Manage your menopause, your way

In this month's Dear Dr Dara column, Dr Dara Hume looks at more traditional ways of managing the menopause...

Hi everyone, and lovely to touch base with you all again. Isn’t it wonderful to see Spring beginning to appear? It gives us all a lift doesn’t it? Thanks as always for your questions - keep them coming! My dedicated Menopause Clinic is now up and running, getting busier by the week, and the feedback so far is most positive.

After my last article, a lot more questions appeared regarding non-HRT options, and also queries regarding options for those women who have had breast cancer. So I think it’s easiest to combine those questions into a general non hormonal Menopause Part 2 article.

Everyone’s experience of menopause is different, just like every woman is different. It is inevitable, so preparation is key, and planning ahead from mid 40s on is important. However it is never too late to make subtle changes that can have a large impact on your physical, emotional and sexual health from perimenopause to menopause (which technically only lasts a day, as then you become post-menopausal).

Some general advice

Lifestyle changes: Less sugar and less processed foods certainly help with both gut and heart health, and promote good liver health. Less caffeine and less alcohol help with reduction in flushes, night sweats, palpitations, anxiety and dehydration.

Increased water intake helps with general health always, but helps with the associated dryness of perimenopause, as all areas of the body becomes dryer.

Exercise: For cardiovascular health, and for bone health (in particular weight-bearing exercises like walking, running). It is excellent for mental health and also exercising with a friend or a group promotes sociability, which helps with low mood and social anxiety that can occur at this time.

Gut health: Water (about 2L/day), good fibre like vegetables, porridge, nuts, seeds, and regular meals.

Nutrition: Particularly phytoestrogens (substances in plants that mimic the oestrogen that you lose at menopause)- there is a long list, but the commonest and easiest to add are soy based products, (including soy sauce, edamame beans, tofu); lentils, flaxseed, oats, berries and lots more. These are not suitable for women who have had breast cancer though.

Omega 3 foods for brain health (helps with the ‘brain fog’) fish, nuts and seeds (particularly toasted seeds), berries, beans, squashes, avocado, plant oils. General multi-nutrition foods or a rainbow of colours on your plate!

Relaxation and stress management: Often menopause occurs at a time and age of your life that is particularly stressful, like kids going to college, your parents getting older, higher work demands, financial stress. So learning to destress with friends, getting involved in group activities, perhaps yoga or mediation.

Working mothers in particular find it so difficult to have any time to themselves - so schedule maybe two classes a week, two hours out of 168 hours per week, just for you.

And adequate and good quality sleep is also so important. For those women for whom HRT is not an option medically, or not a preferred option, there are again lots of treatment options where specific symptoms can be targeted. There are multiple supplements including herbal remedies like black cohosh, sage and others (caution though, as dosage and purity can vary, and they may interact with other medications), St John’s wort, also acupuncture.

Dietary changes that I touched on above. CBT (cognitive behavioural therapy) is certainly helpful, particularly in assistance for mood symptoms. In particular for hot flushes, mood, sleep, restless legs, there are various non hormonal treatments that your GP can prescribe.

Again the key message is that everyone’s menopause journey is different, and therefore the assistance in managing it varies from woman to woman. So, perhaps pick up the phone and make an appointment to see your GP? You have absolutely nothing to lose, and perhaps a wealth of knowledge to gain.

Manage your menopause, your way. Stay safe out there !


Healthwise: Menopause - don't suffer in silence