You turn hot and cold more often than a space heater, a good night's sleep is a distant memory and your snippy mood makes Oscar the Grouch look amateur. Menopause is no fun, but it doesn't have to make you miserable. We talked to top doctors for 16 ways to get relief from these nightmarish symptoms. Plus, test your women's health IQ with our quiz...
With menopause, your body is doing a hormonal break dance. As early as your late 30s, your ovaries start producing less estrogen and progesterone. By the early 50s, they usually stop producing eggs, putting an end to monthly periods. If you haven’t had a menstrual cycle for 12 months, you’re officially in menopause.
But "change of life" woes arrive long before then — irregular periods, vaginal dryness, hot flashes, poor sleep, moodiness and more belly fat. And you’ll have other changes you can’t feel, such as a loss in bone density. None are welcome, but they don’t have to take over your life.
Check out doctor-recommendations for menopause relief:
1. Rev up your exercise.
Working up a sweat may not sound helpful, but exercise is more important than ever during menopause. The decline of estrogen levels diminishes bone density and leaves you at risk for osteoporosis. It also may cause memory loss.
Exercise counteracts those side effects. Weight-bearing workouts, such as walking and jogging, stimulate bone growth and increase density. So does strength-training. It also helps curb the seemingly inevitable weight gain, makes falling asleep easier and lowers stress.
“Do a mix of aerobic strengthening and balancing exercises every day — or at least an hour a day four times a week,” advises Wulf Utian, M.D., executive director of the North American Menopause Society and a consultant in women’s health at the Cleveland Clinic in Ohio.
“Balancing and strengthening will make you less likely to fall and fracture a bone. Aerobics will benefit your heart, lungs and brain, slowing the loss of cognition,” he says.
Consider taking a yoga class once or twice a week too: A 2008 Indian study of 120 women who practiced yoga an hour a day for five days a week over eight weeks found that they had 50% fewer hot flashes and night sweats than those who only did stretching.
2. Overhaul your diet.
Another way to keep your weight down? Eat a healthy diet of at least five servings of high-fiber fruits and vegetables a day; other high-fiber foods such as brown rice and whole-grain breads; and lean proteins like chicken, fish and soy foods.
These foods suppress hunger and steady blood sugar levels so that your moods and energy don’t fluctuate as much.
High-fiber foods also ease the constipation that often accompanies menopause, says Kevin Audlin, M.D., a gynecologist at Mercy Medical Center in Baltimore.
“The lack of estrogen decreases bowel activity, so you get bloated and constipated.”
Eating plenty of foods rich in calcium and vitamin D — low-fat dairy products, green leafy vegetables, beans and fish — is also key to keeping bones strong. (See “calcium and vitamin D supplements" below.)
3. Eat more soy.
“Soy is a weak plant estrogen; adding some to your diet can help fight hot flashes,” says Mary Jane Minkin, M.D., professor of obstetrics and gynecology at the Yale University School of Medicine and author of A Woman’s Guide to Menopause and Perimenopause (Yale University Press).
Even though studies on soy’s effectiveness have had mixed results, Minkin recommends it: “Try it and see if it works within a month or two.”
Drink 1-2 cups of soy milk or eat a cup of edamame (steamed soybeans in the pod) daily, she advises.
4. Take calcium and vitamin D supplements.
“Within the first 5-10 years after menopause, women lose 10% or more of their skeletons,” Utian says. A diet adequate in calcium and vitamin D might reduce the loss.
Because it’s hard to get enough in most diets, he advises women to take supplements. You need 1,000-1,500 mg daily of calcium and 800 units daily of vitamin D in food and pills.
5. Discipline your sleep habits.
Hot flashes and night sweats are no lullaby. Both hormone replacement (see “hormone therapy” on page 4) and exercise can help you sleep better.
So can a few simple lifestyle changes:
Turn down the thermostat at night and open the windows. A cool, well-aired room helps you sleep, Utian says.
Wear loose PJs – or go bare. Don’t risk being awakened by tight or twisted clothing.
Skip caffeinated beverages after noon. They can keep you bouncing for 12 hours after you knock them back.
Go to bed and get up at the same time every day.
Skip tempting afternoon naps — they only make it harder to sleep later, Utian says.
Try relaxation techniques such as deep breathing and progressive muscle relaxation (a process during which you lie down and consciously relax each set of muscles, one by one, from head to toes).
6. Dress in layers.
When you have a hot flash, you want to rip your clothes off. So how can you avoid arrest for indecent exposure?
Dress in layers so you can strip down as you heat up, Utian advises. And stick to breathable natural fibers such as cotton and linen, which are less likely to keep you hot and clammy.
7. Lubricate.
If your vagina feels dry when you’re making love, ask your doctor about an estrogen vaginal tablet, ring or cream. They contain tiny doses of estrogen that increase lubrication, but very little of the hormone is absorbed by the body, Minkin says.
You can also lube up with over-the-counter products such as Astroglide or K-Y — “my patients’ favorites,” Minkin says — or moisturizers like Replens or Vagisil.
“Replens is a longer-lasting one, so you apply it only three times a week,” she says.
Is making love more often a smart move?
“A fabulous idea,” she says. “You increase the pelvic blood flow and that increases lubrication.”
8. Drink water.
Hot flashes and night sweats rob your body of fluids. Menopause’s hormonal changes also dry out skin and mucous membranes. “Water helps moisturize those a bit,” Minkin says.
Staying well-hydrated also lessens the draggy feeling that often comes with menopause.
Aim for six to eight 8-ounce glasses a day and drink a glass of cold water during a hot flash; you’ll feel cooler, she says.
9. Relax.
In a 2005 University of Pennsylvania study, researchers who followed 430 women for six years found that those with moderate anxiety tripled their risk of hot flashes compared with women with normal stress levels. Those overwhelmed with anxiety were five times more likely to feel the burn.
If that’s you, talk to a doctor about SSNRI (Selective Serotonin Norepinephrine Reuptake Inhibitor) antidepressants because they “help with mood swings and hot flashes,” Audlin says.
And consider adding meditation and deep breathing sessions into your day.
“Deep breathing may help reduce hot flashes by helping the body to reset its thermostat,” Utian says.
10. Take black cohosh.
This herb has been shown to have an estrogen-like effect on people and is believed to relieve menopause symptoms. But be careful which you choose because not all brands are effective, says Minkin, who recommends Remifemin, a well-researched and standardized supplement.
American studies on other kinds of black cohosh have shown that it works no better than placebo, says Minkin, but European and U.S. studies on Remifemin show that it’s helpful and safe.
Why? That’s not clear yet, she says.
“Take one tablet twice a day,” Minkin advises. “You’ll know within a month or two whether it’s working.”
11. Consider hormone therapy.
As controversial as hormone replacement therapy (HRT) is, estrogen provides the most effective relief for pesky hot flashes, night sweats and vaginal dryness. It can also reduce the risk of osteoporosis, colorectal cancer, and, if taken before age 60, heart disease.
But HRT isn’t for everyone: The 2002 Women’s Health Initiative study of 10,000 women found that combination hormone therapy — estrogen and progestin — slightly raised the risk of heart disease and stroke, breast cancer and blot clots. But estrogen alone didn’t appear to raise the risk of breast cancer or heart disease.
If you’re on HRT, review your need with a doctor every year, Utian advises. “Ask, ‘Do I still need it? What are my risk factors? Should I take a holiday and see if I still have symptoms?’”
12. Stop smoking.
Smoking can bring on menopause early and intensify your symptoms, Audlin says. “Smokers have menopause 12-18 months earlier than women who don’t smoke.”
A 10-year University of Michigan study also found that smokers had twice the number of hot flashes as nonsmokers. They're also at greater risk for osteoporosis.
13. Avoid alcohol and caffeine.
If hot flashes and night sweats leave you sleepless, alcohol and caffeine will only make it worse. Both are dehydrating stimulants that can bring on those episodes, Minkin says.
“Red wine, in particular, is a hot flash trigger,” although any type of alcohol may set off one, she says. “A hot cup of coffee — or any hot liquid — can do it too.”
Caffeine also increases calcium excretion and reduces how much of the vital mineral you absorb. Alcohol, too, diminishes calcium absorption and inhibits liver enzymes that activate vitamin D.
“But you’d have to be drinking a lot of either [substance],” Minkin says. “A couple of cups of coffee a day and a glass of wine a day is fine.”
Too much alcohol — two or more drinks a day — may raise the risk of breast cancer, according to a 2008 National Cancer Institute study.
Need more incentive to limit drinks? At 100-150 calories per glass of wine, it’s no help for your waistline either, Minkin says.
14. Skimp on sugar.
Sugary sodas and candy provide no nutrients. What’s more, high-sugar foods raise your blood sugar quickly, which causes the pancreas to produce more insulin. The hormone encourages the conversion of calories to fat when you’re already coping with weight gain from the loss of estrogen.
“It’s a caloric issue,” Minkin says. “In general, you don’t want to eat a lot of sugar.”
15. Lighten up on salty and processed foods.
“A high-salt diet increases water retention and your risk for high blood pressure,” Audlin says.
A 2005 study at the Veterans Affairs Medical Center in Miami and the University of Miami Miller School of Medicine found that menopause’s hormonal changes can trigger salt sensitivity, which can lead to increased blood pressure.
Processed foods are notoriously high in salt. Eat fresh foods instead and take the salt shaker off the table.
16. Go bland.
“Spicy foods make you flush,” says Utian, and you don’t need that on top of hot flashes.
“Women are pretty good at figuring out what triggers a hot flash,” Minkin says. “So you have to decide if [spicy food] is worth it.”
For a humorous, provocative look at menopause, check out Hot Flash Havoc, a documentary about women’s “second act.”
For more information, visit our Menopause Health Center.
Women’s Health: How Much Do You Know?
There's no substitute for good health, and when it's gone, it's often gone for good. Don't let it pass you by.
No comments:
Post a Comment