Understanding Menopause Symptoms and Management

Menopause is defined as the point in a woman’s life where she has gone 12 months without a menstrual cycle. The years leading up to menopause are known as the menopausal transition or perimenopause. This generally starts between age 45 and 55 and on average last about seven years. 

Menopause Symptoms

Menopause is not a disease or a disorder, but simply a normal occurrence in a woman’s life. For some women, the transition poses no issues and might even be a blessing as they no longer worry about painful periods or getting pregnant. For others, the transition can bring about uncomfortable symptoms such as:

• Hot flashes
• Sleep disturbances
• Painful sex
• Moodiness
• Depression 

It’s important to talk to your physician or gynecologist as you move into this stage of life to discuss symptom relief strategies. Fortunately, there are many lifestyle modifications which can help lessen symptoms.

Exercise and Menopause

There is no “one size fits all” exercise solution for menopausal women. In a changing hormonal environment with interrupted sleep, exercise that felt good and worked in the past may no longer work during menopause. Women in their 50s tend to be “in and out” of exercise because of uncomfortable symptoms, inflammation and joint pain. 

The benefits of exercise for menopausal women include improved cholesterol, reduced blood pressure and reduced risk of stroke and heart disease. Regular exercise can also improve mood, enhance sleep, lessen the chance of midlife weight gain and can increase bone density reducing the risk of osteoporosis. 

Menopausal women should follow the Physical Activity Guidelines for Americans that recommend at least 150 minutes of cardio exercise (such as brisk walking) per week and at least two days per week of strength training. Cardio exercise should be spread over the week and can be done in short bouts of 10 minutes throughout a day. If sleep is disrupted, avoid heavy weight lifting and high-intensity training. Opt for lower impact exercises such as yoga, Pilates or tai chi that allow for less joint and muscle inflammation.

Sleep and Menopause 

The loss of estrogen during the menopausal years impacts the sleep hormones and 40 – 50% of women complain of sleep disturbances during menopause. It is important to talk to your physician or gynecologist about sleep disruptions. They can recommend supplements and medications that can help. Sleep routines are critical for any sleep disturbances. 

Tips for a night of good sleep: 

• Go to bed at the same time each night and develop a routine of reading a book, listening to music, taking a bath or some other quiet activity.
• Avoid napping in the late afternoon or evening, limit naps to 20 minutes.
• Reduce caffeine intake and stop all caffeine at least six hours before bedtime.
• Avoid large meals close to bedtime.
• Limit alcohol, it will disrupt sleep and may enhance hot flashes.
• Keep your bedroom at a cool temperature (67 degrees is the ideal temperature for optimal sleep).
• Shut off all screens, computers, phones, TVs and any other light-emitting devices at least 30 minutes prior to bedtime.

If these recommendations don't result in a good night's sleep, our Sleep Disorders Program can help.

Nutrition and Menopause

On average, women gain about 1.5 pounds per year when they’re in their 50s and 60s. In menopausal women, fat tends to be stored in the abdominal area more than other areas, which is associated with its own risks such as metabolic dysfunction and insulin resistance. A suggested approach for weight management and general health in premenopausal and menopausal women is a multicomponent behavioral intervention that includes:

• Creating good eating habits and eating a variety of foods from all food groups. Severe calorie restriction in this population results in significant bone loss and is not recommended.
• Shoot for balanced meals that have at least 20 grams of protein (lean meat, low-fat or part-skim cheese, milk, yogurt, cottage cheese, beans/legumes, peas, edamame, non-GMO soymilk, tofu or chickpea pasta) per meal which helps decrease rate of muscle loss. Include protein at snack times as well.
• Eat high fiber to increase satiety and maintain gut health with a goal of 25 grams dietary fiber per day. Choose whole, 100% and sprouted grains, oats, quinoa, brown rice, barley, farro, fruits, vegetables, nuts/seeds and beans/legumes.
• Include calcium sources to combat bone loss. Dairy products, fortified plant-based milk, greens, almonds and fortified cereals.
• Adequate amounts of vitamin D is needed for bone health, immune function and regulation of the growth of vaginal epithelial cells. Get vitamin D levels checked regularly. Natural sunlight, fish, whole eggs, dairy, fortified plant-based milk and mushrooms are good sources.
• Include anti-inflammatory foods (salmon, extra virgin olive oil, avocado oil, olives, avocados, nuts/seeds, nut butters, dark chocolate and chia, flax and hemp seeds). These foods contain healthy Omega 3 fats.
• One may see less menopausal symptoms and benefit from following the Mediterranean diet or way of eating.
• Good quality sleep and stress management play a big part in weight management and are just as important as balanced nutrition and exercise.

OB/GYN Midlife and Menopause Wellness Care Team

Our team takes a whole-person approach to care for women in midlife and menopause. From physical symptoms to emotional changes, our OB/GYN and women’s mental health clinicians work together, along with other medical specialists, and partner with patients to create personalized plans that support patients well-being.