Staying Healthy During Menopause

Fifty may be the new forty, but our bodies still undergo changes based on the

calendar. That's especially true for women entering menopause. In the past, options for treating the symptoms of menopause were limited. Now, however, a wide variety of natural and conventional treatments are available to help you stay healthy while navigating this natural passage in life.

A Natural Passage in Life

The hormonal changes that accompany menopause are as natural as the ones that occur in adolescence and pregnancy. If you are between the ages of 45 and 60, you may already be in or will soon be entering into menopause. This phase represents the passage into the post-reproductive period of life and can last for several years.

As the amount of reproductive hormones in your body decreases, your menstrual period becomes irregular in frequency, duration, and intensity until it ceases altogether; hence the term menopause. Surgery (removal of uterus and ovaries) as well as radiation and chemotherapy can also induce menopause. If you're under the age of 40 and stop having your period, you should see your health care practitioner and be evaluated any possible health problems.

This normal biological process brings with it a myriad of symptoms which can range from mild to severe in intensity:

  • Hot flashes

  • Irregular periods

  • Night sweats

  • Insomnia

  • Dry skin

  • Dry eyes

  • Thinning hair

  • Vaginal dryness

  • Urinary incontinence

  • Decreased sex drive

  • Mood changes

  • Depression

  • Headaches

  • Heart palpitations

  • Poor concentration and memory

  • Weight gain due to a slower metabolism

If you have been experiencing a few of these symptoms and are between the ages of 45 and 60, chances are you're in menopause. While the list of symptoms may sound daunting, don't despair - there are many things you can do to alleviate them and some of them are temporary. Moreover, you may not experience some of these symptoms at all. Your health care practitioner may decide to run a lab test to measure hormone levels such as estrogen, progesterone, DHEA, cortisol or even testosterone to confirm that you are entering menopause. Making sure you have adequate amounts of DHEA is important as this hormone, which is produced by the adrenal glands, is involved in the production of estrogen and testosterone. Although the amount of DHEA naturally decreases as you age, your adrenal glands continue to produce it in menopause, thus enabling your body to use DHEA to produce small amounts of estrogen. Stress - be it from a hectic pace of life or a poor diet - can deplete your adrenal glands, making your body low in DHEA. Healthy adrenal function facilitates a healthy menopause. Since hormone levels fluctuate, these results may not be conclusive, but when taken together with your symptoms, they can point to menopause. A blood test to determine your thyroid function may also be performed to rule out an under-active thyroid - a condition with symptoms similar to those of menopause.

A Healthy Transition

There are many steps you can take to ensure that this transition is a healthy one with positive benefits that will last beyond menopause. The better informed you are about the changes affecting your body, the healthier - and happier - you will be during and after menopause.

One of the first things you should do is to keep track of your symptoms, noting their frequency and intensity as well as any triggers. Here is a quick guide to managing some of the most common symptoms:

  • Hot Flashes: Hot flashes can be triggered by such things as caffeine, alcohol, stress, smoking, heat, spicy foods, and a diet high in refined carbohydrates. Avoiding these triggers can help reduce the occurrence of hot flashes.

  • Night Sweats & Insomnia: Since hot flashes may occur at night and accompany night sweats, sleep is often interrupted, leading to fatigue and irritability. Exercising will not only improve your sleep, but also help reduce your risks of weight gain, heart disease, and osteoporosis, all of which increase with menopause. Just don't exercise 3 hours before going to bed. Be sure to sleep in a cool, well-ventilated room and wear loose clothing in bed. Avoid caffeine and alcohol at night. Night sweats without hot flashes can be a sign of a serious condition, be sure to consult your healthcare practitioner if you have been having night sweats and losing weight.

  • Vaginal Dryness: Among the physical changes that occur during menopause are vaginal dryness, thinning hair, and dry skin. These changes can become bothersome and - in the case of vaginal dryness - may contribute to a decrease in your sex drive and make you more vulnerable to vaginal infections. Fortunately, various vaginal lubricants are available to alleviate the discomfort associated with dryness. And staying sexually active increases vaginal blood flow, actually reducing the problem of dryness. But be sure to choose one without glycerin as it can cause burning and further vaginal irritation. Avoid Vaseline as it may make you more prone to yeast infections.

  • Irregular Periods: Since irregular periods can have numerous causes, it's important to determine if they are truly related to menopause. If you experience very heavy menstrual bleeding, long periods, or bleeding between periods, you should see your healthcare practitioner for an evaluation.

  • Mood Swings & Depression: Engage in activities that decrease stress and improve your overall well-being. This can include yoga, meditation, breathing exercises or an activity that utilizes your creative talents. Cultivate those relationships with family and friends that allow you to nurture and be nurtured.

Should these or other symptoms become bothersome, you should visit your healthcare practitioner to discuss further ways to better manage them. Here is a list of possible treatment options you can discuss with your healthcare practitioner:

  • Conventional Hormone Replacement Therapy: This type of hormone replacement uses either estrogen alone or a combination of estrogen with progesterone. Conventional hormone replacement therapy was prescribed for many years until a 2002 analysis by the Women's Health Initiative showed that the risk of breast cancer, stroke, blood clots, and heart disease outweighed the benefits of symptom relief for menopause. Thus, it's no longer recommended by the American College of Obstetricians and Gynecologists as a form of primary or secondary prevention of coronary heart disease. Instead, its use in menopausal women should be made on an individual basis, carefully weighing the cost-to-benefit ratio for each patient.1

  • Bio-identical Hormone Replacement Therapy: This type of hormone replacement uses derivatives of plant extracts which are modified to be identical to human hormones. Bio-identical hormones are available as commercially prepared hormones with FDA approval and as compounded - or customized - hormones that are not regulated by the FDA. While the compounded hormones are tailored to meet individual needs, "... evidence is lacking to support their superiority over conventional hormone replacement therapy".2

  • Plant-Based Therapies: Certain plants such as soybeans, lentils, and chickpeas have estrogen-like effects and are used to lessen the severity of hot flashes. A recent meta-analysis published in the Journal of the American Medical Association found that plant-based therapies aid in reducing the frequency of hot flashes and vaginal dryness, but not night sweats.3 Various plant-based preparations are available to help manage menopausal symptoms. Ask your health care practitioner if a plant-based therapy like Estrovera or HerSynergy is right for you. Individuals who have had or are suspected of having estrogen-dependent cancers like breast cancer should not take this type of therapy.

  • Acupuncture: Some women find acupuncture beneficial in reducing hot flashes.

  • Yoga: Some studies have shown that yoga is effective in reducing menopausal symptoms.

Finding the best solution for your menopausal symptoms may involve trying more than one treatment option, so it's best to work together with your health care practitioner. Also, there are serious health risks like cardiovascular disease and osteoporosis which result from the hormonal changes and which should be managed by a healthcare professional. Achieving healthy hormonal balance is tricky and more is not necessarily better with regard to hormonal therapy, making it essential to use hormonal testing as a guide for supplementation. The three most important areas you should give attention to as you go through menopause are:

  • Proper Diet: As you age, your body's need for certain vitamins and minerals increases dramatically. What you eat will have a significant impact on the quality of your transition through menopause and your risk of cardiovascular disease and osteoporosis. Eat a diet rich in vegetables, fruits, and healthy fats, and avoid sugar and refined carbohydrates. Vitamin and mineral supplements, as well as digestive enzymes, may be necessary to maintain good health.

  • Exercise: Regular exercise will not only improve the quality of your sleep, increase muscle strength and flexibility, and reduce your risk of cardiovascular disease, but weight-bearing exercise also reduces your risk of osteoporosis. See our blog on exercise for more information on its benefits.

  • Stress Reduction: Stress doesn't decrease with age, although the stressors may change. Be sure to take steps to reduce its detrimental effects on your body and mind as you go through menopause. Your efforts will not only help to alleviate your menopausal symptoms, but will also provide lasting benefits to your health. See our blog on transforming stress for more information.

You can achieve and maintain wellness as you go through menopause. Contact us today for more information or for a personalized consultation.

References

1 The American College of Obstetricians and Gynecologists. Committee Opinion. Hormone Therapy and Heart Disease. Number 565, June 2013.

2 American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and American Society for Reproductive Medicine Practice Committee American College of Obstetricians and Gynecologists, Washington, DC; and American Society for Reproductive Medicine. Compounded Bioidentical Menopausal Hormone Therapy. Fertility and Sterility. 2012; 98(2):0015-0282.

3 Franco, OH et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016; 315(23):2554-2563.

4 Jorge, MP et al. Abstract: Hatha Yoga practice decreases menopause symptoms and improves quality of life: A randomized controlled trial. Complement Ther. Medicine. 2016; 26:128-35.

Women's International Pharmacy. Menopause: A Natural Transition. Connections. August 2013.

Mayo Clinic. Menopause. www.mayoclinic.org.

Cleveland Clinic. Menopause. www.myclevelandclinic.org

The contents of this blog are intended for educational purposes only. The information presented here is not a substitute for proper medical attention, diagnosis, or treatment by a qualified healthcare professional. Always seek the advice of your healthcare provider before starting or making any changes to an existing treatment plan, exercise program or dietary regimen, and before using nutritional supplements.

~ Dr. Sarah Williams ~ Concord & Nantucket, Massachusetts ~

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