How to Cope With Menopausal Symptoms

Woman meditating in bed
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When you enter your menopausal years, you may not realize at first what is happening to you. You wonder if the room is getting warm. You wonder why you are so short with your kids or your spouse. You wake in the night, and can’t get back to sleep. It can be a little unnerving at times, but, just as in adolescence, you will survive this right of passage and live to tell the tale.

There are women who have very few symptoms or problems as they pass through menopause.

But most have at least some temporary symptoms, and some struggle with problems that really disrupt their lives.

Wherever you are on the symptom continuum, here are some hints for dealing with the most common complaints of menopause.

Stress

Stress is a fact of life whether you are having menopause symptoms or not. Learning to deal with it constructively can make your life more satisfying whatever your age or situation. Here are some suggestions for helping you cope:

  • Meditate. Fifteen minutes a day of meditation can dramatically improve your stress level and ability to cope.
  • Exercise. Any sort of physical activity can reduce your stress. The important thing is to do it regularly—at least three times a week to see results. More often is better yet.
  • Do a life inventory. List the things that matter most to you and think about whether your life supports you in doing these things. Make a plan to begin pursuing at least one goal that you have not been able to accomplish. (Or drop something that is damaging your spirit!)
  • Reach Out. When it comes to stress, women don’t seem to have the same “fight or flight” response that men do. Women are inclined to “tend and befriend.” This is a healthy response to stress because it helps establish a social support network. When you notice that you are stressed, get help. Call a friend or see a counselor.
  • Take medication. Talk to your medical provider if you think medication could help you with stress or anxiety. Medication may be helpful if you are chronically stressed out.

Hot Flashes

Your thermostat may be very touchy around menopause. Many women find that they have a very narrow range of comfort, and it doesn’t take much to set off the alarm that tells your body to “cool off now!” Try some of these ways to deal with flashes:

  • Dress in layers. Be prepared to “take it off” if you feel yourself flushing.
  • Use breathing techniques. Breathe slowly and deeply. This sort of controlled breathing just as you start a hot flash can shorten and lessen it.
  • Drink water. If you are flashing, you are sweating. Water helps replenish your stores and it also seems to help regulate your internal temperature. Try to get 48 ounces in a day.
  • Turn down the thermostat. Whenever possible, keep your environment under 70 degrees in the daytime and under 65 degrees at night.
  • Avoid hot places. Don’t sunbathe or sit in a sauna if you are prone to flash.
  • Don't eat hot and spicy foods. Even if you have always been able to eat them, they may trigger you to flash. Stay away from the spices if you find they trip your thermostat. You will be able to eat them again someday.
  • Take estrogen. It's still the most effective treatment for hot flashes. It does carry some risks, so talk it over with your medical provider. Sometimes a short course of a very low dose is enough to get you over the hot flash bump, and then you can phase it out.
  • Use other medications. Some blood pressure medications, anti-seizure medications, and antidepressants have all been shown to improve hot flashes in menopausal women. Check with your medical provider if you think medication is something you’d like to try
  • Try flaxseed or flaxseed oil. It may decrease hot flashes and have the added benefit of reducing joint and muscle pain for some women.
  • Consider vitamin E, yam phytoestrogens, and black cohosh. These have all been used for many years to combat hot flashes. Studies on these alternative remedies usually show them to be only as effective as a placebo. There are plenty of women who swear by them, but so far no hard research bears it out.

Insomnia

Insomnia is very common just before and after menopause. Sometimes it is due to night sweats which are hot flashes. But sometimes women seem to have a hormone shift that makes them wakeful at the same time each night. It can be hard to turn your brain off, and then you will go into your day sleep deprived. This can be frustrating and exhausting. Here are some things to try:

  • Cool your bedroom. Try to keep your nighttime bedroom temperature below 65 degrees.

  • Take estrogen. A short course of estrogen—less than a year—can sometimes help you re-establish your sleeping pattern. Check with your medical provider about your risks.
  • Meditate. Just before bed, meditate for a bit. This can put you in a calm state of mind and help you fall asleep—and stay asleep. Consult your doctor.
  • Take a bath. This can regulate your temperature and send you off to dreamland comfortable and relaxed.
  • Try sedatives. These can sometimes help you regulate your sleep cycle. It’s not a long-term solution, so talk it over with your medical provider.
  • Discuss antidepressants. If you are on an antidepressant that makes you wakeful, talk to your provider about changing to one that has a more sedative effect and take them at bedtime.
  • Consider CPAP. If you snore, or if you are having periods of not breathing in your sleep (sleep apnea), you may need a sleep study to determine whether you would benefit from a continuous positive airway pressure (CPAP) device. Sleep apnea can cause damage to your heart, so if your partner tells you that you are snoring, or if you suspect sleep apnea, get a referral for a sleep study.

Memory Problems

Memory problems are very annoying and sometimes disturbing. They may begin in menopause, and women are sometimes alarmed when they find they are forgetful. Although some memory loss is part of aging, there may be some transitory loss that comes with the dip in estrogen. Here are some suggestions for relief:

  • Take Estrogen. As with the other symptoms listed above, Estrogen can be effective as a short course to ease you through the wild hormone fluctuations of menopause.
  • Try stress management. Whatever memory lapses you may have during this period will be much worse if you are not coping and feel stressed. See the suggestions above for stress management.
  • Sleep. Even youngsters have memory problems if they don’t get enough sleep. If insomnia is making your memory fuzzy, see above for ideas.
  • Eat right. Keep your brain in good form. Get plenty of colorful fruits and vegetable for antioxidants and vitamins. The real memory villains are alcohol, sugar, and caffeine. Try cutting them way down, or out altogether and see if it improves your ability to remember.
  • Explore memory strategies. Use acronyms to remember names or streets, associating one thing with another (cue words to remind you of errands or tasks you want to do).
  • Implement external supports. Leave paper and pencil where you can easily jot down lists and reminders of what you want to remember. Hang your keys in the same place every time you come into the house. Keep a grocery list on your computer and print it out to make your shopping easy. Put information into a personal digital assistant (PDA) so you can easily carry the information you need. Set up your environment to make remembering easier.

Mood Swings

Mood swings, periods of irritability, crying at the drop of a hat, being “hormonal” or “sensitive” is common during menopause. If you are prone to premenstrual syndrome, then you will probably see some mood swings while you are going through menopause. Because mood swings can disrupt relationships or cause conflict women who are emotionally labile will often seek some sort of remedy. Don’t be embarrassed to tell your medical provider that you are raging or crying. There’s help!

  • Exercise. As with earlier symptoms, your mood stability will benefit from exercise. Find an exercise buddy, or walk with your spouse or teenager. That way the “cure” can help strengthen relationships during this challenging time.
  • Use estrogen. It can smooth out those mood swings. Since some of your emotional swinging is a withdrawal phenomenon as your estrogen plunges, keeping a steady, low level of estrogen can level you out. As mentioned earlier, estrogen has risks, so talk it over with your medical provider first.
  • Meditate. What isn’t meditation good for? Calming your mind can calm your mood if you practice it frequently. The benefits of daily meditation can go a long way with your menopause symptoms.
  • Use stress management. It is always helpful to even out your life and moods. See the earlier section on stress management for ideas.
  • Try herbal and plant extracts. The research has not yet proven herbal supplements to be effective, but most of them are safe if used moderately, and many women report benefits from them. If you are on other medications, check with your medical provider or pharmacist before adding herbal supplements since they can interact with other drugs. Some of the herbal choices that have a reputation for smoothing out those moods are black cohosh, kava, chasteberry, ginseng root, SAMe, and DHEA derived from yams. Soy products and red clover are plant estrogens that women use for menopause symptoms, including mood management. Again, there are plenty of studies trying to sort out whether and how these plant remedies work, and so far there is no conclusive data to support them.

Vaginal Dryness/Urinary Incontinence

Vaginal dryness or pain with intercourse is very upsetting for women who experience it during menopause. These symptoms can disrupt your sex life, which may affect your relationships. Incontinence is embarrassing and disheartening for women. Both symptoms can be caused by the change in vaginal and urethral tissue that occurs when estrogen drops.

  • Apply vaginal estrogen. When applied in the vagina, estrogen does not affect your system the way estrogen pills or patches do, and the effect is right there where it is needed. If you use local estrogen for vaginal symptoms, it may take three or four weeks to see the effect.
  • Use lubricant. Because your vaginal wall is becoming thinner, it is easier to tear or damage. Using lots of vaginal lubricant during sex will help prevent damage. Water based lubricants feel natural and wash off easily. Silicone based lubricants last longer, but more women report being sensitive or allergic to them.
  • Try yam cream. This contains a phytoestrogen that, like other estrogen creams, can work locally to help with symptoms.
  • Incorporate vitamin E and flaxseed oil. These can sometimes offer some relief from vaginal and urinary symptoms. Usually, women take them as oral supplements, but there are creams that contain them as well to be applied directly to the vagina.
  • Do kegel exercises. Strengthening the pelvic floor muscles can improve sensation during intercourse and can reduce urinary incontinence. If you do them several times a day, you will probably see results in two to four weeks.

Weight Gain

Any time women tend to gain weight, it can be distressing to them. Since metabolism slows down as you age, menopause is a common time to begin adding pounds. This is frustrating because it comes at just the time when you are wanting to preserve your youth, and when your health risks begin to climb. Weight loss in menopause requires the same approaches that it does at other times in your life, but don’t set unreasonable goals for your target weight. 

  • Weight train. It not only helps you get stronger, it has the benefits of increasing androgen levels for better libido, stepping up your resting metabolism and preventing osteoporosis. Even if you’ve never tried strength training or weight training before, consider it now.
  • Walk. This is good for just about everything that ails you in menopause. It is easy on your joints, requires no special equipment except good shoes, and it burns calories reliably. Try varying your walking speed to improve the calorie burn, with spurts of power walking along with brisk walking. It not only burns more calories, it revs up your metabolism and builds bone mass.
  • Diet. This is always important, and never more than in menopause. If you want to lose or maintain weight, look for a diet that includes all food groups and is made for the “real world.” Successful weight loss diets are not the ones that require a lot of specialized foods, but ones that work with everyday foods and situations. Now is a good time to realize that you don’t need as many calories as you used to, and revamp your ideas about how much food is “enough.”
  • Manage stress. When you are stressed, you release hormones like cortisol that tell your body to hang onto fat. This may have served our prehistoric ancestors when they had to travel around all winter looking for food, but it only raises your risk factors for heart disease and stroke. So keep the stress down and your body will turn off its “keep-the-fat” button.
  • Eat more fruits and veggies. This will add fiber to your diet and give you many antioxidants and micronutrients that you need. Try to get five servings a day of the most colorful fruits and vegetables.

Menopause is a time of many changes and of rapid hormone shifts. When it’s over, you still want to be healthy and cheerful as you head into the next phase of your life. Don’t ignore your symptoms if they seem to be disrupting your life. Read, do research and talk to your medical provider.

Make a plan for getting through the worst of it in ways that will preserve your health and your relationships. Keep your perspective and sense of humor as you tackle and cope with the challenges that will eventually pass.

Sources:

National Institute on Aging, Menopause: One Woman's Story, Every Woman's Story, National Institutes of Health,NIH Publication No. 01-3886 Feb. 2001. 10 Oct. 2007.

North American Menopause Society, (NAMS), Menopause Guidebook: Helping Women Make Informed Healthcare Decisions Around Menopause and Beyond, 6th Edition , North American Menopause Society, 2006. 10 Oct. 2007.

The National Women’s Health Information Center, Menopause and Menopause Treatments, FAQ,U.S. Dept. of Health and Human Services, March, 2006. 14 Oct. 2007.

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