Managing Menopause Symptoms: Part Two

There's no “one-size fits all” approach for managing menopause symptoms. Everyone will need a unique set of tools in their toolkit and this can often involve a large dose of trial and error to find what is right for you. Here are five more tips to help you build your personal menopause toolkit.

1. Hydrate.

It sounds obvious but something so many of us overlook staying hydrated when we have “busy life syndrome” . When your cells have insufficient water they can't function properly, and everything slows down. This includes your bowels, which are important to keep moving to get rid of unwanted toxins and waste. Cognitive function also declines when dehydrated. Aim for 2 litres daily of fluid as a minimum and increase to 3 litres if you are very active or sweating more. All fluids count except alcohol. Water is tooth kind, free from sugar and accessible, making it a great choice. Caffeinated drinks can contribute too but be aware of their impact on anxiety levels and sleep. If you do consume caffeine, keep it to the morning to limit its impact on sleep.

2. Move.

Find whatever way of moving that helps you feel good. Walking, skipping, running, dancing, cycling, rowing, hiking, swimming...or all the above. Weight bearing activity is particularly important for maintaining normal bone mineral density. Yoga, Pilates, weight lifting or functional and body weight exercises are great for maintaining and increasing strength and stability. Building lean muscle mass is also important for metabolic and immune health and can help with weight management. Variety is key to work as wide a range of muscles as possible. Do as much, as intensively and as often as possible whilst also tuning in to when you need rest and recovery. Ideally 30mins 4-5 times per week (or more). Bonus points for getting your movement in whilst out in nature for an added dose of vitamin D and natural nervous system grounding.  

3. Pause, Rest and reset.

Take this opportunity to find who you are again, where you want to go and how you want to get there. Feel empowered to say “no” more often. Put boundaries in place and hold space for yourself and protect your energy. Move away from things that drain you and towards things and people that nourish you. Consider proactive psychological therapy or coaching to help you work through any specific difficulties you are facing. Develop a toolkit of strategies to help you move forward with positivity, purpose, and a plan. Do not underestimate the value of rest and do not be afraid to start putting yourself first AND asking others to start putting you first too. So often as midlife women we are “keystones” and we need support.  

4. Supplements and Sunshine.

Most of us will not get adequate exposure to sunlight throughout the year to maintain normal vitamin D levels. Vitamin D is an important “hormone-like” vitamin that has many roles. These include:

• supporting normal bone growth
• maintenance of bone mineral density
• regulating inflammation
• modulating cell growth for nerve, muscle and immune cell function
• supporting normal glucose metabolism.

I recommend taking a Vitamin D3 supplement containing 1000 International Units ( 25 micrograms) daily as a minimum for perimenopausal and menopausal women. You might need more if you have very low levels. Other supplements to consider are omega-3, iron, B6 and B12 if you are at risk of dietary deficiency (plant-based). There may also be benefit from use of magnesium for anxiety and sleep. 

5. Hormone Replacement Therapy (HRT)

HRT or Menopausal Hormone Therapy (MHT) is the gold standard treatment for perimenopause and menopause. It involves combinations of oestrogen, progesterone and testosterone and should be the first-line treatment recommended by your clinician.

Up to date research indicates that HRT/MHT is safe for most women and not only beneficial for relief of symptoms but also for maintaining normal bone mineral density, metabolic and cardiovascular health, reducing risk of ill-health and may increase longevity. There are many regimes available with hormones delivered via patches, gel, spray, tablets, combined tablets and patches or vaginal tablets and rings. There is no “one size fits all” but body-identical regimes using micronised progesterone and oestrogen delivered through the skin (transdermal) are thought to be safest. The best and safest regime for you will depend on several factors personal to you so please talk to a clinician to explore all your options.  

Trust Your Instincts

And finally, trust your instincts. You known and understand yourself: what is normal and what is not, far more expertly than anyone else. Our bodies are often telling us what we need to know, so tuning in and trusting that intuition is so important at this stage.  

You can see part one of Dr Barton's toolkit tips here.