By Laine Bergeson
In today’s culture, menopause has become synonymous with uncomfortable, quality-of-life-eroding symptoms — from hot flashes, weight gain, and sleeplessness to irritability, depression, and forgetfulness. Most women today just resign themselves to feeling crummy for a few years in their late 40s and early 50s. So why not grab a glass of wine and a cupcake (or three) and grin and bear it?
Here’s why: menopause isn’t just another word for feeling fat, tired, and cranky. A lot happens in a woman’s body during this time, and some physiological changes are inevitable — but, with some strategic lifestyle interventions, feeling generally terrible isn’t one of them.
“Suffering is optional in menopause,” says Sara Gottfried, MD, author of the New York Times bestseller The Hormone Reset Diet (Harper One, 2015) and the forthcoming book Younger (March 2017). “The best strategy to sail through without losing your verve is to prepare and to balance your hormones naturally.”
The first step? Remember that menopause is a process, not a one-day event. Many still consider the 12-month mark after a woman’s last period as the onset of menopause. That’s it. A one-day affair.
In reality, the hormonal changes that culminate with the end of ovulation start as many as 15 years earlier. This period is known as perimenopause, and Gottfried likens it to adolescence, when hormones start to ebb and flow in new directions. In puberty, a woman’s fertility hormones — estradiol and progesterone — start to surge. In perimenopause, they start to slow down. In menopause, the production of these hormones comes largely to a stop.
But women shouldn’t confuse this waning production of fertility hormones with zero activity in the ovaries. They continue to make other key hormones, including testosterone, which plays a key role in maintaining energy, muscle mass, and mood for women as well as men.The key to moving through these shifts with ease, says Gottfried, is to strive for hormone balance — a process that is powerfully and positively influenced by simple lifestyle strategies.
“Lifestyle choices, such as exercise, nutrient-dense food, proven contemplative practice, and nutraceuticals, can play a big role in how favorably you respond to these changes,” says Gottfried.
Here are some of the key shifts:
Know your hormones. Easing menopause symptoms starts by understanding your own unique hormonal profile. “It starts with being fully informed about your hormonal status, regardless of age,” says Gottfried. “My approach is to target the root cause of any symptoms, and then to systematically fix it.” Work with a qualified functional medicine practitioner who can recommend hormone testing and help interpret the results.
Wrestle back stress. “Every woman I’ve met with hormone problems has an issue with stress,” says Gottfried. Addressing adrenal health is paramount. The adrenal system controls the body’s stress response, and it is deeply supported by some of the most straightforward lifestyle shifts. “You need the foundation of nutrient-dense whole foods — not processed foods, and especially not refined carbohydrates which worsen adrenal problems — restorative sleep, and supplements to fill nutritional gaps.”
Treat food as medicine. Food is critical when it comes to easing menopause symptoms. Cruciferous vegetables — think broccoli, cauliflower, cabbage, watercress, and rutabagas — help promote healthy hormone balance. They also help clean the liver, which is where excess hormones are metabolized and begin to make their way out of the body. Avoiding high-glycemic foods and incorporating a good amount of high-quality, healthy fats can help with both adrenal function and mood.
If sleep is an issue… “Cut out all caffeine and alcohol,” says Gottfried, and consider taking an adaptogenic herb. She recommends ashwagandha and phosphatidylserine (the two herbs are paired together in some supplements). Good sleep hygiene — using light-blocking curtains, keeping electronics (including phones) out of the bedroom, and avoiding screens an hour before bed — may seem like negligible changes, but they can have an outsize effect on the quality of your sleep.
If anxiety is an issue… Gottfried recommends paced breathing as a way to decrease anxiety and soothe the nervous system. “Breathing with a 5-second inhale and 5-second exhale for 20 minutes, twice per day, has been shown to reduce hot flashes and night sweats by more than 40 percent.”
If vaginal dryness is an issue… Try a vitamin E supplement. “Doses around 400 IU have been proven to be effective,” says Gottfried.
If hot flashes are an issue… Vitamin E can also help with hot flashes and night sweats. So can supplemental magnesium. Most adults are magnesium deficient, and supplementing with magnesium (especially the glycinate form) can improve several other health outcomes, from reducing the frequency of tension headaches to helping soothe tight muscles.
If memory, depression, concentration, and energy are issues… One of Gottfried’s favorite herbs for menopausal women is maca. Not only does it help energy and mood, it can also improve vaginal dryness and hot flashes. If you try this herb, however, do so with breakfast. Taking it close to bedtime may be too stimulating.
Laine Bergeson is a longtime health journalist and functional nutrition educator and coach with Healthful Elements. She believes lifestyle medicine is a blockbuster drug.