[Read time: 6 minutes]

The signs & symptoms related to ovarian aging can be connected to the fluctuating decline in sex hormones and the key bodily systems they support. Perception of physical discomfort and psychological differences on a daily basis is only comparable to previous experience and as such are relative to the individual.

When combined with the hormone collective and lifestyle experiences the variables are endless.

Menstrual cycle tracking and data collection give us some degree of correlation on a before and after basis, but the individual recipe for what is brain fog, joint aches, and dry skin is personal.

This poses a huge challenge on various levels, throughout the hormone highway journey.

The Symptom Paradox

The signs & symptoms of menopause transition do not appear in a pre-determined order. However, very often the psychological ones occur first during early perimenopause but are rarely noted or connected to the tipping point of accelerated ovarian aging.[1]

The hormone collective creates a unique, whole-person, menopausal experience for each individual. There may be no apparent signs & symptoms at all, but it does not mean that hormonal or ovarian aging has not started.

In addition, there are no specific signs & symptoms indicators to pinpoint where on the Menstrual Health timeline the individual is at any one time.

Even when we have awareness of the process and its effects, we cannot predict whether a new sign & symptom is directly related to menopause transition, or if it is a secondary situation as a result of menopause transition. For example, we change our behaviour according to how we feel e.g. If crushing fatigue is a symptom, we feel less able to go for a walk, as a result, we don’t stimulate circulation and may become less mobile over time. Is the resulting lack of physical strength due to perimenopause or because of the way we responded to the first symptom?

The Symptom Catalogue

The following list of known signs & symptoms is fairly comprehensive but not final.

Psychological:

• Depression/anxiety
• Palpitations, panic attacks, loss of confidence
• Mood changes/irritability/rage

Physical:

• Period changes, irregular, painful & heavy
• Changes in your skin – dry/itchy
• Vaginal dryness
• Allergies
• Brittle nails
• Breast tenderness
• Joint aches & pains
• Unexplained /sudden weight gain
• Headaches/Migraines
• Burning tongue,
• Electric shocks
• Tingling extremities
• Digestive issues/Bloating
• Gum problems
• Muscle tension/weakness
• Breathing difficulties
• Fatigue and tiredness
• Hair loss/thinning hair
• Bladder irritation/incontinence
• Tinnitus

Physiological:

• Brain fog/difficulty concentrating
• Hot flushes, Night sweats
• Sleep problems/insomnia
• Loss of sex drive
• Dizziness
• Change in body odour

[NB. It is possible for many of the symptoms listed to be associated with other health conditions as they have many causes. Symptoms specific to menopause include vasomotor (hot flushes and night sweats) vaginal symptoms and period changes.]

The Symptom Influences & Cofactors

There are cofactors that influence the symptoms. Some we can control some we cannot.

The cofactors we can control are:

• Stress and the individual response to it
• Nutritional choices
• Respiration and the quality of breathing
• Movement and exercise
• Sleep
• Lifestyle factors such as smoking and alcohol consumption
• The environment of the individual and social relationships

The cofactors we cannot control are:

• Aging
• Genetics
• Disease and conditions

The frequency, severity, and time span of symptoms are linked to ovarian aging, the sex hormones and the role they play in the 11 systems of the body.

Once we pass the tipping point of regular ovarian activity the pattern that then unfolds is unique to each person (and hence the symptoms).

That’s the aspect we can predict. The rest is unpredictable.

• The ovaries cannot be controlled.
• The ovarian frequency of hormone creation and level of output cannot be controlled.
• Not even by HRT. That is not how it works.

Are you aware of anyone who has ever been able to control their periods to the day? They may have thought they were in control of the flow, and discomfort, which is true to some extent, but ‘control’ is not really the right word.

Please be mindful when using words like hormone balance and hormone reset in relation to ovarian activity for this very reason.

When we talk about managing symptoms, and applying principles and practice, to support the mind and body we are exerting an influence on the hormone collective, not specific levels of hormones and certainly not ovarian functionality. Fertility is a complex subject.

The whole-person approach

When approaching symptom management, it is much more effective to tackle them as a whole, rather than isolated.

Understanding the cause and effect is probably one of the hardest concepts with regard to menopause. Why a certain symptom suddenly gets worse, or a different one pops up does not, at face value, have a reason or explanation, but if we look at each hormone change pattern – daily, monthly, age, plus the collective as a whole, you can start to join the dots.

Gut health is often affected in a negative way by the change in sex hormones. This leads to digestive challenges which can lead to fewer nutrients being absorbed, which can have a knock-on effect on the hormone collective and therefore symptoms.[2]

Liver health can experience a downgrade and this affects hormone metabolism. If hormone metabolites cannot be removed effectively they can overrun the system and compete with new hormones produced internally and those used externally. Therefore the liver needs to be supported at all costs. Alcohol is classed as a level 1 carcinogen and the liver will make it a priority to remove it over anything else.[3]

Cortisol impairs the efficiency of all hormones, so it makes sense to allow any hormone, but particularly the sex hormones (going up and down, and declining at the same time) to do the best job they can, by reducing large-scale rushes of the stress hormone. Reducing stress lowers cortisol, and can therefore have a big impact when managing symptoms.[4]

Insulin sensitivity is reduced when estradiol levels are low, and fluctuating as in perimenopause. When consuming high-sugar foods the body needs to produce insulin to remove the sugar from the blood. If this mechanism is impaired due to reduced insulin sensitivity it can create something called inflammation, which can make symptoms worse. Therefore reducing food consumption of high-sugar foods can help symptomology or at least being aware of what foods may trigger a symptom reaction is helpful.[5]

In conclusion

The hormone collective creates a unique, whole-person, menopausal experience for each individual, and therefore a whole-person approach is needed to manage symptoms.

There is no set pattern, nor fixed number of signs & symptoms. This is not a game of bingo!

References: