Perimenopause and Menopause: Strategies and Treatments

Jul 23, 2024

Perimenopause and Menopause: Strategies and Treatments

Speaker: Dr. Mary Claire Haver (OBGYN, Menopause Expert) on the Huberman Lab Podcast

Introduction

  • Host: Andrew Huberman, Professor of Neurobiology and Ophthalmology at Stanford
  • Guest: Dr. Mary Claire Haver, expert in perimenopause, menopause, and female health
  • **Discussion Topics: Perimenopause and menopause, actions to navigate these stages, nutrition, hormone replacement therapy (HRT), sleep issues, inflammation, and lifestyle choices.

Definitions and Concepts

Menopause

  • Medical Definition: One year after the final menstrual period
    • Issue: Not all women have menstrual periods (e.g., hysterectomy, IUDs)
    • Represents end of ovarian function and significant loss of sex hormone production (estradiol, progesterone, and testosterone)
  • Average Onset Age: 51-52 years, normal range is 45-55 years
  • Prevalence: Effects millions of women, significant part of female health

Perimenopause

  • Definition: Transitional phase leading to menopause, begins 7-10 years before last period
  • Symptoms: Varied and can include abnormal bleeding, fatigue, anxiety, and cognitive disturbances
    • Mental health changes, sleep disruptions, palpitations
  • Endocrine changes: Irregular estrogen and progesterone, leading to volatile hormonal changes

Hormone Replacement Therapy (HRT)

  • Addressed Misconceptions: Resulting from flawed interpretations of the Women's Health Initiative (WHI) study
    • WHI Study: Flaws include starting treatments in older women (average age 63) and misreporting cancer risks
    • Current Stance: Timing is crucial, ideal to start HRT between ages 50-59 for optimal benefits
    • Delivery Methods: Oral and non-oral forms (patches, gels, vaginal rings, etc.
  • Benefits: Reduced cardiovascular disease risk, bone protection, neuroprotective effects
  • Considerations: Risks vary based on individual health factors (e.g., history of blood clots, liver disease)
  • Testosterone in Women: Address libido and sarcopenia, usually via non-oral forms

Non-Hormonal Strategies

Nutrition

  • Anti-Inflammatory Diet: Importance of Mediterranean and Galveston diets
  • Protein Intake: At least 80-120 grams daily, promoting muscle mass and overall health
  • Fiber: Essential for gut health and lowering inflammation - target 25-30 grams per day

Exercise

  • Resistance Training: Crucial for maintaining muscle mass and bone density
  • Weighted Vests: Aid in osteoporosis prevention and weight-bearing exercises

Supplements

  • Creatine: For muscle support
  • Collagen: Specific types for bone density, skin elasticity
  • Vitamin D: Common deficiency; supplementation recommended

Psychological and Lifestyle Adjustments

  • Mental Health: Importance of addressing psychological symptoms (anxiety, depression, brain fog)
    • Potential benefits from both HRT and lifestyle changes
  • Sleep Hygiene: Managing sleep disruptions; progesterone helps regulate sleep patterns
  • Support Systems: Encouraging male partners and family to understand and support women through these transitions

Special Cases and Additional Considerations

  • Early Menopause: Genetic factors, surgical interventions (like hysterectomy), and lifestyle factors explain variability
  • Contradictions for HRT: Severe liver disease, hormone-sensitive cancers, current blood clots

Summary and Conclusion

  • Key Takeaways: Proper management and awareness can significantly mitigate negative impacts of perimenopause and menopause.
  • Empowerment through Education: Knowledge of symptoms, treatments, and lifestyle adjustments enables better health outcomes.
  • Public Health Impact: Needs increased research funding, improved medical curriculum focusing more on women's health, and spreading awareness.

References

  • The New Menopause by Dr. Mary Claire Haver
  • Further resources available on the Huberman Lab Podcast website.