Managing Menopausal Symptoms

Healthinfi

According to the Office on Women’s Health, the average age women officially start menopause (or experience stopped periods) is 51. But symptoms can start early. Throughout perimenopause and menopause, the levels of estrogen and progesterone in your body fluctuate as your ovaries try to keep up with your normal levels of hormone production.

This fluctuation is what causes symptoms like hot flashes, mood swings, sleep problems, bone loss, problems concentrating, and others. Learn more about these common menopause symptoms, and how to deal with them to improve your overall quality of life.

If you’re having hot flashes, problems sleeping and other menopausal symptoms, you may want to explore your options for relief. While hormone therapy remains the most common and most effective treatment for many menopausal symptoms, a few lifestyle changes can sometimes make a huge difference in how you feel. Specifically:

Managing Physical Changes

Hot Flashes

Phytoestrogens are plant-derived hormones that can partially reverse the hormonal changes that occur due to menopause. Soy-based foods contain high levels of phytoestrogens, so eating lots of tofu and soy sauce can be helpful.

Other supplements in this category include: 

  • black cohosh
  • wild yam
  • dong quai
  • licorice
  • red clover 

Take care when using these, as herbal supplements are not regulated by the FDA.

Exercise also eases hot flashes by lowering the amount of circulating follicle stimulating hormone (FSH) and luteinizing hormone (LH). Aim for at least 20 minutes, three times a week. In addition, acupuncture and acupressure have been shown to limit hot flashes for some women.

You should also avoid triggers that can make you hotter. These include hot beverages, spicy foods, and alcohol. Stay as cool as possible by dressing in layers and keeping water on hand.

Breast Tenderness

Tenderness and swelling of the breasts are also symptoms of menopause. Non-steroidal anti-inflammatory drugs (Ibuprofen, naproxen) can help decrease both swelling and pain. Although it has some negative side effects, testosterone replacement can be effective in reducing severe breast pain. Some herbs are also being studied for potential relief:

  • Black currant oil is extraordinarily high in vitamin C and is also rich in many other nutrients. It can greatly ease breast tenderness.
  • Evening primrose oil is used in some European countries to ease breast pain.
  • Flaxseed (not flaxseed oil) has been shown in preliminary studies to reduce breast pain.

Vaginal Dryness

Vaginal dryness can potentially interfere with your sex life. Over-the-counter lubricants such as KY Jelly can be used prior to sexual intercourse. Others, like Replens, are meant to be applied on a daily basis. Sesame seed oil can also be used as a topical ointment to ease dryness.

Vaginal estrogen cream and sustained-release vaginal estrogen rings both deliver low doses of estrogen to the inside of the vagina. Estrogen can be very effective in treating dryness, but it may increase your risk of dangerous conditions such as:

  • stroke
  • blood clots
  • heart attack
  • breast cancer

For this reason, you should use the lowest dose of estrogen possible.

Loss of Libido

Menopause often causes women’s bodies to stop producing testosterone, a hormone that is believed to be important in the formation of sexual desires and drive. Testosterone replacement therapy is sometimes used to treat sexual arousal disorders. However, it can have serious side effects (similar to those of estrogen therapies), so consult with your doctor.

The following nonmedical treatment strategies may also help: 

  • lubricants
  • sensual massages
  • Kegel exercises
  • therapy

Though not well studied, the herb yohimbine (yohimbe bark extract) is believed by some to increase vaginal blood flow and boost female libido.

Urinary Incontinence

Urinary incontinence can be embarrassing, but it is also a common symptom of menopause. Do Kegel exercises to strengthen the pelvic floor muscles. These exercises can greatly improve urethral control.

Avoid alcohol and caffeinated beverages, which can over-stimulate your bladder. Limit spicy foods, which can also cause bladder issues.

A pessary is a ring made of rubber, plastic, or silicone, which you insert inside your vagina, above the bone. Pessaries help keep your organs in proper alignment and decrease leakage. You may also consider asking your doctor about prescription medications to help urinary incontinence.

Managing Other Changes

Mood Changes

Significant hormonal changes can impact your mood. Irritability, depression, and overall moodiness are the most common effects.

The following solutions can help: 

  • regular, daily exercise (not too close to bedtime)
  • meditation or yoga
  • avoid alcohol
  • keep caffeine consumption to mornings only
  • eat more fruits and vegetables for a better overall mood

Certain herbs may also help, but more studies are needed to prove their safety and effectiveness. Talk to your doctor about these possible mood-boosters:

  • St. John’s Wort
  • garden sage
  • ginseng
  • black cohosh
  • dong quai

Problems Concentrating and Memory Loss

Memory problems are often perceived as occurring with “old age,” when in fact hormones can often be the cause. The following can help improve your concentration and fight memory loss:

  • Ginkgo biloba has been used medicinally for thousands of years, and modern science has shown that it may be useful in treating problems with loss of memory and dementia. Other recommended herbal supplements include sage and ginseng.
  • Taking up a mind-exercising hobby such as Sudoku, crosswords, puzzles, or model building can help keep your mind sharp and active.
  • Lifestyle changes, such as decreased alcohol and caffeine intake, eating more fruits and vegetables, and getting regular exercise can also help.
  • Get adequate sleep to improve short-term memory.

Insomnia and Sleep Problems

During menopause, it seems like you’re always tired. To make matters worse, hot flashes and other symptoms keep you up at night. Consider the following to help you get a better night’s sleep:

  • regular exercise (avoid working out in the evenings)
  • avoid taking naps
  • drink chamomile tea at bedtime
  • ask your doctor about using supplements like passion flower or valerian

Practicing good sleep hygiene is always the first step to better sleep.

Medical Concerns

Preventing Future Medical Concerns

High Cholesterol

Regular exercise and a low-fat, low-calorie diet are the best ways to keep your cholesterol in check. Eliminate foods high in animal fat from your diet and try to get 20 to 30 minutes of aerobic exercise at least three times a week.

Phytoestrogens may also partially reverse the changes in your cholesterol caused by the hormonal shifts associated with menopause.

Bone Loss

The first step in preventing menopause-related bone loss is to increase the amount of calcium and vitamin D in your diet.

There are also a number of prescription medications for bone loss. Bisphosphonates (such as Fosamax) are a new class of non-hormonal drug that can slow bone breakdown. Calcitonin is a hormone administered via nasal spray that also slows bone breakdown. Some selective estrogen receptor modulators (SERMs) have also been shown to effectively treat menopause bone loss. Talk to your doctor to learn if any of these drugs are right for you.

Exercise

Whether your idea of exercise is a walk, a run or a Pilates class, there’s good evidence suggesting that it may reduce the number and severity of your hot flashes. In one study, Swedish researchers evaluated 793 postmenopausal women on their exercise habits and prevalence of hot flashes. Only five percent of highly physically active women said they experienced severe hot flashes, compared to 14 to 16 percent of women who got little or no weekly exercise. One possible reason for the difference, researchers theorized, is that regular physical exercise may affect brain chemicals that regulate body temperature.

Quit smoking

It makes intuitive sense that lighting up a cigarette won’t cool your hot flashes. And research proves it. One study found that smokers were nearly twice as likely to have moderate or severe hot flashes as those who never smoked and more than twice as likely to have daily hot flashes as nonsmokers. The more the women smoked, the more they flashed. So talk to your health care professional today about ways to quit.

Lose weight

It’s no secret that overweight people suffer from the heat more, whether or not they’re having hot flashes. But studies also find that women who are obese are more likely to have frequent and severe hot flashes than women with a healthy weight. Although it gets harder to lose weight in middle-age, talk to your health care professional about options. A healthy diet coupled with moderate daily exercise can make a world of difference.

Dress for menopause

If you’re having hot flashes, the “weather” inside or outside can be as unpredictable as the stock market. So dress for every contingency by dressing in layers. For instance, start with a silk camisole, then a short-sleeved blouse, then a light blazer. When a flash hits, peel off a layer; as you cool down, put it back on. And stick with natural materials that breathe, such as cotton and silk.

Create a “menopausal” environment

That means keeping the temperature on the cool side (try to take control of the thermostat in your office and home) and buying a small fan for your desk.

Practice stress reduction techniques

Deep breathing, mindful meditation and visualization can help you relax and either avoid a hot flash or render it less intense. Such efforts can also help combat insomnia, whether it occurs as you’re trying to fall asleep or when you wake in the middle of the night.

Turn your bedroom into a menopausal haven

Whether you’re having trouble falling asleep, staying asleep or are waking up too early, there are numerous steps you can take to get a good night’s sleep.

  • Nix the caffeine. It interferes with sleep and makes you jittery. Unfortunately, that also goes for the caffeine in chocolate.
  • Cool off your room. Install an overhead fan or buy a standing fan and aim it right at the bed. Open a window or lower the air conditioner. If your partner is too cold, toss him or her an extra blanket.
  • Go natural. Either sleep in the nude, with just a thin sheet covering you, or stick to light, all-cotton or all-silk sleep clothes.

And remember, even if you are taking hormone therapy to manage your menopausal symptoms, incorporating these lifestyle changes should make the medication more effective and may enable you to take a lower dose.

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