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Menopause and health

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A woman can beat middle-aged spread, her disease risks, and her hot flashes with the help of her healthcare provider. And even a short term program can spell success for women and fit into a busy provider's practice, shows a demonstration obesity-fighting and health risk reduction program detailed in an article just published online in Menopause, the journal of The North American Menopause Society (NAMS). The new can-do plan gets women trimmer, healthier, and cuts hot flashes with a new program that shows potential to fit into today's healthcare environment. See the study's abstract, "Clinical intervention to reduce central obesity and menopausal symptoms in women aged 35 to 55 years."

Making lifestyle changes can take a lot of work. Programs that have successfully helped women lose weight and reduce their other heart disease risks have been long and intensive—and they work as long as the program goes on. Most first-line women's healthcare providers, such as obstetrician-gynecologists or primary care providers, don't have the time and might not be reimbursed for so many consultations. You also may be interested in the abstract of a study, "Whole-body vibration exercise training reduces arterial stiffness in postmenopausal women with prehypertension and hypertension."

This pilot program, called WAIPointes (WAI stands for "who am I"), took only five visits that all were reimbursed by insurance

And it kept the participants engaged in achieving their health goals by showing them that they could reduce their menopause symptoms, in addition to their long-term disease risks, with healthy lifestyle changes. The 83 women who completed the 6-month program ranged from 35 to 55 years old, and most were in perimenopause or menopause. At an orientation, the women learned about menopause and the health risks that come with it and were told they have the opportunity to get their personal health risks assessed if they joined the program.

At the first visit, they answered questionnaires and got assessments of body weight and fat and menopause status and went home with a pedometer and a health diary, educational materials, and goal-setting worksheets to develop their personal health goals. From the second to the fifth visit, each woman had health assessments including waist measurement, blood pressure, menopause symptoms, mammograms and bone density tests if needed, and blood tests to look for inflammation, high cholesterol, and diabetes.

Once a woman had her goals set, she discussed with the healthcare providers how to reach those goals, what obstacles stood in the way, and how to overcome them

If distressing menopause symptoms were obstacles, the providers offered the women treatment options, such as lifestyle modifications or medications, to overcome them. "Empowerment through education is a cornerstone of our intervention," wrote the authors, according to the February 13, 2014 news release, "Can-do plan gets women trimmer, healthier, and cuts hot flashes."

Their surveys of the participants and the health assessments showed that approach was working. By the end of the program, the women understood their health risks better, and they had already made significant progress toward achieving their health goals.

They trimmed their waistlines by an average of an inch and a half and lowered their diastolic blood pressure by 2 points. What's more, their hot flashes and other menopause symptoms, such as energy, libido, mood, and vaginal dryness, had all improved significantly. And each woman had a "life action plan," with personalized recommendations, to continue working toward their health goals.

You also may wish to check out the abstract of another study, "Mood disorders in midlife women: understanding the critical window and its clinical implications." Founded in 1989, The North American Menopause Society (NAMS) is North America's leading nonprofit organization dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging.

Its multidisciplinary membership of 2,000 leaders in the field—including clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education—makes NAMS uniquely qualified to serve as the definitive resource for health professionals and the public for accurate, unbiased information about menopause and healthy aging. To learn more about NAMS, visit the Menopause.org site.

Did menopause arise because men prefer younger women?

Local Sacramento and Davis University of California, Davis researcher, Cedric Puleston, who was not involved in the new menopause evolution research but coauthored a 2007 paper in PLOS ONE that examined the role of fathers in the evolution of extended human lifespans, told the Los Angeles Times that the latest study on men being the cause of women's menopause over time, in evolutionary terms was "really compelling," if not the last word on the evolutionary history of menopause, according to the article, "Did menopause arise because men prefer younger women?"

After decades of laboring under other theories that never seemed to add up, a team led by biologist Rama Singh has concluded that what causes menopause in women is men. Menopause is actually an unintended outcome of natural selection generated by men's historical preference for younger mates, the researchers of a new study report.

Even the word 'menopause' evokes a connotation, men pause before seeking a mate their own age or older, perhaps because nature programs or 'wires' humans for choosing the most fertile and hormone-balanced mates, preferably picking the one who's ovulating, at least by looking at the facial and body signs of peak fertility and health.

Rama Singh, an evolutionary geneticist, backed by computer models developed by colleagues Jonathan Stone and Richard Morton, has determined that menopause is actually an unintended outcome of natural selection – the result of its effects having become relaxed in older women

Over time, human males have shown a preference for younger women in selecting mates, stacking the Darwinian deck against continued fertility in older women, the researchers have found. "In a sense it is like aging, but it is different because it is an all-or-nothing process that has been accelerated because of preferential mating," says Singh, in a June 13, 2013 news release, "Researchers conclude that what causes menopause is -- wait for it -- men." Singh is a professor in McMaster University Department of Biology whose research specialties include the evolution of human diversity. Stone is an associate professor in the Department of Biology and associate director of McMaster's Origins Institute, whose themes include the origins of humanity, while Morton is a professor emeritus in Biology.

While conventional thinking has held that menopause prevents older women from continuing to reproduce, in fact, the researchers' new theory says it is the lack of reproduction that has given rise to menopause.

The scientist's work appears in the online, open-access journal PLOS Computational Biology. See the study or its abstract, "PLOS Computational Biology: Mate Choice and the Origin of Menopause."

Menopause is believed to be unique to humans, but no one had yet been able to offer a satisfactory explanation for why it occurs, Singh says

The prevailing "grandmother theory" holds that women have evolved to become infertile after a certain age to allow them to assist with rearing grandchildren, thus improving the survival of kin. Singh says that does not add up from an evolutionary perspective.

"How do you evolve infertility? It is contrary to the whole notion of natural selection. Natural selection selects for fertility, for reproduction -- not for stopping it," he says in the news release, "Researchers conclude that what causes menopause is -- wait for it -- men."

The new theory holds that, over time, competition among men of all ages for younger mates has left older females with much less chance of reproducing

The forces of natural selection, Singh says, are concerned only with the survival of the species through individual fitness, so they protect fertility in women while they are most likely to reproduce. After that period, natural selection ceases to quell the genetic mutations that ultimately bring on menopause, leaving women not only infertile, but also vulnerable to a host of health problems.

"This theory says that natural selection doesn't have to do anything," Singh says in the news release. "If women were reproducing all along, and there were no preference against older women, women would be reproducing like men are for their whole lives."

The development of menopause, then, was not a change that improved the survival of the species, but one that merely recognized that fertility did not serve any ongoing purpose beyond a certain age

For the vast majority of other animals, fertility continues until death, Singh explains, but women continue to live past their fertility because men remain fertile throughout their lives, and longevity is not inherited by gender. Singh points out that if women had historically been the ones to select younger mates, the situation would have been reversed, with men losing fertility.

The consequence of menopause, however, is not only lost fertility for women, but an increased risk of illness and death that arises with hormonal changes that occur with menopause. Singh says a benefit of the new research could be to suggest that if menopause developed over time, that ultimately it could also be reversed.

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