As a part of my holistic approach to health and well-being, there is a general health questionnaire that women complete prior to their initial appointments with me to assess their goals, concerns, and past medical history and evaluate their lifestyle habits. In recent times, I have observed a growing desire among them to seek hormone "balancing" for goals such as weight loss, improving fatigue, and resolving sleep issues, and mood symptoms. It's important to note that these women are not experiencing medical endocrine conditions like hypothyroidism, hyperthyroidism, pituitary disorders, or Addison's disease, which necessitate specialized consultations, diagnoses, and medical treatments.
Additionally, during my menopause and women's health workshops, it is common for women to express an interest in understanding hormone imbalances and assessing the state of their hormone balance. It is important to emphasize that there is nothing inherently wrong with taking a proactive approach to one's health and seeking knowledge in this area. Women suffering from symptoms should receive proper assessment and be given evidence-based options for treatment, but many turn to consumer self-help hormone books that perpetuate a narrow outward gender ideal and unattainable goals regarding hormones and aging.
In this discussion, I would like to address the fact that while certain consumer hormone and menopause products and services are genuinely well-intended, there are others that utilize a marketing strategy of catastrophizing or exaggerating hormone issues to drive sales.
Hormones are secreted by glands in the endocrine system. The ovaries (in females), testes (in males), pituitary, thyroid and pancreas are part of the endocrine system with a feedback mechanism that keeps hormones in homeostasis. As individuals age, there is a natural decline in growth hormones and sex hormones. Women, in particular, are more susceptible to developing thyroid disorders. In fact, according to a study, women are seven to 10 times more likely than men to develop hypothyroidism as they age. However, discussing the specifics of this study will be reserved for another blog post, as the topic of thyroid health is another area fraught with misconceptions.
Throughout the reproductive age, women experience fluctuating menstrual cycles on a weekly basis, which enables fertility and reproduction. Beyond that, women's hormones offer numerous other benefits that safeguard our bones, and cardiovascular health, and support a healthy metabolism. For instance, estrogen plays a crucial role in maintaining bone density, skin health, and heart function. Progesterone, on the other hand, conserves muscle glycogen while favouring fat utilization during the luteal phase. Testosterone in women, maintain bone strength, libido and our overall sense of wellbeing.
However, during the transition to menopause or the early stages of perimenopause, hormone fluctuations become erratic, potentially leading to symptoms in some women (not all) who are sensitive to these changes. Moreover, in post-menopause, the risk of certain health conditions increases. Women have an increased risk of cardiovascular disease, osteoporosis, sarcopenia, dementia, and depression. They may experience heightened or accelerated impacts of these conditions that also overlap with the aging process.
While there is ample discussion surrounding fertility, prenatal care, and pregnancy, there appears to be a lack of structure or framework for addressing the natural transition of menopause and preparing women for this significant life stage. It seems as though society primarily values women for their fertility, and there is an assumption that women live better lives simply because they have a longer average lifespan than men. However, this assumption is far from true. Various socioeconomic and biological factors contribute to a lower quality of life for women in older age. Unfortunately, the failure to adequately address these issues has already resulted in under-diagnosis and inadequate treatment of heart disease and diabetes in women. It is crucial to recognize and rectify this oversight to ensure the well-being and health of women during and beyond the menopausal transition. It requires a holistic approach, not a just hormone-centric view.
Menopause hormone therapy is a viable option for healthy women experiencing symptoms or those at risk of osteoporosis. However, the decision to undergo this therapy should be made through a collaborative process involving a doctor trained in menopause care. It's important to note that hormone therapy should not overshadow the significance of implementing lifestyle strategies for overall healthy aging. To ensure clarity and precision, it is crucial to clearly define the specific targets and expected outcomes of the treatment. But the growing market of consumer menopause wellness products and services do not adhere to the same standards.
The menopause market is projected to reach a staggering worth of approximately US$24.4 billion by 2030. Marketing, media, and commercially driven companies have a vested interest in exaggerating the impact of menopause and hormone imbalances in women.
This issue is becoming increasingly important as there is a gender health gap when it comes to women's menopause health and transition which leaves it open for all kinds of misconceptions, myths and misinformation.
In Asian cultures, menopause often remains a sensitive and taboo subject, which can place women in a vulnerable position. Globally, women are faced with unattainable gender ideals, misogyny, and the burden of harsh self-judgment.
Numerous diets, supplements, tests, devices, and gadgets are marketed and commercialized, claiming to restore hormone balance or serve as effective alternatives to standard medical care for menopause. However, none of these products or services have undergone evaluation against established medical standards to substantiate their claims. Unfortunately, there is no regulatory oversight governing these products or services. This lack of oversight, combined with limited health literacy regarding hormones and menopause, creates an environment where corporations can take advantage of uninformed individuals.
The consumer menopause wellness industry presents alluring, effortless, exclusive, and fashionable solutions that claim to hack hormones for weight loss, increased energy, disease prevention, enhanced longevity, and reversing aging. However, these claims often lack substance and, at best, serve as a cover for promoting healthier lifestyles and behaviours.
It's worth noting the fine print caveat in some of these products should be used alongside a healthy diet and exercise regimen.
In contrast, scientific research extensively supports the benefits of adopting a healthy diet and engaging in regular exercise, and you can find a wealth of relevant studies on this topic through PubMed. PubMed, a widely recognized and extensively used online resource for biomedical literature, serves as an invaluable tool for researchers, healthcare professionals, and anyone seeking reliable and up-to-date information on various medical subjects.
While eating better, moving more and prioritising recovery sound deceptively simple, it's not very sexy, shiny, newsworthy or marketable. But as a side benefit, they provide the foundation the body needs to restore biological homeostasis. Biological homeostasis refers to the body's ability to maintain a stable internal environment despite external changes. It involves a series of processes and mechanisms that work together to regulate various physiological variables, such as body temperature, blood pressure, pH levels, and hormone levels, within a narrow range. The goal of biological homeostasis is to ensure optimal conditions for cells and tissues to function properly, promoting overall health and well-being. Mainstream medicine and science have clearly identified this for decades.
The notion that we can directly manipulate tightly regulated hormones and finely adjust them through specialized products or services, excluding cases of endocrine diseases, can be described as missing the forest for the trees (or majoring in minor issues).
I want to clarify that women's health is not a niche or trivial matter. However, the existing gender health gap, characterized by limited awareness and resources for accessing support in making foundational healthy changes, has placed women in a disadvantageous position, making them susceptible to distractions presented through elaborate marketing strategies.
Altering our dietary choices, exercise routines, rest, and recovery patterns have a multi-faceted impact, affecting various pathways. Attempting to manipulate a single mechanism in isolation to alter hormones is impractical. Therefore, it is essential not to be deceived into believing that we can directly influence a specific aspect of the body's homeostatic mechanism and accurately measure its hormonal effects. The relationship is not as straightforward or uncomplicated as it may seem. There is no validated method to assess hormone balance in an otherwise healthy person.
To summarize, by focusing on mastering the fundamentals of sustainable lifestyle and behavioural changes, it is not essential for additional tinkering to achieve physiological hormone homeostasis. Instead, invest your resources into finding well-informed health providers and evidence-based solutions to navigate the natural menopause transition in a sustainable manner that promotes well-being and healthy longevity.
For more information about this topic or area, educational webinars, workshops or activities for women's health, menopause and healthy longevity, you can contact us via Email or WhatsApp
References:
Gietka-Czernel, Małgorzata. “The thyroid gland in postmenopausal women: physiology and diseases.” Przeglad menopauzalny = Menopause review vol. 16,2 (2017): 33-37. doi:10.5114/pm.2017.68588
Devries MC, Hamadeh MJ, Phillips SM, Tarnopolsky MA. Menstrual cycle phase and sex influence muscle glycogen utilization and glucose turnover during moderate-intensity endurance exercise. Am J Physiol Regul Integr Comp Physiol. 2006 Oct;291(4):R1120-8. doi: 10.1152/ajpregu.00700.2005. Epub 2006 May 11. PMID: 16690766.
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