The New Menopause | with Dr Lucy Caratti
It would be difficult to be a part of Western society at the moment and not be aware of a change in the conversation around menopause.
From celebrities such as Naomi Watts and Halle Berry being open about their journeys to the Senate Inquiry into Menopause, there seems to be a story a day with something about this transitional phase of a woman’s life. As with everything, there are positive reactions to the rush of information available, alongside negative responses, including articles criticising the “over-medicalisation” of what is considered a “normal” part of a woman’s life. It can be confusing when there are conflicting sides, often from different health professionals.
To those who question whether we need to focus so much time on women at this time of life when this is just a part of nature, I respond with a quote from Dr Felice Gersh (OBGYN from the USA) who states that a tornado is also natural, but destructive. If we look at the history of women and their current state of wellbeing, we can see a rapid decline in their health after menopause following the loss of the protective hormones estradiol and progesterone. So this is not a matter of curing a few hot flushes or poor night’s sleep, but of optimising and prolonging a woman’s health span.
This new wave of menopause education in Australia resulted in an incredible event at none other than the iconic Sydney Opera House, where international medical powerhouses educated and inspired women to inform themselves about the physiological changes that occur during the menopausal transition and ways they can prevent health decline and optimise their function. The energy in the room was electric, with menopausal women finally being celebrated and empowered, a far cry from the invisible notion of the aging woman in times past.
For those unable to attend, I thought I would share five take-home messages from these powerhouse medical doctors (not influencers, I might add, despite some of the negative media once again tarnishing women), including Dr Louise Newson, Dr Mary Claire Haver, Dr Kelly Casperson and Dr Vonda Wright.
Estradiol and progesterone are not just "sex hormones".
Traditionally we have thought of estradiol and progesterone as just being important for reproduction, however, we now know that there are receptors for these hormones on almost every cell in the body. Even our mitochondria - the powerhouses in cells that create energy for them to work - have estradiol receptors on them! So after menopause, where the ovarian production of these hormones ceases, it is no wonder that every organ in the body, including the brain and the heart, is affected. These are life hormones!
Testosterone is more than just libido.
Testosterone has always been thought of as being the “male” hormone and only important for libido in women. The bulk of research on testosterone in women has been regarding this. Testosterone is so much more than this. It is vital for mood and cognition, bone and muscle health, and much more. It is often the missing link in menopausal women, with testosterone replacement therapy being life-changing for so many women.
Fight to be strong, not skinny.
Women have been a part of diet culture for decades and while there is a slight shift in this, we still have a long way to go. The idea of being skinny as being healthy and attractive has been so detrimental for women, with their exercise regimes and restrictive dieting leading to low bone density (osteopenia/osteoporosis) and/or low muscle mass (sarcopenia). Muscle mass is a direct determinant of longevity, so eating lots of protein and lifting heavy is of utmost importance for women.
Menopause impacts brain health.
We are starting to recognise the mental health struggles that many women suffer from during perimenopause/menopause with rates of anxiety and depression soaring at this time of life. We also now know that traditional medications used such as antidepressants are not as effective, and actually using body identical HRT (hormone replacement therapy) is the gold standard of treatment. In addition, early menopause has been shown to increase the risk of dementia by up to 20%! The introduction of HRT especially in high-risk patients is being researched currently, with positive findings regarding the early introduction of HRT to mitigate the risks.
Hormones are just one part of the equation.
While we know the benefits of using body-identical HRT on the symptoms and consequences of menopause, this is only one part of the solution. There are some women who cannot or chose not to take hormones. Either way, you cannot ignore the basic pillars of health at this time of life. And these are accessible to all and completely free. Eating good food, moving your body, prioritising sleep, finding your purpose and connection. These are all so important. The menopausal transition is an exciting metamorphosis and leaning in to your body and your authentic self is the most rewarding gift at this time of life.
Let’s keep the conversation going about how we can be our best selves at this pivotal time of our lives and concentrate on the amazing, positive changes that come with it, instead of focusing on the bad. Aging is a privilege, so let’s focus on doing the best we can, however that looks for each of us.
Dr Lucy Caratti is an integrative doctor specialising in women's health.
Dr Lucy Caratti is a highly qualified Integrative Doctor with 15 years of clinical experience and an expert in women's health, particularly issues like menopause and perimenopause.
