5 STEPS FOR A BETTER CHANGE

The menopause is a brilliant time to take control of your health, to help you feel happier and healthier now and in the future

1 KEEP MOVING

Research shows that exercising regularly can help to reduce menopause symptoms, including hot flushes and insomnia, because it helps to stabilise your thermoregulatory system, lowering your core body temperature and improving how your body distributes heat. ‘We’re only now beginning to understand the true power that exercise has to manage menopause,’ says Dr Juliet Mcgrattan, author of Sorted: The Active Woman’s Guide To Health. ‘It can also counteract the fall in muscle and bone mass, plus lower the risk of heart disease and certain types of cancer that increase at the menopause.’

TOP TIP Add weight-bearing or resistance exercises to your routine to help boost muscle and bone mass. These can include lifting weights, working with resistance bands, hill walking, push-ups, sit-ups or squats.

2 MAKE OVER YOUR BEDTIME

Hot flushes and night sweats occur because falling levels of oestrogen and progesterone cause blood vessels to dilate. This allows more blood through the body, bringing more heat with it: hello, uncomfortable nights! ‘Wear fabrics that wick moisture away from the skin to avoid drenching sweats disturbing your sleep,’ says Dr Alanna Hare, a specialist in sleep medicine at the Royal Brompton Hospital in London. Dr Hare suggests trying CBTI (cognitive behavioural therapy, but specialised for insomnia), which has been found to improve sleep in women with hot flushes. ‘It works on sleep behaviours as well as helping you to develop coping techniques,’ she says. Your GP may be able to refer you, but you can also find CBTI online packages and smartphone apps.

3 TRY THE MENOPAUSE DIET

This is not about faddy eating; it’s about choosing nutrient-rich foods to help support your body. LOOK AFTER YOUR GUT There’s a real buzz around gut health right now. ‘The emerging research into the gut microbiome and how it relates to hormonal health may place nutritional interventions more centre stage in the future,’ says Dr Hannah Short, a specialist in menopausal and premenstrual disorders. ‘Eating a fibre-rich diet improves gut health and

evidence indicates that women who eat a wide variety of plant-based foods suffer fewer menopausal symptoms.’

EAT HAPPY-HORMONE FOODS Studies show that symptoms are also reduced in women who eat a lot of phytoestrogens (naturally occurring plant compounds that are structurally similar to oestrogen). ‘Phytoestrogens can cushion the effect of the hormone rollercoaster,’ says Dr Marilyn Glenville, a nutritionist specialising in women’s health. ‘Don’t base everything around soya: also include chickpeas, oats, lentils, flaxseeds (linseeds) and kidney beans, and aim for variety.’

GET YOUR CALCIUM QUOTA We lose up to 20% of our bone density in the five to seven years after the menopause. Good sources of calcium include green leafy vegetables, nuts, seeds, tinned fish (with bones) and dairy products. You also need vitamin D from sunlight, so take a supplement from October to March.

EAT LITTLE, BUT OFTEN ‘Don’t go for more than three hours without eating,’ says Dr Glenville. ‘If you wait longer, your blood sugar will drop and adrenaline and cortisol will be released, giving rise to anxiety-related symptoms.’

RETHINK DRINKS Now is a great time to cut back on unhealthy habits, like drinking too much caffeine or alcohol, which can stimulate your body and make symptoms worse. Try decaf coffee and having alcohol-free days to see if it helps.

4 MIND YOUR MENTAL HEALTH

We have numerous oestrogen receptors in the brain, so it’s little wonder that wayward hormones can trigger everything from mood swings to ‘brain fog’. In fact, a survey by Healthspan found that a third of menopausal women had feelings of anxiety and almost a third felt depressed.

‘There’s sadly a huge lack of awareness of psychological symptoms: I’ve seen women worried that they’ve developed dementia,’ says Dr Meg Arroll, a chartered psychologist and co-author of The Menopause Maze. ‘However, psychological symptoms are often the first signs of plummeting oestrogen, which has soothing properties in addition to its physiological roles.’

Menopausal mental-health concerns can affect anyone, but some studies suggest those who’ve struggled with premenstrual syndrome (PMS) or postnatal depression, who might have a higher sensitivity to hormones, might be more predisposed. So, what should you do? First, don’t blame yourself. ‘Dropping levels of hormones are causing the symptoms: they’re not a reflection on your ability to cope, so treat yourself with compassion,’ says Dr Arroll. Then take the following steps.

SEE YOUR GP Your GP can refer you for CBT or recommend an online course. If you live in England, you can refer yourself to NHS counselling through IAPT (Improving Access to Psychological Therapies) at nhs.uk.

TACKLE STRESS ‘This is of huge importance,’ says Dr Short. ‘When you’re stressed, your cortisol levels shoot up, which can affect the balance of oestrogen and progesterone in your body, as well as exacerbating any symptoms you’re having.’ So, prioritise yourself, delegate more and talk to supportive friends and family. The latest studies show that mindfulness can ease anxiety, while mind-body exercises such as yoga can help reduce psychological difficulties in menopause.

REFRAME YOUR THINKING In some cultures, such as Japanese, the menopause is seen as a time to embrace the wisdom and freedom that come with age, and this is thought to be one reason why women in those countries tend to experience fewer symptoms. Eileen Durward, a menopause expert for A. Vogel, suggests that turning your thoughts to silver linings can be helpful. ‘Period-free life, without anaemia, fatigue and the emotional rollercoaster, can provide huge opportunities, both practically and healthwise,’ she says.

5 EASE THE OUCH

Your vagina needs hormones in order to stay supple. Being less naturally lubricated can not only affect your sex life but also lead to urinary tract infections and painful skin thinning. Your GP can prescribe creams, tablets or rings containing oestrogen to ease these symptoms, and lubricants and moisturisers may also help.

TOP TIP The tissues of your bladder and its supportive structures are affected by declining oestrogen levels, so don’t forget to keep doing your pelvic floor exercises.

Exercise has true power to manage menopause