What do you envisage when you hear the word menopause? Up until recently, it was widely unspoken about unless you were a woman of a certain age, and even then, it would only be mentioned in hushed tones.
But in the last few years, thanks to campaigners such as Dr Louise Newson, Diane Danzebrink, Liz Earle, Meg Mathews, Carolyn Harris MP and editor of Women’s Health magazine Claire Sanderson, the often-debilitating symptoms of perimenopause and menopause are becoming more widely recognised, written about and discussed. National media outlets mention the menopause on a weekly if not daily basis and no longer is the word silently mouthed, it is being spoken aloud.
Menopause is part of the natural evolution process for women, and the majority of things we can do to age in a healthy way also can ease some of us through this sometimes-challenging time of life.
The average age of the menopause in the UK is 51 years, but often earlier for some women with perimenopause symptoms often starting around the mid 40’s and being ignored, put down to stress, general fatigue or coping with a busy day to day life.
The word menopause actually means your last menstrual period. Meno- refers to your menstrual cycle and –pause literally means stop. However, the actual definition of being menopausal is when you have not had a period for one year. The menopause occurs when your ovaries stop producing eggs and, as a result, the levels of your hormones oestrogen, progesterone and testosterone fall.
The term perimenopause refers to experiencing menopausal symptoms but you are still having periods. During your perimenopause, these hormones fluctuate greatly this often leads to symptoms of the menopause occurring. For some women these symptoms only occur for a few months and then their periods stop completely. However, other women experience symptoms for years before their periods stop. Oestrogen protects a number of different systems in your body: your brain, skin, bones, heart and vagina – so low levels can affect all these parts of your body.
Stress and the menopause
The symptoms of stress and peri/menopause are very similar which is why so many women are incorrectly offered anti-depressants instead of Hormone Replacement Therapy (HRT). I ignored my own perimenopausal symptoms for a good 18 months because I was writing them off as a result of a busy life and some low-level stress.
If you check out the 34 recognised symptoms of menopause you will see why this confusion can occur.
Another cruel blow is that stress will exacerbate menopausal symptoms. Cortisol levels (nicknamed the stress hormone) can rise if our levels of oestrogen fluctuate and continue to drop. Too much cortisol over a long period of time can cause all manner of health problems.
But what will help alleviate stress – YOGA! The physical movement, the breathwork and the meditation, options of Yin yoga and yoga Nidra, the choice is vast, and enjoyable. Yoga will work for you whatever your symptoms as they can be varied when your cycle is erratic and your hormone spikes and dips and are giving you more mood swings that a room full of teenagers.
Yoga is exercise without exhaustion, and it is clever exercise. It boosts endorphins with a big plus, builds strength by stealth, gets the heart pumping, strengthens bones, eases aching joints and muscles, improves circulation and the immune system, soothes an overactive anxious mind and allows you to ease into a relaxed state, switching on our parasympathetic nervous system.
It is also slap bang in the middle of what I call The Golden Triangle of wellbeing, menopause and ageing. There is a lot of crossover and repetition on advice and guidance on the trifecta of WELLBEING and reducing stress whatever your age, MENOPAUSE, and the AGEING process in general, irrespective of gender or health condition. What is a common suggestion for all three – yoga!
All the foods!
Ideally your diet should be rich in calcium and vitamin D from fatty fish such as mackerel and salmon as well as dairy products to keep your bones strong and healthy as women are prone to Osteoporosis (more info on this below.)
Keeping sugar to a minimum is important as it can contribute to that ‘middle age spread’ and high blood sugar can increase the hot flushes. Heart disease is another huge problem for ageing women, which can be combatted by reducing saturated fats and processed foods (which can also be loaded with hidden sugars). Eating plenty healthy fats such as avocado, nuts and olive oil (a good rule of thumb is plant fats not animal fats), and plenty fibre from fresh fruit and vegetables, wholegrains (brown rice, quinoa, rye etc) beans and pulses can have significant benefits to improving menopausal symptoms.
Phytoestrogens (alongside HRT, not instead of) such as soy, flaxseeds, lentils, oats and chickpeas (all hail the hummous!) are also linked to a reduction in hot flushes for some women.
Warning! Some women find that things such as spicy foods, caffeine (in tea, coffee, cola, chocolate, etc), smoking, and alcohol may trigger hot flushes.
Osteoporosis is a condition in which your bones lose their strength making them more likely to break or fracture. Your bone tissue is made up of protein hardened by calcium salts and other minerals to make it strong. Bone tissue is alive and it constantly changes throughout your life in order for it to be as healthy as possible.
Up to about 30 years old, you normally build more bone than you lose. But as we age and during the menopause when our oestrogen levels drop, bone breakdown occurs at a faster rate than your bone build up, which means we lose bone mass and our bones become weaker. Once this loss of bone reaches a certain point, a person has osteoporosis.
Around 10% of a woman’s bone mass is lost in the first five years of the menopause and this increases your risk of osteoporosis developing. You need to have adequate vitamin D levels because it keeps your bones healthy as it enables calcium to be absorbed. HRT is the best treatment for the prevention and also the treatment of osteoporosis and taking HRT has been shown in many studies to improve bone density and reduce the risk of fractures occurring. The earlier HRT is taken the better it is for our bone health.
Most health guidelines suggest keeping our drinking habits to a minimum. Alcohol can worsen symptoms such as hot flushes and also tends to be full of sugar. Even one large glass of wine can have a negative effect on your sleep quality. Anecdotally, as we age, hangovers can feel like actual death and a lot of women (I include myself here) find they can no longer tolerate wine.
Herbal preparations and supplements
Agnes castus may improve some symptoms such as mood swings, tension and anxiety, Black cohosh and red clover may help improve some symptoms. There is no good evidence that any of these preparations are beneficial. However, this does not mean they do not work. There has simply been very little research in this area. It is important that if you do take any herbal treatment then it should have a traditional herbal registration logo which should be clearly marked on the packaging. If you do choose to explore herbal medicine as a treatment option, it would be best to consult with a qualified medical herbalist first.
NHS guidelines state that we should get moving for 30 minutes about 5 times a week. It is important for heart and bone health and can also help to alleviate or lessen stress and anxiety symptoms.
I’m biased as I am a yoga teacher, but there are also many benefits of yoga that also help with managing symptoms of the menopause. But don’t rule out walking, swimming, Pilates, tai chi, jogging, dancing – really anything that gets you moving!
Check your boobs!
The risk of breath cancer rises with age, and also rises more if you are overweight, drink and smoke - make this check at least a monthly habit. Check out our Breast Cancer awareness mats - each design is unique, and each mat has a guide on how to know your boobs and detect early signs of Breast Cancer.
Give them up. No good comes of smoking. Spend the money on something really amazing instead.
Get the right medical advice
GP’s usually get half a day’s training on menopause at medical school, if that! I’ve had some good experiences with my GP but sadly for a lot of women this is not the case. Do your research and if necessary, go armed with a copy of NICE guidelines and factsheets from the websites listed here. Download the Balance app by Dr Louise Newson – www.balance-menopause.com
Vulva and vaginal symptoms, and/or increased UTI’s
I always thought that a ‘sneezy pee’ or passing a bit of urine when you coughed a lot was something that a) happened to us all as we got older and b) you had to live with it because c) there was no treatment available. And let's face it, the look of horror when anyone mentions the word vagina, never mind adding on ‘dryness’ or ‘atrophy’ is widespread. I also know a number of women who have started to suffer from really unpleasant and debilitating urinary tract infections during perimenopause and beyond. Basically, it’s all fixable and WE DON’T HAVE TO PUT UP WITH IT! For evidence-based information to take to your GP head to the Menopause Charity.
Getting your zzzzzzzz’s
Disrupted sleeping patterns can be a huge problem for women during menopause. In fact, for me, it was one of the first symptoms of my perimenopause.
Pay attention to your general sleep ‘hygiene’ – if you are suffering from night sweats, try sleepwear formulated to keep your body cool, choose sheets that wick moisture away from skin, and invest in a cooling gel pad to put under your pillowcase. Many women find it useful to sleep with a window open so having fresh air circulating in the bedroom. Avoiding caffeinated drinks for a few hours before bedtime can also be helpful.
A warm bath before bedtime using lavender oils or Epsom salts (which you can get scented with lavender and other essential oils) can also help sooth stiff joints and muscles, as well as relax your mind. Don’t read using your screen as the blue light affects melatonin levels and keeps your brain active. Go old school and read a book! CBD oil is a new discovery of mine. It’s a natural muscle relaxant, can help to ease stiff muscles, joint pain and improve quality of sleep.
Napping – schedule naps like you would a meeting. I love a good nap. I set an alarm so I don’t over sleep (we’ve all done it, ‘oh I’ll just close my eyes …’ and when you wake up the seasons have changed and the clocks have gone back.)
Breathing exercises can provide you with a focus to quieten the mind and distract from the sheer frustration of not being able to sleep and before you know it, you’ve drifted off and it’s time to get up! Meditation, yoga Nidra and breathwork can also help to alleviate symptoms of anxiety, brain fog and stress.
‘Mature skin’ – what does that mean? It’s the polite way of saying you are going to wrinkle up like a prune! Again, it’s part of the general ageing process, but it’s also linked to changes in hormones. Oestrogen helps to boost moisture production, build and maintain collagen and elastin so as this declines so does the moisture in our skin.
HRT does not cause breast cancer. HRT does not make you gain weight. Some women do NOT have hot flushes or night sweats. Menopause happens in your 50’s. It is nonsense to diagnose menopause based on age. Many women begin to experience perimenopausal symptoms in their early to mid 40’s. You can take HRT when you are still having periods. Testosterone is a female hormone. Modern HRT is not made out of horse urine. HRT in patches and gel will not cause blood clots. Bladder issues and UTI’s are NOT something we have to live with as we age, excellent treatments are available. You can take HRT for longer than 5 years. There is no scientific evidence
There is a wealth of evidence-based advice and guidance available for further, research-based information on menopause. For further in-depth information on what the menopause actually is, we have collated a collection of resources from podcasts, to books, to websites, to help you navigate through this shift in life.