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WHAT'S NEW
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Zen menopause: The calm, cool change
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Yes, it is possible to take charge of "the change" and have a symptom- and stress-free menopause.
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By Ylva Van Buuren
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Exercise
Zhao recommends gentle mind-body exercises, such as tai chi and yoga, to reduce the intensity of, or prevent, mood swings, hot flashes, insomnia and sore breasts. "These activities teach you to calm your body through your breath," she explains. "When the body is calm and relaxed, there are fewer hormone fluctuations -- and symptoms."
More vigorous exercise, such as cycling and fitness classes, may also help. Huh says there's no science behind why regular daily exercise decreases hot flashes, "but it may be the increase of the feel-good endorphins in the brain." At the same time, "systematically, we're more prepared to deal with hot flashes if we're feeling better overall because we exercise," says Huh.
Studies also show that women who are physically active and who haven't suffered from major depression in the past are less likely to develop depression that may occur with perimenopause, and exercise is a known stress reliever (which may reduce headaches). It helps with weight-loss goals, too.
Sleep
Most women feel less stress when they are well rested -- and that means they're better able to cope with their perimenopause symptoms, such as headaches, says Prior.
Wales offers these suggestions to improve your sleeping environment
- Sleep in the dark. Light at night can decrease the production of a hormone called melatonin, which we need for sound sleep. If you do have to get up, says Wales, leave the lights out or use a red light.
- Wear breathable cotton pyjamas and layer on covers that you can remove one at a time.
- Preset the thermostat so it is a lower temperature during the first four hours of sleep -- when women tend to wake up from night sweats. Keeping your body cool may help avoid hot flashes.
- Herbal sleep inducers can help prevent insomnia. Try valerian tea or capsules, herbal "sleepy-time" combinations (including passionflower, skullcap and hops) and lemon balm. Lavender, a calming herb, under your pillow is thought to help as well.
Stress
Studies have shown that women with the most perceived stress in their lives, no matter what their ethnicity or genetic background, have the worst hot flashes, says Prior. Calm the mind with gentle yoga, meditation and other mind-body modalities. Destress the body with regular exercise, and try massage, acupressure and other body treatments. Consider group or talk therapy because talking with others can be helpful. And think positive, says Prior. "For women with mild hot flashes, just believing they're going to get better can cause a 50 per cent improvement."
Hormone Update
Some doctors prescribe natural (or bio-identical) progesterone for symptoms in perimenopausal women. Studies have shown that progesterone can help reduce hot flashes (by 75 to 95 per cent), heavy menstrual flow, breast tenderness and sleep problems in perimenopause without any serious health risks, says Dr. Jerilynn C. Prior, a perimenopause researcher.
Once menopause is reached, estrogen therapy, on the other hand, has been controversial. For example, the 2002 Women's Health Initiative studies on hormone replacement therapy (an estrogen or estrogen-progesterone-like hormone combination) in healthy menopausal women without symptoms showed an increase in heart disease, strokes and possibly breast cancer in users.
However, the Society of Obstetricians and Gynaecologists of Canada recently issued new guidelines that say hormone therapy is safe for moderate to severe menopausal symptoms, including hot flashes and mood changes, when prescribed at the lowest effective dosage for the appropriate duration.
Sex & Health
Vaginal dryness can appear in perimenopause for unknown reasons, although it is more typical in menopausal women due to low estrogen levels. Regular sexual activity (ranging from once a week to a few times a month or more) helps maintain vaginal health because it promotes increased blood flow to the area. If dryness is a problem, says Prior, gentle sex, mental stimulation and nonhormonal lubricants will help.
Periods During Perimenopause
When heavy bleeding is a symptom of perimenopause, you can decrease the amount of flow by 25 to 45 per cent by taking ibuprofen (200 mg) every four to six hours during heavy flow, says Prior. Also, eat iron-rich foods (dried fruits, dark green vegetables, meat, nuts or eggs) and check in with your doctor. If your blood count is low, you may need to take an over-the-counter iron supplement.
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