Menopause: breaking the taboo

From the media to my friends - and not least within myself - my mind is being preoccupied this week with the menopause. While we live in a time which (at least in the Western world) embraces wider gender expression and encourages us to open up about mental health, there is a distinct lack of awareness and openness about something that has, is or will affect half the world’s population: the menopause.

While I expect it will be mainly the women who will now continue reading; men, please bear with me: even though this won’t happen to you, your understanding of what your wives, girlfriends, mothers, sisters and female friends and colleagues are experiencing will greatly help your relationship with them.

I think most people know that it is the time when a woman’s periods and reproductive potential end, and the most familiar symptoms are hot flushes and night sweats. But are you aware of the other, often more damaging, symptoms? And you may be surprised to learn that it starts sooner than you thought.

While the full menopause (when periods stop) usually hits in your early fifties, many are caught out by the earlier arrival of the ‘peri-menopause’, with on average symptoms being experienced from age 45. But each women’s experience of the menopause is different in timing and symptoms.

The first sign is usually a change in the normal pattern of your periods: they may become lighter or heavier. Their frequency may change too: they become more, as well as less, frequent. A wide variety of other symptoms may be experienced and these can also continue after periods stop.

“I’m still hot, it just comes in flashes!”

In addition to the hot flushes and night sweats, other common symptoms include: tiredness, difficulty sleeping, mood changes such as irritability, anxiety and depression, panic attacks, forgetfulness, ‘brain fog’, loss of memory and concentration. It may feel like you’ve got early dementia. Most women experience weight gain together with a changing body composition. Lean muscle mass declines and body fat increases, especially in the abdominal region. Sex may be impaired by a low libido and vaginal dryness, discomfort and pain. You may experience general joint aches, stiffness and pain, as well as headaches. Watch out for heart palpitations and increased urination urgency and frequency. Muscle mass and bone density may decline, the latter risking osteoporosis and fractures. Your thyroid may also become underactive.

So, what’s causing all this? Falling levels of the sex hormones, mainly oestrogen. But while we’re all aware of the hormonal effects in teenagers, sadly society has swept this later hormonal change under the proverbial carpet. And the effects can be at least as profound, significantly impacting on daily life.

What can be done about it? Firstly, the menopause is not a disease to be treated but a natural part of life. However many women benefit from symptom support to help them through. Hormone replacement therapy is the conventional choice but may carry increased risk of blood clots, stroke and cancer.

By the time women experience this mid-life change, they are likely to still have a third, for some even a half, of their lives ahead of them, so think long term. This is a critical time to adopt healthy behaviours and preventative strategies which will optimise our health over the years to come. Diet, exercise and lifestyle changes can really help to ease the transition. Studies have shown that following a Mediterranean diet which is rich in fruits, vegetables, legumes, wholegrains, lean protein and unsaturated healthy fats is highly beneficial.

10 natural ways to improve menopausal symptoms:

1. Eat more foods that are high in phytoestrogens: these include soy products, hops, beans, sesame and flax- or linseeds. Phytoestrogens are naturally-occurring compounds found in plants and their chemical structure resembles oestrogen so closely that they have an oestrogen-like effect within the body, albeit to a lesser degree. Red clover and black cohosh are also phytoestrogenic. Sage might help improve hot flushes and night sweats.

2. Fruits and vegetables: we all know that we should eat our ‘5-a-day’; most nutritional therapists would recommend 8-10 a day. The fibre, micronutrients, including the anti-oxidants, calcium and phytoestrogens contained within them are especially beneficial during the menopause.

3. Eat adequate protein with every meal and snack to minimise muscle loss.

4. Calcium and vitamin D for bone health: ensure you are getting enough calcium in your diet. Calcium-rich foods include dairy, sardines and the green leafy and cruciferous vegetables. The best way to get vitamin D is from sun exposure; however as you get older, your skin gets less efficient at making it. Consider supplementation, especially during winter.

5. Avoid (or reduce) caffeine, alcohol and spicy foods as these can trigger hot flushes, night sweats and mood swings.

6. Magnesium and B vitamins. Most people do not consume adequate magnesium. Magnesium is essential for many things including energy production, nerve and cognitive function, cardiovascular function, (muscle) relaxation, and bone structure. B vitamins support energy levels and cognitive function.

7. Achieve and maintain a healthy weight: it is normal to gain weight during the menopause, but this may exacerbate your symptoms. Take regular exercise, including weight-bearing exercise. Regular exercise will help with weight management, improved energy and metabolism, healthier joints and bones, decreased stress, anxiety and depression and improve sleep. It has also been shown to reduce the number, and intensity, of hot flashes. Weight-bearing exercise especially will help to preserve bone density and prevent osteoporosis. [If you’re still a smoker, this worsens bone density too].

8. Drink plenty of water: this will help with weight management and dryness.

9. Balance your blood sugar: don’t skip meals and reduce refined sugar and processed foods. This will improve your energy and weight management. It will also reduce anxiety, depression and irritability. Diets high in processed foods are also associated with poor bone quality.

10. Minimise stress: this will support your adrenal glands which are already working harder producing the sex hormones. Share your experience with supportive friends - you are all going through this together.

And finally, hang in there - although the menopause lasts, on average, about 7 years and at times that may feel like forever, you will get through it! Don't be afraid to talk about it - friendship and humour are possibly the best natural support of all.