Menopause is a natural change that affects all women at some point in their lives. This article aims to discuss why these physiological changes occur and to provide guidance on how to manage key symptoms for women in this stage of life.
  

What is menopause?

Menopause is part of the natural ageing process for women and starts occurring when your supply of ovarian eggs gets low. This decrease in the number of eggs causes an irregularity of menstrual periods and a reduction in female sex hormones (oestrogen and progesterone).

However, the body does not stop producing these hormones overnight. In fact, it can take many years for this to happen. In the interim, your hormone levels can continue to fluctuate, which often causes an imbalance. This imbalance can result in your body behaving differently and is responsible for the menopausal symptoms many women feel. This phase is called ‘peri-menopause’.

‘Menopause’ occurs when you have had no periods consecutively for 12 months. This usually happens around the age of 50-55 years (the average age is 51 in the UK). However, this can occur earlier or later. Treatments such as chemo- or radiotherapy, and underlying medical conditions such as Down’s syndrome, can accelerate the start of menopause.
  

What are the symptoms of menopause and how do I treat them?

There are many different symptoms which may be experienced by women going through menopause, and it’s not uncommon to be experiencing more than one at once. Symptoms range from person to person, as does the severity of each symptom. Below we explain the most common ones and ways to help manage them.
  

Hot flushes and night sweats

Hot flushes and/or night sweats are experienced by approximately 75% of women going through menopause. They occur as a result of reduced oestrogen and progesterone levels affecting the hormones responsible for body temperature regulation.

Unfortunately, there is no way to stop the onset of these hot flushes. However, these strategies may help to reduce the frequency and severity of hot flushes/night sweats when they do arise.

  • Reducing hot beverages and alcohol
  • Sipping on cold beverages
  • Smoking cessation
  • Lowering the shower temperature to lukewarm instead of hot
  • Wear loose clothing
  • Avoid synthetic clothing fabrics and choose breathable fabrics made from natural fibres (such as cotton)

In bed:

  • Keep the room cool and use a fan if necessary
  • Use light sheets
  • Wear loose clothing 

Weight gain/redistribution

There has been much discussion around whether weight gain/redistribution during menopause occurs as a result of the menopausal transition or secondary to the ageing process itself. However, it’s known that changes in hormone levels during peri-menopause do alter your metabolism and therefore the rate at which you use energy from foods.

Hormonal changes can also accelerate stress and increase cortisol levels in the body resulting in additional visceral fat storage (the fat that is stored around our organs). This results in the unwanted ‘belly fat’.  

However, that being said, a reduction in physical activity and poor dietary choices will also contribute. Therefore, the weight gain/weight redistribution is likely to be due to a few different reasons. Whilst we unfortunately cannot change our natural hormone levels, it’s important we focus on positive lifestyle behaviours. Here at Second Nature we recommend:

  • Eating three healthy, balanced meals per day
  • Staying hydrated
  • Regular exercise: a combination of cardiovascular, resistance and balance training
  • Reducing stress levels by taking some time out for yourself eg. hot baths, catching up with friends, massage, pedicures.

Please speak with your mentor if you would like more personalised dietary or exercise advice.
  

Cravings

Cravings for refined carbohydrates, sugars or fats can be very common during peri-menopause and, like weight gain, happens as a result of increased cortisol levels secondary to stress. To help reduce cravings it’s important we continue to make healthy dietary choices each day. Some specific recommendations include:

  • Aiming to eat three balanced meals per day and spacing them evenly throughout your schedule
  • Including a good source of lean protein at each main meal. Proteins take longer to be digested, so they can help to keep you feeling more satisfied after eating. They also slow the release of glucose into your bloodstream.
  • Regularly consume foods rich in fibre as these will help satisfy your hunger and can curb food cravings.
  • Drink plenty of water. Our body can easily mistake thirst for hunger when we’re dehydrated.

Sleeplessness

Reduced levels of oestrogen and progesterone can also significantly affect sleep quality. This occurs for two reasons:

  1. Oestrogen controls the levels of magnesium in the body, a mineral which allow your muscles to relax. Therefore, as oestrogen and consequently magnesium levels fall, it’s harder to fall asleep at night.
  2. Progesterone is the hormone responsible for helping you stay asleep. As these levels also reduce, it can be difficult to stay asleep and/or fall into a deep REM sleep.

There are many strategies that can help to improve your sleep at night. These include:

  • Ensuring you have a regular sleep schedule, and going to bed at a reasonable hour each night
  • Eliminating screen time at least one hour prior to bed. This is because the blue light emitted from the screens can reduce your sleep hormone (melatonin). Try reading a book or having a hot bath instead.
  • Ensure your bedroom is dark and quiet – use eye masks or ear plugs if necessary
  • Exercise each day
  • Try not to eat immediately before bed
  • Avoid caffeine at least 6 hours prior to bed

Low mood/anxiety/mood swings

Changes in mental health are also common as a result of fluctuating oestrogen levels. We commonly hear of a change in mood when oestrogen levels fall during our monthly menstrual cycle, commonly termed ‘PMS’. The same concept is true during menopause. When oestrogen levels are high, this increases positive feelings of wellbeing. However, as these levels fall, feelings of low mood and anxiety can set in.

Tips to help with improving mental health include:

  • Relaxation techniques such as meditation and breathing exercises to help calm the body and mind
  • Consume a healthy balanced diet including foods from all food groups. It’s well documented that micronutrient deficiencies can increase the risk of low mood and depression.
  • Take part in regular exercise. This will increase endorphins, your body’s natural ‘feel good’ drug.
  • Reduce caffeine intakes, especially after lunch
  • Cognitive behavioural therapy (CBT) is another valuable tool used by many to help improve their thought processes and control low mood and anxiety. If you are interested in learning more, you are able to find some additional information on the NHS website (see below) or discuss with your GP. 

As discussed above, there are many symptoms that affect women throughout the menopause and we have only touched on the most prevalent ones in this article. Hair loss, reduced libido/sex drive, changes in memory and concentration levels are also some of the other symptoms commonly reported.

It’s also important to acknowledge that your body is going through significant changes at this time, so be kind to yourself and focus on self-care. Many women can feel uncomfortable speaking about menopause in the open, which means we can end up suffering with symptoms in silence.

However, it can be really helpful to discuss your symptoms with friends, family and your workplace so they’re aware of what you’re going through. Often workplaces will also be happy to help make you more comfortable, whether that’s organising a desk fan or providing more flexibility with your working hours. 

If you’re finding your symptoms are significantly impacting on your quality of life, we would strongly advise you chat to your GP, as there are treatments available. They will be able to provide further support and may be able to discuss other sources of action to take, including whether Cognitive Behavioural Therapy or Hormone Replacement Therapy is suitable for you.

You can also find some additional information on the NHS website:

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