By Hanna Keith Santos Barrientos edited by Christopher Cirino, DO, MPH

Here is an article specific to women’s health: menopause and the hormonal changes of aging. It also discusses how older women can maintain a healthy body and be able to adapt to the changes that come with aging.

As women, our bodies have constantly been developing and they will continue to evolve throughout life.But we must remember that getting old is a natural process in life.

Aging is inevitable. And although rapid changes in our bodies and emotions can take us by surprise, going through them shouldn’t be too hard as long as we’re prepared.

Understanding the changes we face is crucial for maintaining a healthy body as we grow older. Since we can’t really stop aging, it’s essential that we at least become aware of the changes in our bodies so we can make informed decisions and be prepared for potential health issues that may arise.

Senior women are more likely to experience chronic health conditions such as heart disease, cancer, osteoporosis, and Alzheimer’s disease. We must recognize the risks associated with these conditions to know what steps to take and be able to prevent them.

Table of contents

1. What Are The Physical Changes That Occur With Menopause?
2. The Role of Estrogen in Aging
   1. What is Estrogen, and What Does it Do?
   2. When Does Estrogen Begin to Decline?
   3. How Does Low Estrogen Levels Affect Your Health?
3. 6 Ways to Adress Low Estrogen Levels
   1. 1. Hormone Replacement Therapy (HRT)
   2. 2. Vaginal Estrogen
   3. 3. Take foods and supplements rich in phytoestrogens
   4. 4. Regular Exercise and Maintain a Healthy Weight
   5. 5. Managing stress
   6. 6. Avoid smoking 
4. Conclusion: Embracing Change at Any Age

What Are The Physical Changes That Occur With Menopause?

As women reach the age of 45-50 years old, their ovaries start to shut down, which typically results in a number of physical and emotional changes. This phase signifying the end of a woman’s reproductive years, is called menopause.

Menopause means the end of menstruation. As women get older, the ovaries slowly stop functioning, and as a result, may experience irregular menstrual periods. Someone will know that they have reached menopause if their period completely stops for at least 12 months.

Aside from changes in menstrual cycles, most women also report other symptoms of menopause. Some of the most common physical changes that occur during menopause are the following:

• Hot flashes
• Night sweats
• Urinary changes (ie. frequent urination and urinary tract infections)
• Changes in body composition (ie. increased abdominal fat and decreased muscle mass)
• Change in bone density
• Vaginal dryness
• Vulvar itching
• Lack of libido
• Sleep disturbances/insomnia
• Irritability

The symptoms of menopause may differ from one person to another. While it’s a welcoming experience to some, the onset signs of menopause can be very intense and alienating for most women. So it’s important to brace ourselves and reach out for support as we go through this phase.

The Role of Estrogen in Aging

Most changes that come with menopause are due to the decline of the hormone called estrogen. We commonly know estrogen for its function in sexual and reproductive health in women, but its role is not only limited to the reproductive system. It also contributes to maintaining cardiovascular health, brain functions, and skeletal health.

What is Estrogen, and What Does it Do?

Estrogen is a steroid hormone primarily produced by the ovaries in females but can also be found in the testes of males. A small amount of this hormone is also produced by non-gonad organs like the heart, brain, and adrenal glands. Although both sexes have estrogen, women have much higher estrogen levels than men. 

This hormone is critical for regulating the growth and development of the reproductive system. Specifically, estrogens stimulate the growth of egg follicles and are responsible for developing a thick vaginal wall. They also regulate the mucous secretion in the uterus and the formation of breast tissues.

Aside from the reproductive system physiology, estrogens are also involved in the nervous, endocrine, and cardiovascular systems. For example, estrogen promotes bone formation and helps increase the formation of good cholesterols. This hormone also affects the muscle structure, skin, and urinary tract.

When Does Estrogen Begin to Decline?

Women produce large amounts of estrogen once their periods start (menarche) during puberty. Estrogen levels begin to decline as they approach menopause, a stage known as perimopause. At this stage, the ovaries produce less estrogen and the pituitary gland tries to compensate by producing more follicle-stimulating hormone. Because of these hormonal changes, a woman may experience irregular or late menstrual periods.

Once someone reached menopause and postmenopause, the ovaries no longer make estrogen, and the cycle completely stops. Other organs in the body like the adrenal glands and fat cells will still produce estrogen, but to a much lesser degree.

Note that we can experience low estrogen levels earlier in life if our ovaries were injured or surgically removed. This occurs when we have health conditions like polycystic ovary syndrome or taking radiation therapy during cancer treatments.

How Does Low Estrogen Levels Affect Health?

Normally, estrogen levels fluctuate throughout a woman’s life. For instance, estrogen levels rise during ovulation and decrease after ovulation or at the end of the menstrual cycle. The production of this hormone also increases in pregnant women and drastically drops soon after labor. 

But when the estrogen level is consistently low, it’s a sign of approaching menopause, which may significantly impact one’s health. The most common symptoms associated with low estrogen levels are what women mostly experience during menopause: hot flashes, night sweats, vaginal dryness or itching, and irregular or missed periods. Some also find it hard to fall asleep or get tired easily.

In some cases, the decline of estrogen concentrations can contribute to several health complications, such as: 

• Osteoporosis
• Heart disease
• Vaginal atrophy
• Mood changes and depression
• Urinary tract infections (UTIs)

6 Ways to Address Low Estrogen Levels

While it’s impossible to prevent the deterioration of ovaries because of aging, there are several steps women can take to maintain healthy estrogen levels and reduce their risk of associated health issues. Here are some treatments and lifestyle tips to address low estrogen levels during menopause.

1. Hormone Replacement Therapy (HRT)

Hormone replacement therapy is one of the most common treatments for women who experience severe symptoms of menopause. HRT restores the estrogen levels in the body and relieves the symptoms of menopause, such as hot flashes and night sweats.

HRT also comes in many forms. Women can take it as an injection or in the form of a tablet, skin patch, gel, or cream. And sometimes, doctors may recommend taking a combination of estrogen and progesterone therapy, as progesterone is also an essential hormone for females.

However, note that HRT may pose some risks to other people. Long-term use of this treatment may increase the risk of breast cancer and cardiovascular disease. It’s important to consult with a healthcare provider to know whether HRT is safe and suitable for you.

2. Vaginal Estrogen

Estrogen can be administered directly to the vagina to treat vaginal dryness or itching, painful urination, and avoid discomfort during sexual intercourse. In this treatment, estrogen is administered using a vaginal cream, tablet, or ring in small doses, which is absorbed by the vaginal tissues. Like other HRT treatments, vaginal estrogen may have side effects, so make sure you talk to your doctor about it.

3. Take foods and supplements rich in phytoestrogens

Eating a balanced diet is an excellent way to maintain healthy estrogen levels. In particular, consume foods and supplements that are rich in phytoestrogen. Phytoestrogens are naturally occurring compounds that are structurally similar to estradiol. They can be found in soybeans, whole grains, lentils, chickpeas, flaxseed, and other fruits and vegetables. 

4. Regular Exercise and Maintain a Healthy Weight

Studies have shown that regular aerobic and anaerobic exercise improves the estrogen level in postmenopausal women, particularly those that are overweight and osteoporitic. Moreover, regular exercise also increases muscle mass and lowers body fat, ultimately enhancing the quality of life of women experiencing menopause.

Maintaining a healthy weight is beneficial, as excess body fat can lead to imbalances in estrogen levels. However, it’s important to note that extreme diets and excessive exercise can do more harm to the body. The best way to manage your weight is by having a balanced diet and performing moderate physical activity

5. Managing stress

Cortisol is a hormone that helps regulate blood pressure, reduce inflammation and respond to stress or danger. However, severe stress or mood changes can cause your body to produce too much of this hormone, which can cause a hormone imbalance that negatively affects your estrogen levels. To avoid this, practice meditation, yoga, or deep breathing exercises to manage your emotions.

6. Avoid smoking 

Cigarettes can cause lung disease, cancer, and other health problems. But did you know that cigarettes can also affect estrogen? One study shows that cigarette smoking reduces or completely cancels the efficacy of estrogen, depending on the duration and intensity of smoking.

Conclusion: Embracing Change at Any Age

Menopause is a normal stage of every woman’s life. The changes that come with aging can be challenging, but consider it a new beginning and a great opportunity to prioritize one’s health and plan for the future. Consider consulting your healthcare provider for assistance and reaching out for the support and community of loved ones during this crucial life change.