Through the Menopause with Ease

Many women dread the menopause, because this stage of life brings both physical and emotional change. Many think only of periods stopping and of hot flushes, but the body faces far more than that in this time. We looked at exactly that in depth in the article „Understanding the menopause".

On top of that, women have to come to terms with fertility ending at their last period. That process does a great deal to a woman's mind. But the menopause need not go hand in hand with suffering. With the right preparation and support it can become a positive process of growth. In this article we will look together at some of the things you can do for yourself to make this transition an enriching experience.

That prevention is the best thing you can do for your body will hardly be news to you. It holds for the menopause too: through healthy habits before it begins — regular movement, a balanced diet, ways of handling stress in daily life — you can soften how many symptoms you get, which ones and how strongly. And not only that: you give your body the basis to age more slowly and in better health.

So what does a healthy, balanced diet mean? Try to make better decisions when choosing what you eat. Avoid ready meals and go for freshly prepared food that holds a good mix of all three macronutrients (protein, fat and carbohydrate). Eat plenty of vegetables, green leafy vegetables, berries and fruit. These contain not only plenty of fibre but plenty of vital nutrients and antioxidants. Watch your mineral intake and, if need be, top it up with high-quality food supplements.

A balanced diet with enough fibre, vitamin D and magnesium can reduce inflammation and at the same time lower the risk of the chronic conditions that become more common around the menopause.

A good supply of important nutrients such as calcium, vitamin D and omega-3 fatty acids can support bone health — a major theme of the menopause — and support general wellbeing.

Eating pulses and plenty of omega-3 fatty acids can, according to research, even delay the start of the menopause by up to three years.

Environmental toxins such as pesticides, herbicides and solvents, and heavy metals such as lead and mercury, can impair how the ovaries work and bring on an early menopause. To reduce your exposure to such substances, check your cosmetics and care products for hormonally active ingredients. Keep food and drink in glass or stainless steel rather than plastic. Choose natural cosmetics and buy food from pesticide-free, organic growing. Avoid smoking and drinking too much alcohol, and cut down on caffeine.

Regular movement, and strength training in particular, helps slow muscle loss and maintain bone density. Unfortunately the picture lodged in our heads is that women should train to become or stay as slim as possible. That comes back to bite us in later life and in the menopause, because hormonal change costs us muscle mass — and with it our body's stability, firmness and strength. So it matters that women train deliberately too, to strengthen the muscles and build physical strength.

Handling stress and enough sleep are indispensable for physical and emotional wellbeing as well.

For menopausal complaints many doctors reach for medication, hormones for instance. Not every woman wants to take hormones or other medicines, and hormone replacement therapy is not a suitable option for every woman. The good news is that there are many adjustments to how you live, and many plant-based options, that you can use to help yourself and ease the symptoms.

If the first signs of the menopause are already showing (more on the symptoms: here), then now at the latest is the time to look at how you live and see where you can make sensible, healthy changes. Let us look at some areas where your body can benefit particularly from them.

Eating during the menopause

A balanced diet plays a key part in managing hormonal imbalance in the menopause. Cutting down on sugar can help stabilise hormones, while healthy fats from avocados, fish, coconut oil and nuts support hormone production.

Particularly valuable are foods rich in fibre such as wholegrain products, vegetables and fruit, which support digestion and prevent blood sugar swings. Fermented foods such as yoghurt or sauerkraut encourage a healthy gut flora, which matters for hormone metabolism.

Nutrients such as omega-3 fatty acids, vitamin D and iodine matter too, as they support hormonal balance. The B vitamins, above all B6, B9 and B12, are important for hormone metabolism as well. And vitamin D, K2 and calcium contribute substantially to maintaining bone density, which is particularly relevant in the menopause.

Hormonal swings during the menopause cost our body muscle mass, which is why enough protein matters especially for keeping the muscles.

Our brain also undergoes strong changes in the menopause, and we can support it with a diet rich in antioxidants, omega-3 fatty acids, magnesium and lean protein.

Drink enough good quality water as well. Avoid water in plastic bottles, since parts of the plastic can pass into the water and affect our hormone balance. Prefer water in glass bottles. There are also very good water filter systems for the home (reverse osmosis units, for example) that remove all pollutants from the water.

Do without stimulating substances such as coffee, alcohol and smoking as far as you can.

Detoxifying during the menopause

Toxins play a significant part in the menopause, because they can disturb the hormone balance and influence how the hormonal changes run their course. Chemicals such as xenoestrogens, found in pesticides, plastics or cosmetics, can imitate the body's own oestrogen and so throw the hormonal balance off.

These substances can contribute not only to hormonal disturbance but also make menopausal symptoms worse — hot flushes, sleep problems or mood swings. Try therefore to reduce toxins in your food and your daily life considerably, and support your body's detoxification through healthy eating.

Movement during the menopause

Alongside an anti-inflammatory diet, regular movement matters just as much. Strength training helps build and keep strong muscles and bones, while endurance exercise strengthens the cardiovascular system. The recommendation is strength training with weights or your own body weight three to four times a week, plus at least 150 minutes of endurance training such as walking or running.

Yoga and Pilates help improve mobility and balance. Regular physical activity, cardiovascular training in particular, can reduce hot flushes and memory problems, while strength training supports bone density. Regular movement also brings better sleep quality. An important guiding principle here: train to be strong, not to be thin.

Sleep during the menopause

Sleep is a very big theme, because without restful sleep our body cannot recover properly, which ages us faster, leaves us very susceptible to illness and affects us mentally and emotionally too. Good sleep quality is also indispensable for managing menopausal symptoms. Unfortunately a great many women have sleep problems during the menopause, often because of night sweats, restlessness or other disturbances. Without enough sleep (7–8 hours a night) the cortisol level rises, which can lead to inflammation and a weakened immune system. That raises the risk of chronic illness among other things.

A little coffee in the afternoon is still fine? Did you know that caffeine can stay in your body for up to 12 hours? Drinking a coffee or another caffeinated drink too late in the day can affect your sleep.

And alcohol can affect sleep during the menopause, because it disturbs the sleep cycles and inhibits the production of melatonin, the sleep hormone. Although alcohol can feel relaxing at first, it often leads to frequent waking later in the night and to poorer sleep quality overall. In women going through the menopause, alcohol can also make hot flushes and night sweats stronger, which puts further strain on sleep. Alcohol can raise the cortisol level as well, leading to further sleep problems.

Smoking can affect sleep quality too. Nicotine acts as a stimulant and can make falling asleep harder and lead to lighter, more restless sleep. It can also raise the risk of sleep apnoea, which means frequent waking in the night. Smoking also makes the typical menopausal complaints stronger — hot flushes and night sweats — which disturbs sleep further. It affects hormone balance as well, which can make the whole transition harder.

A fixed evening routine, and doing without caffeine, alcohol and nicotine, help you sleep more restfully.

Make sure you build regular sleeping hours into your life. A dark room and cool air support better sleep.

Electronic devices such as smartphones, tablets and computers give off blue light, which can affect sleep. Blue light inhibits the production of melatonin, the hormone that regulates the sleep-wake rhythm. That makes falling asleep harder and sleep quality can suffer. In the evening especially, electronic devices disturb the natural body rhythm. So do without these devices for at least an hour before bed, or use blue light filters as apps or as glasses.

Avoid wireless headphones as well, since they give off electromagnetic fields (EMF). Although research into how EMF affects sleep is not yet complete, there are concerns that they could affect sleep quality.

If you are stressed, relaxation techniques such as meditation or breathing exercises before bed help you settle.

A cold shower before bed can also help improve sleep quality. Cold water lowers body temperature, which makes falling asleep easier, since the body naturally cools before moving into sleep. A cold shower can also ease hot flushes and calm the circulation, which can be helpful in the menopause in particular. Every body reacts differently, though, so it is worth trying out whether this works for you.

Taking valerian or melatonin helps regulate sleep. Doctors sometimes also prescribe progesterone (where it is lacking), since it has a calming effect on the body and supports sleep quality.

Reducing stress during the menopause

Our modern world asks a great deal of women in particular. You are meant to work, look after children and partner, run the household and not neglect yourself along the way. No day is long enough to fit all that in without stress. Self-care is often what falls by the wayside.

We should be clear that nobody gains anything if this level of stress pushes us to our limits, makes us physically ill and emotionally unhappy. That is why it matters so much to put our own care first, to learn to say no, and simply to do the things on our list that are not vital to survival at a time when they cause us no stress.

There are good techniques for reducing stress that can lessen many symptoms, the cortisol level and the discomfort of the menopause. Mindfulness, meditation and breathing techniques help reduce acute stress over the long term. There are many free apps that can support this, for instance. Keeping a journal is an effective way of handling stress as well. Do not hesitate to get help if you cannot manage on your own. Good counselling can be helpful too, since it supports you in questioning your own beliefs and patterns and in developing realistic expectations and workable thoughts.

Talking with others going through it

You do not have to go through the menopause alone. Look for others living through this phase as well. Such communities offer a chance to be inspired, to solve problems, to laugh together, to share frustrations and to celebrate successes. Being part of one means both giving support and benefiting from it. You can learn from one another, encourage one another and build trust and solidarity. Connections like these strengthen self-confidence and help you reach your own goals.

If you would like to go into the menopause in more depth, I can warmly recommend the following books. Both came out recently and are therefore unfortunately available only in English so far.

The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power and Facts (Dr Mary Claire Haver)

The Menopause Brain: The New Science Empowering Women to Navigate Midlife with Knowledge and Confidence (Dr Lisa Mosconi)

You can see that how you live has an immense influence on your body and your mind, particularly during the menopause. So try, for your own sake, to make better decisions day to day. Every small improvement pays off over time and helps you feel better and go through this phase with more strength.

You can of course support your body during the menopause beyond adjusting how you live — whether with natural means such as herbs or with medical options such as hormone replacement therapy. In the article Hormone replacement therapy (HRT) in the menopause you can read more about bringing your hormones into balance and easing the symptoms.