What really happens to your body during menopause | Body Stuff with Dr. Jen Gunter

267,031 views ・ 2021-06-10

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There's a lot of mystery and confusion surrounding menopause,
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so I'm going to take the next few minutes
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to tell you exactly what's happening in our bodies when we go through it.
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You can almost think of menopause as puberty in reverse.
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[Body Stuff with Dr. Jen Gunter]
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Hey, it's your favorite ob-gyn,
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and I'm here today to talk about a subject that I find truly fascinating: menopause.
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Chances are you probably don't find it quite as gripping as I do,
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but I promise that if you can get past the horror stories,
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you'll be riveted too.
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Whether you're going through it or know someone who is,
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you'll recognize there's nothing to fear.
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So what exactly is menopause?
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Technically, "menopause" is diagnosed one year after the final period,
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but most people use it to refer to the entire span of time
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when our menstrual cycle is changing in length,
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a process that lasts several years,
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and then all the time afterwards.
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So it's best to think of menopause as a continuum, starting years before,
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during what is called the menopause transition.
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Just like puberty, the process happens over many years.
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The menopause transition is one bookend of our reproductive cycle,
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opposite puberty.
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When we're born, we actually have all the eggs we're ever going to make,
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about one to two million of them,
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unmatured and encased in follicles in the ovaries.
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Around the age of eight to 10, the hypothalamus, a region in your brain,
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starts releasing a hormone
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that essentially wakes up those dormant eggs,
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beginning the monthly cycles of ovulation.
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This is what increases production of a class of hormones
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you've probably heard about -- estrogen.
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Estrogen, along with other hormones,
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begins a delicate hormonal dance that, once a month,
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results in the most mature egg leaving its follicle
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and traveling down a fallopian tube.
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The body builds up the lining in the uterus, the endometrium,
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to house the egg,
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and if the egg isn't fertilized,
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the lining sheds, and we have our period.
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This cycle repeats over and over and over, for decades.
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On average, sometime in the mid-forties, ovulation starts to get erratic.
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We just don't have as many eggs,
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and the ones that remain may not be as healthy anymore.
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Estrogen can be lower some cycles,
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and even higher during others.
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This is the menopause transition --
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hormonal chaos, like puberty,
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only this time, when estrogen levels stabilize,
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they'll be much lower than they were before.
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This very normal decrease in estrogen and other hormonal changes
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does come with medical concerns,
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such as osteoporosis, heart disease,
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diabetes and vaginal dryness.
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Some of us are lucky and we will have no or mild symptoms.
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Others will experience trouble sleeping, irritability,
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depression or decreased sex drive.
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And then there's the most classic symptom, hot flushes.
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They're a wave of heat
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that makes it feel like the furnace just got cranked up on the inside.
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Scientists aren't completely sure why this happens,
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but the resulting heat makes you feel sweaty and off-kilter.
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Some women even have symptoms that overlap with anxiety,
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like nausea and palpitations.
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But for me, it feels as if I've had too much to drink.
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Those are some of the negatives,
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but there are positives too.
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After menopause, you don't have to worry about periods or cramps,
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and people who partner with men who make sperm
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don't have to be concerned about unintended pregnancy.
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You're through all that.
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To me, menopause is something we go through, like puberty.
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And like puberty, there's a range of experiences.
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We continue to make vital contributions to society after menopause.
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It's not your dotage.
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Your worth has nothing to do with your ovaries.
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So let's say you're in the menopause transition.
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What are the best things you can do?
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If you're suffering, there's almost always some kind of help.
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If you smoke, definitely try to quit.
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It will reduce your risk of heart disease,
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it might also reduce some symptoms of menopause.
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Reducing stress and getting enough sleep is also good.
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Focus on eating a healthy, balanced diet
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rich in calcium and vitamin D for healthy bones,
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and try to get at least 150 minutes of moderate physical activity a week,
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especially if it's weight-bearing exercises,
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like hiking, dancing or jogging.
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If you're losing sleep or having hot flushes,
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or experiencing other symptoms that affect your quality of life,
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talk to your doctor.
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Don't rely on wearable magnets or so-called compounded hormones.
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These are unproven and have risks.
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There are a variety of proven options,
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from cognitive behavioral therapy to FDA-approved estrogen,
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and some nonhormonal medications that can be very helpful.
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There are so many permutations and combinations of options
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that safe therapy can be customized for almost every woman.
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One more idea, have a mantra ready.
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When I get a hot flush, sometimes I tell myself
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I'm feeling this because women have evolved
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to drive humanity forward.
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This is a sign of my strength.
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And then, I can make it until it goes away.
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