How to manage your menopause
Hormone replacement therapy is one answer to the menopause, but controversial, and natural therapies can also be very helpful. Remember that menopause is not a disease and it won't last forever. Try some of these approaches for relief in the meantime.
- If you've been having hot flushes, keep off alcohol, coffee, spicy foods and hot drinks. Many of these foods are triggers.
- To help prevent accelerating bone loss–osteoporosis–make sure you get enough protein. It doesn't take much chicken, fish or meat to supply your daily requirement of protein. As long as you have a serving that's about equal to the size of the palm of your hand, you're getting enough.
- Try taking a daily supplement containing 600mg calcium, 300mg magnesium and 10mcg vitamin D. Low-fat dairy products such as skimmed milk are good sources of calcium.
- Tofu is high in phytoestrogens–compounds with mild oestrogen-like qualities that have been found to ease menopausal symptoms. Certain kinds of phytoestrogens, called isoflavones, found in soya products can help to ease hot flushes and vaginal dryness. The recommended amount of isoflavones is 60mg daily, which is what you get by eating 200mg of tofu.
- Flaxseeds are another source of phytoestrogens. Grind some in a spice mill or coffee grinder and add 1-2 tablespoons to cereal, yogurt or fruit smoothies.
- Women have used chasteberry for around 2000 years to help restore progesterone levels, which decrease during menopause. Chasteberry may be particularly useful for combating very heavy bleeding, which some women experience during the perimenopause. It may also help with other symptoms, including hot flushes and depression. Take tablets or capsules according to manufacturer's instructions. Look for a product standardised to contain up to 1g dried fruit equivalent. And be patient: you may not notice any effects for 3 months or so. (Caution: Do not use chaste-tree products at the same time as the oral contraceptive pill or hormone replacement therapy [HRT].)
- Red clover may help with menopause symptoms, including hot flushes, sweating, mood swings and sleep disorders. Look for tablets or capsules standardised for isoflavone content; or try a rosy-coloured tea brewed from red clover flower heads. Try Meno Joy it's based on a combination extract of hops and red clover which provides a variety of natural isoflavone types.
- If you take synthetic hormones (HRT), you may have symptoms related to excess hormone levels–such as breast tenderness, bloating or headaches. But some of these symptoms can be alleviated with milk thistle, a herb that helps the liver to clear away some by-products from the synthetic hormones. Take according to manufacturer's instructions, and look for a product standardised for its content of silymarin, the active ingredient.
- Some women find that taking vitamin E can help to relieve hot flushes and night sweats as well as mood swings and vaginal dryness. The suggested dose is 250mg twice a day. However, you should talk to your doctor before you start taking vitamin E regularly. This is especially important if you have diabetes, bruise easily or have high blood pressure.
SHOULD I USE HRT?
HRT is the administration of oestrogen and, perhaps, progestogen (a progesterone-like preparation) to women at or after the menopause. HRT replaces the lost oestrogen and can counteract some of the effects of the menopause. But the decision to take HRT is an individual one: the benefits of alleviating flushes and vaginal dryness in the short term, and protecting against osteoporosis in the long term, must be balanced against the slightly increased risk of heart attack, stroke, breast cancer and ovarian cancer. And while some studies suggest that HRT may protect against heart disease, others show that oestrogen increases the risk of heart attacks and strokes, and encourages potentially dangerous blood clots.
Some types of HRT cause a monthly bleed, rather like a scanty period. But postmenopausal bleeding not associated with HRT, or bleeding between periods in the perimenopausal period, may be a sign of more serious problems and you should discuss this with your doctor.
Remedies for hot flushes
- Increase the amount of aerobic exercise you get to at least 20 minutes a day. Studies show that daily vigorous physical activity decreases hot flushes and night sweats, helps to improve mood and sleep, and improves the balance of hormone levels. Weight-bearing activities such as walking, running and resistance training also help to keep your bones sturdy.
- Make a cooling aromatherapy facial mist to relieve hot flushes. Combine 200ml rosewater, 5 drops lavender essential oil and 1 tablespoon witch hazel in a plastic spray bottle. Store it in the fridge and use it to spray your face whenever required.
- Stay cool by wearing lightweight clothing made of natural fibres, and carrying a small, battery-powered fan with you. See our page on night sweats for more information if hot flushes are disturbing your sleep.
Sex and the menopause
Vaginal dryness, the result of waning oestrogen levels, is enough to put anyone off sex. It hurts. Try a water-soluble lubricant, such as K-Y Jelly, and avoid oil-based lubricants such as petroleum jelly (Vaseline). Studies suggest that oil-based moisturisers don't work as well and can actually increase irritation if used long term.
A menopause treatment to avoid
Some women turn to progesterone creams or suppositories to ease menopause symptoms, but doctors and researchers are concerned that overuse of progesterone might increase the risk of breast cancer. Talk to your doctor before using the cream.