Oestrogen production during reproductive years has an important role in the protection against two major illnesses: osteoporosis and heart disease.
As the production of oestrogen significantly drops at the time of menopause, this protection is no longer provided and so the risk of developing both diseases increases.
Osteoporosis
The bones of men and women lose density and mass as part of the natural aging process. In osteoporosis this loss is exaggerated to the stage where bones break or crumble in response to little or no trauma. Osteoporosis has no warning signs, so sufferers are usually unaware that they have it until a fracture occurs. Oestrogen protects against losing bone mass, so at menopause the risk can increase.
Since other factors, such as genetics, lifestyle, exercise and diet, also make a large contribution to the risk of developing the disease, menopause does not automatically predispose women to it, but the loss of the protective effect of oestrogen does increase the risk. Changes in lifestyle, especially diet and exercise, can help to reduce this risk.
Weight-bearing exercise in particular is an effective way to maintain bone mass, even after the menopause. It is estimated that 50% of post-menopausal bone loss will occur within the first seven years of reaching menopause, thus it is important to guard against bone loss as soon as possible.
Almost 40% of women risk suffering a fracture as a result of osteoporosis at some point in their life, therefore the additional risk often brought on by the menopause should not be ignored.
Heart disease
It is commonly believed that women's risk of heart disease is much lower than men's, but 10 to 15 years after menopause a woman's risk equals that of a man. This is due to the loss of oestrogen that previously had a protective effect on women's circulatory systems.
The exact nature of this protection is as yet unknown, but it is thought to be linked to levels of high-density lipoprotein (HDL) cholesterol (the 'good' type of cholesterol) in the blood, which positively correlate with levels of oestrogen.
As with osteoporosis, other factors - including genetics and lifestyle - contribute to the risk of developing heart disease, but the loss of protective oestrogen following menopause does put post-menopausal women at a higher risk than their premenopausal counterparts.
As with osteoporosis, lifestyle changes made around the time of menopause can help to reduce this risk by eliminating other possible contributory factors, such as smoking, obesity, and lack of exercise.
Alzheimer's disease
Recent research indicates that oestrogen may also protect against the onset of Alzheimer's disease and other types of dementia. The study shows that women who took oestrogen following the menopause had a 40% lower incidence of Alzheimer's than those who did not.
Previous research in similar areas has already shown oestrogen to be effective in maintaining the health of brain cells, which may go some way towards explaining this finding.
Other complications
Since oestrogen has a number of protective effects, long term post-menopausal oestrogen deficiency can lead to other increased health risks such as stroke due to increased fatty deposits in the arteries, and weight gain due to changes in body-fat distribution and metabolism.
Another complication can be a uterine prolapse, where the womb drops into the vagina. This can be dealt with quite simply by a GP.
Aging increases the risk of the majority of these conditions, as well as others including diabetes, joint problems, and some cancers, so it is especially important at the time of menopause to look after general health as well as targeting specific issues through diet and exercise.
20/05/2009