Menopause is a scary word for many women—so scary, in fact, that few want to talk about it, even with each other. Given that every woman will go through menopause in her life, it’s time to take this transition out of the closet and bring it into the light. Let’s start by reframing menopause— while it’s the end of childbearing years, it is also a new beginning and time for regrowth and increased personal power. Often the signs and symptoms of menopause are so unpleasant—and for some, unbearable—that they can get in the way with embracing who you’ll be on the other side of it. My approach is to give women tools to ease these effects and help make the journey more bearable, with a focused eye on what a woman’s body needs at this time and beyond.
Menopause is defined as the permanent cessation of menses after one year of being completely period free. The hot flashes, sleep disturbances and mood issues of perimenopause should be on their way out by this time, but may linger for some. Here’s where many experience weight gain, overall dryness including vaginal dryness, stress incontinence, bladder infections, increased wrinkles, fatigue, low libido, hair loss, facial hair, joint pains, insulin resistance, as well as increased risk of osteoporosis, heart disease and memory problems. Some women may have no significant symptoms, while others can have symptoms for years. Here are a few actionable tips to help with some of the more common symptoms:
Weight Gain - You’re not alone if you haven’t changed a thing in your eating and/or exercise habits and have gained weight, especially around the middle. Estrogen increases insulin sensitization and can help increase muscle mass. Losing estrogen can be a big player in higher insulin levels, known as insulin resistance, and can lead to decreased muscle mass and subsequently decreased metabolism. High insulin levels cause more fat storage, weight gain, and inflammation. Insulin resistance can lead to type 2 diabetes, metabolic dysfunction and contribute to heart disease. Elevated cortisol can also lead to insulin resistance by increasing abdominal fat and increasing blood sugar. What can help: Exercise, a lower carbohydrate diet with higher protein and good fats like olive oil, and intermittent fasting. Thyroid problems are more common after 40, so making sure your thyroid is working optimally is important. I typically run a full thyroid panel and support with nutrients and possibly thyroid hormone to ensure optimal thyroid function.
Stress and Adrenal Health The adrenal glands make the stress hormone cortisol, which can lead to more hot flashes when dysregulated. Elevated cortisol can also contribute to abdominal body fat. The adrenals also make the hormone DHEA which is a hormone of well being and can be metabolized to estrogen which can help the body when the ovaries have stopped making estrogen. Adaptogens like ashwagandha, cordyceps, ginseng, eleuthero, and rhodiola, can help with resistance to stress and can help regulate cortisol. Incorporating a mind-body technique like meditation or yoga can also help to regulate the stress response, as can sleeping and eating well.
Hot Flash Help - See if you can find the triggers of your hot flashes. Often the culprits are alcohol, stress, caffeine, spicy foods, blood sugar problems (highs and lows), hot drinks, and warm environments. Black cohosh is an herb that has been extensively studied for hot flashes. Some studies see a benefit and others don’t, but many women do find it helpful. And magnesium helps here too.
Bio-identical Hormones - Estradiol, micronized progesterone, testosterone, DHEA, and thyroid hormones can all be very helpful with many of the menopausal symptoms and can offer protection for heart disease, osteoporosis and memory problems. You can speak with a healthcare provider to see if bio-identical hormones would be a good fit for you.
Embracing the menopausal transition can help you feel like you’re more in the driver’s seat rather than just a passenger. Remember, you don’t have to go it alone. Sharing your experience with friends can ease the burden and even help you find some humor in it. And find a health care provider who is knowledgeable in lifestyle support and bio-identical hormones for menopause—it can make a big difference in quality of life during this time and well beyond.