Network Magazine summer 2015 | Page 18

The 30-second article recognised until after 12 months of a woman’s periods ceasing. This cessation of menses is known medically as the climacteric, the end of a woman’s reproductive potential. With the huge decrease in oestrogen levels that occurs at this time, it is no wonder that, for some women, havoc is wreaked on the endocrine (hormonal), psychological and somatic (bodily) systems. This is the time when thousands of women may spiral into negative health changes, which may affect how healthy they will continue to be as they age. Let’s examine these changes and take a look at why it can be a time of physical and psychological chaos. It’s all about the hormonal cascade In the peri-menopausal transition, women experience an accelerated loss of ovarian follicles. This can take from two to eight years. With the human endocrine system working as a negative feedback loop (i.e. when a single hormone production is decreased or increased it influences other hormone production in the body), this subsequently has an effect on the amount of follicle-stimulating hormone (FSH) released from the pituitary gland. FSH simply tells the ovary to recruit eggs, and oestrogen is made by the developing eggs. In normal ovulation another hormone, luteinising hormone (LH), works in tandem with FSH in oestrogen- 18 | NETWORK SUMMER 2015 For fitness professionals, especially personal trainers, training menopausal women can be challenging producing ovulation. This cycle forms the normal menstrual cycle in younger women. As peri-menopause approaches, however, the ageing ovaries become less responsive to FSH. As such, the amount of FSH rises 10 to 20-fold as more and more FSH is released by the pituitary gland to ‘bribe’ the ovaries into responding. LH is cleared from the blood faster, so the real culprit in peri-menopause – causing havoc on menopausal symptoms during this time – is FSH, and for some it can go on for years. As a woman hits her fifties, fewer and fewer follicles respond. The overwhelming effect of this is that the amount of oestrogen made begins to decrease significantly. This drop in oestrogen (which is quite dramatic in some women, especially those who are already overweight) can often be the start of the chaos that some women experience at this time, both physically and psychologically. Another hormone, progesterone, is also implicated in all of this turmoil. In the younger menstruating female, progesterone is made by the cells of the uterus to ready it for receiving a fertilised egg. Progesterone is the hormone of pregnancy and in perimenopause progesterone levels also fluctuate. Although this uneven rising and falling of various hormones can impact hugely on how your client may be feeling at this time of peri-menopause, it is post-menopause that the real health impacts might occur. Hormone production after menopause Once menstruation stops completely for 60 days or more (amenorrhea) there are few remaining ovarian follicles. This doesn’t mean that the ovaries cease functioning, however. Post-menopause, the ovaries continue to secrete hormones, although not Figure 1. Hormonal fluctuations during menopause 80 Hormone levels • Defined as the permanent cessation of menstrual periods, the mean age of menopause is 51.3 years • Regardless of how active or healthy a woman has been in the past, menopause can seriously impact hormones and metabolism • A huge decrease in oestrogen levels, as well as fluctuating levels of progesterone and other hormones, can result in both physical and psychological disruption • Some women experience irritability and depression, weight gain around the mid-riff, poor sleep patterns, hot flushes and night sweats • PTs can assist menopausal clients by helping them put sleep strategies in place, adopt a Mediterranean-style diet, and adapting their training to match their energy levels and how they are feeling. 50 40 20 35 45 55 65 75 Age Oestrogen FSL Progesterone LH