Menopause: How It Might Affect You
It’s often rather unkindly referred to as ‘the change’, but what is the menopause exactly, and how might it affect you?
As women approach their 40s and 50s (or younger, in some cases), their bodies start producing smaller amounts of oestrogen and other hormones that control their menstrual cycles. When there finally aren’t enough hormones to stimulate ovulation, the result is your periods stop – which marks the onset of the menopause. Currently, the average age for a woman having the menopause is 51, though it can affect women in their 40s or younger. If you experience the menopause before you reach your 40th birthday, you’re said to have had a premature menopause (i).
What are the signs?
During the years leading up to the menopause (a period called the perimenopause) your periods may change, becoming lighter and less frequent or more frequent and heavier. Then when you haven’t had a period for a year, you’re classified as menopausal if you’re aged 50 or over (women under 50 have menopause diagnosed when they haven’t had a period for two years) (ii).
At the same time, along with an estimated 80 per cent of women going through menopause, you may also start experiencing hot flushes and night sweats (iii). During a hot flush you may feel a surge of warmth to your upper body making you feel very uncomfortable. If you experience night sweats, you may wake up with your bedding drenched.
Many menopausal women also suffer from vaginal dryness, urinary incontinence or recurrent urinary infections. Meanwhile psychological problems, such as mood swings, memory loss and poor concentration are common menopausal symptoms, with other symptoms including loss of sex drive, palpitations, headaches and sleeping problems.
Long-term consequences of the menopause can affect your health too. That's because prior to the menopause, you produce plenty of the hormone oestrogen, which protects your heart and bones. But when that oestrogen supply starts to dwindle, the result is an increased risk of heart disease and osteoporosis (thinning bones).
Everyone’s risk of heart disease increases as they get older, but the decline of oestrogen production that comes with the menopause is thought to increase stroke and heart disease risk in women (iv). Following a healthy lifestyle and giving up unhealthy habits such as smoking can help you take care of your heart after the menopause. It’s also a good idea to keep an eye on your blood pressure and cholesterol by asking your GP for a check-up.
Oestrogen also helps to keep your bones strong, which explains why many post-menopausal women experience bone thinning. But again, a healthy lifestyle, which includes a balanced diet and plenty of exercise, can help.
Not sure you’ve gone through the menopause? Your GP can offer a test to measure your hormone levels.
Coping with hot flushes
Hot flushes are thought to be the most common symptom experienced during the menopause, with an estimated eight out of 10 women affected (iii). Thought to be caused by hormone changes that affect the body’s temperature control, they vary in frequency and severity from one woman to another, and can last anything from a few years to 10 years or more.
Most women experience hot flushes as a feeling of intense heat that starts at the chest and rises up through the face, though they can also spread throughout the body. Your skin may flush visibly and you may also break into a sweat, especially during the night. Some women also experience palpitations when they have a hot flush. According to experts from Harvard Medical School, some women have up to 20 flushes a day, while others have them just occasionally (v).
And while they usually happen without warning, certain things such as drinking alcohol or coffee, eating spicy foods, stress and wearing warm clothing can trigger a hot flush.
The most effective treatment for hot flushes is thought to be hormone replacement therapy (HRT). However, it’s important to weight up the pros and cons of taking HRT carefully, since there may be undesirable side effects of taking hormones in the long term. According to the NHS, for instance, HRT isn’t advisable for some women, such as those who’ve had certain types of breast cancer or are at a high risk of getting breast cancer (vi).
Meanwhile, there are some other things you can do to make hot flushes more manageable, including the following:•Wear several layers of light clothing made from natural fibres such as cotton or silk instead of one thick layer (you can remove some layers if you feel hot).
Wear several layers of light clothing made from natural fibres such as cotton or silk instead of one thick layer (you can remove some layers if you feel hot).
Find out if you have any triggers for hot flushes, and avoid them if possible (avoiding drinking tea and coffee, for instance, may help).
Try to drink less alcohol, and if you smoke, consider giving it up.
Have plenty of ice cubes in the freezer to add to cold drinks, as iced drinks can help cool you down considerably.
Avoid having hot steamy baths or showers – aim for warm or even lukewarm water instead.
Store your duvet and use just sheets on your bed, especially during the summer (in winter, try using a duvet with a lower tog rating), and try to keep your bedroom as cool as possible.
Keep a cooling facial spray or a fan handy for whenever you feel a flush coming on.
Menopause and exercise
Studies suggest women who take part in regular physical activity may experience fewer menopause symptoms such as mood disturbances, weight gain, sleep and sexual problems, vaginal dryness and loss of bone density (vii). For some helpful weight loss advice, see our guide to breaking down the facts.
Most experts recommend doing aerobic exercise at this time, such as brisk walking, swimming, jogging, cycling or aerobic fitness classes. One of the reasons these types of exercise are beneficial is they’re thought to help reduce abdominal fat, which is where many women who have been through the menopause tend to put on weight (it’s also the type of fat that can do the most damage to your heart).
Aerobic exercise also gets your heart pumping and can help reduce your blood pressure and cholesterol levels, all of which are good for heart health. It’s also good for relieving stress and keeping your blood sugar levels normal. You need to work out just hard enough to get your heart rate up and break into a little bit of a sweat. If you feel warm and slightly breathless but still able to carry on a conversation, you’re working at the right level. But you should be too breathless to sing.
To keep your bones healthy, aim to do plenty of weight-bearing exercise too. Walking and jogging – but not swimming or cycling – are good examples. You should also do some resistance exercise, such as weight training. In fact, you don’t even need weights – you can use the weight of your own body as resistance, which will challenge your muscles as well as your bones.
Exercises such as push-ups (try half push-ups on bent knees), squats and lunges are good examples of body resistance moves. Or you could try taking yoga or Pilates classes, as both use body weight to work both upper and lower body muscles (plus they can help you stay flexible). The other benefit of yoga and Pilates is that they can help you to relax too.
Aim to do at least 150 minutes of aerobic exercise each week (half an hour five times a week, or break each half hour up into 10-minute sessions if you’re short of time). However, avoid doing any formal exercise within two hours of going to bed.
Menopause and diet
Eating healthily is important, whatever your age. But around the time of the menopause, it’s even more essential, as a healthy and balanced diet can help keep your heart and bones healthy, as well as help to manage your weight.
Eating a wide variety of foods in the right proportions is the way to go, as there’s no special diet designed for women going through the menopause. But while eating a wide variety of nutritious foods, it’s also bearing a few other things in mind:
Eat fewer saturated fats
Products that contain high amounts of saturated fats include meat and dairy products. However, a diet high in saturated fats has been associated with raised cholesterol levels (viii), so choose heart-friendly fats instead, including olive oil (monounsaturated fats) and oily fish (polyunsaturated fats, including those all-important omega-3 fatty acids). And remember, saturated fat is found in lots of processed foods too, including biscuits, cakes and pastries.
Choose bone-healthy foods
It’s more important than ever to make sure you’re getting enough calcium in your diet when you’re around the time of the menopause. Calcium can help keep your bones strong, and you need it even more at this age because of the way the lack of oestrogen in your body can cause bone thinning. Some of the best sources of calcium include dairy products (low-fat dairy contains the same amount of calcium as full-fat products), canned sardines or salmon (with soft bones), tofu, almonds and sesame seeds. Other bone-healthy nutrients include vitamin D (fish, egg yolk, fortified breakfast cereals and low-fat spread and margarines) and magnesium (seaweed, Brazil nuts, sunflower seeds, wheat bran).
Opt for wholemeal starches
Dieticians recommend basing all of your meals on starchy foods, which should make up around a third of everything you eat (ix). But go for wholegrain or wholemeal varieties such as brown rice, wholewheat pasta and wholemeal bread, as well as potatoes with their skins on. The extra fibre found in these foods may help to keep your digestion healthy as well as help with weight management.
Pack in the protein
Aim to have some protein with every meal. If you choose meat, try to pick cuts that are as lean as possible, and remove the skin from chicken and turkey to reduce your saturated fat intake. Fish is an important source of protein – aim for at least two portions a week, one of which should be oily (salmon, fresh tuna, sardines, pilchards etc). If you’re a vegetarian, eggs, beans, nuts and seeds are ideal protein sources.
Don’t forget your five a day
Make sure you’re getting a good all-round supply of vitamins and minerals by eating at least five portions of a variety of fruit and vegetables every day. Having plenty of fruit and veg in your diet also means you’ll be getting a good amount of fibre.
Things to eat/drink less of
Drinking too much alcohol on a regular basis can increase your risk of developing osteoporosis, not to mention trigger hot flushes. Stick to the current recommended guidelines for moderate alcohol intake (up to 14 units of alcohol a week spread over at least three days).
Other things you may want to avoid or cut back on include caffeine, which can aggravate hot flushes (x) and contribute to sleep problems, which many women experience during the menopause. Decaffeinated versions, however, shouldn’t cause any problems. Try to eat fewer sweet foods too, as eating too many cakes, biscuits, chocolate, pastries and other sweet treats can cause weight gain.
Natural menopause remedies
While hormone therapy is one of the most widely used conventional treatments for menopause symptoms, some women prefer to use natural methods. And the good news is several natural treatments have been shown to be effective.
However, while natural products are thought to have minimal side effects when compared with conventional medicines, several may interact with other medicines you may be taking.
If you do decide to try natural menopause remedies, it’s generally thought to be a good idea to avoid taking too many different ones at the same time, especially if you’re taking any other medicines, natural or otherwise. If you want to try a natural supplement and you’re taking one or more conventional medicines, speak to your GP first or consult a nutritional or herbal expert for further advice.
Meanwhile, the natural and nutritional remedies you may want to consider trying could include the following:
The isoflavones – or phytoestrogens – found in soya are naturally occurring substances that are thought to mimic the hormone oestrogen, which is why many experts believe they may reduce the severity of uncomfortable menopause symptoms. Studies, for instance, suggest that soya isoflavones reduce the frequency of hot flushes when compared to a placebo (dummy pill) (xi). A review of several studies also acknowledges that soy isoflavones may be effective in reducing hot flashes and help relieve some other menopause symptoms including bone density, cardiovascular risk and quality of life (xii).
Sage is widely used by herbal practitioners to treat hot flushes, and there is evidence it may be effective, not just for hot flushes but also for other associated menopausal symptoms (xiii).
Some women find their stress levels increase when they reach menopause. Described as an adaptogen – which means it helps the body adapt to different types of stresses – Siberian ginseng is thought to support the adrenal glands, which produce the stress hormone cortisol.
St John’s Wort
If low mood is a particular problem during the menopause, this herb may be useful, as studies suggest it’s more effective at treating mild to moderate depression than placebo (xiv). Other studies suggest St John’s wort is at least as effective as some popular prescription antidepressants (xv), but without the associated side effects (St John’s wort is, however, known to interact with several medications).
Sleep problems are a common menopause symptom. However, valerian has been used as a herbal remedy for insomnia for centuries, with more recent studies suggesting it may indeed help tackle insomnia as well as help you to fall asleep faster (xvi). There is also some evidence that valerian may help you to feel calm when faced with stress (xvii).
A popular herbal remedy for stress, this has been shown to be effective against stress-related fatigue, helping to increase mental performance, including the ability to concentrate (xviii). A review of studies also concludes that rhodiola offers a comprehensive treatment of stress symptoms and can prevent chronic stress and stress-related complications (xix).
High-strength multivitamin and mineral
During and after the menopause, women’s bones become more susceptible to thinning. But getting a good supply of bone-health nutrients – including calcium, magnesium, vitamin D and vitamin K – may help to keep bones strong. These can all be found in a good quality multivitamin and mineral supplement.
Meanwhile vegans can now take a vitamin D3 supplement – the recommended form of vitamin D – sourced from lichen (most vitamin D3 products are made from the fat of lamb’s wool). You can also get veggie-friendly vitamin D3 supplements in drop form if you prefer to take liquid vitamins.
We know that menopause can be a difficult period to get through, but these steps should help to make it a little easier to cope with. For more advice on a range of other common health conditions, feel free to visit our health library.
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Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.