What is Menopause?

Did you know that the term "menopause" was coined by a French (male) doctor in the 19th century? His was the first dissertation in 1816 about menopause and his advice to women in menopause was to not dress like you're younger; and to cover your arms because flesh is dangerous.

He then blamed every single disease on menopause. Even if it also affects men. Did you hear my eyes rolling there?

For many years, menopause was seen as "ovarian failure" - meaning that women were past their sell-by date just because they were done with reproduction.

Without going all "smash the patriarchy" on you (OK, maybe just a little), not all cultures view menopause as failure.

In Celtic cultures, menopausal women were considered to be the “seeds” of their community (the seed containing all the knowledge and potential of all the parts in it).  And in some cultures menopausal women were thought be more powerful because they retain their wise blood rather than shedding it.

From an evolutionary point of view, menopause is a way to ensure the continuation of the species. Another "did you know?" - this time that the only female animals that survive for any length of time after the end of their reproductive function are whales and humans?

Why is that?  It's because raising a child (or a baby whale, apparently) is very labour intensive.  Therefore your youngest child needs to be self-sufficient in time for you to be able to help your other offspring with their children.

Your travel guide to menopause.

Any time from around the age of about 40, the amount of oestrogen produced by your body slowly starts to decline. This journey can last from 6 to 13 years and is known medically as the climacteric or "peri-menopause".

During your travels in peri-land, you're likely to experience a range of symptoms - this is because oestrogen is involved in a lot of your body's other activities.

Your menopause expedition comes to an end when you've stopped ovulating - you're usually considered to be in menopause 12 months after your final period. In the UK, on average, women reach their menopausal destination at around the age of 51.

Isn't peri-menopause just about hot flushes and bad moods?

Side- comment: Is it just me or do you find the US term "hot flashes" makes you imagine middle-aged ladies showing their knickers in public? ....that'll just be me then...

As I mentioned, oestrogen is involved in a lot of bodily functions so fluctuating levels can lead to any of around 30 different symptoms. These can include, in no particular order:

• weight gain and in particular increased abdominal fat leading to increased risk of diabetes, strokes and heart attacks;
• night sweats and hot flushes;
• mood swings, low energy, anxiety or irritability;
• thinning hair, painful joints, plantar fasciitis;
• loss of muscle tone and bone density leading to increased risk of falls and osteoporosis/ bone fractures;
• loss of libido and vaginal dryness;
• insomnia;
• "brain fog".

That's a delightful list isn't it? It’s no wonder we can feel overwhelmed and out of control.

These seemingly random and unconnected symptoms can also leave many women feeling like they're going mad. This can be further exacerbated by GP's being generally under-trained on the topic.

So, when approaching your doctor for assistance with symptoms, you may well be offered anti-depressants (as I was).

What can I do to help myself?

There are loads of things that you can do for yourself.

These may or may not include obtaining HRT from your GP. Be aware that many women can go for up to five years before being accurately diagnosed as being peri-menopausal; and that many doctors will still tell you that HRT causes breast cancer (this particular piece of research from twenty years ago was discredited a long time ago and yet...).

If you don't want to, or can't take HRT - for example if you've had a hormone-receptive cancer in the past - there are still loads of things that will help you manage your symptoms.

The super good news is that all of these things will help multiple symptoms and reduce your long term risks of cardio-vascular disease which is the biggest killer of women over the age of 50.

Do weight-bearing exercise regularly

What symptoms will this help?

• weight gain;
• mood swings and anxiety;
• insomnia and disturbed sleep;
• loss of muscle tone and bone density;
• painful joints.

Did you know that without any stress on your skeleton, you can lose up to 1% of bone density every week? And that by the age of 70, you can have lost up to 30-40% of your bone mass? Well of course, if you read my previous blog  on bone health, you know that!

Or that oestrogen plays a role in muscle regeneration so as levels drop, your muscles regenerate less. Less muscle makes moving more difficult and leads to further decreases in bone density (less muscle puts less stress on the skeletal system).

Pilates is a fabulous form of weight bearing activity, of course. In addition, the mind-body focus and breath work will both help with anxiety, low mood and disturbed sleep.

It doesn't have to be Pilates - anything where you're using some sort of resistance, weights, bands or body weight - will work so long as you can do it regularly.

Raise your heart rate

What symptoms will this help?

• mood swings, low energy and anxiety;
• brain fog;
• decreases risks of heart-attacks, strokes and diabetes;
• painful joints;
• insomnia, and disturbed sleep.

Those of us now in our fifties grew up with Jane Fonda. You don't need to still be doing that. Or running. I mean if you enjoy it and you've always done it, crack on!

But if you're looking for something to raise your heart rate, you can't go wrong with walking or dancing.

Try and move enough that your heart rate is raised for about 30 minutes every day/ 150 minutes every week.

Moving your body has incredibly positive benefits for your brain and your body. If you think I'm making it up, I really recommend you watch this Ted Talk by Wendy Suzuki, a neuroscientist who's studied the effects of exercise on your brain.

And then, check out this booklet if you'd like more tips on getting more movement into your daily life.

Stay hydrated

What symptoms will this help?

• hot flushes;
• brain fog;
• painful joints;
• weight gain

Even mild dehydration leads to reduced cognitive ability and mood in anyone! 

You might recall me mentioning that we often mistake thirst for hunger, leading us to eat more than we need to. This can lead to increased weight gain, particularly at this age, in the abdominal area. Weight gain here is strongly correlated with increased insulin sensitivity as a precursor to diabetes.

Want some tips on getting more water into your day? Check out this booklet.

Eat a "Mediterranean diet".

What symptoms will this help?

• weight gain;
• low energy;
• brain fog;
• hot flushes.

There are some thirty-odd countries around the Med so pick any cuisine that you like (did I mention that my favourite is Lebanese?)

But the key things are:

• Increase your intake of plant-based foods: This can be in the form of beans, pulses, wholegrains or vegetables. They're high in fibre; support healthy cholesterol levels; are low in saturated fat; and are high in minerals like magnesium and potassium which are needed for healthy blood pressure; the high level of antioxidants in fruit and vegetables also fight inflammation which is one of the hallmarks of cognitive dysfunction.

• Increase your intake of oily fish:  The omega 3 found in oily fish (and walnuts) has been found to slow cognitive decline.

• Also, not exactly Mediterranean, but try and include some soy foods especially fermented soy like tempeh as these are beneficial for your hormones as are sweet potatoes and yams. 

• Supplementing with a good multi vitamin that includes calcium and magnesium and a probiotic is also a good idea.

• Reduce your intake of processed sugar: OK, sample size of one, but I find that processed sugar is one of the things that kicks off my hot flushes!

Reduce your stress levels

What symptoms will this help?

• mood swings and anxiety;
• insomnia and sleep disturbance;
• weight gain;
• brain fog.

Again, a sample size of one, but I notice that when I'm stressed, or anxious I get into a loop of night-sweat induced sleep disturbance that makes me more stressed/ anxious.

You may recall the series of blogs I wrote about the impacts of stress and lack of  sleep a couple of years ago. I can tell you that all of the impacts that you experience from stress are worse in peri-menopause.

What can you do to reduce anxiety?

Errrr, Pilates obvs!  The focused breathing of the exercises, lowers stress levels and anxiety,  calming the mind and helping you to get a good night’s sleep. 

And, let's be honest, there's no point just treating the symptoms of stress. Now's the time to focus on removing the sources of stress as much as you can - delegate more; stop doing things that aren't serving you; focus on more of the things that bring you joy.

If you're looking for more resources, I have plenty! Please email me

Let's carry on making this, totally normal, transition that happens to every woman a part of every day conversation. We should not be ashamed, silent or left in the dark any more!