Menopause and chronic diseases: what role do nutrition and physical exercise play in their prevention?
Menopause is a significant change in a woman's health; many women will live longer during this stage than during their reproductive years. This affects most of the body's organs, not only the reproductive system, but also the neurological, cardiovascular, and skeletal systems. Menopause is no longer a problem that should be addressed solely from a gynecological perspective, but requires a multidisciplinary approach, given its association with an increased risk of various chronic diseases. How can physical exercise and diet help prevent them? Our specialist in Gynecology and Obstetrics and Functional Medicine, Elisa Llurba, explains., Professor at the Autonomous University of Barcelona and Medical Director of BeDona.
Longer life expectancy, more years in menopause
Menopause is caused by a significant decrease in the production of sex hormones (estrogens and progestogens) by the ovaries and the cessation of ovulation. Although it is considered a physiological or normal stage in women's health, this does not mean it has no impact on health. This impact, when life expectancy was 60 or 70 years, was relatively minor. But in the 21st century, the scenario is completely different: not only are we living longer, but we also still want to live well.
Women become mothers at an average age of 32. Many of them still have school-aged children or children in daycare when they reach menopause. We feel good, strong, and young. Today's 50 is the 40 of years past. But 60 will also be the new 50, and we want to feel good, to continue feeling beautiful and strong, eager for new projects, to dress in the latest fashions, capable and wanting to dance and have sex until we're 100, if possible. However, menopause doesn't help us, and now I'll explain why.
Impact of menopause on health
The impact of menopause is not only on the reproductive system, but estrogen and progesterone receptors are present in most organs of our body, including the brain, heart, and bones.
Menopause is no longer just a problem that is addressed solely from a gynecological perspective, but which requires a multidisciplinary approach, considering that it is related to an increased risk of various chronic diseases. This is especially important in cases of early menopause (that which occurs before age 40). But it's also true for women who experience it at the typical age. The consequences will be experienced differently at a later stage of life, but we've already discussed a woman's needs at age 50 and life expectancy, so in a way, the decline in hormones catches us all relatively young (in terms of our stage of life).
1 Cardiovascular health and menopause
The decline in sex hormones during menopause affects, for example, how our endothelium (the inner lining of blood vessels) reacts, which is key to regulating blood pressure. Most women experience an increase in blood pressure during menopause, and their blood vessels exhibit a pro-inflammatory state that increases their risk of cardiovascular disease.
Contrary to what was previously thought, menopausal and postmenopausal women have a high risk of developing coronary heart disease and, therefore, of having a heart attack. Estrogens are potent cardioprotective agents, a protection that is lost during menopause. Furthermore, if other pro-inflammatory factors are present, such as an inadequate diet, digestive problems, or an overactive immune system, this lack of protection is further amplified.
Have you noticed how a woman's body changes after 50? It becomes more masculine: we accumulate fat in our abdomen, and our bodies increasingly resemble those of our male counterparts. Well, this level of fat accumulation is directly and clearly linked to an increased risk of cardiovascular disease.
The good news? It's known that women who maintain a healthy lifestyle, including a Mediterranean diet, phytoestrogen supplementation, or natural estrogens, and who exercise regularly, continue to protect their cardiovascular system to some extent. That's why we've prepared a program specifically for this stage.
2 Bone health and menopause
Bone health is determined by several factors, such as gut health, kidney function, and blood sugar regulation, as well as by the decrease in estrogen associated with menopause. A number of interrelated hormones are involved in bone formation, maintenance, and remodeling:
– The parathyroid hormone. It is a hormone that regulates calcium in the blood and stimulates bone resorption and bone formation.
- The 1,25–dihydroxyvitamin D o calcitriol (the Vitamin D circulating hormone). It is another calcium-regulating hormone and is produced from vitamin D and is required for calcium absorption.
– Calcitonin. It is the other regulator of calcium levels and its mission is to prevent high calcium levels.
– Estrogens. They are regulators of bone remodeling in women and men.
– Thyroid hormones. They influence bone maintenance
– Cortisol. It inhibits bone growth. That's why people who take corticosteroids long-term have a high risk of osteoporosis.
– Insulin. It regulates both bone formation and resorption.
The good news? Recent studies indicate that the Mediterranean diet, resistance exercise to increase muscle mass, and improved stress levels contribute to good bone health. Supplements such as calcium, vitamin D, a diet rich in soy, omega-3 fatty acids, and probiotics are also recommended to protect our bones.
3 Brain and menopause
The brain reacts to female sex hormones. Scientific studies have shown how the brain changes with hormonal fluctuations and during menopause. Estrogen levels interact with neurotransmitters such as serotonin, dopamine, GABA, and glutamate.
The prevalence of depression is twice as high in women as in men. In Spain, it stands at 7.11% in women and 3.51% in men. Women with menopause, whether early or not, are at greater risk of experiencing depressive symptoms and mood swings and are diagnosed with depression more frequently than women without menopause.
The impact of menopause on neurodegenerative diseases, particularly the changes in sex hormones, has been described in experimental models, both in animals and in humans. These hormones decrease in the blood and also in the brain during menopause. Estrogens regulate various processes related to emotions and cognitive functions. Estrogens are also known to be cardioprotective and neuroprotective, influencing immune response, neurogenesis, cellular function, and the response to toxins.
Scientific studies have shown that women experience a decline in concentration and memory during menopause. Women with early menopause have a higher risk of dementia. Despite the link between estrogen levels and changes in the brain, hormone therapy has not been shown to prevent the development of dementia. It appears that existing studies have been conducted with different treatments, at different stages of life, and with important factors that may also be decisive, such as socioeconomic status and other contributing factors.
The most significant scientific evidence relates to lifestyle changes that promote cognitive health, such as the Mediterranean diet, regular exercise, and eliminating harmful habits like smoking and alcohol consumption. Managing emotions, maintaining a social life and pursuing new projects, and engaging in stress-reducing activities can also help us care for our neurons.
