There are many ways that we can prepare ourselves to move through the peri-menopause and menopausal years, so that these life stages can be experienced without some of the unpleasant and extreme characteristics that many women are familiar with. Whilst some women seek pharmaceutical medication such as hormone therapy to obtain some amelioration of their symptoms there are numerous studies that have demonstrated the beneficial effect of natural therapies, exercise, nutrition and stress management on how a women experiences these years.
It is the preparation before the onset of menopause that is the most crucial time in affecting how a woman transits through this period and how severe are her menopausal symptoms. It is therefore essential that we focus on empowering women with the knowledge, skills and lifestyle before she reaches her menopausal years. The word menopause literally means “stopping menstruation”, and can only be diagnosed retrospectively, when the last menstrual period has occurred 12 or more months previously.
Menopausal syndrome refers to the cluster of symptoms that women can experience during menopause and includes the mood and sleep changes, vasomotor symptoms, lowered libido, vaginal dryness and joint pain and stiffness. Changes occur in the cardiovascular system as well as to bone density. Although the cardiovascular and bone density changes are silent, these have the potential to have the most detrimental effects on women’s long term health. However there is so much that women can do to improve and lessen the severity of these symptoms, strengthen their overall general health while also reducing their risk of cardiovascular disease and diabetes, which are significant risk factors among post-menopausal women.
Menopause appears to be perceived as a medical event requiring intervention. In many cases prior knowledge of and implementation of lifestyle and dietary changes can make a significant impact on the severity and perception of menopausal associated symptoms. Studies have shown a clear link between physical activity and mood and menopause related quality of life indices. Improved cardiorespiratory fitness along with dietary awareness will also have the additional benefit of reducing the cardiovascular risk factors in this group.
Diet, alcohol and smoking issues
Both alcohol and cigarette smoking have both been shown to aggravate the intensity of hot flushes and their frequency. Diet directly influences menopausal symptoms and is believed to contribute to the differences in symptoms experienced by women from other cultures, especially hot flushes. Women with mild symptoms who want to avoid medication could try adding 1 tablespoon of ground linseed (phyto-estrogens) to their diet every day, to reduce hot flushes and improve vaginal dryness. Consuming coffee, spicy food and alcohol can trigger hot flushes. Similarly very hot foods and beverages can aggravate these.
A woman’s attitude around menopause and aging will influence her experience of menopause. Studies have shown that women with a negative attitude towards menopause and/ or aging tend to experience more menopausal problems than women who view these more positively. Women who engage in regular exercise, manage daily stress and avoid stimulants are less likely to experience the sleep difficulties which many women experience during menopause.
Menopause is associated with a reduced basal metabolic rate (BMR), resulting in reduced energy expenditure during rest and physical activity, and an accelerated loss of fat-free mass. Exercise is the most significant of the lifestyle factors to modify these changes. Endorphin concentrations in the hypothalamus decline with decreasing oestrogen, while exercise seems to increase peripheral and hypothalamic endorphin production. Aerobic exercise and low-intensity exercise such as yoga are associated with improved quality of life, sleep and vasomotor symptoms in menopausal women.
It can be quite difficult to ascertain, even with tests if a women is menopausal. Awareness of the symptoms and maintaining a menstrual diary can be helpful. However often a woman will only know she is menopausal once she has not menstruated for one year.
Assessing thyroid function is important during the menopausal transition due to the increased incidence of thyroid disease and the number of overlapping symptoms between menopause and hypo/ hyperthyroidism. The reduction in oestrogen levels can give rise to a state of transient hyperthyroidism because thyroxine becomes more biologically available. Symptoms such as palpitations and insomnia can develop which are similar to anxiety states. A trained medical herbalist can prescribe safe, effective herbal medicine for menopausal women who develop symptoms associated with a temporary increase in bioavailability of thyroid hormones. With hot flushes, herbs that have specific hormone-modulating effects are chosen to moderate the symptoms of declining oestrogen. In addition herbs that specifically address the type of hot flush the woman may be experiencing are chosen. Herbs might need to be included that work with other factors or symptoms being experienced such as anxiety, stress or exhaustion. Herbal medicine can also offer relief for the sleep disturbance and insomnia that may be a problem for some women at this time. There are many herbs which have been safely used for centuries which are non-habit forming and do not cause daytime drowsiness. These can offer temporary relief to sleep problems as well as the ability to break a habit of poor sleep. Meditation, yoga and a relaxing bedtime ritual can also serve to enhance the quality of sleep.
In conclusion – a holistic approach
In summary, a holistic approach to the maintenance of health and well-being through appropriate diet, lifestyle and exercise programs should be the focus of treatment for all women approaching the menopausal years. These interventions need to be initiated prior to the onset of menopause. Ideally, they should be slowly incorporated in to the daily lifestyle of women in their forties to reduce the severity of symptoms once hormone levels begin to decline. A comprehensive and integrative approach of all health practitioners can assist women to move through the menopausal transition in a positive way, while improving general, cardiovascular and mental health, bone density and body weight.