then add another toxin, alcohol, to the mix, the liver becomes bunged up, rather like a sieve which is over-used without cleaning it. An under-functioning liver tends to wake us between 3 and 4am, so again, we lose sleep, and without sleep, stress levels stay high.
And so the cycle begins – poor sleep after alcohol, coffee to wake us up, stress levels elevated and compounding adrenal overload, oestrogen levels falling naturally, and due to low residual adrenal function, hot flushes and night sweats due to low oestrogen, brain fog and low mood due to fatigue.
Dr Libby Weaver in her book ‘Rushing Woman’s Syndrome’ explains this in more detail and I highly recommend the read. Dr Libby is a nutritionist and biochemist who’s calling is to help women overcome issues of stress in 21st century life. You can find her on YouTube and Instagram.
So before you head to the doctor for a solution to your menopause symptoms, try cutting out caffeine and alcohol for a month and see what happens. By working on the root cause of your symptoms, it may just reduce them to manageable levels and negate the need for medical intervention. It definitely worked for me!