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- <html>
- <head><title>Menopause and its causes</title></head>
- <body>
- <h1>
- Menopause and its causes
- </h1>
- <p>
- When I was in graduate school at the University of Oregon, everyone in our lab was working on the problem of
- reproductive aging. Previously, people in the lab had established that the ovaries didn't "run out of eggs."
- There was never really any basis for that ridiculous belief. Many people just said it, the way they said
- "old eggs" (but never old sperms) were responsible for birth defects, or that "estrogen is the female
- hormone," a deficiency of which is the cause of menopausal infertility. (Old sperms have been implicated in
- some birth defects<strong>. </strong>
-
- People who are newly married, for example, were found to have children with fewer birth defects than people
- of the same age who had been married a long time, suggesting that more frequent intercourse involves fresher
- sperms.) When ovaries have been treated with x-rays to destroy their ability to ovulate, they have been
- found to produce more estrogen than before. Ovulation is one thing, and the production of hormones is
- another thing. You can't determine whether ovulation has occurred by measuring the hormones.
- </p>
- <p>
- Knowing the large amount of work that has gone into our understanding of the age-related decline in
- fertility, it is disturbing to see people on television and in popular health books saying that menopause
- occurs when the "ovaries run out of eggs."
- </p>
- <p>
- Around 1970, many people were saying that aging was caused by the loss of brain cells. There is a glimmer of
- truth in that silly idea, just as there would be in saying that "aging is caused by the death of skin
- cells," making the skin thinner and drier and less elastic. Both the brain and the skin are sources of
- steroid hormones, and it is possible that the death of skin cells and neurons is one factor in the
- age-related decline in the "sex steroids." An organism would be an easier thing to understand if cells just
- did their job for a certain period of time, and then died. A man named Hayflick has given people some
- publications to cite, when they want to simplify things by saying that aging occurs when cells have used up
- their quota of 50 divisions, but there are many more studies that clearly show that Hayflick's limit is
- nothing but a product of the cells' environment. The cell's environment, the signals and substances and
- energy it receives, is complex, but real progress is being made in understanding the things involved in the
- aging process. Luckily, the infinite complexity of the environment is channeled into an understandable array
- of processes by the cell's systematic ways of responding.
- </p>
- <p>
- I knew, from talking with L. C. Strong,1 that early reproductive maturity was associated with early death;
- in his strains of cancer-prone mice, he showed that high estrogen was the cause of early puberty, a high
- cancer incidence, and a relatively short life. D. A. Snowdon, et al., showed that the occurrence of
- menopause at an early age in women is associated with a greater risk of death from all causes, including
- strokes and coronary heart disease.2 (They saw ovarian aging as an indicator of general aging.) P. W. F.
- Wilson, et al., reported that postmenopausal estrogen use was associated with an increased incidence of
- heart disease and stroke.3 P. M. Wise showed that estrogen accelerates aging of the central nervous system,
- destroying the nerves which regulate the pituitary gonadotropins, and causing ovarian failure and
- infertility.4 Many other studies of particular tissues show that estrogen accelerates the rate of aging.
- </p>
-
- <p>
- In my work with hamsters, I found that the infertility that developed at middle age was caused by a high
- rate of oxygen consumption in the uterus, causing the oxygen needed by the developing embryo to be consumed
- by uterine tissues, and causing suffocation of the embryo. This is the central mechanism by which the
- estrogen-containing contraceptives work<strong>:</strong> at any stage of pregnancy, a sufficient dose of
- estrogen kills the embryo.
- </p>
- <p>
- Polvani and Nencioni,5 among others, found that in women, the onset of menopause (the first missed period,
- suddenly increased bone loss, nervous symptoms such as depression, insomnia, and flushing) corresponds to
- the failure to produce progesterone, while estrogen is produced at normal levels. This results in a great
- functional excess of estrogen, because it is no longer opposed by progesterone. Typically, it takes about
- four years for the monthly estrogen excess to disappear. They suggested that the bone loss sets in
- immediately when progesterone fails because cortisol then is able to dominate, causing bone catabolism;
- progesterone normally protects against cortisol. Other researchers have pointed out that estrogen dominance
- promotes mitosis of the prolactin-secreting cells of the pituitary, and that prolactin causes osteoporosis;
- by age 50, most people have some degree of tumefaction of the prolactin-secreting part of the pituitary. But
- estrogen dominance (or progesterone deficiency) also clearly obstructs thyroid secretion, and thyroid
- governs the rate of bone metabolism and repair. Correcting the thyroid and progesterone should take care of
- the cortisol/prolactin/osteo- porosis problem.
- </p>
- <p>
- P. M. Wise4 has demonstrated that the "menopausal" pituitary hormones, high levels of LH and FSH, are
- produced because the regulatory nerves in the hypothalamus have lost their sensitivity to estrogen, not
- because estrogen is deficient. In fact, he showed that the nerves are desensitized precisely by their
- cumulative exposure to estrogen. If an animal's ovaries are removed when it is young, the regulatory nerves
- do not atrophy, and if ovaries are transplanted into these animals at the normally infertile age, they are
- fertile. But if animals are given larger doses of estrogen during youth, those nerves atrophy prematurely,
- and they become prematurely infertile.
- </p>
- <p>
- The mechanism by which estrogen desensitizes and kills brain cells is now recognized as the "excitotoxic"
- process, in which the excitatory transmitter glutamic acid is allowed to exhaust the nerve cells. (This
- explains the older observations that glutamic acid, or aspartic acid, or aspartame, can cause brain damage
- and reproductive failure.) Cortisol also activates the excitotoxic system, in other brain cells, causing
- stress-induced atrophy of those cells.6 Progesterone and pregnenolone are recognized as inhibitors of this
- excitotoxic process.
- </p>
-
- <p>
- Besides estrogen's promotion of excitotoxic cell death, leading to the failure of the gonadotropin
- regulatory system, estrogen's stress-mimicking action probably tends to increase the secretion of LH, in
- ways that can be corrected by supplementing progesterone and thyroid. Since Selye's work, it has been known
- that estrogen creates the same conditions as occur in the shock phase of the stress reaction. (And shock, in
- a potential vicious circle, can increase the level of estrogen.7) It has recently been demonstrated that
- estrogen stimulates the adrenal glands, independently of the pituitary's ACTH. This can increase the
- production of adrenal androgens, leading to hirsutism, and other male traits, including anabolic effects.8
- </p>
- <p>
- It was established in the 1950s that estrogen "erases" memories in well trained animals. I suppose that
- acute effect is related to the chronic toxicity that leads to cell death. (In the 1940s, DES was sold to
- prevent miscarriages, though it was already known that it caused them<strong>;</strong> then there was the
- argument that it slowed aging of the skin, despite the Revlon studies at the University of Pennsylvania
- showing that it accelerates all aspects of skin aging<strong>;</strong> lately there has been talk of
- promoting estrogen to improve memory<strong>.</strong>)
- </p>
-
- <p>
- Estrogen's nerve-exciting action is known to lower seizure thresholds<strong>;</strong> premenstrual
- epilepsy is probably another acute sign of the neurotoxicity of estrogen.
- </p>
- <p>
- When fatigue and lethargy are associated with aging, the brain stimulating action of estrogen can make a
- woman feel that she has more energy<strong>.</strong>
- (Large doses given to rats will make them run compulsively<strong>;</strong> running wheels with odometers
- have shown that they will run over 30 miles a day from the influence of estrogen.) Estrogen inhibits one of
- the enzymic routes for inactivating brain amines, and so it has more general effects on the brain than just
- the glutamate system. This generalized effect on brain amines is more like the effects of cocaine or
- amphetamine. If that is a woman's basis for wanting to use estrogen, a monoamine oxidase inhibitor would be
- safer.
- </p>
- <p>
- The reason for the menopausal progesterone deficiency is a complex of stress-related causes. Free-radicals
- (for example, from iron in the corpus luteum) interfere with progesterone synthesis, as do prolactin, ACTH,
- estrogen, cortisol, carotene, and an imbalance of gonadotropins. A deficiency of thyroid, vitamin A, and
- LDL-cholesterol can also prevent the synthesis of progesterone. Several of the things which cause early
- puberty and high estrogen, also tend to work against progesterone synthesis. The effect of an intra-uterine
- irritant is to signal the ovary to suppress progesterone production, to prevent pregnancy while there is a
- problem in the uterus. The logic by which ACTH suppresses progesterone synthesis is similar, to prevent
- pregnancy during stress. Since progesterone and pregnenolone protect brain cells against the excitotoxins,
- anything that chronically lowers the body's progesterone level tends to accelerate the estrogen-induced
- excitotoxic death of brain cells.
- </p>
-
- <p>
- Since progesterone and pregnenolone protect brain cells against the excitotoxins, anything that chronically
- lowers the body's progesterone level tends to accelerate the estrogen-induced excitotoxic death of brain
- cells.
- </p>
- <p>
- Chronic constipation, and anxiety which decreases blood circulation in the intestine, can increase the
- liver's exposure to endotoxin. Endotoxin (like intense physical activity) causes the estrogen concentration
- of the blood to rise. Diets that speed intestinal peristalsis might be expected to postpone menopause.
- Penicillin treatment, probably by lowering endotoxin production, is known to decrease estrogen and
- cortisone, while increasing progesterone. The same effect can be achieved by eating raw carrots (especially
- with coconut oil/olive oil dressing) every day, to reduce the amount of bacterial toxins absorbed, and to
- help in the excretion of estrogen. Finally, long hours of daylight are known to increase progesterone
- production, and long hours of darkness are stressful. Annually, our total hours of day and night are the
- same regardless of latitude, but different ways of living, levels of artificial illumination, etc., have a
- strong influence on our hormones. In some animal experiments, prolonged exposure to light has delayed some
- aspects of aging.
- </p>
- <p>
- General aging contributes to the specific changes that lead to menopause, but the animal experiments show
- that fertility can be prolonged to a much greater age by preventing excitotoxic exhaustion of the
- hypothalamic nerves. The question that still needs to be more clearly answered is, to what extent can
- general aging be prevented or delayed by protecting against the excitotoxins? Minimizing estrogen (and
- cortisone) with optimal thyroid activity, and maximizing pregnenolone and progesterone to prevent
- excitotoxic cell fatigue, can be done easily. A diet low in iron and unsaturated fats protects the
- respiratory apparatus from the damaging effects of excessive excitation, and--since pregnenolone is formed
- in the mitochondrion--also helps to prevent the loss of these hormones.
- </p>
- <p><strong>Copyright: Raymond Peat, PhD 1997</strong></p>
- <p>
- <strong><h3>REFERENCES</h3></strong>
- </p>
- <p>
- 1. L. C. Strong, Biological Aspects of Cancer and Aging, Pergamon Press, 1968.
- </p>
- <p></p>
- <p>
- 2. D. A. Snowdon, et al., "Is early natural menopause a biologic marker of health and aging? Am. J. Public
- Health 79, 709-714, 1989.
- </p>
- <p>
- 3. P. W. F. Wilson, et al. [The Framingham Study], N. E. J. M. 313(17), 1038-1043, 1985
- </p>
- <p>
- 4. P. M. Wise, "Influence of estrogen on aging of the central nervous system: Its role in declining female
- reproductive function," in Menopause: Evaluation, Treatment, and Health Concerns, pages 53-70, 1989.
- </p>
- <p>
- 5. Nencioni, T., and F. Polvani, Calcitonin, p. 297-305, A. Pecile, editor, Elsevier, N.Y., 1985.
- </p>
- <p></p>
- <p>
- 6. T. I. Belova, "Structural damage to the mesencephalic reticular formation induced by immobilization
- stress," Bull. Exp. Biol. & Med. 108(7), 126030, 1989.
- </p>
- <p>
- 7. F. Fourrier, et al., "Sex steroid hormones in circulatory shock, sepsis syndrome, and septic shock,"
- Circ. Shock 43(4), 171-178, 1994.
- </p>
- <p>
- 8. E. C. Ditkoff, et al., "The impact of estrogen on adrenal androgen sensitivity and secretion in
- polycystic ovary syndrome," J. Clin. Endocrinol. Metab. 80(2), 603-607, 1995.
- </p>
- <p>
- 9. C. Bain, et al., "Use of postmenopausal hormones and risk of myocardial infarction," Circulation 64,
- 42-46, 1981.
- </p>
- <p>
- 10. T. L. Bush, et al., "Estrogen use and all-cause mortality: Preliminary results from the Lipid Research
- Clinics Program follow-up study," JAMA 249, 903-906, 1983.
- </p>
-
- <p>
- 11. M. S. Hunter and K. L. M. Liao, "Intentions to use hormone replacement therapy in a community sample of
- 45-year-old women," Maturitas 20(1), 13-23, 1994. (Women who expressed an intention to use hormone
- replacement therapy at menopause reported significantly lower self-esteem, more depressed mood, anxiety, and
- negative attitudes toward menopause. The also expressed stronger beliefs in their doctors' ability--as
- opposed to their own--to control their menopause experience.)
- </p>
- <p>
- 12. L. Dennerstein, et al., "Psychological well-being, mid-life and the menopause," Maturitas 20(1), 1-11,
- 1994.
- </p>
-
- <p>
- © Ray Peat 2006. All Rights Reserved. www.RayPeat.com
- </p>
- </body>
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