Dr. Tariq Jagnarine
Family Medicine/Endocrinology, Diabetes
Hormonal changes that define the transition to menopause can cause minor or temporary issues, but also significant and longer-lasting ones that can affect women’s quality of life. As they work to manage physical symptoms like hot flashes and insomnia, it’s also important to find ways to cope with emotional ones, be they mood swings or challenges in regard to mentally adjusting to this new phase.
EMOTIONAL
The emotional impact of menopause depends largely on an individual woman’s personal history and life circumstances, among other factors, but increased stress and mood swings are nearly universal.
This is often a time of reflection and realization that one important phase of life is giving way to another. A woman may feel like her self-identity and sense of femininity have been based on factors that change at menopause, such as her physicality or her ability to have a monthly cycle and bear children. Women might feel grief or regret as they go through this transition. Their social roles may be changing with the end of their fertile years, which can be stressful as well, even if it is welcome. New tactics will be needed to cope with this. There are a multitude of strategies that may help with this, many of which may also contribute to improving a woman’s overall mental, physical and emotional health and well-being.
• Meditation: A mere 15 minutes a day of meditation can effectively alleviate stress, and make it easier to cope.
• Exercise: Any sort of physical activity can reduce stress. The important thing is to do it regularly (at least three times a week).
• Goal setting: Do a life inventory. List things you’d most like to accomplish, hobbies you’re interested in, or skills you’d like to hone. Consider any obstacles that might be in your way, even if it’s simply a negative mindset. Plan to begin pursuing at least one goal.
• Social support: This is a healthy response to stress, because it helps establish a social support network. When overwhelmed by stress, anxiety or worry, call a friend, or see a counsellor.
PHYSICAL
If needed, there are a host of treatments that can help persons cope with the physical symptoms of menopause. Beyond medications, people may find relief by trying some of these approaches.
• HOT FLASHES
The internal thermostat may be very touchy around menopause. Many women find that they have a very narrow range of comfort, and it doesn’t take much to become overheated. Try some of these ways to deal with flashes:
• Dress in layers so you can easily remove clothing if you start to feel hot.
Breathe slowly and deeply: Doing this sort of controlled breathing just as a hot flash begins can shorten its duration and lessen its severity.
• Drink water if flashing and sweating: Water helps replenish and seems to help regulate internal temperature. Try to get at least 48 ounces in a day.
• Turn down the heat: Whenever possible, keep the environment under 70 degrees in the daytime.
• Avoid hot places: Don’t sunbathe or sit in a sauna if prone to flash.
• Don’t eat hot and spicy foods: Even if people have always been able to eat them, they may trigger hot flashes.
• Try flaxseed or flaxseed oil: It may decrease hot flashes, and have the added benefit of reducing joint and muscle pain for some women.
• Consider vitamin E, yam phytoestrogens, and black cohosh: These have all been used for many years to combat hot flashes, though studies on these alternative remedies usually show them to be only as effective as a placebo. Because some supplements can have estrogenic effects, it is best to discuss them with your healthcare provider before deciding to take them.
INSOMNIA
Insomnia is very common just before and after menopause. Sometimes it is due to night sweats, which are hot flashes. But sometimes women seem to have a hormone shift that makes them wakeful at the same time each night. This can be frustrating and exhausting. Here are some things to try:
• Cool the bedroom: Try to keep the nighttime bedroom temperature below 65 degrees.
• Meditate: Just before bed, meditate for a bit. This can put persons in a calm state of mind and help them fall asleep — and stay asleep.
• Take a bath: A warm or cool bath can regulate the temperature, and cause a person to drift off to dreamland comfortable and relaxed.
• Try sedatives: These can sometimes help to regulate the sleep cycle. It’s not a long-term solution, so talk it over with a medical provider.
• Discuss changing antidepressant: If using an antidepressant that makes you wakeful, talk to a health provider about changing to one that has a more sedative effect, and about taking it at bedtime.
• Consider CPAP: If snoring, or if having periods of not breathing while sleeping (sleep apnea)
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VAGINAL DRYNESS AND URINARY INCONTINENCE
Vaginal dryness or pain with intercourse can be very upsetting for women who experience it during menopause. These symptoms can disrupt one’s sex life, which may affect one’s relationship. Incontinence can also be embarrassing and disheartening. These symptoms can be caused by the change in vaginal and urethral tissue that occurs when estrogen drops. In addition to seeking vaginal estrogen treatment:
• Use a lubricant: Because the vaginal wall is becoming thinner, it is easier to tear or damage. Using lots of vaginal lubricant during sex will help prevent damage. Water-based lubricants feel natural, and wash off easily. Silicone-based lubricants last longer, but more women report being sensitive or allergic to them.
• Incorporate vitamin E and flaxseed oil: These can sometimes offer some relief from vaginal and urinary symptoms. Usually, women take them as oral supplements, but there are creams that contain them as well, to be applied directly to the vagina.
• Do Kegel exercises: Strengthening the pelvic floor muscles can improve sensation during intercourse and reduce urinary incontinence.
• There are additional treatments, such as vaginal rejuvenation and platelet-rich plasma injections that a gynecologist may recommend in addition to vaginal estrogen treatments.
WEIGHT GAIN
Since metabolism slows down with age, menopause is a common time to begin gaining weight. Weight loss in menopause requires the same approaches that it does at other times in life. Set a goal for a target weight — one that is both reasonable and driven by achieving good health, not a certain size. Enjoy a varied diet in the calorie goal range.
• Use weight training as an exercise to get stronger, prevent osteoporosis, and step up your resting metabolism.
• Managing stress has a place here as well, as it can help tame the release of hormones like cortisol, that tell the body to hang onto fat.
MEMORY PROBLEMS
Although some memory loss is part of aging, there may be some transitory loss that comes with the dip in estrogen which is associated with menopause. Here are some suggestions for relief:
• Consider the diet: Get plenty of colourful fruits and vegetables for antioxidants and vitamins. Cut back on (or cut out) alcohol, sugar, and caffeine, and see if it improves the ability to remember.
• Explore memory strategies: Use acronyms to remember lists of names or streets. Associate one thing with another; for example, green apples to remember a person with the last name Green.
• Implement external supports: For example, hang keys in the same place every time, or put important information into a cell phone, to be easily accessed.
SOCIAL
Nurturing and leaning on existing relationships is beneficial for everyone, and that’s certainly the case in menopause. But it can also help to try to make new relationships with women who are in this life stage.
Every woman’s experience is unique, and how they can best cope with menopause is, as well. Keep in mind that menopause is another life stage. Just like adolescence, women can cope with the changes leading up to it, and enter this new chapter confidently by adopting some useful strategies.
