When menopause sets in around age 50, many changes occur.
In addition to the disappearance of menstruation and decreased fertility, the main characteristics of menopause, other symptoms and events occur during this period of transition in women. Gynecologist Dr. Ellen Tamborini explains to us what happens at this new stage in women’s lives.
End of ovulation and fertilization
Every woman has a Capital of ovarian follicles at birth. The latter develops every month under the action of FSH (follicle-stimulating hormone) and the secretion of estrogen, female hormones, which cause the thickening of the uterine lining, creating a regular menstrual cycle. During perimenopause, The ovaries become less sensitive for the action of FSH. The Cycle shortens or lengthens And this is how ovulation happens Irregular Then not at all. The cycle finally closes when The minimum threshold of follicles has been reached. “So there’s no more ovulation, no more transformation of the follicle into the corpus luteum and, as a result, no more production of progesterone, the reproductive hormone.” The endometrium is no longer ready to accommodate a fertilized egg and becomes less and less thick, The rules are getting shorter then disappears.
Redistribution of abdominal fat mass
During menopause, metabolism changes. Changes in body composition often occur during menopause and can distort and “weight” the silhouette: “4 out of 5 women will gain weight unevenly before and during menopause. It’s often more a problem of centimeters than kilos”, Mentions Dr Tamborini. therefore, Decreased lipoprotein lipase activity and decreased lipolytic response of abdominal adipocytes to norepinephrine. These changes in the metabolic activity of adipose tissue result in a redistribution of fat mass toward the abdomen. “There is also a gap between ideal and desired body image imposed by medical standards and fashion in general.”
Increase waist-to-hip ratio
Weight gain, which may begin around perimenopause and cycle disruption, Therefore, with menopause, by altering fat distribution in an android way, the waist/hip ratio increases, Increased cardiovascular risk. “If body fat increases with age, it increases as a percentage of total body weight after menopause.” At the same time, belly fat increases Lean mass decreases, especially at the femoral level (thighs). These changes in body composition are also seen in obese women.
“Weight gain during menopause is better prevented than treated”
“All women should be warned about the high probability of these changes,” he concludes, “ Take the necessary (sometimes drastic…) lifestyle and dietary measures To fight them or better yet, prevent them.” Indeed, weight gain during menopause is better prevented than treated, and belly fat at this time of life is an area that often resists dieting. So all women can benefit from advice aimed at avoiding mistakes and overeating:
- Limit and balance intake,
- Better distribute the ration over three meals,
- Ensure calcium intake,
- Fighting a sedentary lifestyle,
- Encourage regular physical exercise,
- Increase muscle mass.
a Hormone replacement therapy Appropriate regimens combining natural estrogen and natural progesterone or a progestin close to progesterone should not result in normal weight gain or iatrogenic weight gain during this period. Hormonal treatment for menopause (THM) should be effective on menopausal disorders (hot flashes, night sweats, insomnia, etc.) but also Mostly well toleratedBecause it is a long-term treatment, usually over many years. “In all cases, with or without THM, it is worth adopting strict lifestyle and dietary measures to maintain your weight and figure during menopause. It is often an uphill battle but it is possible” It turns out.
The question of osteoporosis
It affects about 1 in 4 women and represents a major long-term complication of menopause. From the age of 40, bone mass naturally decreases. In women, bone loss accelerates during menopause. “When there is significant loss of bone mass, it can result fracture (vertebrae, wrist and later femur). The first fracture is often a collapse of a lumbar vertebra, which occurs around age 65. Subsequently, other vertebral compressions can occur and increase pain and disability. Mentions Dr Tamborini. l’Bone density assessment Bone densitometry (absolutely painless and very low radiation examination) at the beginning of menopause is particularly interesting to identify which women are at risk. Means exist to maintain bone health, esp Calcium diet : Foods rich in calcium, adequate intake Vitamin D that promote calcium absorption and fixation (1,200 mg/day or 3 to 4 dairy products), and the practice of regular physical activity. “Dietary calcium intake is often inadequate in middle age even though needs are increasing. Therefore calcium rich foods are recommended : Dairy products, cheese (Comte, Emmental, Cantal), yogurt, and white cheese (some are Wisely enriched with calcium and vitamin D), mineral water with high calcium content. Supplemental calcium intake can also be very helpful. He insists. For prevention, in the years after menopause, hormonal treatment is especially indicated because it slows or even stops this bone loss.
Skin, nails… also change
Menopause with its estrogen deficiency contributes more or less depending on each woman Skin aging and highly variable skin changes (Decrease in collagen content, hyaluronic acid, dryness, appearance of Wrinklesdecrease in skin thickness, etc.). “Our patients often talk“Old Look” at Menopause Or, perhaps, rather middle age, an age in which the stigma of skin aging is expected and feared in a Western socio-cultural environment that is not too forgiving, not even cruel, which gives a “bonus” to youth and heightens their perception. ” Dr. Emphasis on Tamborini. support Preserve skin hydration Through the use of specific “anti-ageing” products and ranges and to ensure year-round sun protection. Sometimes nails can become more fragile and brittle.
Hair growth is reduced
This physiological hormonal upheaval can also affect both hair and body hair: in the more or less long term, the activity of the skin’s androgen receptors and the production of sebum decrease. there Growth of limb hair slows down when Pubic and armpit hair becomes rareor disappear. “Infrequently and in the absence of any abnormal androgen secretion, we can see that Chin hair growth and/or upper lip electric hair removal or, related to the stimulation of a rat started in perimenopause” It turns out.
Thanks to Doctor Alain Tamborini, Gynecologist (Paris).
