Your guide to the menopause

Your guide to the menopause

Challenges await at every life-stage, and in midlife, menopause can be a biggie. Although some women will sail through it symptom-free, others will struggle.

It doesn’t help that it’s an information minefield: type ‘menopause’ into Google and you’ll be confronted with about 115,000,000 results on topics ranging from dwindling sex drives to treatment scares.

But here’s the thing: being involved in your journey by dispelling the myths and getting to grips with the latest developments will help to keep you in the driving seat.

Of course, no advice can be one-size-fits-all because the process of oestrogen and progesterone withdrawal affects each of us in different ways, but we hope we can help you make positive and informed choices. But first – what you need to know about the menopause

What is the menopause?
It’s a normal biological stage that happens when you stop menstruating and reach the end of your natural reproductive life. It’s defined as when you haven’t had a period for 12 consecutive months. After this time, you’re considered to be postmenopausal, but you might experience symptoms for many more years to come.

What age does it start?
Normally between 45 and 55, when your oestrogen levels decline; the average age in the UK is 51. But symptoms such as changes in cycle length, worsening PMS, hot flushes, night sweats and changes in sex drive can happen years beforehand: this is known as the perimenopause. The age your mother went through the menopause may offer clues, as it’s partly influenced by genetics, but smoking, ethnicity and having ovarian surgery or chemotherapy also have an impact.

What’s an early menopause?
About one in 100 women experience a premature menopause before the age of 40. If you’re experiencing symptoms before the age of 45, see your GP as you may have an increased risk of osteoporosis and heart disease.

What are the symptoms?
Periods stopping is just one of many. Hot flushes, night sweats and insomnia are common complaints, but it’s estimated there are more than 40 symptoms, which can include vaginal dryness, low mood or anxiety, reduced libido, palpitations, joint stiffness, UTIs and problems with memory and concentration.

How is menopause diagnosed?
According to NICE guidelines, all GPs should treat women aged over 45 based on their symptoms, with no need for blood tests (which can show false readings due to regular hormone fluctuations). 5 steps for a better change

The menopause is a brilliant time to take control of your health, to help you feel happier and healthier now and in future.

1. Keep moving

Research shows that exercising regularly can help to reduce menopause symptoms, including hot flushes and insomnia, because it helps to stabilise your thermoregulatory system, lowering your core body temperature and improving how your body distributes heat. “We’re only now beginning to understand the true power that exercise has to manage menopause,” says Dr Juliet McGrattan, author of Sorted: The Active Woman’s Guide To Health . “It can also counteract the fall in muscle and bone mass, plus lower the risk of heart disease and certain types of cancer that increase at the menopause.”

TOP TIP Add weight-bearing or resistance exercises to your routine to help boost muscle and bone mass. These can include lifting weights, working with resistance bands, hill walking, push-ups, sit-ups or squats.

2. Make over your bedtime

Hot flushes and night sweats occur because falling levels of oestrogen and progesterone cause blood vessels to dilate. This allows more blood through the body, bringing more heat with it: hello, uncomfortable nights! “Wear fabrics that wick moisture away from the skin to avoid drenching sweats disturbing your sleep,” says Dr Alanna Hare, a specialist in sleep medicine at the Royal Brompton Hospital in London. Dr Hare suggests trying CBTI (cognitive behavioural therapy, but specialised for insomnia), which has been found to improve sleep in women with hot flushes. “It works on sleep behaviours as well as helping you to develop coping techniques,” she says. Your GP may be able to refer you, but you can also find CBTI online packages and smartphone apps.

3. Try the menopause diet

This is not about faddy eating; it’s about choosing nutrient-rich foods to help support your body.
Look after your gut: There’s a real buzz around gut health right now. “The emerging research into the gut microbiome and how it relates to hormonal health may place nutritional interventions more centre stage in the future,” says Dr Hannah Short, a specialist in menopausal and premenstrual disorders. “Eating a fibre-rich diet improves gut health and evidence indicates that women who eat a wide variety of plant-based foods suffer fewer menopausal symptoms.”

Eat happy-hormone foods: Studies show that symptoms are also reduced in women who eat a lot of phytoestrogens (naturally occurring plant compounds that are structurally similar to oestrogen). “Phytoestrogens can cushion the effect of the hormone rollercoaster,” says Dr Marilyn Glenville, a nutritionist specialising in women’s health. “Don’t base everything around soya: also include chickpeas, oats, lentils, flaxseeds (linseeds) and kidney beans, and aim for variety.”

Get your calcium quota: We lose up to 20% of our bone density in the five to seven years after the menopause. Good sources of calcium include green leafy vegetables, nuts, seeds, tinned fish (with bones) and dairy products. You also need vitamin D from sunlight, so take a supplement from October to March.

Eat little, but often: ” Don’t go for more than three hours without eating,” says Dr Glenville. “If you wait longer, your blood sugar will drop and adrenaline and cortisol will be released, giving rise to anxiety-related symptoms.”

Rethink drinks: Now is a great time to cut back on unhealthy habits, like drinking too much caffeine or alcohol, which can stimulate your body and make symptoms worse. Try decaf coffee and having alcohol-free days to see if it helps. 10% of women have considered giving up work due to their menopausal symptoms 4. Mind your mental health

We have numerous oestrogen receptors in the brain, so it’s […]


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