My good friend Gene returned recently from ten days with her lovely grandsons: delighted but exhausted. We shared a good laugh about how glad we are to not have young children now. We can be mothers of adults and grandparents to wee ones, but parenting young children takes a younger parent’s energy.
In ancient times, fertility past the age of 50 would not only have imposed a burden on the aged mother, but indeed her whole family and community. Childbirth itself is more difficult with advanced age; running around after toddlers is even more hazardous! Women should not be having children past the age of 50 (perhaps even younger), but that doesn’t mean women should necessarily live the rest of their lives without hormones. It just requires wise hormonal replacement.
Hormone prescriptions are generally shunned for two reasons: the misapprehension that they cause cancer and the objection that they’re unnatural, that a healthy life shouldn’t need a hormone prescriptions. Let's talk about that second point a bit.
What are the issues of aging?
Let’s consider that you are my patient and a woman in your 60’s or older: it’s not hard to attribute some if not all of your problems to menopause. You stopped cycling long ago and were promised by your gynecologist that a few years of hot flashes would complete menopause, and then you’d be better off than ever before. Only problem is that it just ain’t so for many women. And we have only to turn to ancestral communities to see why menopause is more of a problem than a cure.
In ancestral and primitive societies, most women died between the age of 65 and 75, just like most men. Actually, "most" men and women probably died before the age of 40: childbirth, infections, and injuries with nary a suture nor an orthopedist, not an antibiotic nor a refrigerator handy. Which is why you hear the oft-repeated disdain, “Why should I eat Paleo, their average lifespan was between 25-40!” Such folks need a little instruction in first aid (it does really save lives and we depend on it for our longevity) and statistics (when some folks die really young, it drags down the average.)
For those in ancient times that survived the obvious threats to life and limb, they tended to live to about the age of 70. What’s really remarkable is that they left zero to little evidence of chronic disease: not cavities and certainly not evidence of heart disease or cancer. No osteoporosis, either: you can thank a protein-rich, heavy-lifting and lots of walking lifestyle for that!
Back to our modern woman though: let’s take me as an example. I’m 69 as I write this, and I’ve been pretty darn clean Paleo for over 4 years. (In this case, by Paleo I mean close to no grains, legumes, dairy, sugar, or vegetable oils. I do eat some rice, dark chocolate, and cream in my coffee!) Prior to that, I was eating according to the Weston Price traditions for about a decade: yes to grains and legumes, but always sprouted, yes to dairy but mostly raw. I’ve been off vegetable oils for almost 15 years, which might be the most important step to take. (By the way, if I can do it, so can you: make your own salad dressing!) I’ve always been fairly athletic, about normal weight, and didn’t take the stress of medical school or residency too seriously. My health has been pretty good.
However, since my 50’s, I’ve developed some mild arthritis, low thyroid and some middle of the night sleep interruption. (In the past, I had some difficulty getting to sleep but then slept deeply through any noise til morning.)
Sick might just be "worn out"
I like to look at health complaints—mine and my patients’—through the lens of: is this an illness or did something just wear out? In my case, most of my complaints amount to “wearing out.” (For a quick summary of just a few of the systems that can wear out, check out my infographic here on What Wears Out. Too much small type, I know: enlarge the print on your browser.)
Truth of the matter is that some stuff does just wear out. Our ancestors, living much healthier lives than we do, were dropping off at about the age I find myself now: in their case it was somehow their heart that stopped working. That doesn’t work for me: I have a lot more healthy years ahead, particularly if I can support my physiology in every reasonable way possible. In my mind that includes:
- Healthy dietary choices, determined by how I feel, perform, and look: both in person and on paper
- Smart lifestyle choices: enough exercise, enough sleep, good work and good community
- Supplements as needed
- Hormone prescriptions where safe and indicated
- Prescription medications if all else fails!
In addition to careful nutritional choices, a consistent exercise and sleep schedule, I rely on supplemental fish oil and turmeric for the arthritis, and prescription thyroid, estrogen and progesterone hormones for the rest.
Life isn't fair, it's true: the process of aging involves a big gender difference!
- For men the transition is more vague: many men can keep robust levels of testosterone into their advanced years and for those men, they might have a “natural” aging process that works well.
- For women the menopausal passage marks a dramatic shift from youth to whatever comes next: maturity? Elder status? Old age? And while it may entirely be possible, even in our crazy modern world, to have a healthy and perfectly natural youth, without reliance on supplements or prescriptions, I just don’t believe it’s possible for the great majority of women past menopause. Both estradiol and progesterone are key female hormones that essentially disappear at that time of life. Prior to that, those hormones help to maintain the health of our brains (mood and cognition), bones, gums, breasts, and more.
- Not surprisingly, some of the problems encountered in menopause linked to hormone deficiency, are dementia, depression, insomnia, osteoporosis, gum disease with loss of teeth (and loss of the ability to chew which increases your risk of dementia!), breast cancer, colon cancer and loss of libido.
Why should women stop enjoying the benefit of hormones?
For me and for most of my patients, menopausal hormone replacement therapy, using bio-identical hormones, carefully prescribed and monitored, is incredibly helpful. A separate article is way overdue on the particular pro’s and con’s of hormone replacement, as I imagine you have heard that “You can’t take those hormones, they’ll cause cancer!” (Some will, but not the ones I recommend, prescribe and take.)
Soon, I promise.