You've heard about the symptoms. But the truth is menopause doesn't have to be miserable. It turns out your attitude towards the hormone shift can make a big difference in how you handle it. "Women who know what to expect and have a positive outlook often have an easier time," says Karen Deighan, MD, chair of obstetrics and gynecology at Loyola University Health System at Gottlieb Memorial Hospital in Illinois. But knowing the facts helps, too. "Being prepared gives you a sense of control … which may lead you to make healthier choices and help you feel better overall," she adds. Read on to learn what you should expect and surprisingly easy ways to weather the post-period storm.
Consider taking birth control pills.
As your hormone levels become erratic, foggy thinking and PMS-like mood swings can happen, and taking the birth control pill can help by evening out your hormones, says Steven R. Goldstein, MD, president of the North American Menopause Society. Doctors prefer the Pill to hormone therapy early in perimenopause because it substitutes your own hormones with a steady dose (unlike hormone therapy, which only adds hormones). Another plus: The Pill helps with irregular periods and heavy bleeding.
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"As long as you don't smoke and you don't have high blood pressure, the Pill is safe—and it'll lower your risk of ovarian and uterine cancer," says Dr. Goldstein. You should feel better in about two months; if not, discuss other factors like stress and depression with your doctor. Photo: Thinkstock
Stay on top of your heart stats.
Exercise is key to protecting against heart disease as you approach menopause, but just as crucial is keeping tabs on your potential risk factors, including waist circumference (over 35 inches ups your chances of developing heart disease), blood pressure and cholesterol levels, says Lori Daniels, MD, associate director of the coronary care unit at the University of California, San Diego. Even if you've always had good cholesterol and blood pressure levels, these numbers can go up as you approach menopause, so you want to be sure to check them every year, says Jennifer Mieres, MD, a nuclear cardiologist and medical director for the Center for Learning and Innovation at the North Shore-LIJ Health System in Lake Success, New York.
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Also be sure to talk to your doctor about any new symptoms, including heart palpitations, sweating, nausea and shortness of breath. "Many menopausal symptoms are similar to those of heart disease, so you want to make sure you and your doctor know what's going on," says Dr. Mieres.
Eat mindfully to help with hot flashes.
At least 75% of women going through menopause get hot flashes, but stats show that fewer than 20% of women are so bothered by them that they need treatment, says Dr. Pinkerton. And, as annoying and uncomfortable as they are, hot flashes may be a good sign. A study of 60,000 women found that those who got them were 11% less likely to develop cardiovascular disease than those who didn't.
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Still, when you're sweating and red-faced, you want a solution—fast. The best place to start: lifestyle changes. "Tofu and other soy foods contain natural plant estrogens that may keep hot flashes in check," says Dr. Pinkerton. In fact, a study from the Journal of Women's Health showed that women who ate soy nuts daily had 45% fewer hot flashes, and the episodes were less severe. On the other hand, spicy foods, alcohol (especially wine) and caffeine may trigger hot flashes, so try to avoid them. Yoga and other stress-reduction techniques are also effective. One study found that women who did mindfulness techniques such as deep breathing daily were less bothered by hot flashes (even though they happened just as often).
If those changes don't help, consider hormone therapy (HT), formerly called hormone replacement therapy. "I've also had success with gabapentin, a drug developed to treat epilepsy," says Dr. Goldstein. "It works just as well as HT and is safe. It's a good choice when you can't or don't want to take hormones." Photo: Getty Images
Sleep smarter.
"Research shows that a cool bedroom—between 64 and 72 degrees—improves sleep, and it has the bonus of minimizing hot flashes," says Grace Pien, MD, assistant professor of medicine at the University of Pennsylvania's Division of Sleep Medicine. Getting enough shut-eye can also help ease other menopausal symptoms including fatigue, forgetfulness, weight gain and moodiness.
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Cut 100 calories a day.
Weight gain tends to happen during perimenopause and menopause, but again, the change in hormones isn't the only cause. Even if you're eating and exercising exactly the same way at age 45 as you did at 35, you're still getting more calories than you need. That's because your metabolism slows 4% to 5% per decade, which may sound like a lot, but it really just means that you need about 100 fewer calories a day. Cutting out one slice of bread, ounce of cheese, glass of juice or ½ cup of icecream will do the trick. Or you could burn it off by taking a 10- to 15-minute walk. Even better: Combine the two. A recent study from Fred Hutchinson Cancer Research Center in Seattle found that overweight women over 50 who cut calories and walked, biked or used an elliptical trainer for 45 minutes five days a week were able to drop 9% to 11% of their weight in a year. Photo: Shutterstock
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Pump some iron.
Lifting weights builds muscle—and the more muscle you have, the more calories you burn and the stronger your bones are, says Kathy Kaehler, a veteran fitness expert. This protects against weight gain as well as heart disease and osteoporosis, which you're at higher risk for after menopause. The weights have to be heavy enough for you to feel the burn. You'll know you have the right amount when you can do two to three sets of 10 reps but the last three reps of every set are tough to finish.
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The effort is worth it: Researchers at the South Shore YMCA in Quincy, Massachusetts, found that a two-month program of weight and cardio training led to a 9-pound weight loss and 3-pound muscle gain.
Don't discount your sex life.
It's not hormones that put the biggest damper on your sex life during midlife, it's how you feel about your partner, according to The Melbourne Women's Midlife Health Project, a nine-year study of women ages 45 to 55. If you were happy with your sex life before perimenopause started, chances are that you'll also be happy with it afterward, says Nanette Santoro, MD, chair of obstetrics and gynecology at the University of Colorado School of Medicine in Aurora.
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The drop in estrogen, however, can cause vaginal dryness. "It can make intercourse painful and—no surprise—make you averse to sex," says Dr. Santoro. If that happens, talk to your gynecologist about trying an estrogen vaginal cream, tablet or ring. Because you insert them directly into your vagina, less estrogen enters your system than if you took it by mouth or via a patch. "Lubricants can also help, but they're not nearly as effective," says Dr. Santoro. Photo: Corbis
Bone up.
Women can lose about 20% of their bone mass after they've hit menopause, but if you've been getting enough calcium, exercising and not smoking, you've probably got plenty of bone to spare. Just don't slack off on calcium and vitamin D now. A study published in The Lancet found that people 50 and over taking calcium and vitamin D supplements lowered their odds of breaking a bone by 12%. However, it's worth noting that some research found a link between calcium supplements and increased heart attack risk.
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Talk to your doctor about whether you should be exploring alternative ways to supplement your calcium intake, such as increasing it with food instead of pills. Aim for 1,000 mg of calcium and 400 to 800 IU of vitamin D a day. If you're over 50, up your calcium to 1,200 mg and your D to 800 to 1,000 IU.
Exercise is also crucial, not only because it builds and maintains bone, but also because it keeps you strong. "Take two women with the exact same bone mass who trip on a curb," says Dr. Goldstein. "One is flexible, agile, mobile and strong, and the other is frail. The first woman will have the ability to catch herself, while the other will likely fall and maybe break a bone."
Trisha Calvo is a health writer who lives in Norwalk, Connecticut. Her work has also appeared in Fitness andShape magazines.Article originally appeared on WomansDay.com.
