"People are disturbed not by things but by their view of things"
Epictetus
I love to start today's blog with this sentence because it embodies the goal that I propose to myself: to talk about a topic that interests us all, highlighting its constructive point of view, moving away from the stigmatized idea we are used to.
Above all, explaining how to know what happens or will happen to our body and how exercising can have a fundamental impact can help us set the correct routine and correct habits regardless our age.
Let's start here: do we actually know what “menopause” is?
It is a phase of female life that is divided into three steps:
- Peri-menopause: means "around the menopause", it is the transition phase towards the end of the reproductive age. It starts at different times for each woman, usually between the ages of 35 and 40 and can last up to 8-10 years.
You may begin to experience some symptoms - not necessarily - but the menstrual cycle is present and you can have pregnancies.
Personally, what I have been experiencing for a few years is a greater need for recovery after working out and when I don't take enough sleep.
Even the post-pregnancy recovery after my second child, at 44, from a functional point of view was longer than my first pregnancy 10 years earlier.
- Menopause: it is a specific DAY which corresponds to exactly 12 months from the last menstrual cycle. It can take place between 40 and 50 years and the statistical average of this passage is 51-52 years.
- Post-menopause: it is the whole life after this step!
We therefore understand how important it is to live it to the fullest. Right!?
An ESSENTIAL point should be emphasized here: the onset of post-menopause represents a new phase from the point of view of health.
The incidence of cardiovascular disease and osteoporosis increases greatly.
Just think - I didn't know it - that in the UK, 60% of female mortality after the age of 50 is due to a heart attack.
It is easy to deduce why exercise and nutrition play a crucial role, MUCH more than they could at 20.
I now describe the main SYMPTOMS that a woman MAY experience.
The conditional is a must because for every woman it is different, the complete symptoms are not necessarily experienced, genetics and environment do not affect "how" menopause will be for a woman.
The EMOTIONAL aspect, how you approach this phase of change, however, can make the REAL DIFFERENCE.
I find "awareness" to be one of the key words to better deal with changes without feeling overwhelmed.
- Irregular menstruation (during the peri-menopause phase)
- Urinary incontinence (this is one of the symptoms that can create more discomfort and undermine one's self-esteem. Working on the pelvic muscles can prevent or solve this problem)
- Hot flashes and intense sweating (various studies have shown that women who take regular sessions of muscular resistance training experience a net decrease in this reaction thanks to the physiological changes supported by exercising)
- Worse quality of sleep (also here studies show how resistance training, especially if performed in the first part of the day, can improve this aspect)
- Migraine
- Vaginal dryness due to a drop in estrogen (this can greatly affect a woman's sexual life, with a a strong emotional impact)
Now the appearance changes:
- Hair becomes finer and more fragile, the skin drier and less dense
- The breasts lose fullness
- There is an increase in fat mass, especially in the abdominal area
- Slowing of the basal metabolic rate caused primarily by the decrease in muscle mass (and resistance training plays a crucial role here, as we will see later)
And at last but not at least:
- Frequent mood swings
- Fatigue more and more evident
- Depression
The list could go on and on ... It is really extremely personal, but what leaps to the eye is how much the different symptoms can "intersect".
If you let yourself be overwhelmed without a good plan of action, you can really be affected by these changes in a painful and deep way, at a physical and psychological level.
The good news is that we can really do a LOT to approach and live this part of our life with awareness and fullness. The action plans are there!
A "PLASTIC" APPROACH
First of all, let's think about this: menopause is like puberty. The hormonal changes "upset" a pre-existing structure and the previous equilibrium at several levels, from the physiological to the psychological one.
For many women this moment leads to a real questioning, and even their own identity, the perception of who they are, feels put on stake.
The same thing happens to adolescents, if we think about it.
Certainly thinking about it is scary, but let's look at everything from another perspective: we can "rebuild" on the basis of the tools we have but also those that are arriving now and are new!
It is a moment of extreme PLASTICITY, even at a neuronal level, you literally have the possibility to build new patterns of thoughts, new beliefs, and by deciding it you really have the possibility to shape who you want to be for the rest of our life to come!
EXERCISE OR NOT EXERCISE?
Here the answer is easy: there are many reasons why YES is the right one.
Let's start with a cliché that is also an actual fact: exercise has positive effects on mood and the ability to manage stress: it is an actual fact determined by the physiological changes caused by movement.
My experience here is that when I am tired or worried about something, when I workout everything changes: the feeling of anxiety or tiredness decreases and also my way of looking at things becomes more lucid. I often feel more nervous and intolerant on days when I have no way to workout.
Personally, I never claimed that physical activity is a cure for depression, the latter being an absolutely more complex pathology.
But it can certainly help and positively influence, especially for depressive states resulting from menopause, which may be due to the perception of self that has undergone a strong change.
Exercising means counteracting some of these changes: you can absolutely control your weight and the percentage of fat mass, you can continue to have a strong, agile body and high energy levels, keep your muscle tone high, feel good in your body.
RECOGNIZE YOURSELF, instead of losing some of the control over yourself.
POST-MENSTRUAL OSTEOPOROSIS
Before talking about training,, it is necessary to talk about osteoporosis.
I start by saying that bones are a reactive tissue, subject to a continuous phase of remodeling, given by the action of cells that "create the bones" called osteoblasts. Every year our skeleton is renewed for the 10%.
Around the age of 20, peak bone density is reached.
From the age of 30, the balance begins to shift in favor of a decrease in density: the resorption of bone begins to prevail over its formation. In parallel with the gradual decrease in muscle mass (Sarcopenia) it causes a small but stable decline of about 0.4% body mass per year.
POST-MENSTRUAL osteoporosis is a metabolic disease due to the decrease in estrogens, characterized by the loss of bone mass and deterioration of the microarchitecture of the bones.
Decreased bone mass causes increased risk of skeletal and muscle fractures. It causes chronic pain, loss of functionality and worsening of daily life itself.
ESTROGENS, sex hormones that determine the entire reproductive cycle of a woman's life, also play a key role in the formation of bone tissues, stimulating the absorption of calcium.
Their decline therefore has a strong impact.
From about a year before the last menstruation to about a year after the day of entry into menopause, therefore a period of about 3 years, women lose on average 6% of bone density, with peaks of up to 15%, per year. It means that in 3 years the density of our bones decreases from 18% to 45%! That adds up to the slow but present previous loss.
25% of Italian women at 50 already suffer from osteoporosis.
It is a reality of which we are not very aware, which we do not think about, which is almost experienced as a "normal" aging process.
But why passively undergo this process when so much could be done?
STRENGTH AND IMPACT TRAINING
The advice that is often given for those suffering from post-menstrual osteoporosis is to "move" and do light, low-impact physical activity, walk or swim.
This protects against possible accidents, but studies have shown that they are activities that have little stimulation of the bone tissue.
Training AGAINST A RESISTANCE (weights, tools, body weight) and with IMPACT causes muscle mass to increase and also has a great influence on bone tissue: as seen it is a reactive tissue, perfectly able to adapt and respond to various stimuli, like those coming from mechanical vibration: during physical activity with impact the mechanical forces are exerted on the bones through the forces of reaction to the ground and thanks to the contractile activity of the muscles, stimulating the maintenance or gain of bone mass.
Therefore, from the age of 30, MUSCLE STRENGTH training should become part of our routine, in order to INCREASE in frequency and intensity FROM 45-50 years ONWARDS.
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