As one of the menopause leads in my practice I naturally have a lot of discussions about Hormone Replacement Therapy (HRT) but there are many of us who are unable to take HRT or who’s symptoms aren’t fully controlled by it. Just as important as medication is looking at what symptoms can be reduced by lifestyle and environment changes. To be honest a lot of the lifestyle advice is the same as we discuss with our patients all the time – eat a healthy diet, do more exercise, don’t smoke and drink less. I worry that the repetition of this advice decreases it’s impact, but there are specific reasons in menopause why it’s so important to focus on this.
Activity and Exercise
For me the most important message I can communicate is how important activity and exercise is in perimenopause and post menopause life. Increasing physical activity, and for those who can, adding in moderate and vigorous activity like running, has a direct impact on menopause symptoms. It reduces hot flushes and temperature intolerance, probably because a lot of the physiological changes the body makes to cope with being hot and sweaty during exercise then help us to regulate temperature control at other times. Increasing activity, especially outdoors, decreases stress and improves cognitive function and brain fog. The link between exercise and the brain is becoming increasingly understood with increasing evidence all the time. All of these improvements can then add together to improve sleep, so important as one of the tortures of menopause is insomnia.
As well as a direct impact on symptoms increasing activity has a huge effect on post menopausal health. It has a huge positive benefit to the risk of heart attack and strokes that increases markedly post menopause. It limits the loss of bone density and the change of developing osteoporosis. It helps maintain muscle mass allowing us to be active longer and prevent falls and musculoskeletal pain. It is a powerful tool to prevent weight gain and especially fat placement around the middle which is more dangerous for our health.
Smoking and vaping
Smoking and vaping makes hot flushes worse, make sleeping, anxiety and cognitive function deteriorate and moods swings increase. We all know how damaging smoking is to the body generally, damaging our lungs and cardiovascular system and adding to thinning of the bones (vaping seems to be as bad for bones as cigarettes are), but quitting at any time of life can be positive.
Alcohol and caffeine
Alcohol and caffeine make hot flushes worse at the time of drinking and for some hours after, again compounding a lot of the other symptoms of menopause. Alcohol and caffeine also have a direct impact on the brain increasing anxiety, mood swings and brain fog independent of the insomnia.
Diet
Eating large meals late, especially high sugar or spicy meals can have a huge impact on flushes and sleep during the night. Avoiding high sugar or ultra processed foods and eating more whole foods can decrease menopause symptoms, be a part of losing or controlling weight and improving our health as we age. Foods containing phytoestrogens, for example lentils and chick peas, can improve menopause symptoms.
Environment
I think any menopausal woman knows the importance of a cool environment, light clothing that can be altered quickly when hot flushes occur, and cool calming sleep environments. One area of life we have less control over is our working environment but menopausal women are entitled to work in a place that allows them to feel well and this is supported in law.
Stress and mental wellbeing
This is a more difficult thing to tackle. Menopause tends to hit just at the point of life where work can be stressful, family commitments can include caring for both children and elderly relatives, and the pressures of life at present are intense. Menopausal symptoms are compounded by stress, and feeling unwell then decreases wellbeing – a vicious circle. It’s important to prioritise wellbeing for yourself and not just care for others.
Useful Links:
https://www.cuh.nhs.uk/patient-information/menopause-a-healthy-lifestyle-guide/
https://www.talkworks.dpt.nhs.uk/workshops/talkworks-for-menopause
https://www.menopausematters.co.uk/
https://rockmymenopause.com/resources/
https://www.acas.org.uk/menopause-at-work