Menopause and Health
As women, we often dread and fear the coming of menopause. It’s usually presented to us as this turning point when we can no longer do the things we used to do.
Everything gets messy, painful, and uncomfortable. We tend to see menopause as this stage in our lives that we must avoid. But can we really do so?
Most likely, and from the current evidence and research, no. We cannot skip this part of our experience.
So, if we have to go through it, how can we make it better? How can we take care of ourselves and give ourselves what we need to manage our expectations and experiences during menopause?
Before we dive in, I think it will be good to refresh some concepts:
Menopause is what we tend to know more about, and the concept is more engrained in our minds.
However, it doesn’t just happen. Before menopause, we have an earlier stage called Perimenopause. And before that, we are in Pre-menopause.
Pre-menopause is when we still have menses. We still get our periods more or less regularly.
Perimenopause is the transitional period between our reproductive and non-reproductive phases in life, and it can last from 4 to 8 years. At this stage, we often get more irregular cycles and maybe some mood swings and hot flashes. It usually starts at the age of 45, though it can be between 39 and 51 years of age.
Menopause is actually having been 12 consecutive months without a period. Sadly, we only know we hit menopause once it is over, as this full year has to go by first. Normally, this happens between 48 and 52 years of age, though it can vary from woman to woman.
It is during menopause that we see the biggest physical and emotional effects.
Physically, we can experience hot flashes, joint stiffness and pain, increased fatigue, and urinary incontinence.
Emotionally and psychologically speaking, we may find ourselves navigating through depression, anxiety, mood swings, and brain fog.
Post-menopause is the final stage. We can consider we are in this phase after all the above are over. It is at this point that we have a higher risk of heart disease and some types of cancer. With estrogen levels having dropped to a bare minimum, LDL (the so-called “bad cholesterol”) increases, and thus the risk of cardiovascular disease (CVD)
Remember that the above are general considerations and manifestations of each stage but that each woman is different and may not go through all the same symptoms.
How does it all relate to nutrition and exercise?
During menopause, it is completely normal to see a decline in one’s energy levels, some difficulty sleeping, and unexplained weight gain. We usually blame hormones on this last one, especially as we see our midsection grow most of the time. And, yes, hormones do play a role in this change but that is not all.
Research has shown that between 40 and 50 years of age, we tend to gain weight simply as a consequence of the aging process. Also, we keep eating more or less the same as we are used to but we naturally move less. These two factors, plus the drop in estrogen and other hormonal changes that regulate how fat is stored, seem to be the drivers of the weight increase.
A study from the ASCM Health and Fitness Journal shows that physical activity has positive effects on our mood and the ability to reduce stress and regulate weight.
This in itself can help alleviate some of the symptoms of menopause or make it so that they feel easier to ride. This is especially true when we think of depression being one of the symptoms. Movement and exercise can be a successful treatment for mild to moderate cases. And together with therapy if needed, it can help us better navigate this phase of life.
In essence, exercising is a positive thing to do at this stage as it is throughout our whole lives.
Now, we might want to add a few considerations. Know them so you don’t beat yourself about it when they happen. We want to understand more of what is happening so we can become better at riding the wave that is menopause.
At this point in life, muscles may need more time to recover. No pain, no gain? Not always the answer!
There is no one size fits all approach, but there are some strategies we can all try to ensure we maintain movement and are kind to ourselves as well:
1)Make strength training a priority:
As I’ve mentioned before in this article, as we grow older we start getting the effects of sarcopenia and osteopenia. And menopause can accelerate both of them.
Sarcopenia is the loss of muscle mass. So, one way to manage it, is to make sure we intake sufficient amounts of protein and do weight-bearing exercises 2 to 3 times per week.
Osteopenia is the predecessor of osteoporosis, meaning a decrease in bone density.
Strength training has been proven to contribute to the increase in bone density, especially during post-menopause and menopause.
When considering exercise, do remember that more is not always best. So 2 or 3 sessions a week of about 30 to 40 minutes can be enough to make a positive impact on you.
Also, consider your symptoms, and always listen to your body. It’s good to have a plan, but it’s even better to be adaptable. So, if you are not feeling great one day, you can still work out! You might just need to do something different according to what your body is up to that day.
More is not always better, but something is always better than nothing at all
2)Try to add more movement to your everyday
Movement has been proven to increase longevity and health, reduce stress and improve recovery, and help in physical as well as mental health.
When we talk about adding more movement to your daily life, this is doing things you enjoy that are low to moderate intensity and can be easily incorporated. These could be activities like walking, cycling, swimming, playing with kids or grandkids, walking the dog, taking the stairs, or dancing.
As with strength training, try to at least do any of these activities 2 to 3 times a week.
What about food?
Focus on what you can control:
Get enough protein: protein tends to make us feel full for longer and it is critical to repair and grow muscle (The average adult needs a minimum of 0.8 grams of protein per kilogram of body weight per day.)
Eat plenty of fruits and veggies: this adds fiber and water to help with bowel movements. Also, provide volume that leads to satiety (feeling full)
Regulate beverage intake: alcohol and caffeine can worsen some of the symptoms of menopause, like anxiety, hot flashes, and insomnia. Calorie-rich drinks, like sodas, contribute to sudden changes in blood sugar levels. This doesn’t mean you cannot have any of these at all. Rather, if you do, do it in moderation.
Try to slow down when eating: this is about being present and enjoying the food. Not about how long you take to eat it 😊
Final considerations:
Making sure we move more, including strength training 2 to 3 times a week, and consuming adequate levels of protein, fruits and veggies is just one half of the pie.
When it comes to improving our health and reducing the symptoms of menopause, we need to look into our lifestyle in general as well.
I’d like to close this article with a brief reference to the main aspects that can influence our well-being:
Sleep
Stress
Mental Health
Sleep deprivation impacts everything, from workout results and recovery, to how much and what we eat, our mood and energy through the day, and our response to pain.
If necessary and possible, double down on your sleep during perimenopause and menopause.
Episodes of hot flashes through the night may make this a challenge, so you might consider taking naps through the day or some non-sleep deep rest moments (Just sitting or lying on the couch doing nothing for 20 minutes can help. Or some form of meditation)
When it comes to stress, it is often not easy to tackle and keep in check. Some things you can try are:
Noticing what is causing the stress and action on that
Take deep breaths
Do something you enjoy every day. No matter how small.
Regarding mental health, we now know that general stress, depression, mood swings, and anxiety are common during menopause.
When we struggle with mental health, we will also struggle with nutrition and exercise.
If you need it and can do it, find a therapist to help you navigate the changes and ups and downs of this phase.
However, there are a few other resources you can use for help:
Notice negative self-talk and try to work on reducing it. Practice training your brain to reply to these thoughts and potentially replace them with more positive ones.
Find a community of other women in a similar situation. Support is key.
Curate your environment: who do you follow on socials? How do they make you feel? What do you watch on TV?
In conclusion, women go through an array of changes since perimenopause. But we have tools to deal with these and make our lives better. Exercise and nutrition are key to keeping us healthy and maintaining a good quality of life, as is keeping our mental health in check.
Ask for help when needed. You are not alone!