It is only in the past couple decades that women’s hormonal health has become a mainstream topic.
This is because the baby boomer generation was a huge influx of women turning middle age and entering menopause. Unfortunately, the many changes that women face have not traditionally been discussed in ‘polite society’ (to quote my mother).
But the brave (and sometimes brazen) women of the baby boomer generation started talking about menopause and the corresponding health issues.
Because of them, their daughters and granddaughters inherit both a broader awareness and better access to information and resources.
Understanding menopause
Menopause is the term used to signify the end of fertility and the menstrual cycle (the pause in menses).
It is diagnosed after women have gone 12 months without a menstrual period and usually starts by about 50 years old (sometimes earlier).
In the late 30s, estrogen and progesterone levels (produced in the ovaries) start decreasing, and fertility declines.
During the 40s, menstrual periods change (becoming lighter or heavier, and longer or shorter) and usually within the next 10 years the ovaries stop releasing eggs, indicating the end of menstruation.
Perimenopause: The transition phase
Many women do not seriously consider their long-term hormonal health until they enter perimenopause, the years leading up to menopause.
For some, changes are subtle, and the transition is almost effortless — they go from being fertile to post-menopausal without much disturbance. But this is the exception, not the rule.
Most women experience a range of symptoms, including:
· Hot flashes, night sweats, and occasional chills
· Weight gain and slowed metabolism
· Mood swings and increased stress sensitivity
· Vaginal dryness
· Insomnia or poor sleep
· Changes in appetite and digestion
· Reduced energy levels
· Thinning hair and skin changes
· Headaches and vision fluctuations
· Loss of breast fullness
· Joint pain, arthritis flare-ups, and other inflammatory conditions
· Urinary incontinence and pelvic floor issues
These shifts can affect not only physical health, but also emotional well-being and relationships.
The hormonal landscape
Menopausal symptoms are linked to imbalances in several key hormones, including:
· Estrogen and progesterone – regulate reproductive function, mood, and bone health
· Insulin – manages blood sugar and metabolism
· Androgens – influence libido and muscle tone
· Leptin and ghrelin – control appetite and energy storage
· Cortisol – governs stress response
· Thyroid hormones – regulate metabolism and energy
· Growth and pituitary hormones – affect cellular repair and vitality
Fluctuations or deficiencies in these hormones can increase the risk of several health conditions.
Health risks after menopause
1. Cardiovascular disease
Estrogen has protective effects on the heart and blood vessels. After menopause, its decline contributes to a higher risk of heart disease — the leading cause of death in older women. While hormone replacement therapy (HRT) was once widely used, concerns over its risks have reduced its popularity. Heart health can be supported through regular exercise, a balanced diet, avoiding smoking, and limiting alcohol intake.
2. Osteoporosis
Estrogen plays a critical role in bone density by promoting the production of osteoblasts (bone-building cells). After menopause, reduced estrogen accelerates bone loss, increasing the risk of fractures — particularly in the hips, wrists and spine. Bone density scans should be part of routine care for menopausal women, especially if there’s a family history of osteoporosis.
3. Urinary incontinence
As estrogen levels drop, the tissues of the vagina and urethra lose elasticity, leading to sudden urges or leakage during laughter, coughing, or exercise. While research is mixed on whether estrogen therapy helps long-term, pelvic floor exercises — often taught by physiotherapists — can greatly improve symptoms.
4. Weight gain and metabolic changes
Lower estradiol levels slow metabolism, while shifts in insulin, leptin, and ghrelin affect how the body processes and stores energy. Unfortunately, many women must eat less and exercise more just to maintain their pre-menopausal weight.
The case for preventive care
Midlife should be a time of proactive self-care, not simply reacting to health problems as they arise. Ideally, physicians should be well-versed in menopausal medicine and order appropriate screenings, including:
· Pelvic and breast exams
· Mammograms
· Hormone level blood tests
· Thyroid function tests
· Blood sugar, cholesterol, and triglyceride checks
· Blood pressure monitoring
· FSH (follicle-stimulating hormone)
· Colonoscopies (especially if digestive changes occur)
· Bone density scans
Why are symptoms more severe today?
It’s possible that today’s women face more intense menopausal symptoms than past generations. Diet may be a major factor as modern lifestyles include more processed foods, excess sugar, and fewer nutrient-rich meals. We’re also less physically active, more exposed to environmental toxins, and subject to chronic stress, all of which can impact hormone balance.
Hormone therapy and lifestyle solutions
Hormone replacement therapy remains controversial, with benefits and risks varying for each woman. For those seeking natural approaches, certain foods may support hormonal health, including those rich in phytoestrogens, omega-3 fatty acids, and essential minerals.
Honouring the midlife woman
Hormonal shifts are a natural part of a woman’s life cycle, yet their impact on comfort, confidence, and well-being can be profound. Many midlife women have already devoted decades to raising families, advancing careers, and contributing to society — often without adequate recognition. To then endure the challenges of menopause, sometimes for the rest of their lives, speaks to their resilience. It’s no wonder some refer to women as “the stronger sex.” (No offence, men.)
Here’s to celebrating the midlife woman — with understanding, compassion, appreciation and support — as she navigates this powerful life transition.
May she move forward with health, grace, humour, and confidence into her elder years, surrounded by women who understand her and can support her though this challenging time.
Claire Nielsen is a health coach, author, public speaker and founder of www.elixirforlife.ca. The information provided in the above article is for educational purposes only and is not a substitute for professional health and medical advice. Please consult a doctor, health-care provider or mental health practitioner if you're seeking medical advice, diagnoses and/or treatment.
