And here’s another positive news flash about menopause: It’s not a disease, nor does it have to present life-altering changes. Many women cruise through menopause with minimal symptoms, and many of the symptoms that women do experience can often be controlled naturally. Doctors commonly define menopause as the absence of periods for 1 year without other obvious causes. According to the North American Menopause Society, American women enter menopause between the ages of 40 and 58. The symptoms of menopause vary widely from woman to woman. There may be few for some women, and others may be hit like a gale-force wind. As women age, their estrogen levels drop, which triggers menopause and also increases the risk of cardiovascular disease and osteoporosis. The most common symptoms are weight gain, vaginal changes (including dryness and loss of tissue elasticity), sleep disturbances, emotional changes, and hot flashes. But that doesn’t mean you have to have these symptoms. Eat right, exercise, and talk to your doctor about the possibility of hormone replacement therapy (HRT), other medications, or herbal remedies. They all can help smooth your transition, enabling you to enjoy the benefits of menopause: no more periods, no more PMS, and no more pregnancy worries.
Stamp Out Cigarettes
Your chances of developing heart disease and osteoporosis jump during menopause. Smoking makes these odds even higher. That’s not the only reason to quit. “Smokers have a 2-year-earlier menopause on average than nonsmokers,” says Mary Jane Minkin, MD. Quitting smoking at an early age is critical both for your reproductive health and for a healthy transition into menopause. Granted, if you quit at 48, it won’t stop early menopause, but if you’re 22 or 23, it might help, she says. Here’s another good reason to quit smoking: When there’s smoke, there’s more likelihood of hot flashes. Research has found that 50% of smokers have troublesome hot flashes, compared with 33% of women who have never smoked, Minkin says. MORE: How Long Will My Hot Flashes Last?
Refrain From Binge Drinking
Too much booze is another no-no for both bone and heart health as you transition into menopause. “Drinking a glass of wine a day is fine,” says Minkin. But drinking a bottle a day is definitely not good for either your heart or your bones. Drinking alcohol excessively inhibits bone formation, according to the National Osteoporosis Society, and this is the time of your life when fragile bones become a bigger health concern. And alcohol brings on hot flashes, one of menopause’s greatest discomforts, says Minkin.
Bone Up On Calcium
You can get a healthy dose of daily calcium from dairy products. “The reality, however, is that most women don’t drink a lot of milk and eat a lot of cheese because they’re legitimately worried about saturated fat and calories,” says Minkin. To ensure adequate calcium intake, Minkin recommends taking 1,000 milligrams of supplemental calcium a day. (Here’s 10 dairy-free ways to get calcium.)
Don’t Forget Vitamin D
This is the other nutrient that Minkin pinpoints as crucial to good menopausal health. Although the standard minimum vitamin D recommendation is 400 to 800 IU per day, experts recommend no less than 800 IU daily for women older than 60, Minkin says.
Know The Truth About HRT
A persistent myth exists that it’s dangerous to go on and off HRT. “It’s not,” says Minkin. In fact, she adds, women should feel free to experiment with HRT until they find the combination that works best for them—or decide they don’t need it at all. Minkin also addresses the other major concern surrounding HRT—the risk of breast cancer. “Taking estrogen for 2 months will not give you breast cancer,” she says. Most providers are comfortable with patients continuing estrogen therapy for up to 5 years, she says. After that, you face a small rise in the risk of breast cancer. She doesn’t stop HRT for those women taking it for 5 years. Instead, she reviews their dosage at every visit. The North American Menopause Society suggests that estrogen and progesterone are more beneficial if you use them for short-term symptom relief at a younger age. HRT consistently turns up as one of the best remedies for one of the most troublesome symptoms of menopause: hot flashes, says Minkin. MORE: The Benefits And Risks Of HRT
Know The Truth About Your Diet
“Women metabolize foods differently than men,” says Larrian Gillespie, MD. “Where men use carbohydrates for energy, women use carbohydrates to store as fat so we’re able to procreate in the face of starvation.” Plus, she notes, alterations in estrogen levels make these diet differences even more pronounced as we progressively age. To counteract the weight gain typical of menopausal women, Gillespie recommends eating five or six smaller meals interspersed throughout the day rather than three large meals. “These meals should each be around 250 to 300 calories,” she adds. (Avoid these 10 common post-menopause eating mistakes.)
Try A Lubricant
Another typical complaint of menopause is decreased sexual desire, sometimes caused by low estrogen–induced physical changes in the vagina. “If the lack of interest in sex is caused by physical discomfort, there are a number of over-the-counter lubricants you can try. You can also ask your doctor about estrogen creams, tablets, or rings,” says Minkin. You can safely use vaginal estrogens “forever,” she says, since only a minimal amount is absorbed in your body. “If there are emotional issues involved, however, the couple really needs to focus on matters in their relationship.”
Try Old-Fashioned Sleep Remedies
If sleep is a problem, Minkin advises some of the old tricks that your grandmother might have taught to you to help you sleep better. “Drinking a warm glass of milk, taking a warm bath, or not focusing on the day’s events can help you sleep more restfully,” she says.
Share Your Troubles With Friends
Much of the stress of menopause for women is from other life changes that may be occurring at the same time. “Kids are finishing college and moving back home, parents are aging and developing health problems, and husbands are going through their second childhoods. These are all issues I hear from my patients,” says Minkin. Friendships can help you overcome these emotional land mines. “Volunteer your time for a charitable organization, or join a menopause support group,” she says. “These are great ways to meet friends, share life’s stresses, or just get together and share experiences.” MORE: 10 Things No One Ever Told You About Menopause
Breathe Deeply
In one study, 33 women with frequent hot flashes were given lessons in deep breathing, muscle relaxation, or a placebo treatment. Those in the deep breathing group saw their hot flashes cut in half. Practice by sitting comfortably and inhaling deeply through your nose so your belly expands, then exhale through your mouth. Repeat for 15 minutes, taking 5 seconds to breathe in and 5 seconds to exhale. Do this for 5 minutes whenever you have a hot flash.
Give Your Partner A Book
You might feel comfortable with your understanding of your physical and emotional transitions at this point in life. But your partner may be totally oblivious to the changes going on in your body and doesn’t understand why things get tough for you from time to time. “Have your partner read up on it to understand the changes your body is going through and then hopefully react with patience and encouragement,” says Minkin.
Buy Black Cohosh
“This is my favorite herb to use for menopausal symptoms. It really does make a big difference,” says Connie Catellani, MD. Studies in menopausal women show that black cohosh may be helpful in treating mild to moderate hot flashes. Research focusing on a standardized black cohosh extract called Remifemin has found it performs on par with estrogen replacement treatment. Scientists have yet to determine precisely how black cohosh works, but it may help control the effects of estrogen. Some doctors say it shouldn’t be used daily for more than 6 months because its long-term effects have not been studied. But women appear to tolerate it well, and adverse events seem to be rare when women take it for 6 months at a time. To prevent menopausal symptoms, take one or two 40-milligram capsules or tablets of extract (standardized to 2.5% triterpene glycosides) twice a day. The dosage for standardized extract is 1/2 to 1 teaspoon (60 to 120 drops) twice a day, says Catellani. If you are currently taking HRT and would like to switch to black cohosh, talk to a health care practitioner. You may need guidance to make the transition. Otherwise, you’ll have a flare-up of menopausal symptoms.
Get Milk Thistle
If you’ve been taking synthetic hormones and having symptoms related to excess hormone levels—such as breast tenderness, headaches, or bloating—it may mean that your liver isn’t “clearing” the breakdown products of these drugs well, says Serafina Corsello, MD. To help it out, she recommends milk thistle, or silymarin, an herb that protects the liver against harmful substances and even helps repair and regenerate injured liver cells. Milk thistle is best taken as a standardized extract. The usual dose for milk thistle is 420 milligrams, divided into two or three doses a day for 6 to 8 weeks, then a reduction to 280 milligrams daily, Corsello says.
Seek Out St. John’s Wort
Hormone-related depression, if experienced at an earlier stage in life, may return during menopause, Catellani says. St. John’s wort, long recognized for its ability to fight “melancholy,” has been shown to be effective for mild to moderate depression. “It’s less likely than prescription antidepressants to cause side effects, such as fatigue, loss of sexual interest, or dry mouth,” she explains. The dosage used in most clinical trials was 300 milligrams in capsule form, three times a day, of an extract containing 0.3% hypericin, one of the active ingredients in St. John’s wort. And you may need to use it regularly for 2 to 3 weeks before you see an effect. If symptoms persist, seek immediate help from a qualified mental health professional. MORE: 6 Workout Mistakes Women Make When They Hit Menopause
Consider Kava
Kava is emerging as the herb of choice for women who want to mellow out when life puts them on edge. A 2007 article in the journal American Family Physician recommended kava for short-term use in people with mild to moderate anxiety, based on the results of a number of studies. Kava has few side effects compared with prescription antianxiety drugs, is not addictive, and in therapeutic doses does not affect concentration or alertness. The standard dosage is 70 milligrams of standardized kava extract, taken two or three times a day. “It does work, and it does have a sedating effect, so I might recommend it for short-term situational anxiety,” Catellani says. “But personally, I prefer that women look at and change the things that are causing them anxiety rather than take a pill, whether it’s herbal or not.”
Menopause Kitchen Cures
As a natural phytoestrogen, soy has proven useful for helping women overcome the symptoms of menopause in numerous studies. You can choose from a variety of soy food products readily available at your grocery store. Minkin recommends 45 to 60 milligrams of isoflavones per day. A 1/2 cup of tofu or a glass of soymilk each day is a good source of isoflavones.
When To Call A Doctor
Minkin has a few rules for when you should see your doctor about menopause-related symptoms. First, she recommends an annual exam no matter what. Also, if you have irregular spotting or strange bleeding for any reason, see your doctor, she says. Finally, if menopause leaves you feeling unwell in general, see your doctor. MORE: 9 Things Your Gynecologist Wishes You’d Stop Doing
Panel Of Advisors
Connie Catellani, MD, is a physician in Skokie, Illinois, who uses alternative therapies as part of her practice. Serafina Corsello, MD, was the medical director of the Corsello Centers for Complementary-Alternative Medicine in New York City, and currently focuses on lifestyle and nutritional counseling. She is author of The Ageless Woman. Larrian Gillespie, MD, is a retired assistant clinical professor of urology and urogynecology in Los Angeles and president of Healthy Life Publications. She is author of the books The Menopause Diet and The Goddess Diet. Mary Jane Minkin, MD, is a clinical professor of obstetrics and gynecology at Yale University School of Medicine and an obstetrician-gynecologist in New Haven, Connecticut. She is coauthor of What Every Woman Needs to Know About Menopause and A Woman’s Guide to Menopause and Perimenopause.
