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  • Writer's pictureOrsolya Szathmari

How Not To Suffer From Menopause

"Not sleeping, memory loss, angriness and frustration, pains all over my body and hot flashes at least 15 times a day. If I was a dog, I’m sure I would be put down.” Unknown

This might sound funny but unfortunately for many women this is the painful reality. The good news is that it does not have to be this way, because we can do plenty of things for prevention during our 20s and 30s and a lot of things to improve and eliminate the symptoms in our 40s and 50s.

What is menopause exactly?

Menopause technically means the ceasing of menstruation. It happens because at the age of 45-55 the level of estrogen in the body decreases. When the estrogen level is low enough the ovaries stop making new cells, so fertility comes to an end. Overall, it is critical to understand that menopause is not a disease, but an integral part of a woman's lifespan. In any case, migraine, osteoporosis, hot flashes, forgetfulness, low sex drive and agonising nervousness cannot be considered normal. One argument to highlight this point is that 12-20% of women have no symptoms whatsoever during their menopause.

Let’s see where these symptoms are coming from. Can this be a modern problem? It is a fact that women in industrialized countries have higher estrogen levels throughout their lives than women in hunter-gatherer societies. Because of these high levels, an estrogen drop during menopause will be much more significant and will cause many unwanted symptoms. Evidence also shows that the risk for many diseases, such as metabolic problems, weight gain, obesity, CV disease, hyperlipidemia, hypertension, insulin resistance, and type two diabetes are much higher after menopause. The evolutionary perspective suggests that an elevation of circulating estrogen caused by an unhealthy modern diet during the premenopausal period may have an effect on postmenopausal metabolic conditions and disease risk. As we saw before, the main problem that will cause symptoms during menopause is too high estrogen levels preceding menopause.

But where are these high estrogen levels coming from?

The most logical answer is Nutrition.

All these symptoms lead back to a sub-optimal nutrition. Grains, sugar, various vegetable oils, seeds, milk and most dairy products, some other plant foods, food chemicals and processed foods cause and maintain inflammatory and autoimmune processes in the body. The increased number of cardiovascular diseases after menopause are mainly caused by the overconsumption of sugar, carbohydrates and other inflammatory foods. Low estrogen levels during menopause make women more sensitive to all the negative effects of unhealthy eating habits and with that, more susceptible to different illnesses.

In addition to nutrition, there are other things we have to do to reduce estrogen levels in the body. For example, it is critical to use only natural and organic skin care products, avoid plastic dishes, plastic bottles and canned food. The quality of the water we drink is crucial too and paying attention to a high-quality sleep is vital as well.

So, what do I do and what is my advice to you?

I am 50 years old, with no perimenopausal symptoms so far. My waist circumference is 69 cm and my body fat is about 18% (BIA and 22% with DXA), with a 45% of lean body mass. My waist-hip ratio is 0.74. This is just to say that we don’t need to have those extra kilos around our waist, we don’t need to increase our body fat and lose muscle mass just because we are over 40 and have kids! I eat an ideal diet, exercise frequently and avoid environmental toxins as much as possible. If you do the same, you too can have a very smooth transition to menopause. When one has severe symptoms, it is possible to use different herbs and plants to make life easier, but we have to remember that these are just band-aids and not real solutions. They can even have serious side effects. Some of them has been used for a long time and might work for some women but most of them have very weak evidence, if any, in randomised controlled studies.

Estrogen dominance

I mentioned the problems related to estrogen dominance above, including the increased risk of breast, uterine and ovarian cancers, as well as of cervical dysplasia. Women with too much estrogen are also more likely to have intense and unpleasant menopausal symptoms. So addressing estrogen dominance and aiming for a good hormonal balance in our body are extremely important objectives.

Symptoms of estrogen dominance include:

  • Breast swelling and tenderness

  • Irregular/abnormal menstrual periods

  • Anxiety, mood swings, irritability, depression

  • Fatigue

  • Slow metabolism

  • Water retention (bloating)

  • Headaches

  • Brain fog, memory loss

  • Decreased sex drive

  • Weight/fat gain (around the abdomen and hips)

  • Sleeping problems

  • Thickening of endometrial lining, clotted menses

  • Increased risk of uterine fibroids

  • Increased incidence of ovarian cysts

  • PMS

When is estrogen a real problem?

It is very important to know which type of estrogen metabolites women have. To make this clearer, we have to look at how estrogen is metabolised in the body by the liver. There are three different pathways of estrogen metabolism. To make it simple, regarding disease risk, we can say that estrogen will be converted into good or bad metabolites. If your body converts most estrogen using the 2-hydroxy pathway you have a lower risk for cancer and other health problems related to estrogen dominance. However, if most of the conversion happens through the 16-hydroxy and the 4-hydroxy pathways you will have a higher risk for disease. Nutritional status, liver health, chronic stress, diet, and sleep all determine which metabolic pathways are used.

Let’s now look at the mechanisms that lead to estrogen dominance

1) Stress and high cortisol

Chronic stress has a huge impact on our health in many different ways. It can cause a production of excess cortisol, insulin, and noradrenaline, which creates hormonal imbalance and leads to a series of health problems. The adrenal glands contribute to female hormone production during the pre-menopause as well as after menopause. Cortisol, one of our stress hormones, is primarily produced from progesterone. When the body is under constant stress, it will need more cortisol which means that more progesterone will be converted to cortisol. After a while this leads to low progesterone levels and to a relative estrogen dominance. In addition, excess levels of cortisol can block progesterone receptors, contributing to even lower progesterone levels and more estrogen dominance.

2) Xenoestrogens

Xenoestrogens are a type of xenohrmone that imitates estrogen. The amount of xenoestrogens we are exposed to has increased enormously in the last years. These chemicals mimic estrogen and act on estrogen hormone receptor sites in the body. When xenoestrogens enter the body they increase the total amount of estrogen resulting in increased estrogen dominance. They are not biodegradable but stored in our fat cells. Xenoestrogens are found in foods, like commercially raised meat, dairy products and commercially produced grains, vegetables and fruits, and different food additives. They are also in our drinking water and in many products like sunscreen and other cosmetic products, plastic water bottles and plastic dishes. Non-stick coated cookware can release xenoestrogens into our food as well.

3) Compromised Liver Health

One function of the liver is to filter excess estrogen. Taking care of our liver is therefore extremely important because impaired liver function can result in estrogen not being broken down adequately. Excess alcohol, bad nutrition, stress and emotional problems as well as environmental toxins can limit the liver’s ability to cleanse excess estrogen.

4) Body Fat

As we all know, having an ideal weight and body composition has many health benefits. It is also important in maintaining a hormonal balance because excess body fat stores and produces more estrogen, thus contributing to estrogen dominance. The worst type of body fat is that around our waist. Regardless of height, as a woman, your waist measurement shouldn’t be greater than 80 cm (ideally much less than that)!

What to do to reduce estrogen dominance?

Following an ideal diet, exercising correctly, avoiding environmental toxins, reducing stress and having good sleep are all important factors. In my own practice I combine diet with lifestyle advice to help women achieve appropriate levels of estrogen as they head towards menopause.



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