Menopause
The many faces of menopause: Why it is a unique stage for each woman
While the symptoms may be similar, women go through menopause differently
No one told me that hot flashes could start in your mid-30s and continue into your 60s, says Cindy Moy Carr, founder of mySysters app. She tells FemTech World how menopause can affect women in different ways at different ages.
The menopause is a natural time of ageing when a woman’s periods stop and the ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55, but as Cindy Moy Carr found out, this is not the case for everyone.
“After I turned 40, I started having these horrendous migraines which I had never had before,” she remembers. “For a year and a half, they would just come and go. I went to the hospital, I had an MRI and I was told that it was all in my head.”
Her case is not singular. A Yale University review of insurance claims from more than 500,000 women in various stages of menopause states that while 60 per cent of women with significant menopausal symptoms seek medical attention, nearly three-quarters of them are left untreated.
Moy Carr had not been told about menopause until she turned 50. “I was talking to a nurse practitioner and she said ‘Well, this is all menopause-related’. And that was the first light bulb moment when I asked myself, ‘Why didn’t anybody tell me that?’
“I lived in Minneapolis – the home of big medical device companies – and if I couldn’t get any help, what chance do other women have? When I saw that none of my friends seemed to talk about it, I realised how taboo menopause was.”
Cindy’s app, mySysters, was launched as a social and self-care platform to help women manage perimenopause and menopause, helping them to track symptoms, recognise patterns and share advice in discussion forums.
“At the time there were no period trackers for women of my age,” the founder says. “That’s why we decided to launch mySysters. We made a little beta version, and after it became available in the AppStore, women from different countries started using it and about 5,000 of them still use it today.
“The app is that validation that women need to understand that they are not alone in this.”
But launching it was far from easy. “I got laughed at by men who thought it was the stupidest thing ever,” Moy Carr confesses. “Talking to the people who are making decisions about these things can be very frustrating.
“With the app, it was that community feeling that we wanted to create because most women find us after they no longer trust the medical community. Once people feel connected, life becomes easier, clearer and it feels easier to make decisions and advocate for yourself.
“We don’t know what the other person is going through, so let’s ask questions, find some information, share it and ultimately, support each other in whatever decision we make. It’s easier to feel empowered this way.”
Actively tracking symptoms has been repeatedly shown to result in greater symptom reporting and better understanding and recovery. A report from the British Psychological Society has found that a greater proportion of people were classified as high period symptom reporters after using a symptom-tracking app.
Moy Carr says that taking five minutes to check in with yourself is key. “After a few weeks, you get a checkerboard that shows the severity of your symptoms and over time, you can notice patters or triggers that influence how you feel.
“What is it that you did on Sunday that worsen your headaches on Monday? So often we say, ‘This came out of nowhere’. In fact, it didn’t. It was building up to that, but we just didn’t notice it because we weren’t paying attention to it.
“Tracking what’s happening in your body means becoming more aware of how you’re feeling. Then when something goes wonky, you will be able to recognise it quicker.”
The recent US Supreme Court’s decision to overturn Roe v Wade may have serious consequences on tracking apps like mySysters. If there is a warrant, court order, or subpoena for the release of certain medical records, then a clinic could be required to hand them over, leaving patients and providers legally vulnerable.
“As a UK-based company, I’d like to think that our data is completely safe, but I worry about women in the US and what the current climate means for them,” Moy Carr says. “We found out that HIPAA – the US regulator providing data privacy and security provisions – will not protect women’s data.
“Roe v Wade is a step backwards for women’s health, not just for abortion, but for women’s health in general. The fact that data protection is not guaranteed can have huge consequences that we’re not even aware of.”
While the situation remains uncertain across half of the states, Cindy hopes that women will have autonomy over their bodies. “I’m hoping that at some point we can get away from these labels of menopause, perimenopause, post-menopause, fertility, age, puberty and focus on hormonal health.
“Not everybody goes through menopause at 50. Sometimes they’re 30. It’s our hormonal health and there’s no need for labels.”
For more info, visit mysysters.com.
Osteoporosis may raise the risk of death in postmenopausal women by up to 47 per cent, a new study suggests.
The findings point to an inverse relationship between femoral bone mineral density and mortality risk, especially within certain ranges.
Femoral bone mineral density is the amount of mineral in the thigh bone, which is often measured to assess bone strength and osteoporosis risk.
Dr Monica Christmas is associate medical director for The Menopause Society.
She said: “Osteoporosis often remains a silent threat after menopause, despite its profound effect on women’s lives—from loss of height, poor balance, and reduced mobility to disfigurement, pain, and even premature death.
“Early screening and preventive measures, including a calcium-rich diet (preferably from food sources), regular weight-bearing exercise, and hormone therapy when appropriate, can significantly improve bone health and reduce risks not only of fractures but also cardiovascular disease, certain cancers, and dementia.
“It’s time we bring this conversation to the forefront.”
In the study involving nearly 3,000 postmenopausal women, bone mineral density at four femoral sites was assessed using dual-energy x-ray absorptiometry, a scan commonly used to measure bone strength and fracture risk.
The analysis found that mortality risk was significantly higher when femoral bone mineral density reached the osteoporotic threshold or when osteoporotic fractures were present.
After full adjustment, osteoporosis was associated with a 47 per cent increased risk of mortality.
A stronger inverse association between increased bone mineral density and mortality risk was seen within specific ranges, suggesting bone mineral density could serve as a prognostic marker of wider health.
The relationship appeared especially notable within the range of 0.46 to 0.71 g/cm² for total femur bone mineral density.
Previous research has shown that postmenopausal women face a significantly higher risk of death within one year of hip or vertebral fractures.
A new study will investigate why women’s hearts may be affected differently by type 2 diabetes before and after menopause.
The researchers are among a cohort of leading mid-career scientists to receive a total of almost €6m, about £5.2m, through a partnership between the British Heart Foundation, the Dutch Heart Foundation, the German Centre for Cardiovascular Research and the Lefoulon-Delalande Foundation to support international research collaborations over four years.
The menopause project will be led by Dr Lisa Heather, from the University of Oxford, Dr Miranda Nabben, from Maastricht University and Dr Annie Turkieh, from the Pasteur Institute.
Professor Metin Avkiran is director of international partnerships and special programmes at the British Heart Foundation.
Avkiran said: “We’re delighted to be supporting these ambitious research programmes alongside our European partners, and to welcome CNIC and CIBER-CV to this pioneering partnership,” said
“By joining together, we can make the money donated by BHF’s generous supporters go further to drive more lifesaving research.
“By placing mid-career researchers at the heart of this scheme, we’re backing emerging leaders in cardiovascular science.
“These partnerships are designed to last well beyond the lifetime of the awards and help address the biggest unmet needs in cardiovascular research.”
Before menopause, women are largely protected from diabetic cardiomyopathy, a type of heart muscle damage linked to diabetes, yet after menopause they become more vulnerable than men and more susceptible to heart failure.
Researchers do not yet fully understand why this happens, but believe changing hormone levels after menopause may disrupt cell signals sent out by fat tissue.
This may lead to diabetic cardiomyopathy and trigger damage to the heart.
The study will examine how the hearts and fat tissue of women with type 2 diabetes differ before and after menopause, using animal models, human cells, computer modelling and patient data.
The team says this could lead to a blood test for earlier diagnosis and better treatments for women living with type 2 diabetes.
Cognitive behavioural therapy (CBT) may offer short-term relief for menopause insomnia and night-time hot flushes, a pilot study suggests.
CBT is a structured, short-term talking treatment that helps people change thoughts and behaviours that can worsen sleep problems.
Researchers found the intervention was linked to meaningful short-term improvements in insomnia severity, hot flush interference, sleep self-efficacy, or confidence around sleep, and depressive symptoms.
The Menopause Society said insomnia affects an estimated 20 to 60 per cent of perimenopausal and postmenopausal women in the US.
Ongoing research is focusing on effective treatments because insomnia can have serious physical and psychological effects.
Dr Monica Christmas, associate medical director for The Menopause Society, said: “Nocturnal hot flushes (night sweats) and sleep disruption can have a significant effect on the quality of life with many women claiming extreme impairment due to symptoms that often start in early perimenopause and last 10 or more years.”
“Sleep disturbances can persist even in those using pharmacological therapy to manage hot flushes.
“The study’s findings highlight the utility of cognitive-behavioural therapy as a standalone treatment for insomnia and hot flushes, offering women an alternative or adjunct to pharmacological treatments.”
Insomnia is defined as disturbed sleep associated with distress or impaired daily functioning and is one of the most common complaints in perimenopause and postmenopause.
It can reduce quality of life and is linked to higher healthcare use and costs, disability, depression and cardiovascular disease.
Hot flushes occur in 60 to 80 per cent of women during the menopause transition and can persist for four to five years on average.
Night-time hot flushes are linked to sleep disruption, and women may respond by napping or spending longer in bed, which can help keep insomnia going.
Previous studies have shown that cognitive behavioural therapy is an effective treatment for insomnia and may also help women cope with hot flushes and other menopause symptoms.
However, few trials have looked at both insomnia and hot flushes together.
Insomnia during and after the menopause transition is complex and can have many causes, including ageing, hormone fluctuation, hot flushes, other sleep disorders, psychiatric and medical conditions and psychosocial stressors.
Because women with acute and sustained insomnia can experience greater negative health effects, effective treatment is important.
The pilot study concluded that CBT was feasible and may be a promising approach for menopause-related insomnia and nocturnal hot flushes, although the benefits appeared to lessen after three months.
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