The Power to Manage Menopause

When it comes to menopause, hormone replacement therapy absolutely has its place. It can be life changing for so many women, but there’s more to the story than that. Thankfully, there’s growing awareness about HRT, but what many women still don’t realise is that the power to manage menopause symptoms is also in their hands. 

Lifestyle medicine, for those of you who don’t know, focuses on preventing, treating and reversing chronic diseases by making changes to nutrition, physical activity, sleep and stress management, alongside promoting healthy behaviours. It’s something I’m especially passionate about. I should be, because it’s what I do. 

It’s an approach that is personalised, what works for one person may not work for another. And that’s why it’s especially useful for women in menopause. Every woman’s experience of this normal life stage is different, and the way they deal with symptoms should be too, but there are key areas to focus on. 

Eating Well 

Weight gain is extremely common in the years leading up to and during perimenopause and menopause, and almost all women experience it to some degree, even when they exercise more and eat less. There is a reason for this and in all likelihood, it’s hormones. Fluctuating and falling hormone levels impact the way our bodies deal with carbohydrates and sugar, leaving higher levels of sugar in the blood which, if not used as energy, are laid down as fat, often around the stomach. 

The solution is not about deprivation and restriction; it’s about reframing the way we think about food and changing ingrained habits. Shifting the focus to the right types of carbohydrates (the slower-digesting types like lentils and certain vegetables) and pairing these with quality protein and healthy fats, alongside plenty of fibrous vegetables can make a huge difference. As can avoiding ultra processed ingredients as much as possible. 

Adequate levels of protein are important as this is what keeps you full, but you don’t need too much. Definitely avoid labels that say ‘high protein’ as they’re almost always highly processed. A whole food will never state this, it doesn’t need to, it just is! 

Add meat, fish, eggs, natural fats (avocado and olive oil) and vegetables growing above ground to your meal plan and limit starchy foods like bread, potatoes, pasta and sugar. Beans can be a useful substitute for rice and pasta and low GI fruits like berries are fine in moderation, but other fruits should be an occasional treat. Enjoy foods that are rich in iodine, magnesium, zinc, B vitamins, folate and vitamin C, alongside probiotic and prebiotic foods and those rich in omega-3. And consider meal timings, concentrate on eating during daylight hours, the earlier the better. 

Movement for Life

Many menopausal women make the mistake of increasing HIIT and cardio workouts, wrongly thinking this will help to burn fat, when, in fact, a different approach is needed. Muscles, joints and ligaments are particularly affected by hormones and that’s why the amount of weight-bearing (or resistance as it’s also known) exercise we do should increase as we age. Pushing, pulling, twisting or turning against gravity or weights is weight-bearing and repetition is key, as is challenging yourself, so that when you come to the end of a set of exercises, you’re finding them really tough.

Strength training is also important. This is where you use really heavy weights, so much so, that you can only do six repetitions or less.   This builds muscle strength and power, which is vital as we age. That’s not to say you should ditch your yoga and Pilates sessions or cardio and concentrate solely on weights. It’s about balance and ideally you should choose activities from each of the three exercise groups: cardio, weight-bearing and holistic, whilst shifting the focus so that weight-bearing makes up more of your weekly workout.  Make sure you do things that you enjoy too, as you’re much more likely to keep going with something that doesn’t feel like an endurance test. 

Sleep

Of course, one benefit of physical activity is that it promotes better sleep but that’s something that many menopausal women struggle with. Insomnia, or waking really early, is one of the most common and early signs of perimenopause. Again, this is due to changing hormone levels as melatonin, the sleep hormone (and body-clock regulator) declines and low progesterone levels can also impact sleep. This, coupled with other symptoms such as hot flushes, restless leg syndrome and night sweats makes sleeping, for so many women, less of a dream and more of a nightmare. 

But there are steps you can take, changing your evening routine is one. In an ideal world we’d eat at least three hours before bed and avoid caffeine and alcohol as these are stimulants, we’d also have a warm bath with Epsom salts, avoid all screens and enjoy a good book instead. I’m a realist though and know this isn’t always possible and in all likelihood, not every night. 

Exercising can help, but done late in the evening, and it can have the opposite effect, especially when we don’t take enough time to wind down, stretch and rebalance our hormones. Delaying bedtime in favour of a bath or some gentle stretches, may seem counterintuitive, but it should pay dividends when it comes to a good night’s sleep. 

It’s not just about the evening routine, good sleep hygiene actually starts the moment you wake up. Throw the curtains open wide, instead of turning on the lights and go outside into daylight as soon as possible as this sets your circadian rhythm (internal alarm clock). And avoid looking at screens first thing, remove phones and devices from the bedroom and invest in an old-fashioned alarm clock, or a SAD lamp instead.  

Stress

Increased stress and anxiety are extremely common in perimenopause and menopause as fluctuating and declining levels of oestrogen, progesterone and testosterone amplify existing menopausal symptoms and trigger new ones such as low mood, low energy, anxiety, brain fog and panic attacks. Often, when women go through menopause, they’re still caring for children, and, increasingly, also for ageing parents, and on top of that, they’re trying to manage work-life balance alongside their symptoms.

So, what can be done? A balanced diet, regular physical activity and healthy sleep patterns can help but there are other things you can try too. Yoga promotes the Parasympathetic Nervous System which calms the body, slows the heart rate and breathing and in doing so, counteracts the body’s fight or flight response. Forward bend postures are particularly effective. Simple things like walking in nature, spending time with family and friends and finding purpose can also make a difference. Many, myself included, find meditation, mindfulness and journalling help carve out snippets of time in the day just for you. 

Reframing what you class as a ‘treat’ is also an important step. You don’t need to be a saint, and can still enjoy a glass of wine or chocolate pudding, but make this an occasional reward, rather than a daily or every weekend one. And switch your mindset so that a treat becomes something more nourishing, such as a phone call with a friend, time with a loved one, or even just a moment or two to yourself. 

Of course, another huge stress trigger at this life stage is lack of advice and misinformation about what menopause actually means and how it manifests itself. Whilst it’s fantastic that we’re all now more informed, this has bred a storm of  misinformation, leaving many women not knowing who to turn to and what to believe.  They may have been turned away from their GP, or given sleeping tablets or antidepressants which, in many cases, make symptoms worse. 

The key issue in menopause is hormones and how to balance them and it’s vital that all women know where and how to access the right advice and course of treatment. At London Hormone Clinic, who I partner with, no women is turned away, they are listened to, their symptoms understood. The exceptional doctors there believe, as do I, that no woman should ever suffer as a result of hormone imbalance, when the life changing symptoms are often so easy to treat, with medications readily available on the NHS. 

But, as I hope you now see, it is about more than HRT. It’s about making changes to lifestyle and daily habits that improve symptoms now, and help to counteract health issues in the future. We’re all living longer, and surely we owe it to ourselves to make those years the best they can be.