Managing Menopause

Good Health Lifestyles Expert Corner, Features, Get Healthy

No matter how often popular culture drops the term “power surge,” any woman in the midst of a hot flash will likely be ready to flip that power switch off! While menopause is a natural part of every woman’s life, for many it’s not necessarily a pleasant process. Yet there’s no reason you have to get sidetracked by symptoms—or resort to risky therapies. Check out our primer on natural ways to safely tame the unpleasant symptoms and side effects that can mark the change of life.

No, You’re Not Crazy

The term ‘menopause’ is a catch-all for the physiological changes in a woman’s body leading up to the time when her menstrual cycles permanently stop happening. But true menopause doesn’t occur until after a woman has missed 12 periods in a row—usually around the age of 51. Everything leading up to this is technically known as perimenopause.

Menopause is due to the natural depletion of eggs in the ovaries as a woman ages. At the same time, the body produces lower levels of reproductive hormones, especially progesterone and estrogen. Lower hormone levels are the main culprit behind your hot flashes and night sweats, as well as those unpredictable mood swings, bouts of depression, fuzzy thinking, insomnia, vaginal dryness, the loss of your sex drive, and the changes to your complexion (hello fine lines and wrinkles).

Most women don’t discover they are actually perimenopausal until symptoms drive them to the doctor. Although a fairly accurate diagnosis can be obtained from a combination of symptoms and your medical history, laboratory testing can confirm the diagnosis. If you are perimenopausal, you’re tests will typically show high follicle-stimulating hormone (FSH) and low estrogen (estradiol) levels. Why typically and not definitively? Because if you’re taking birth control pills or another hormone therapy, your test results won’t be accurate.

Perimenopause, on average, lasts for about four years. But every woman’s menopause journey is different. Some women may only experience mild symptoms for a few months. Others may report more severe symptoms lasting as long as a decade! No matter what your journey looks like or how long it takes before you’re officially period-free, managing your symptoms while you are in the trenches in a safe and healthful way can enhance both your overall health and your quality of life.

When I Asked for a Hot Body, This Isn’t What I Meant!

Maybe the warmth starts mid-body and slowly travels to your face and neck, making your skin hot and blotchy. Or maybe you feel a sudden, unannounced rush of blood from your toes all the way to the top of your head, bringing with it intense heat. You may also break out in a sweat, feel anxious, or experience dizziness, a rapid heartbeat, and a quickening of your pulse. Welcome to the hot flash—a phenomenon that affects about 70 percent of all perimenopausal women.

Hot flashes are caused by fluctuating estrogen levels, which affect the hypothalamus (the area of the brain that regulates body temperature). But while the underlying cause might be the same for all women, we each experience hot flashes in our own way. Some women get them during the day, at night (night sweats), or both. They can be mild or severe. Some last only seconds, others stick around for up to 10 minutes. In fact, for 2 in every 10 women, hot flashes can be severe enough to interfere with daily life.

While keeping a folding “flash” fan handy can provide instant relief, the respite is temporary at best. Instead, head off your hot flashes with black cohosh. Black cohosh is a perennial herb that’s been clinically shown to reduce the severity, duration, and frequency of hot flashes and night sweats. It works thanks to compounds in the herb that bind to estrogen receptors without actually changing hormone levels in the body. But to get these benefits, it’s important to choose a full-spectrum black cohosh supplement. One study conducted by the Mayo Clinic evaluated the safety and efficacy of black cohosh among a group of 50-something women in the midst of menopause. Not only was the daily frequency of hot flashes cut in half among the women taking the herb, weekly hot flash scores measuring the severity and duration were reduced by 56 percent compared to those taking a placebo. Plus, there weren’t any adverse side effects among the participants.

Other studies pitting black cohosh against hormone replacement therapy (HRT) have found even more surprising results. For example, one clinical trial involving 244 midlife women compared black cohosh with tibolone, a synthetic hormone often used in HRT. At 12 weeks, the severity of menopausal symptoms—especially the frequency, duration, and severity of hot flashes—showed similar improvement in both the black cohosh group and the tibolone group, leading the researchers to conclude that black cohosh is just as effective as HRT! Yet when it comes to black cohosh, more is not better. In fact, large doses actually diminish the herb’s effectiveness. A daily dose of 13 to 26 mg can be enough to do the trick—if you take a black cohosh supplement offering a full spectrum of beneficial compounds. Just be aware that it can take 30 to 90 days to fully feel the effects. Even so, black cohosh’s clinically proven effectiveness combined with its stellar safety profile make it an essential herb to include in your menopause toolkit.

This Is Your Brain on Menopause

Menopause can make you feel forgetful, overly sensitive, depressed, not as smart as you used to be, and generally like you want to kill all things. And it’s not unusual to ping-pong between all of these feeling within the span of an hour! It can feel like living on a razor’s edge. But it’s not just your imagination. Science has confirmed that the hormonal changes during menopause actually do affect the way the brain functions, causing temporary cognitive decline and memory problems, as well as mood swings, irritability, and even temper tantrums.

Putting yourself first can often help smooth out this emotional craziness. Strive to adopt a healthy diet, hydrate, get eight hours of sleep per night, and learn to meditate. If you can, splurge on the occasional massage. Exercise is important too. Findings presented at the 2015 North American Menopause Society annual meeting show that regular exercise clearly helps to counteract the dip in cognitive function that can occur during menopause while also helping to enhance well-being.

Rhodiola can also help preserve your sanity. Well-known for its ability to reduce fatigue and enhance energy, studies show that this adaptogen also improves memory, enhances concentration, and increases overall well-being. According to a recent overview in the journal Phytomedicine, rhodiola modulates selective estrogen receptors. This, in turn, may prevent or delay menopause-related cognitive and psychological changes. In fact, the researchers noted that the herb might even improve cognition, memory, and mood. But to get all that rhodiola has to offer, opt for a supplement standardized to contain at least 5 percent rosavins and 1.8 percent salidrosides.

The Sleep Thief

Even if night sweats aren’t keeping you from a good night’s sleep, you’re likely not getting the shut-eye you need to support good health and emotional stability. Fluctuating hormone levels can knock your circadian rhythm out of whack, making it hard to fall asleep or stay asleep during perimenopause and beyond. Black cohosh to the rescue (again)! During a randomized, double-blind, placebo-controlled study, 48 postmenopausal women who experienced sleep problems were given either black cohosh or a placebo daily for six months. By the end of the study, the women taking the supplement reported significantly less trouble falling asleep or staying asleep compared to those taking the dummy pill.

Not This Year, Dear

Plummeting hormone levels can also contribute to a decrease in your libido. As you’ve seen, rhodiola can improve your mood. But what you might not know is that it can also boost desire. Studies show that this helpful little herb increases norepinephrine, dopamine, and serotonin neurotransmitter activity in the brain. Not only does this put you in a better place mentally, it also helps to alleviate two well-known romance killers: stress and fatigue.

But, even if you’re in the mood, desire can quickly go up in smoke if intercourse is painful. Low estrogen levels can cause vaginal dryness, as well as inflammation and the thinning of delicate vaginal tissue. While topical lubricants can offer a certain degree of momentary relief, a more sustainable solution is to heal and fortify these tissues naturally. According to research in the journal Maturitas, sea buckthorn can do just that! Rich in vitamin E, carotenoids, and essential fatty acids—especially omega-7s—sea buckthorn naturally supports healthy mucous membranes throughout the body, including the vagina. During this three-month randomized, placebo-controlled study, 116 postmenopausal women suffering from vaginal dryness were given a daily sea buckthorn supplement or a placebo. At the end of the study, the researchers found that those taking the supplement had a significant improvement in the health of their vaginal tissue. Specifically, the epithelial integrity of the vaginal mucosa had improved compared to the placebo group. To ensure you’re getting a healthy dose of omega-7’s, make sure to choose a sea buckthorn supplement that contains both the seed oil and the pulp.

Fragile! Handle with Care

Even after your symptoms are a mere memory, menopause can still have long-term effects. As a postmenopausal woman, the pounds can seem to magically pile on. Plus, you’re at greater risk of type 2 diabetes and cardiovascular disease. The years after menopause can also result in bone loss, boosting your odds of developing osteoporosis in your later years. Fortunately, all three of the herbs used to relieve the symptoms of menopause can also protect against the loss of bone mass and density. Findings reported in the journal Chemistry & Biology show that black cohosh blocks the activity of bone-destroying cells called osteoclasts. Rhodiola has been found to prevent oxidative damage to bone-forming cells and it also inhibits the release of compounds that trigger the reabsorption of old bone. And preliminary studies suggest that sea buckthorn may help to regulate healthy bone metabolism and foster better bone density in postmenopausal women. Adding these three nutrients to a healthy diet and doing regular weight-bearing workouts can keep you on the move and at your best for the second (and possibly the most rewarding) half of life!

Menopause At A Glance

Average Age: 51

The 3 Stages of Menopause

  • Perimenopause: The 4 to 10 years before periods stop permanently.
  • Menopause: Defined as occurring 12 months after your last period.
  • Postmenopause: The years that follow menopause.

The 3 Types of Menopause

  • Natural: When the body naturally produces less estrogen and the eggs in the ovaries become depleted.
  • Premature: Due to an autoimmune disorder or genetics.
  • Induced: After a hysterectomy or after chemotherapy or radiation.

Typical Symptoms

  • Hot flashes
  • Night sweats
  • Irregular periods
  • Insomnia
  • Mood swings
  • Anxiety
  • Foggy thinking and forgetfulness
  • Headaches
  • Breast tenderness
  • Low libido
  • Vaginal dryness
  • Weight gain
  • Urinary incontinence

Lifestyle Changes to Try

  • A whole-foods diet rich in antioxidants, omega-3s, and protein.
  • Reduce your intake of sugar, processed foods, and alcohol.
  • Regular exercise. Aim for at least 30 minutes of activity per day and include both cardio and weight-bearing resistance training.
  • Kegel exercises to strengthen the pelvic floor.
  • If you smoke, QUIT! Smoking can worsen symptoms and related health risks.

Postmeno Tests Every Woman Needs

Menopause changes things. And some of these changes can be good. No more periods or PMS, no worries about an unplanned pregnancy, and often a greater sense of self-confidence. But menopause can also put you at a higher risk for a number of life-altering diseases including cardiovascular disease, stroke, osteoporosis, breast cancer, and more. Adopting a healthy lifestyle can go a long way towards maximizing your post-period health. But it’s also important to talk with your healthcare provider about scheduling the following medical tests:

  • Breast examination annually and a mammogram every one to two years.
  • Blood pressure check every two years (more often if it’s chronically high), and blood cholesterol screening every five years (more often if it’s chronically high or you have other risk factors for heart disease or stroke).
  • Bone density screenings (DEXA) if you are over age 65, or at a younger age if you are at risk for developing osteopenia or osteoporosis.
  • Blood sugar testing annually.
  • Colonoscopy every 10 years beginning at age 50.
  • Gynecological exam annually with a Pap test every three years or a Pap test combined with an HPV test every five years up to age 65 (unless you have a new sexual partner or are at high risk of cervical cancer).
  • Thyroid function testing every five years. However, be aware that conventional testing may miss low-level hypothyroidism.


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