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What are the most common symptoms of menopause? And which can hormone therapy treat?

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers. Adding to the uncertainty, a recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">series in the Lancet</a> medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate. So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says. <h2>Remind me, what exactly is menopause?</h2> Menopause, simply put, is complete loss of female fertility. Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause). Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months. Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder). <h2>What are the most common symptoms of menopause?</h2> <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">Our study</a> of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are: <ul> <li>hot flushes and night sweats (known as vasomotor symptoms)</li> <li>disturbed sleep</li> <li>musculoskeletal pain</li> <li>decreased sexual function or desire</li> <li>vaginal dryness and irritation</li> <li>mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.</li> </ul> However, none of these symptoms are menopause-specific, meaning they could have other causes. In <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">our study of Australian women</a>, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats. But the severity of these symptoms <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">varies greatly</a>. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55. So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are <a href="https://journals.lww.com/menopausejournal/fulltext/2022/05000/prevalence,_severity,_and_associated_factors_in.9.aspx">similarly affected</a>. Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span. The <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">most robust guidelines</a> do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of <a href="https://www.cell.com/cell/abstract/S0092-8674(23)00905-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867423009054%3Fshowall%3Dtrue">menopausal hormonal changes</a>. The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">Some studies</a> suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">have not been shown to change</a>. <h2>Who might benefit from hormone therapy?</h2> The Lancet papers <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">suggest</a> menopause hormone therapy <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02799-X/fulltext">alleviates</a> hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats). In contrast, the highest quality <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">clinical guidelines</a> consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy. Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency). However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”. Despite musculoskeletal pain being the most common menopausal symptom in <a href="https://journals.lww.com/menopausejournal/abstract/2016/07000/prevalence_and_severity_of_vasomotor_symptoms_and.6.aspx">some populations</a>, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied. Some guidelines, such as an <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Australian endorsed guideline</a>, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease. <h2>What are the risks?</h2> The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot. Oestrogen-only menopause hormone therapy is <a href="https://www.nice.org.uk/guidance/ng23">consistently considered</a> to cause little or no change in breast cancer risk. Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, <a href="https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Women%20Health/CPG_Management_of_Menopause_2022_e-version-1.pdf">has been associated with a small increase</a> in the risk of breast cancer, although any <a href="https://www.bmj.com/content/bmj/371/bmj.m3873.full.pdf">risk appears to vary</a> according to the type of therapy used, the dose and duration of use. Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels <a href="https://www.bmj.com/content/bmj/364/bmj.k4810.full.pdf">prescribed at standard doses</a> <h2>What if I don’t want hormone therapy?</h2> If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats. In Australia, most of these options are “off-label”, although the new medication <a href="https://australianprescriber.tg.org.au/articles/management-of-menopause.html">fezolinetant</a> has just been <a href="https://www.tga.gov.au/resources/artg/401401">approved</a> in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat). Unfortunately, most over-the-counter treatments promoted for menopause are either <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">ineffective or unproven</a>. However, cognitive behaviour therapy and hypnosis <a href="https://journals.lww.com/menopausejournal/abstract/2023/06000/the_2023_nonhormone_therapy_position_statement_of.4.aspx">may provide symptom relief</a>. The Australasian Menopause Society has useful <a href="https://www.menopause.org.au/health-info/fact-sheets">menopause fact sheets</a> and a <a href="https://www.menopause.org.au/health-info/find-an-ams-doctor">find-a-doctor</a> page. The <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Practitioner Toolkit for Managing Menopause</a> is also freely available.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">original article</a>.

Body

From straight to curly, thick to thin: here’s how hormones and chemotherapy can change

<a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Head hair comes in many colours, shapes and sizes, and hairstyles are often an expression of personal style or cultural identity. <a href="https://pubmed.ncbi.nlm.nih.gov/36631178/">Many different genes</a> determine our hair texture, thickness and colour. But some people’s hair changes around the time of puberty, pregnancy or after chemotherapy. So, what can cause hair to become curlier, thicker, thinner or grey? <h2>Curly or straight? How hair follicle shape plays a role</h2> Hair is made of <a href="https://my.clevelandclinic.org/health/body/23204-keratin">keratin</a>, a strong and insoluble protein. Each hair strand grows from its own <a href="https://www.ncbi.nlm.nih.gov/books/NBK470321/">hair follicle</a> that extends deep into the skin. Curly hair forms due to asymmetry of both the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6894537/">hair follicle and the keratin</a> in the hair. Follicles that produce <a href="https://www.medicalnewstoday.com/articles/318524">curly hair</a> are asymmetrical and curved and lie at an angle to the surface of the skin. This kinks the hair as it first grows. The asymmetry of the hair follicle also causes the keratin to bunch up on one side of the hair strand. This pulls parts of the hair strand closer together into a curl, which maintains the curl as the hair continues to grow. Follicles that are symmetrical, round and perpendicular to the skin surface produce straight hair. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567020/original/file-20231221-29-fp0wci.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="A diagram shows the hair follicle shape of straight, curly and coiled hair." /></a><figcaption>Each hair strand grows from its own hair follicle. <a class="source" href="https://www.shutterstock.com/image-vector/diagram-hair-follicle-shape-vector-illustration-2248429145">Mosterpiece/Shutterstock</a></figcaption></figure> <h2>Life changes, hair changes</h2> Our hair undergoes repeated cycles throughout life, with different stages of growth and loss. Each hair follicle contains stem cells, which multiply and <a href="https://www.frontiersin.org/articles/10.3389/fcell.2022.899095/full">grow into a hair strand</a>. Head hairs spend most of their time in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5905671/">the growth phase</a>, which can last for several years. This is why head hair can grow so long. Let’s look at the life of a single hair strand. After the growth phase is a transitional phase of about two weeks, where the hair strand stops growing. This is followed by a resting phase where the hair remains in the follicle for a few months before it <a href="https://www.healthline.com/health/stages-of-hair-growth">naturally falls out</a>. The hair follicle <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/exd.13347">remains in the skin</a> and the stems cells grow a new hair to repeat the cycle. Each hair on the scalp is replaced <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606321/#b3">every three to five years</a>. <h2>Hormone changes during and after pregnancy alter the usual hair cycle</h2> Many women notice their hair is <a href="https://www.medicalnewstoday.com/articles/pregnancy-hair">thicker during pregnancy</a>. During pregnancy, high levels of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908443/">oestrogen, progesterone and prolactin</a> prolong the resting phase of the hair cycle. This means the hair <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/">stays in the hair follicle for longer</a>, with less hair loss. A drop in hormones a few months after delivery causes increased hair loss. This is due to all the hairs that remained in the resting phase during pregnancy falling out in a fairly synchronised way. <h2>Hair can change around puberty, pregnancy or after chemotherapy</h2> This is related to the genetics of hair shape, which is an example of <a href="https://www.biologyonline.com/dictionary/incomplete-dominance">incomplete dominance</a>. Incomplete dominance is when there is a middle version of a trait. For hair, we have curly hair and straight hair genes. But when someone has one curly hair gene and one straight hair gene, they can have wavy hair. Hormonal changes that occur around <a href="https://clinicalepigeneticsjournal.biomedcentral.com/articles/10.1186/s13148-019-0780-4">puberty</a> and <a href="https://www.mdpi.com/1422-0067/23/20/12698">pregnancy</a> can affect the function of genes. This can cause the curly hair gene of someone with wavy hair to become more active. This can change their hair from wavy to curly. Researchers have identified that activating specific genes can change hair in pigs <a href="https://www.frontiersin.org/articles/10.3389/fgene.2023.1184015/full">from straight to curly</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759815/">Chemotherapy</a> has very visible effects on hair. Chemotherapy kills rapidly dividing cells, <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2628766">including hair follicles</a>, which causes hair loss. Chemotherapy can also have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1988866/">genetic effects</a> that influence hair follicle shape. This can cause hair to <a href="https://www.medicalnewstoday.com/articles/chemo-curls">regrow with a different shape</a> for the first few cycles of hair regrowth. <h2>Hormonal changes as we age also affect our hair</h2> Throughout life, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/">thyroid hormones</a> are essential for production of keratin. Low levels of thyroid hormones can cause dry and brittle hair. <a href="https://pubmed.ncbi.nlm.nih.gov/36578854/">Oestrogen and androgens</a> also regulate hair growth and loss, particularly as we age. Balding in males is due to <a href="https://theconversation.com/starting-to-thin-out-hair-loss-doesnt-have-to-lead-to-baldness-34984">higher levels of androgens</a>. In particular, high dihydrotestosterone (sometimes shortened to DHT), which is produced in the body from testosterone, has a role in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7269836/">male pattern baldness</a>. Some women experience <a href="https://theconversation.com/health-check-why-does-womens-hair-thin-out-39126">female pattern hair loss</a>. This is caused by a combination of genetic factors plus lower levels of <a href="https://www.mdpi.com/2077-0383/12/3/893">oestrogen and higher androgens</a> after menopause. The hair follicles become smaller and smaller until they no longer produce hairs. Reduced function of the cells that produce <a href="https://www.health.com/mind-body/what-going-gray-early-can-tell-you-about-your-health">melanin</a> (the pigment that gives our hair colour) is what causes greying.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219329/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-straight-to-curly-thick-to-thin-heres-how-hormones-and-chemotherapy-can-change-your-hair-219329">original article</a>.

Beauty & Style

I’m trying to lose weight and eat healthily. Why do I feel so hungry all the time? What can I do about it?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Benjamin Franklin, one of the founding fathers of the United States, famously said nothing is certain except death and taxes. But I think we can include “you’ll feel hungry when you’re trying to lose weight” as another certainty. The reason is basic biology. So how does this work – and what can you do about it? <h2>Hormones control our feelings of hunger</h2> Several hormones play an essential role in regulating our feelings of hunger and fullness. The most important are ghrelin – often called the hunger hormone – and leptin. When we’re hungry, <a href="https://pubmed.ncbi.nlm.nih.gov/11739476/">ghrelin</a> is released by our stomach, lighting up a part of our brain called the hypothalamus to tell us to eat. When it’s time to stop eating, hormones, including <a href="https://pubmed.ncbi.nlm.nih.gov/8717038/">leptin</a>, are released from different organs, such as our gut and fat tissue, to signal to the brain that we’re full. <h2>Dieting disrupts the process</h2> But when we change our diet and start losing weight, we disrupt how these <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">appetite hormones function</a>. This triggers a process that stems from our hunter-gatherer ancestors. Their bodies developed this mechanism as a survival response to adapt to periods of deprivation and protect against starvation. The levels of hormones <a href="https://pubmed.ncbi.nlm.nih.gov/23126426/">managing our hunger increase</a>, making us feel hungrier to tell us to eat more, while the ones responsible for signalling we’re full decrease their levels, intensifying our feelings of hunger. We end up increasing our calorie consumption so we eat more to regain the weight we lost. But worse, even after the kilos creep back on, <a href="https://pubmed.ncbi.nlm.nih.gov/22029981/">our appetite hormones don’t restore</a> to their normal levels – they keep telling us to eat more so we put on a little extra fat. This is our body’s way of preparing for the next bout of starvation we will impose through dieting. Fortunately, there are things we can do to manage our appetite, including: <h2>1. Eating a large, healthy breakfast every day</h2> One of the easiest ways to manage our feelings of hunger throughout the day is to eat most of our food earlier in the day and taper our meal sizes so dinner is the smallest meal. <a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. <a href="https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00344-8">Another study</a> found the same effect. Participants went on a calorie-controlled diet for two months, where they ate 45% of their calories for breakfast, 35% at lunch and 20% at dinner for the first month, before switching to eat their largest meal in the evening and their smallest in the morning. Eating the largest meal at breakfast resulted in decreased hunger throughout the day. <a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> also shows we burn the calories from a meal 2.5-times more efficiently in the morning than the evening. So emphasising breakfast over dinner is good not just for hunger control, but also weight management. <h2>2. Prioritising protein</h2> Protein helps contain feelings of hunger. This is because protein-rich foods such as lean meats, tofu and beans suppress the appetite-stimulating ghrelin and stimulate another hormone called <a href="https://www.sciencedirect.com/science/article/pii/S1550413106002713">peptide YY</a> that makes you feel full. And just as eating a breakfast is vital to managing our hunger, what we eat is important too, with <a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">research</a> confirming a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado. <h2>3. Filling up with nuts and foods high in good fats and fibre</h2> Nuts often get a bad rap – thanks to the misconception they cause weight gain – but nuts can help us manage our hunger and weight. The filling fibre and good fats found in nuts take longer to digest, meaning our hunger is satisfied for longer. <a href="https://pubmed.ncbi.nlm.nih.gov/12791613/">Studies</a> suggest you can include up to 68 grams per day of nuts without affecting your weight. Avocados are also high in fibre and heart-healthy monounsaturated fats, making them another excellent food for managing feelings of fullness. This is backed by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567160/">study</a> confirming participants who ate a breakfast incorporating avocado felt more satisfied and less hungry than participants who ate a meal containing the same calories but with lower fat and fibre content. Similarly, eating foods that are high in soluble fibre – such as <a href="https://pubmed.ncbi.nlm.nih.gov/24820437/">beans</a> and vegetables – make us feel fuller. This type of fibre attracts water from our gut, forming a gel that slows digestion. <h2>4. Eating mindfully</h2> When we take time to really be aware of and enjoy the food we’re eating, we slow down and eat far less. A <a href="https://pubmed.ncbi.nlm.nih.gov/28718396/">review</a> of 68 studies found eating mindfully helps us better recognise feelings of fullness. Mindful eating provides our brain enough time to recognise and adapt to the signals from our stomach telling us we’re full. Slow down your food consumption by sitting at the dinner table and use smaller utensils to reduce the volume of food you eat with each mouthful. <h2>5. Getting enough sleep</h2> Sleep deprivation disturbs our <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945708700133">appetite hormones</a>, increasing our feelings of hunger and <a href="https://www.nature.com/articles/ncomms3259">triggering cravings</a>. So aim to get at least seven hours of uninterrupted sleep a night. Try switching off your devices <a href="https://journals.sagepub.com/doi/full/10.1177/1477153515584979">two hours before bed</a> to boost your body’s secretion of sleep-inducing hormones like melatonin. <h2>6. Managing stress</h2> Stress increases our <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">body’s production of cortisol</a> and triggers food cravings. So take time out when you need it and set aside time for stress-relieving activities. This can be as simple as getting outdoors. A <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">2019 study</a> found sitting or walking outdoors at least three times a week could reduce cortisol levels by 21%. <h2>7. Avoiding depriving ourselves</h2> When we change our diet to lose weight or eat healthier, we typically restrict certain foods or food groups. However, this <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">heightens activity</a> in our mesocorticolimbic circuit – the reward system part of the brain – often resulting in us craving the foods we’re trying to avoid. Foods that give us pleasure release feel-good chemicals called endorphins and learning chemicals called dopamine, which enable us to remember – and give in to – that feel-good response. When we change our diet, activity in our hypothalamus – the clever part of the brain that regulates emotions and food intake – <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">also reduces</a>, decreasing our control and judgement. It often triggers a psychological response dubbed the “what-the-hell effect”, when we indulge in something we think we shouldn’t feel guilty about and then go back for even more. Don’t completely cut out your favourite foods when you go on a diet or deprive yourself if you’re hungry. It will take the pleasure out of eating and eventually you’ll give into your cravings. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-trying-to-lose-weight-and-eat-healthily-why-do-i-feel-so-hungry-all-the-time-what-can-i-do-about-it-215808">original article</a>.

Body

9 signs you might have a hormone imbalance

<h2>You can’t stay out of the fridge</h2> If you’re way more ravenous than you used to be, hormone imbalance symptoms might be to blame – specifically, thyroid hormones. Thyroid hormones help regulate your metabolism, so if you’re hyperthyroid, you’ll burn through kilojoules faster and be left craving more. On the other hand, if you’re stressed, too much of the stress hormone cortisol could signal you to eat up to fuel you through a fight or flight. “The body is perceiving that it’s under stress and needs to build a reserve,” says Dr Pauline Camacho, FACE, a professor of medicine in the division of endocrinology and metabolism. <h2>You’re losing hair where you want it</h2> Polycystic ovary syndrome (PCOS) stimulates an overproduction of testosterone. It can cause hair loss in women that may resemble male pattern baldness with unwanted hair growth on the body. PCOS often first appears in adolescence, so your symptoms might have started after you first got your period. “You would know even in early teen years that they have manifestations,” says Dr. Camacho. “They have irregular periods, heavier than usual compared to other peers.” <h2>Your weight is changing</h2> Whether you’ve lost or gained kilos, weight change when your diet has stayed the same could signal a hormone imbalance. “The weight changes go beyond what people perceive would be expected for their activity or eating,” says Dr Camacho. “They’re eating the same, but weight goes up over weeks or years.” Extra cortisol or testosterone – for instance from PCOS – might lead you to pack on kilos. On the other hand, excessive thyroid hormones might trigger sudden weight loss. <h2>You’re just not feeling like yourself</h2> It probably comes as no surprise that hormonal changes during PMS or menopause can cause mood swings. But hormonal changes can happen for reasons beyond menopause. Thyroid hormones can affect your emotional state, too. “People who have hyperthyroidism can be kind of short-tempered and anxious,” says Dr Camacho. “On the reverse side, those with hypothyroidism would be more depressive and passive.” <h2>You’re never in the mood</h2> Hormone imbalance symptoms can definitely affect your reproductive health and your desire for sex. A system called the gonadal axis connects the reproductive gonad organ to the pituitary gland and hypothalamus, parts of your brain responsible for hormone production. When one of these gets out of whack, libido changes may result. “Those three affect each other so that when you have a pituitary problem or a hypothalamus problem, there’s a problem in the gonadal hormones: testosterone and estrogen,” says Dr Camacho. Too little estrogen or testosterone, or a fluctuation in thyroid hormones, are all connected, which could affect your sex drive. <h2>You feel fatigued</h2> When any of your systems are unbalanced – including hormones – your body’s energy is going to suffer. For example, low thyroid hormones slow your body down while high levels kick you into high gear and can make you anxious; either way, you’re going to feel worn out. “Either there’s not enough energy or fuel, or your muscles are over-stimulated, and it uses up too much energy and you feel tired,” says Dr Camacho. <h2>You’re tossing and turning</h2> Without enough sleep for your body to restore itself, your hormone levels could get out of whack. On the other hand, hormone imbalance symptoms could be the cause, rather than effect. An overactive thyroid is the most common hormonal cause of sleeplessness, says Dr Camacho. “Every part of the body is moving at twice or however many times normal speed, and that includes the brain too. They can’t fall asleep and keep waking up, and sleep is lighter,” she says. “If it’s hypothyroidism, the patients are kind of lethargic and sleep a lot.” <h2>You’ve got brain fog</h2> Growth hormones boost your brain, so if you’re low, you could find yourself with memory loss and decreased mental function. Low thyroid hormones could leave you with a hard time remembering information too. “Because patients are lethargic, they might be slow in terms of mental function,” says Dr Camacho. <h2>Your bones are weak</h2> Under normal conditions, the body turns vitamin D into a hormone called calcitriol, which is needed for strong bones. “With fractures or broken bone, you would think about alterations in vitamin D,” says Dr. Camacho. The parathyroid hormone, which helps control the amount of calcium in the blood, could also affect bone health, which could explain why your bones are so brittle. This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/9-signs-you-might-have-a-hormone-imbalance" target="_blank" rel="noopener">Reader's Digest</a>. Image: Shutterstock

Body

EXCLUSIVE: Claudine Ryan talks hormones, PMS and the brain

If you have ever had your feelings of anger dismissed because you are dealing with fluctuations in hormones - whether that’s around your period, pregnancy-related or due to menopause - you’re not the only one. While the vast majority of women experience these dips and peaks in hormones without many severe symptoms, the dismissal of symptoms as a side effect of hormones can have severe consequences. Between 2009 and 2018, suicide was the <a rel="noopener" href="https://www.theguardian.com/society/2021/may/09/the-chemical-question-does-focusing-on-hormones-undermine-mental-healthcare" target="_blank">third-highest cause</a> of mortality among women who had recently given birth. For women entering menopause, the incidence of depression <a rel="noopener" href="https://www.health.harvard.edu/womens-health/menopause-and-mental-health" target="_blank">doubles</a>, and those who have experienced mental illness in the past may see their symptoms return. Claudine Ryan is one half of the duo behind the popular podcast Ladies, We Need To Talk, alongside host and co-creator Yumi Stynes. Claudine spoke to OverSixty about the pair’s latest book - named after their podcast - which tackles the thorniest of issues relating to women’s health, biology, and sex lives. In particular, she shared her thoughts on the overlap between hormones, PMS. and mental health, as well as advice for those navigating these issues with friends and family. O60: Throughout Ladies, We Need to Talk there’s a core message of opening up conversations on ‘taboo’ topics to improve awareness and help women feel less alone. Do you have particular hopes about how the awareness of and conversations around mental health and hormones will change? When it comes to our hormones and mental health, every woman is different. For reasons that aren't totally understood, some of us can really feel the impact of changing levels of certain hormones at certain times during our cycles or at certain times in our lives. So some of us experience really severe hormonal symptoms (severe insomnia, trouble concentrating, depression and even suicidal thoughts), while others find their hormones have no noticeable impact on their mood. [My] version of PMS looks different to Yumi's. But when we share our stories with each other we can start to see that there is a range of different women's experiences and this can help us to place our own somewhere on this spectrum. One hope is that these conversations foster a rich and diverse community of people who understand each other so that fewer of us feel alone or isolated, and also so we have a better understanding of what this spectrum of normal is. Another hope is that these conversations give women courage to speak out and ask for help when something does seem right for them. We have heard so many stories of women's symptoms being dismissed, or them being what they are living with is in their head. Understanding how your experience fits in with others can help you to know that what is happening for you is real and that if someone isn't listening to you, then you need to find someone who will. O60: In chapter six you both talked about anger and how it surfaces around the same time as other PMS symptoms, how do you feel about the association between anger and other ‘uglier’ emotions with being hormonal? It is very infuriating to have your feelings or frustrations dismissed as being purely hormonal. But it is also very helpful to understand that there might be certain times when your mood might be really low or you might be more inclined to feel frustrated by pee on the toilet seat or a sink full of dishes. For some women, just understanding how their hormones may affect their mood is all they need. But for others, knowing their hormones are making them miserable is the first step in figuring out what their options are to get some relief. It's important to acknowledge, as is the case with many many women's health issues, there needs to be more research for us to better understand the relationship between our hormones and our moods. O60: Do you have any advice for other women struggling with family/friends/partners/colleagues/strangers commenting on their mental health and being hormonal or dealing with PMS? You could swear at the person, and that is a legitimate response. You could explain to them these conditions are recognised by leading women's health experts and that for those who experience symptoms on the more severe end there are treatment options available. You could take the approach of women's health psychologist Professor Jane Ussher, who's spent decades researching PMS. Over the years many women have told her that when they are on holidays or away from the usual stress and pressures of their lives that they are much less likely to have PMS. But when life is as normal, all the crap they normally put up with just becomes too much. Women tell her that it's their real feelings that are coming out when they get PMS. So for three weeks of a month they can play nice and bottle it all up, but then at that point in their cycle they don't have the energy to keep up this front. These women often then ask those around them to help out a bit more so they don't get so worn out and frustrated. <a rel="noopener" href="https://www.hardiegrant.com/au/publishing/bookfinder/book/ladies_-we-need-to-talk-by-yumi-stynes/9781743797518" target="_blank">Ladies, We Need To Talk</a>, published by Hardie Grant, is now available to purchase. Image: Supplied

Mind

12 reasons you might have a migraine (besides hormones)

You consume “trigger” foods According to Headache Australia, foods such as cheese, chocolate and processed meats may trigger migraine headaches. However, the foods that cause migraines often differ depending on the individual; surprising foods such as snow peas, olives, and soy sauce have reportedly triggered migraines in some people. Be your own expert by keeping a log of the foods you have eaten before a migraine attack. Doing so can help you determine which foods to avoid in the future. You drink sugary or caffeinated drinks Sugary, caffeinated and alcoholic drinks are also on the ‘Migraine triggers’ list. These drinks can result in dehydration and also contain preservatives that increase blood flow to the brain, both common causes of migraines. Your sleeping patterns have changed Many migraine sufferers find that missing sleep or getting too much sleep can trigger a migraine attack. If the migraines are temporary, there’s probably no need to make a change, but if they persist it might be time to regulate your sleeping pattern. You’re at risk of a stroke If migraines are unusual for you, they could be a sign that you are having a stroke. “Migraine headaches can masquerade as a stroke because they have the same neurological symptoms,” Ralph Sacco, MD, professor of neurology at the University of Miami, told Reader’s Digest. “I tell people to treat it like a stroke and call for help; let us figure it out.” Vision problems and numbness in your arms and legs are also migraine symptoms that could signal a stroke. You’re stressed out Yes, it’s true – stress at home or work could be causing that intense, throbbing migraine pain in your skull. But here’s the good news: research has shown that meditation could be a solution to chronic migraines. One study at the Wake Forest Baptist Medical Centre found that adults with migraines who participated in a meditation and yoga program for eight weeks had shorter and less debilitating migraine headaches than those who received standard medical care. The members of the first group also tended to have less frequent and less severe migraine attacks, and reported having a greater sense of self-control over their migraines. You’re sensitive to sensory stimulation Flickering lights and strong-smelling perfumes could be triggering your migraine. A study published in Nature Neuroscience found that when the membranes around the central and nervous system get irritated, pain receptors are stimulated in the brain. For sensitivity to light, wearing sunglasses – even at night – can limit this irritation. You have hidden heart problems Studies have found that those who suffer from frequent migraines could be more prone to vascular problems like heart attacks and heart disease. Researchers stress the importance of maintaining a healthy lifestyle that lowers high blood pressure and cholesterol, as well as quitting smoking. You’re dehydrated Migraines can strike when your body loses too much water. Make sure you are drinking the recommended 2.5 to 3.5 litres of water per day to decrease your risk of a migraine attack. You have a brain tumour If nausea, vomiting, motor weakness or changes in memory, personality or thinking accompany your migraine, you could be at risk for a brain tumour or brain cancer. Talk to your doctor right away if your migraine worsens. You’re near bad weather Certain weather patterns are associated with the onset of migraines, according to researchers at the University of Cincinnati. Their study found that migraines were 28 percent more likely to occur when lightning struck, perhaps due to electromagnetic changes. You have caffeine withdrawal Although caffeine withdrawal is commonly known as a migraine trigger, researchers aren’t quite sure what causes the headache. Some believe it may be due to a signalling chemical, called adenosine, whose receptors are typically blocked by caffeine intake. But caffeine headaches don’t normally occur unless the individual has been used to drinking many cups of coffee a day, according to everydayhealth.com. Thankfully, caffeine withdrawal only lasts for a few days, and cutting back on caffeine gradually instead of quitting cold turkey can limit the painful side effects of withdrawal. You’re genetically inclined to have migraines Sometimes, all you can do is chalk up your migraines to your genes. A 2013 study at the University of California linked migraines with a certain genetic mutation in humans. It found that a significant proportion of migraine sufferers in the families they studied either had the mutation or were the offspring of a mutation carrier. Written by Brooke Nelson. This article first appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/12-reasons-you-might-have-a-migraine-besides-hormones">Reader’s Digest</a>. For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.com.au/subscribe">here’s our best subscription offer</a>.

Body

What you can expect from menopausal hormone therapy consultation

We have seen increasingly dramatic headlines over the years on the risks of menopausal hormone therapy (MHT), also known as hormone replacement therapy. An alarming <a href="https://www.ncbi.nlm.nih.gov/pubmed/12117397">study in 2002</a>, which found an apparent increased risk of breast cancer in women who took MHT, prompted the first of these headlines. But newer evidence has been reassuring. It’s also a reminder that when considering your options, any risk associated with taking MHT needs to be balanced with the benefits. This balance is the main thing your GP will consider when discussing whether MHT is right for you. Remind me, what’s all this about breast cancer? In 2002, the <a href="https://www.ncbi.nlm.nih.gov/pubmed/12117397">Women’s Health Initiative study</a> found women who took MHT had a 26% increased risk of breast cancer. This finding, which was later disputed, led to a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0146494">55% drop</a> in MHT use in the next three years. A reanalysis of the data showed <a href="https://jamanetwork.com/journals/jama/fullarticle/1745676">a lower risk</a> of breast cancer in some women. And in 2016, a statement from the world’s leading menopause specialists <a href="https://www.tandfonline.com/doi/full/10.3109/13697137.2013.771520">said</a> the benefits of MHT are more likely to outweigh the risks if women with symptoms start taking it before they turn 60 or within ten years after menopause. Then <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext">a study</a> published in The Lancet in recent months suggested the risks might be greater than once thought. However, this study combined the results of previous ones, including observational studies, which have limitations. Observational studies show associations between one factor and another, rather than one causes the other. So factors other than MHT might be at play in increasing a woman’s risk of breast cancer. As a result, these studies tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818421/">overestimate the risks</a>. Other risks linked with MHT include <a href="https://www.ncbi.nlm.nih.gov/pubmed/30626577">thromboembolism</a> (a type of blood clot). And in older women, there’s an increased risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675220/">stroke</a>. So, if you are one of approximately <a href="https://www.ncbi.nlm.nih.gov/pubmed/25706184">one-third of women</a> aged 40-65 suffering moderate to severe menopausal symptoms, what do you need to know? What type of symptoms are we talking about? Most women experience menopause (the date of her last period) at around <a href="https://www.nature.com/articles/nrdp20154">45-55 years of age</a>. Some women’s periods stop before then, either spontaneously or due to some medical treatment, with varying symptoms and health risks. However, menopausal symptoms may start before periods stop, and last on average seven to ten years. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25706184">For a minority of women</a>, symptoms can last for longer. Physical symptoms include hot flushes, night sweats and vaginal dryness, with <a href="https://www.ncbi.nlm.nih.gov/pubmed/25706184">severe symptoms</a> <a href="https://www.ncbi.nlm.nih.gov/pubmed/26115590">profoundly reducing</a> women’s quality of life. What are the benefits of MHT? MHT is available in different forms such as a tablet, skin patch, gel, and vaginal pessary or cream. These have <a href="https://jeanhailes.org.au/contents/documents/Resources/Tools/Menopause_tool.pdf">advantages and disadvantages</a>. For example, some act on the whole body such as tablets, gels, and patches while others such as vaginal creams and pessaries act on the local area only. Those that act locally have <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext">no increased risk</a> of breast cancer or thromboembolism. MHT is an <a href="https://www.ncbi.nlm.nih.gov/pubmed/26444994">effective treatment</a> for hot flushes, night sweats and vaginal dryness. Other treatments, such as bioidentical or natural hormones, have <a href="https://theconversation.com/natural-hormone-therapy-no-panacea-for-menopause-symptoms-25869">safety concerns</a>. Others, such as <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001395.pub4/full">phytoestrogens</a> and many <a href="https://www.menopause.org.au/health-info/fact-sheets/complementary-medicine-options">other herbal preparations</a>, <a href="https://canceraustralia.gov.au/publications-and-resources/clinical-practice-guidelines/menopausal-guidelines">don’t work</a>. MHT also helps <a href="https://www.ncbi.nlm.nih.gov/pubmed/29234813">prevent</a> osteoporosis, and may help prevent colon cancer, type 2 diabetes and coronary heart disease. Different risks and benefits for each woman The balance of risks versus benefits of MHT varies from woman to woman, depending on a number of factors. Here are some hypothetical examples. 1. Gina is a healthy 52 year old with menopausal symptoms, a family history of breast cancer (her mother was diagnosed at 65), and low bone density If Gina’s menopausal symptoms are troubling her, then MHT is a reasonable option. Not only is it the <a href="https://www.ncbi.nlm.nih.gov/pubmed/15495039">most effective treatment</a> for her symptoms, it has the <a href="https://www.ncbi.nlm.nih.gov/pubmed/30907953">added benefit</a> for bone health. Gina will need a comprehensive assessment to decide the best type of MHT. Breast cancer is the most feared risk of MHT. The risk depends on the type of MHT and how long it’s used. But that risk declines after Gina stops using it. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext">The Lancet paper</a> showed that for women with a family history of breast cancer like Gina, MHT use does not further increase her breast cancer risk. But it also showed that longer use of MHT is associated with a slower decline in risk after stopping using it. 2. Sarah has menopausal symptoms, has had both ovaries removed and a hysterectomy, is obese and drinks moderately Sarah’s going through what’s called a “surgical menopause” and has the physical symptoms that go with it, including hot flushes. Her obesity and moderate drinking already increases her risk of breast cancer. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext">The Lancet paper</a> showed that the use of oestrogen only-MHT (the type of MHT she’d take because of her hysterectomy) does not further add to this risk. However, her obesity is associated with an increased risk of blood clots. As the risk of blood clots increases if she takes oestrogen in tablet form, MHT as a <a href="https://www.tandfonline.com/doi/abs/10.1080/13697137.2018.1439915">skin patch or gel</a> would be the best choice. Losing weight <a href="https://www.ncbi.nlm.nih.gov/pubmed/23084519">may also improve</a> Sarah’s hot flushes. 3. Sam went through menopause before she turned 45 <a href="https://www.thelancet.com/action/showPdf?pii=S1470-2045%2812%2970425-4">One in 10 women</a> experience menopause before the age of 45, like Sam. This puts her at a <a href="https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70425-4">30% lower risk</a> <a href="https://www.menopause.org.au/about-ams/media-info/1468-mht-and-breast-cancer-risk-lancet-29-august-2019">of breast cancer</a> compared with women who experience menopause later in life. However, early menopause is associated with a <a href="https://www.ncbi.nlm.nih.gov/pubmed/21993082">greater risk</a> of premature death, including from <a href="https://www.ncbi.nlm.nih.gov/pubmed/27627190">heart disease</a> as well as substantially greater risk of <a href="https://www.ncbi.nlm.nih.gov/pubmed/17476146">osteoporosis and fragility fracture</a> in later life. So her GP will likely advise her to take MHT until the average age of menopause. This <a href="https://www.ncbi.nlm.nih.gov/pubmed/19733988">restores</a> her breast cancer, heart, and mortality risk to approximately what it would have been if she had not gone through an early menopause. It also reduces her risk of bone thinning (osteoporosis). 4. Lee is 65, has vaginal dryness but no more hot flushes Vaginal symptoms, including discomfort from vaginal dryness, <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2017.1421923?scroll=top&needAccess=true">are common</a> in postmenopausal women like Lee. And vaginal oestrogen preparations as a pessary are <a href="https://www.ncbi.nlm.nih.gov/pubmed/27577677">an effective and safe option</a>. Vaginal oestrogen acts locally so <a href="https://www.ncbi.nlm.nih.gov/pubmed/27577677">does not</a> improve bone health and does not increase blood clots or breast cancer risk. So how best to act on this? The decision about whether to use MHT, which form, or to consider an alternative to MHT to manage your symptoms can be a complex one. So, it’s important to form a partnership with your doctor who can guide you to make an informed decision. You may need several discussions over a period of time to fully consider what is right for you.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/124174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rhonda-garad-783705">Rhonda Garad</a>, Senior Lecturer and Research Fellow in Knowledge Translation, <a href="http://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/amanda-vincent-842862">Amanda Vincent</a>, Adjunct Clinical Associate Professor and Endocrinologist, <a href="http://theconversation.com/institutions/monash-university-1065">Monash University</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/thinking-of-menopausal-hormone-therapy-heres-what-you-can-expect-from-your-gp-124174">original article</a>.

Body

Menopausal hormone therapy: What are the risks and benefits?

At menopause, a woman’s ovaries lose their reproductive function. Eggs are no longer released and the production of the hormones oestrogen and progesterone falls. It’s the lowered levels of oestrogen after menopause that gives rise to troublesome postmenopausal symptoms. Most women experience menopause between the <a href="https://www.nature.com/articles/nrdp20154">ages of 45 and 55</a>. It’s a natural event, but for many women it has significant health consequences. The fortunate few have minimal symptoms, but at least <a href="https://www.ncbi.nlm.nih.gov/pubmed/25706184">three-quarters</a> of women will have some symptoms. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25706184">One-third of all menopausal women</a> are moderately to severely affected. Typical symptoms include hot flushes, night sweats, anxiety, low mood, disturbed sleep, joint pain and vaginal dryness. These symptoms <a href="https://www.ncbi.nlm.nih.gov/pubmed/26115590">can be debilitating</a>. The fall in oestrogen also leads to bone loss and an increased risk of fragility fractures. And women going through menopause have increased central abdominal fat, even without an increase in weight. This contributes to <a href="https://www.nature.com/articles/nrdp20154">a heightened risk</a> of diabetes and heart disease. An absence of symptoms doesn’t mean bone loss and other metabolic changes aren’t occurring, as these develop silently. Menopausal hormone therapy (MHT) – which used to be known as hormone replacement therapy, or HRT – is <a href="https://www.ncbi.nlm.nih.gov/pubmed/26444994">the most effective treatment</a> we have for menopausal symptoms. Yet many women and health-care providers remain confused about the benefits and risks of MHT. <h2>What is menopausal hormone therapy?</h2> MHT replenishes oestrogen supplies in the body to treat the symptoms of menopause. Taking oestrogen causes thickening of the lining of the uterus, so progestogen (which acts like progesterone) is added to MHT to stop this. This is important because a thickened uterus lining may undergo <a href="https://www.ncbi.nlm.nih.gov/pubmed/8569016">cellular changes</a> that have the potential to develop into uterine cancer. For a woman who has had a hysterectomy (surgery where the uterus is removed) MHT will be oestrogen-only. Oestrogen is usually taken in tablet form, but can be applied as a skin patch or skin gel, or as a vaginal pessary. Progesterone is taken as a capsule. There are a range of single formulations and combinations, so the dose and formulation of MHT should be tailored to each woman’s health profile and personal preferences. Women shouldn’t take MHT if they have a malignancy sensitive to oestrogen, like breast cancer, or have undiagnosed vaginal bleeding. Unless there’s a specific reason they can’t, it’s especially important women with early menopause take MHT to optimise their health. This is true regardless of how severe their symptoms are. Menopause before age 45 is classified as early menopause. Prematurely menopausal women are at <a href="https://www.ncbi.nlm.nih.gov/pubmed/27627190">significantly greater risk</a> of osteoporosis and fracture, heart disease and premature death. For women going through menopause at the usual time, the choice may be less clear-cut. Importantly, MHT cannot be seen in one dimension; that is, as only having one benefit or one risk. To make an informed choice, it’s essential to evaluate the total effects of MHT, including how it influences the risk of premature death, heart disease, fracture, other cancers, and of course, well-being and quality of life. <h2>Balancing the risks and the benefits</h2> Clinical trials have found specific formulations of oral oestrogen with progesterone result in a small increase in breast cancer risk. One study reported roughly a <a href="https://jamanetwork.com/journals/jama/fullarticle/195120">1.25-fold increase in risk</a>. This is equivalent to about four extra cases of breast cancer per 1,000 women per year in women who were taking this specific MHT formulation before and during the study period. However, this risk estimate may be incorrect as the women in this study who had never used MHT prior to starting the study had no increased breast cancer risk compared with the placebo group. So some degree of uncertainty as to the risk remains. There was <a href="https://jamanetwork.com/journals/jama/fullarticle/198540">no increase in risk</a> for oestrogen-only therapy, and whether these risks apply to non-oral therapies is not yet known. These risks should be balanced with the benefits. Women who take MHT gain less abdominal fat and are <a href="https://www.ncbi.nlm.nih.gov/pubmed/16440209">less likely to develop diabetes</a>. MHT prevents bone loss and therefore the risk of fragility fracture, an effect that continues <a href="https://www.ncbi.nlm.nih.gov/pubmed/20711081">after treatment is stopped</a>. Oestrogen alone is associated with <a href="https://www.ncbi.nlm.nih.gov/pubmed/24084921">reduced heart disease risk</a>, while oestrogen plus progestogen also <a href="https://www.ncbi.nlm.nih.gov/pubmed/24084921">lowers the risk</a> of colon and uterine cancer. The most comprehensive summary of the safety of MHT is from the Women’s Health Initiative study in which 27,347 participants were randomised to receive MHT or a placebo for five to seven years. The researchers followed up to see <a href="https://www.ncbi.nlm.nih.gov/pubmed/28898378">if death rates differed</a> between women who had taken MHT compared with the placebo. After 18 years, cancer mortality and death overall from any cause did not differ between the groups, irrespective of whether the MHT was oral oestrogen-only or oral oestrogen plus progestogen. So if we add symptom relief to the equation, the benefits of MHT will outweigh the potential risks for most symptomatic women who start MHT within ten years of menopause (the time frame measured in this study). Some women using MHT will continue on the treatment for five or ten years to manage their symptoms. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25706184">More than 40%</a> of women aged 60 to 65 still have hot flushes and night sweats, and one in seven of these women describe their symptoms as “severe”. The <a href="https://www.tandfonline.com/doi/abs/10.3109/13697137.2015.1129166?journalCode=icmt20">length of time</a> a woman uses MHT for will depend on her symptom severity and individual needs, which should be re-evaluated alongside her risk profile every year with a health professional. <h2>The alternatives aren’t evidence-based</h2> Claims over-the-counter or internet-purchased nutritional supplements or herbal tablets will “balance your hormones” and relieve symptoms <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001395.pub4/full">cannot be substantiated</a>. Studies have consistently <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/">failed to show meaningful benefits</a> of nutritional supplements or herbal tablets over placebo for hot flushes. And these treatments do not prevent bone loss or protect against heart disease. Further, unproven therapies can also have side effects. Women considering herbal or naturopathic remedies should have a face-to-face consultation with a qualified therapist (as opposed to internet-based communication) to ensure their full symptom and health profile, as well as medication use, are documented to minimise adverse effects. For more information about treatment options visit the <a href="https://www.menopause.org.au/">Australasian Menopause Society</a> website and view the International Menopause Society <a href="https://www.youtube.com/playlist?list=PLAjwoYuItHS-4jvjL6gJgM7o-vpr0PVk6">YouTube videos</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/124084/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="http://theconversation.com/institutions/monash-university-1065">Monash University</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/making-sense-of-menopausal-hormone-therapy-means-understanding-the-benefits-as-well-as-the-risks-124084">original article</a>.

Body

Do hormone diets actually work?

When it comes to losing weight and getting healthy, there is never a shortage of diet and fitness crazes claiming to hold the secret to easy, sustainable weight loss. Some of the most recent popular diet crazes include the <a href="https://theconversation.com/keto-diet-a-dietitian-on-what-you-need-to-know-99867">ketogenic diet</a> (low carbohydrate, high fat), the <a href="https://www.healthline.com/nutrition/carnivore-diet">carnivore diet</a> (only eating meat and other animal products), and <a href="https://theconversation.com/intermittent-fasting-whats-the-best-method-118212">intermittent fasting</a> (eating only within a strict timeframe or on certain days). But another diet plan that’s come into the spotlight recently is <a href="https://www.washingtonpost.com/lifestyle/wellness/what-are-hormone-diets--and-can-they-really-help-you-lose-weight-quickly/2019/08/02/19ce5ab4-9f51-11e9-b27f-ed2942f73d70_story.html">the hormone diet</a>, which claims that the reason people struggle to lose weight is because their hormones aren’t working properly. Many books have been written on this topic, with advocates of the hormone diet claiming people can quickly lose a significant amount of weight by using diet and exercise to manipulate or “reset” their hormones. There are a few variations of the diet, but the main idea with each is that the key to losing weight is by correcting perceived hormonal imbalances in the body. Hormones play an important role in our body’s everyday processes, from digesting food to helping bones grow. They’re transported around the body through the bloodstream and act as “chemical messengers” that instruct cells to perform specific jobs. For example, <a href="https://www.endocrineweb.com/conditions/type-1-diabetes/what-insulin">insulin</a> is essential for regulating metabolic processes and allows the body to store the carbohydrates from food as energy in our muscle cells. When we eat, it causes blood sugar levels to rise, which results in the pancreas releasing insulin into the bloodstream. The insulin then attaches itself to cells and signals them to absorb sugar from the bloodstream and store it for later use. Insulin was once thought to play a key role in weight gain, but recent research shows that <a href="https://www.ncbi.nlm.nih.gov/pubmed/28765272">total calorie intake</a> is the primary factor in gaining or losing weight. Fat loss can only be achieved by creating a calorie deficit, which simply means that you must burn more calories than you consume. Similarly, this is why many people have success with intermittent fasting, as it typically results in people eating less food and therefore fewer calories. One <a href="https://www.amazon.co.uk/Hormone-Diet-Program-Strength-Younger/dp/1609611411">popular book promoting the hormone diet</a> uses a three-step programme that claims it will help people lose weight, gain strength, and feel younger. Steps one and two of the diet focus on changing nutritional habits. Step three concentrates on exercise. According to the author, readers must “detox” their body. In step one, readers remove foods such as alcohol, caffeine, sugar, red meat, cow’s milk and milk byproducts (such as cheese or yoghurts) from their diet, while simultaneously eating more fruits and vegetables, poultry, fish, eggs, dairy products from sheep and goats, and plant milks. In step two, readers must then cut out processed foods, artificial sweeteners and refined grains. Step three involves an increase in cardiovascular and strength exercises. The dietary recommendations provided in steps one and two require a decrease in food products that are typically high in calories and low in nutritional value, such as alcohol, high-sugar foods and processed foods. The diet also promotes foods such as vegetables, fish and fruit, which increase fibre intake (important for the digestive system) and provides the body with a variety of vitamins and minerals that perform many bodily functions needed for overall health and well-being. These foods are also generally lower in calories than alcohol, high-sugar foods and processed foods. And paired with the recommended exercises in step three, this “hormone diet” will probably increase calorie “burning” along with other health benefits. <h2>Does the ‘hormone diet’ work?</h2> Generally, the hormone diet recommended in this book is not bad nutritional advice. But the key here is that any potential weight loss will probably be from the change in calorie intake, rather than an effect (if any) on your hormones. Weight loss (or body fat loss) is achieved by creating a calorie deficit, not by “resetting your hormone balance”. Despite what advocates of the hormone diet might claim, hormonal imbalances are usually the result of a more serious underlying health condition, such as diabetes (impaired insulin function) or <a href="https://www.nhs.uk/conditions/overactive-thyroid-hyperthyroidism/">hyperthyroidism</a> (where the thyroid produces too many thyroid hormones), which couldn’t simply be fixed through diet alone, and would require medical treatment. Currently, there is no viable theory to demonstrate that a person can “reset” their hormones to influence fat loss. There is also no peer-reviewed research in a major journal that has specifically studied the hormone diet and its effects. But there might be a simple explanation for why people think the hormone diet works: it helps to create a calorie deficit through improved nutritional habits and exercise, which will probably result in weight loss. Ultimately, anyone that wants to lose weight or body fat should focus on creating a calorie deficit. How a person creates this calorie deficit may vary from person to person, and might even include following popular diet plans like keto or intermittent fasting. However, the best approach is whichever someone finds the most compatible with their lifestyle.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/122744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Written by Robert Naughton, Senior Lecturer, University of Huddersfield. Republished with permission of <a rel="noopener" href="https://theconversation.com/hormone-diets-are-all-the-rage-but-do-they-actually-work-122744" target="_blank">The Conversation</a>.

Body

Why your hormones might be to blame for weight gain

You might think you know the basics of weight gain and weight loss. Simply put, weight gain is caused by your body storing energy from food without the ability to release the excess energy through physical activity. Well, you’re right… but that’s not the whole story. There is so much more to the mysteries of weight gain and weight loss than just too much food and not enough exercise. Fitness and nutrition expert Amelia Phillips provided insight on Today Extra. She shared the most important part of understanding weight gain – sleep. This doesn’t mean the longer you sleep the less time you have to eat, but rather focuses on the impact sleep has on controlling and balancing hormones. "There's a hormone called ghrelin which is our hungry hormone," explained Phillips. "When people are sleep-deprived, their ghrelin levels shoot through the roof." Ghrelin isn’t the only hormone affected by sleep – it’s partner in crime, leptin, is also affected and is responsible for leaving us feeling satisfied and full after eating. "People who are sleep-deprived never feel full," Phillips said. "Their leptin becomes resistant." <a href="https://coach.nine.com.au/2016/11/03/10/08/poor-sleep-effect-on-weight-gain">A 2016 study </a>indicated that people who suffered just one night of poor sleep were subconsciously compelled to eat an extra 385 calories the following day. Vitamin D is believed to also play a part in weight gain. <a href="https://www.medicalnewstoday.com/articles/321851.php">Studies</a> have discovered the correlation between low vitamin D levels and high levels of body fat. One-third of Australian adults are thought to be vitamin D deficient and although the vitamin can be supplied through consuming foods, the best way to boost vitamin D levels is exposing skin to sunlight. "You want to make sure that you're getting that sun but it's a delicate balance between sun smart," said Phillips, advising just a few minutes out in the sun a day. Lastly, Phillips touched on thyroid – "a magic hormone that regulates your metabolism" – and highlighted the importance of a mineral called iodine, which is not common in Australian diets. "Seaweed and seafood are the two best sources of iodine but in Australia [supermarket] bread and salt are [fortified with iodine]," said Phillips, adding that Himalayan rock salt and artisan breads are not iodised. If you think your weight gain has been influenced by hormones or vitamins, visit your local doctor.

Body

A family's difficult journey: Meet the 7-year-old girl going through menopause

At just four weeks old, little Emily Dover had grown a whole four centimetres taller in just a week. Emily’s parents, Tam Dover and Matt McAuliffe from Woy Woy on the NSW Central Coast – who are both tall – were told by medical professionals their newborn girl was a reaction of her genetics. However, a year-and-a-half later when Matt pulled little Emily out of the bath, he was hit with the smell of body odour and a little pimple on her face. Not long after, the child began complaining of discomfort around her chest area. “When she was two she started complaining that she had a sore chest and we thought, 'well that's a little bit different' ... and she was breast budding at the time and that came with cystic acne,” Tam explained to <a rel="noopener" href="https://10daily.com.au/news/australia/a190703ylpem/meet-the-seven-year-old-girl-going-through-menopause-20190703" target="_blank">10Daily</a> and Studio 10. <img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7828320/studio-10-1.jpg" alt="" data-udi="umb://media/d7467fc58a7a4ff7bf6b0562f4915714" /> Tam and Matt, with the help of doctors, investigated why their child’s hormones were developing at such a fast and unusual pace, and during that time they discovered Emily had autism and a sensory processing disorder. “When Emily was about two or three she had such a yearning to have a child that there was a child at her daycare who called her 'Mum' and ... you see the yearning and the nurturing because the hormones are driving it,” Tam said. “We all have had time to grow into our hormones and have life experience and know what is appropriate and what is not appropriate, and then you have someone who says I feel these things and then the joy of autism on top of it is that there is no filter.” Then when Emily was four years old, she began getting her period. Both Tam and Matt had starting hormone testing with their daughter when they had to teach the young pre-schooler how to use a menstrual pad. Emily’s condition left a financial burden on the family, as injections were required to stop their little girl’s puberty from developing until she was old enough to undergo the changes – and cost both Tam and Matt $1,500 per month. However, the injections failed to stop the growth of little Emily’s pubic hair, her breasts or halt her periods. While the family have stopped with the injections and Emily is now going through menopause, she will still be treated symptomatically. Despite the difficult journey for the family, Emily has managed to maintain her bright and positive nature at just seven years old. Tam and Matt hope that sharing the story of their little girl will aid in raising awareness for other families and children who are going through similar hardships.

Caring

4 natural ways to banish facial hair

When it comes to hair, it seems that us ladies want it all long and luscious on top with minimal hair everywhere else. Unwanted facial hair can be a result of hormones (especially as estrogen levels change around the menopause) as well as genetics, medications and other medical issues such as polycystic ovarian syndrome (PCOS). The good news is there are plenty of ways to deal with the issue using natural products that you probably already have in the house. 1. Honey and sugar wax All you need is sugar, water and honey for this homemade wax. How to: <ol> <li>In a small saucepan on a medium heat, place two teaspoons of brown or white sugar, a teaspoon of honey and a teaspoon of water.</li> <li>Stir for around 30 seconds until it starts to bubble and go darker. Set aside to cool.</li> <li>When cool enough to touch, use a plastic spoon to apply it to the hair on the face.</li> <li>Put a strip of cloth over the wax and use your finger to smooth it out in the direction of the hair growth.</li> <li>Rip off the strip in the opposite direction of hair growth.</li> </ol> 2. Chickpea flour face mask Available from health food stores and some supermarkets, chickpea flour (also known as gram flour or besan) is a great way to remove unwanted fine hair. How to: <ol> <li>In a small bowl, bring together 2 tablespoons chickpea flour, 1 tablespoon of cream, 1 ½ teaspoons of milk, and ¾ teaspoons of ground turmeric.</li> <li>Mix well and use your fingers to apply the face pack. Leave on for 20 minutes until dry, then scrub off with a damp face washer.</li> <li>Repeat three to four times per week for up to a month to see results.</li> </ol> 3. Spearmint tea Often unwanted hair is due to an excessive production of androgen in the body. Spearmint tea is a popular method for regulating the hormones and is regularly used in Turkey. How to: <ol> <li>Boil and pour water for a cup of tea.</li> <li>Add a teaspoon of dried spearmint or 5 leaves of fresh spearmint leaves.</li> <li>Allow to steep for 10 minutes before drinking.</li> <li>Repeat twice a day</li> </ol> 4. Lemon juice and honey face scrub The stickiness of this scrub will help you to remove fine facial hair. Lemon juice cleanses the skin while also lightening the hair, while the honey helps to soften the hair, making it easier to remove. How to: <ol> <li>In a small bowl, combine 1 tablespoon of freshly squeezed lemon juice and 4 tablespoons of honey.</li> <li>Use the fingers to apply to your face and allow to dry for 20 minutes.</li> <li>Use a warm face washer to scrub the mixture off the face.</li> <li>Repeat twice a week for up to 3 months. </li> </ol> Have you used any natural methods for removing facial hair? We would love to hear your tips in the comments. Related links: <a href="/lifestyle/beauty-style/2016/07/problem-with-all-natural-skincare-products/">The problem with “all-natural” skincare products</a> <a href="/lifestyle/beauty-style/2016/07/ways-to-make-your-perfume-last-longer/">6 ways to make your perfume last longer</a> <a href="/lifestyle/beauty-style/2016/07/5-of-the-most-elegant-accessories/">5 of the most elegant accessories</a>

Beauty & Style

5 signs you have a hormone imbalance

Hormonal fluctuations are part and parcel of being a woman. It's natural to feel more emotional on some days, or experience small weight fluctuations. Lifestyle factors, however, such as a stressful timetable and dietary choices can throw things off balance. And when things aren't functioning right, hormones have the capacity to affect your life on a much deeper level. So what are the tell-tale signs of a hormone imbalance? 1. Stress, anxiety and mood swings This is a chicken-and-egg scenario. Most women have experienced mood swings and PMS earlier in life have experienced the full throttle effect of hormones. However, it also works the other way around. Ongoing stress can cause a hormonal imbalance, as it prompts your adrenal glands to release a wave of hormones such as cortisol (aka the 'stress hormone') and adrenaline. 2. Unexplained weight gain/or weight loss If you're eating well and physically active but you continually gain weight it could be caused by to hypothyroidism. Hypothyroidism is a condition caused by insufficient levels of the thyroid hormone, which can slow down your metabolism and cause your pancreas to store fat. Hyperthyroidism, on the other hand, refers to an overactive thyroid gland which can result in weight loss and muscle weakness. 3. Fatigue Hypothyroidism can also result in fatigue and constant exhaustion. The thyroid gland controls your body's metabolism and when the hormone levels are low everything slows down, including your heart rate, digestion and mental functioning. Constant tiredness and exhaustion can also be a result of adrenal fatigue, which occurs when the adrenal glands are functioning below the necessary level. 4. Belly fat Carrying excess weight around the abdomen may be a sign of excess cortisol, and your body may be struggling to process insulin, causing fat storage around the belly. Other contributors to insulin resistance, or fat storage around the abdomen include excess testosterone in females, or excess oestrogen in both sexes. 5. Hot flushes Excessive sweating, hot flushes and night sweats can be caused by a range of hormonal imbalances that may come from the adrenals, ovaries, thyroid or gastrointestinal tract. So what should you do? If you are showing any of these symptoms and suspect it may be the result of a hormonal imbalance, it's important to consult with a healthcare professional. A functional pathology test can determine exactly what imbalances are occurring, so that a treatment plan can be tailored to your specific needs. A personalised treatment plan may entail stress management techniques, dietary changes, exercise and therapeutic supplements. Some supplements assist with oestrogen detoxification, increasing progesterone, decreasing or increasing testosterone and assisting thyroid hormone production, often reducing the need for medication, and allowing the body to perform optimally. Healthy swaps to make in the meantime <ul> <li>Where possible, consume organic grass fed meat and dairy. Non-organic meat and dairy often contains artificial hormones to help the animal grow faster and produce more. Consuming artificial hormones can affect your own delicate hormone balance.</li> <li>Opt for organic fruit and vegetables, if they are available and within your budget. Pesticide residue from fruit and vegetables, especially edocrine disrupting chemicals (EDC) can have a negative effect on your hormone balance and health.</li> <li>Processed foods often contain pesticides so reducing the amount in your diet is also beneficial.</li> <li>Avoid plastic water bottles, including those which are BPA free. As much as possible, stick to glass bottles, and use glass food storage containers too.</li> </ul> Written by Pip Reed. First appeared on <a href="http://Stuff.co.nz" target="_blank">Stuff.co.nz.</a> Related links: <a href="/health/body/2016/04/does-your-kitchen-need-a-plastic-detox/">Does your kitchen need a plastic detox?</a> <a href="/health/mind/2016/04/simple-ways-to-ease-anxiety/">5 simple ways to ease anxiety</a> <a href="/health/body/2016/03/struggling-to-lose-weight/">5 reasons why you may be struggling to lose weight</a>

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4 natural ways to banish facial hair

5 signs you have a hormone imbalance

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