SORT THE SIDE EFFECTS
The menopause can present wide-ranging and challenging symptoms, including fatigue, weight gain, anxiety and hair loss. Here’s how to overcome the obstacles and come out stronger... ‘Yoga may be good for helping improve fatigue related to menopause’
‘Hormonal imbalance impacts mood, energy levels and sleep’
Fight the fatigue
Feeling tired, zapped of energy and like you’ve lost your get up and go? You’re not alone. Research has found that fatigue is one of the most frequently reported symptoms by women during the menopause, especially during the later phases.
“There are two main reasons fatigue is so prevalent during the menopause,” says Dr Kate Panter, Consultant Gynaecologist and British Menopause Society recognised menopause specialist.
“When a woman approaches the menopause her hormone levels f luctuate. This hormonal imbalance impacts her mood and energy levels, but it also affects sleep, often causing frequent wake ups, and the impact of this can be huge.
“If you’re constantly getting poor quality sleep, this is going to have a huge knock-on effect on your work, relationships and your whole life really, and when you think this transition can last for up to 12 years, this can feel very overwhelming.” So, what can someone do if menopause fatigue is taking over their life?
“If you’re suffering from fatigue, it’s important to speak to your GP to rule other possible causes out,” says Kate. “But, if menopause is responsible, there are certainly measures you can take, which may help.”
● EXERCISE THE RIGHT WAY
Understandably, a workout is often the last thing you feel like doing when suffering with fatigue, but research suggests that exercise, especially moderate to high-intensity exercise, is associated with higher energy levels for people going through the menopause. “Regular exercise is really beneficial for improving energy levels,” says Kate. “But if you’re not exercising much at the
moment, don’t rush in and over-do it. One of the worst things you can do is join a bootcamp, get injured and be put off.
“Instead, start with something like swimming, walking or Pilates, which may feel less daunting. Lifting weights is useful too, for maintaining bone density and building some muscle mass in menopausal women.
“The mindfulness element tied in with yoga can also be very helpful. In fact, some studies indicate that yoga specifically may be good for helping improve fatigue symptoms related to the menopause.”
● TRY HRT
“By helping to regulate hormone levels, HRT can certainly help with fatigue and many studies have shown the benefits of HRT for improving sleep in menopausal women,” says Kate.
“This is because sleep disturbances during the menopause are normally due to vasomotor symptoms, such as hot f lushes or night sweats, and these respond pretty rapidly to oestrogen replacement. In fact, following HRT, some women start sleeping better after a few weeks, or even quicker.”
● USE CBT
According to research, Cognitive Behavioural Therapy (CBT) reduces menopausal symptoms, including sleep disturbance, which can impact fatigue.
“If you’re woken by night sweats, try not to get worked up,” advises Kate. “If possible, cool yourself down and try to go back to sleep. You could try paced breathing, where you breathe slowly from your stomach to induce relaxation.
“If, once you’re awake, you notice that your mind is racing, start setting aside regular time in the day to address worries. If you find yourself thinking thoughts like, ‘I’ll never get back to sleep’ or ‘I’m going to feel awful tomorrow’, instead try to tell yourself, ‘This will pass’, ‘I might be a little foggy tomorrow but I’m sure I’ll be able to achieve what I need’ or ‘I’ve coped before on little sleep’. After a bad night’s sleep it’s actually better not to cancel activities and plans, as this can make unhelpful thinking patterns around sleep worse, whereas when you just get on with your day, you prove to yourself you can cope, making you less likely to worry.”
● SWITCH UP YOUR DIET
“During the menopause, women can become relatively insulin resistant so it can be helpful to limit the amount of really sugary things we eat,” says Kate. “This is because if we’re eating all available carbs and sugar and not controlling our blood sugar levels, they may become uneven and this can impact our energy levels and weight.
“Instead try eating small amounts of fruits, vegetables, nuts and seeds, lean protein and wholegrain foods regularly, which are much better for keeping blood sugar levels from spiking and energy levels from dipping.”
Ward off weight gain
Gut microbiome diversity, reduced exercise, poor sleep quality, low mood and the way the body metabolises sugar and fat – all of these can play a part in why women often feel that they are gaining weight during the menopause and perimenopausal stages of their lives.
Menopausal weight gain has also been linked to the natural decline in oestrogen levels at this time. Oestrogen enhances the body’s fat-storing ability, especially around the hips and thighs, hence why many women tend to have more of an hour-glass figure in their younger years as opposed to in middle age. Declining levels of oestrogen trigger the body to start shifting fat from around the hips and thighs, where it is stored as subcutaneous fat just under the skin, to around the belly, where it is stored as deep visceral fat around the organs.
Menopause symptoms can lead to making poor food choices and emotional binge eating. This in
turn can make it difficult to find the enthusiasm to exercise, another contributing factor to weight gain. Furthermore, the body releases a steroid hormone called cortisol to deal with stressful situations, so if a woman is experiencing menopauserelated stress, cortisol can cause extra calories to remain around the belly.
It’s a fact of life that your 50-year-old self is not going to look the same as your 20-year-old self, but with a few lifestyle changes and some adjustments in the way you view things, you should be able to manage your weight.
Make better food choices
Experts agree that a healthy diet is key – it’s important to find something that works for you and that you can stick to. As a general rule, upping your intake of fruit, vegetables, whole grains, legumes, nuts, fish, lean meat, complex carbohydrates, nutrient dense foods and healthy fats such as olive oil and avocado, is a good place to start. Cut down on excess sugar, fatty foods, refined carbohydrates, processed meat, fizzy drinks and fruit juice, and also try to limit alcohol consumption, which often contains additional sugar and empty calories, as well as having a detrimental effect on sleep quality.
Get moving
The NHS recommends a minimum of 2.5 hours of moderate exercise a week – think a brisk walk, a round of golf or a swim – or around 1.5 to 2.5 hours of energetic exercise like jogging, fast cycling or playing an energetic team sport. Or try a combination of the two. You should ideally aim to add in a couple of sessions of strength or resistance training every week, too.
It’s about making sensible choices and small changes. The more you move your body, the more calories you will burn. A good goal is to stay on your feet for as much of the day as you can, so meet a friend for a walk in the park instead of for coffee, take regular breaks away from your desk (sitting still for lengthy periods has been linked to increased abdominal fat) and try to increase your step count, whatever you are doing.
Taking time out for yourself with mindful meditation, Tai Chi or gentle yoga can be highly beneficial to mental wellbeing, relaxing both mind and body and reducing stress levels. Finding an activity that you enjoy makes it easier to maintain – a virtuous circle where exercise lifts your mood, making you feel better
and sleep better, therefore you are more likely to exercise the following day. As you gain muscle, your body will burn calories more efficiently, helping you to lose or maintain weight.
‘Having the right nutrition can be a real game-changer’
Get a handle on hair loss
“Many women complain of their hair becoming thinner during these years and much of this is down to hormonal change,” says Suzie Sawyer, Clinical Nutritionist from Aminoscience (Nhco-nutrition.co.uk). “One of the results of oestrogen loss is hair appearing thinner and slower to grow, and it may shed more noticeably.
“However, it’s not all doom and gloom as we can feed the hair and support hair growth from the inside out,” explains Suzie. “Having the right nutrition, including specific nutrients, can be a real game-changer for arresting hair loss and improving the condition of hair.
“Eating sufficient protein is essential. Proteins are made up of amino acids and the hair is especially rich in cysteine, with approximately 18 per cent of keratin being produced from this key amino acid. Indeed, it’s the main structural protein in hair. Oats, eggs and Brazil nuts are your friends in this respect. These foods are also rich in the essential amino acid methionine, needed to
produce cysteine. Meat and dairy provide methionine and it’s worth noting that traditional vegan foods of beans and soy are poor sources. It’s important, therefore, to be mindful of overall protein intake if you’re vegetarian or vegan. “Collagen also helps to produce keratin, which in turn needs vitamin C to do its work. Vitamin C is rich in all fruits and vegetables, hence another great reason for enjoying a rainbow diet. However, vitamin C is water-soluble and easily lost during food preparation and cooking, so a supplement may provide additional support.”
● PLAN B
B vitamins are important for helping with hair loss, too. “The B-vitamin biotin has become synonymous with healthy hair over recent years and encourages hair growth,” says Suzie. “Biotin is found in many different foods but especially eggs, organ meat, whole grains and nuts.
“Additionally, erratic and heavy bleeding can be a factor during the perimenopause, which can leave women depleted in iron. This hard-working mineral is needed for hair growth, as well as energy, yet another issue for women during these years. Iron also delivers lots of oxygenated red blood cells to the scalp.
“Unfortunately, the stress of having hair issues, together with ongoing menopause symptoms, can encourage the ‘fight or flight’ response, which happens normally when we’re stressed but we don’t want it switched on all the time. Vitamin B5 is needed for normal mental performance and to help the stress response and it’s found in a wide range of foods.
“As with everything, it’s important to be consistent with nutritional intake as results won’t be noticed overnight, but certainly over two or three months, your hair can be restored to its former glory!”
Hormones and anxiety
According to a survey by Anxiety UK, 98 per cent of women experience feelings of anxiety during the menopause and perimenopause.
“Anxiety is a prevalent symptom of the menopause, but awareness amongst women – and indeed healthcare practitioners – is low, says Nicky Lidbetter, Anxiety UK CEO. “Societally, most of us are familiar with hot flushes and weight gain as being symptoms of the menopause, but we need to get much better at recognising anxiety as being a key symptom.’
Anxiety occurs when your body’s “fight or flight” defence works continuously. An imbalance in the way the body processes environmental and sensory stimuli leads to a disproportionate “excitatory” response – an excessive release of neurotransmitters between nerve cells in the brain leading to overstimulation of the nervous system and feelings of anxiety.
During the menopause and perimenopause, changing hormone levels contribute to this imbalance in the brain.
Kathy Abernethy, Past Chair of the British Menopause Society, says: “When you start the menopause, oestrogen levels begin to decline and fluctuate. Your body also produces less progesterone. Both hormones influence the production of a neurotransmitter called serotonin, which is a mood-regulating transmitter. Alongside these emotional changes, coping with physical symptoms, such as sleeplessness and hot f lushes, can leave women feeling worn out, frustrated and anxious.”
Self-help solutions
“For some, simple lifestyle changes could be enough to stabilise their mood,” says Cheryl Lythgoe, Matron at not-for-profit healthcare provider Benenden Health. “Talking therapies, such as Cognitive Behavioural Therapy or counselling can be helpful ways to improve low mood.”
“The food choices you make will have a dramatic effect on the way you feel,” adds Rosie Letts, nutritional therapist at Health & Her. “Pack your plate with powerful goodness that’s proven to balance low moods and mood swings, support optimal brain function and keep you feeling happy and calm.
“Don’t skip meals. When your blood sugar is low and you need energy, a surge of adrenalin triggers glucose release. This surge can make you feel edgy and anxious. Naturally lower levels of progesterone during this period are linked to lower GABA, a neurotransmitter that blocks impulses between nerve cells in the brain. GABA may boost mood or have a calming, relaxing effect on the nervous system, so support its production with magnesium-rich green vegetables, nuts and wholegrains, as well as B vitamins found in meat, offal, fish, eggs, oats, brown rice and nutritional yeast.”
“Minimising alcohol, processed sugar and caffeine can also help to reduce the likelihood of low mood or mood swings,” adds Cheryl.
“Speaking to other people who are also going through the same thing, or have recently experienced the menopause themselves, can provide a great source of comfort and reassurance,” says Cheryl. “While everybody’s symptoms are different and the impact on their lifestyles will vary, knowing that you’re not alone and that the symptoms don’t last forever can make a huge difference.”
‘Food choices will have a dramatic effect on the way you feel’