Gym & Health

Know the stages of menopause, so you know what to expect:^[1]

• Pre-menopause. Periods just start to get irregular, usually mid-to-late 40s. There are usually no classic menopausal symptoms but menopause-like symptoms may start to appear during this stage.
• Perimenopause. Erratic cycles, hot flashes, vaginal dryness. On average, begins at age 47. Other symptoms that you may begin to see:
  • Mood swings
  • Decreased sex drive
  • Sweating
  • Racing heart (palpitations)
  • Headaches
  • Trouble sleeping
• Menopause. The first year that you haven't had any periods. You won't know you're in this phase until you've completed it (when you have a year without periods behind you).
• Postmenopausal. After the first period-free year (menopause) and for the rest of your life. If you have any vaginal bleeding in this phase, it's considered abnormal and should be discussed with a doctor.

Learn how to cope with hot flashes. Hot flashes are the body's response to lowered estrogen levels. It's a temporary dysfunction in the temperature regulating portion of the brain until the body gets used to the missed estrogen. A typical hot flash lasts about 2 - 3 minutes. During a hot flash, your face and upper body feel extremely hot. Your face reddens and you sweat heavily as your skin temperature suddenly rises 7-8 degrees. It usually returns to normal within 30 minutes.

• Dress lightly and in layers. Wear natural fibres. Synthetic fibres trap heat and perspiration during a hot flash, making this symptom even more uncomfortable. Natural fibres such as cotton or wool will give your body more ventilation, and keep it cooler by wicking moisture away from your body and cooling you naturally. Another option is to wear one layer of a thick sweater that permits air flow yet keeps heat after the body temperature has gone back down. Try standing up, fluffing the bottom of the shirt discretely, or going for a slow gentle walk to circulate air around the body. Perhaps consider V- or scoop-neck tops which can be conducive to a chimney effect if you hold out the bottom of the shirt. Heat rises, bringing cool air up.
• If you are having hot flashes, keep a diary to track when they happen. You may be able to use this information to help find out what triggers them.
• Avoid triggers like caffeine, alcohol and spicy foods (excessive alcohol will also hasten bone loss^[2]). For some women, emotional upset is a trigger; others may find a hot meal, a warm room, or a warm bed will trigger a flush.
• Try slow, deep breathing to combat hot flashes (six breaths per minute)^[3]

Take steps to combat osteoporosis. There will be a rapid loss of bone in first 3-5 years after menopause. If you don't take enough calcium through life, by midlife your bone store is already partly empty and much closer to osteoporosis.^[2]

• You need 1,200 to 1,500 milligrams of calcium daily if you're over age 50.
  • Dietary sources of calcium: low-fat and nonfat milk and yogurt, hard cheeses, collard greens, tofu, calcium-fortified orange juice and breakfast cereals, sardines, canned salmon with bones.
  • Supplemental calcium: calcium carbonate (e.g. Tums), least expensive; calcium citrate (e.g. Citracal with D), best absorbed and less constipating.
• For vitamin D, you need 400 international units daily until age 70; 600 to 800 afterward.
  • Dietary sources: fortified milk and cereals, eggs, fish oil, salmon, herring, liver.
  • Your best source of vitamin D is the sun. Whenever possible, expose some skin (without sunscreen) to sunlight for 15 minutes a day.
• Protein. Get 15-20% of your daily calories in animal protein sources (meat, poultry, eggs, and cheese) to foster bone mineral density - vegetable protein sources are not protective.^[2]

Maintain vaginal health. With less estrogen in your system, you may find that the walls of your vagina become more dry and less elastic, which can make you feel sore and uncomfortable.

• Be or remain sexually active. This may help to keep the vaginal walls from thinning^[1] and preserve elasticity of vagina.^[3]
• For vaginal dryness, use moisturizers and non-estrogen, water-based lubricants.
• Perform kegel exercises to strengthen muscles of vagina and pelvis.^[3]

Maintain a healthy lifestyle overall. If there was ever a reason to finally get into shape, kick unhealthy habits, and clean up your diet, the symptoms of menopause might be it.

• Stop smoking, it can cause early menopause^[3] and hasten bone loss^[2]
• Control risk factors for heart disease - blood pressure, cholesterol
• Eat a low-fat diet
• Exercise regularly, especially resistance exercise to strengthen bones

Weigh the benefits and risks of prescription treatment.

• Combination hormone therapy (HT) or hormone replacement therapy (HRT) (or estrogen alone if you no longer have a uterus) can reduce symptoms of menopause and help prevent osteoporosis, but long term HT may increase the risk of heart disease, breast cancer, blood clots, and stroke; estrogen-only therapy might increase the risk of blood clots and stroke.^[1]
• Antidepressants can be prescribed for mood swings and difficulty sleeping.
• Clonidine and gabapentin may be prescribed to reduce hot flashes.

Consider alternative treatments.

• acupuncture
• relaxation techniques
• herbal remedies (Remifemin [black cohosh], dong quai, chasteberry, flaxseed, vitamin E and ginseng)^[1]
• Soy protein found in soy-based food and soy milk can help reduce hot flashes.
• meditation

Herbs for menopausal syndrome: Herbs are potent sources of phytoestrogens and can replenish the deficiency of estrogen especially in menopausal women. Research on these herbs also supports their beneficial effect in many menopausal symptoms like Hot flashes, Irritability, Osteoporosis etc.

• Shatavari ^[4][5]
• Tribulus terrestris ^[6]
• Tinospora cordifolia ^[7],