Osteoporosis, hormonal changes, fat accumulation, fatigue, low libido, dryness... These are negative and intimidating words that we associate with women in the climacteric, a stage in which 11 million women in Spain find themselves. Although the association of this stage with decline and discomfort persists, insistently and erroneously, the taboo on those 10 or 15 years of a woman's life - which encompass premenopause, menopause and the years immediately following - has been broken. -.
About those later years, starting at age 55, we spoke with Marta León, a chemical engineer, specialized in nutrition and female hormonal health. “Engineering opened the door to biochemistry for me to understand health,” says León, who - driven by her interest in endocrine disruptors - studied a postgraduate degree in Naturopathic Medicine at the University of Zaragoza, and later Food, Nutrition and Health. Public at the Carlos III Health Institute in Madrid.
Menopause, climacteric, postmenopause... Let's find ourselves in the last phase of these years of changes. From the age of 55 or 60, at what point can a woman be?
At age 55 or 60 we are in the second part of the climacteric stage, which begins before age 50 and can end at age 60, generally speaking, but depending on each woman. Two, three and four years after menopause, after finishing menstruating, things continue to happen in the female body. The climacteric encompasses everything, from perimenopause to postmenopause.
After menopause, what happens to our body?
It makes a transition from cyclicity, menstruation-ovulation, to the ovaries remaining almost without activity. The ovaries, the main factories of estradiol - estrogens with very specific effects on our health - are producing less and less. This influences our hormonal health, skin, brain, metabolism... Estradiol stops being produced, but the body needs estrogen to function. What does the organism do? Look for creative strategies to make estrogen in other ways. This happens a lot at 55, 60, in postmenopause. We continue to manufacture estrogens, but in fat deposits, in adipocytes; In this case they are called estrones and are not as effective as estradiol.
Is that why we gain weight and notice more abdominal fat?
As we need to manufacture estrone in fat deposits, our metabolism slows down, we begin to gain a little weight, there are women who notice fat deposits in the abdomen. Furthermore, the same effect of estrones causes the metabolism to slow down, because they are not as effective as estradiol. A woman with estrogen is thinner, she has more energy, her liver metabolizes better... With age, the metabolism slows down.
What do women need at this moment in life, after 55?
Guarantee good raw materials so that the body can manufacture estrones and does not need to gain much weight. We can do it through physical exercise, which is key. Estrone is less effective than estradiol at growing muscle and preserving muscle. Movement and physical exercise will be the way to protect the muscles, the glutes, the legs... We are one of the first generations of women who are filling the gyms, we do CrossFit, fitness...
Why do we have to do more strength and muscle-building exercise than in other stages?
The ideal would be to do a little of everything. Cardio helps activate the metabolism and burn energy. The stretches and relaxation of yoga or Pilates, like conscious breathing, help us manage hot flashes, which can last in some cases until we are 65 years old, which is why we must work on stress management and relaxation of the sympathetic system. . Strength exercise, the third important leg, helps us preserve muscles and joints, and take care of bone density. At 55 or 65 we can go 10 years without menstruating, without good estradiol levels, and if we do not have good movement habits and muscle protection, we run a risk.
So, the key to healthy aging at this specific stage is not losing muscle?
Losing muscle is the highway to osteoporosis. Muscles also have another effect that we did not know a few years ago: they work as endocrine organs, the better muscle mass I have, the better I will metabolize sugar and insulin; that is, less likely to have pre-diabetes, diabetes and overweight.
What feeding instructions do you think are essential for the hormonal changes of this stage?
We are all worried about bone density and think that we should take more calcium. It is important, but not as important as having good levels of magnesium in our diet, that we include green leaves, seeds (sesame and chia, for example). Also increase omega-3, the body's raw material, to manufacture estrones. We need healthy fats from oily fish, typical of the Mediterranean diet, which is the best for the climacteric and for aging, with more fish than meat. In addition, these omega-3s protect circulation, tissue, neurological health at a cognitive level. It is not only about eating blue fish, but also white fish, octopus, cuttlefish, mussels, clams...
Movement, nutrition… What else?
Vitamin D is key for its ability to protect bone and introduce calcium into the bone matrix. That is, it is not that we have to ingest more calcium, but rather that we have to get that calcium to go to the bone. After 55, having low vitamin D can be the prequel to osteoporosis in the future, it should never be below 45. This is simple by sunbathing at non-dangerous hours, it can be late in the day or in the morning. Vitamin D can be ingested in supplements, but we need to sunbathe, as long as there is no melanoma, sun allergy or a contrary medical indication. The sun also helps us produce serotonin - the happiness hormone - which makes us sleep and rest better. If the day is sunny we are in a better mood... Vitamin D affects our mood and emotional health.
What happens to sexuality at this stage of women, around 55 or 60?
In many cases around 55 or 60 there is a feeling of liberation from not having to worry about fertility. Also a security that is not like that of the 20s, in which we wanted to please others, but is generated because we are very aware of our pleasure. It is true that there is a change in the hydration and humidity of the tissue, which we have to take care of. From nutrition and self-care (based on vaginal moisturizers, for example) we can find solutions. Omega 3 also helps preserve tissues and hydration.
And to avoid vaginal problems derived from dryness, what other tools do we have?
Doing pelvic floor work is important, an exercise routine to irrigate the genital area and maintain the muscles, which will help tissue and moisture. In addition to that, what helps irrigation the most are orgasms, and we must value them without taboos, as a way to mobilize and preserve the cell wall. Masturbation is a matter of health, just like any other massage, it activates the circulation of the area. Vaginal atrophy is spoken of in gynecology, and in reality atrophied tissue is that which is not used. We have to break taboos about masturbation, although the orgasms we have in relationships with another person also have these effects. We must think about functionality so as not to relegate ourselves to vaginal atrophy.
What do you think of hormonal treatments?
We have gone from hormone replacement therapy prescribed to all women to “save” them from menopause, to a type of personalized treatment that is how it should always have been done, with closeness between the professional and the patient, with constant review and with different results. . The effect on women of these treatments is very good, I wish it had been done before in such a personalized way.
He says that “the climacteric has a great gift for women, changes occur at the level of consciousness, an increase in maturity, and there is a certain relativity when facing life.” Is the outlook more serene?
From the age of 55 or 60 you realize that, due to hormonal changes and the effect they have on our neurological biochemistry, we reach a state of consciousness in which we feel more secure in ourselves, self-confidence comes, many Women connect with internal authority. It is a time when many women undertake, allow themselves passions, dedicate spaces for self-care, review the family or relationship structure... It is an enormously powerful moment.
