What are the four stages of menopause and their symptoms. HRT and other treatments. Menofriendly workplace. The importance of good nutrition: Yoga Tools and Techniques.
Over 15 million women are in active employment in the UK, yet in 2022 only 25% of UK companies and organisations reported having a menopause policy in place. 10% of women said they stopped working because of the symptoms of menopause and only around 15% of women between 45-64 years of age are on hormone replacement therapy.
It does not have to be this way.
I provide Menopause Mentorship to women of all ages and to organisations who wish to adopt a menopause friendly workplace.
Did you know that every single cell in your body contains oestrogen receptors? Therefore when your oestrogen levels start to fluctuate in perimenopause (usually in our late 30’s) 90% of us will feel it everywhere and not always as expected. Therefore, we do not always associate what we are feeling with fluctuations in our oestrogen levels, especially when we are used to the fluctuations that happen in our monthly cycle, which will overlap with perimenopause.
Many women are so concerned about how they feel that they visit their GP. Sadly many GPs and healthcare professionals in the UK have still not completed their menopause training and a misdiagnosis can be common, with sleeping tablets or antidepressants being offered rather than hormone replacement or other helpful treatments.
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The image below shows the typical rise and fall of our oestrogen levels during our life time.
We live more of our life with lower levels of oestrgen, which can result is unnecessary suffering.
THE FOUR STAGES OF MENOPAUSE
1. Pre-menopause: when you do not experience menopause symptoms.
2. Perimenopause: when you experience menopause symptoms due to hormone fluctuations and still have periods which may be changing in nature and frequency
3. Menopause: when you do not have a period for 12 consecutive months
4. Post menopause: The time in your life after you have not had a period for 12 consecutive months.
Menopause is a normal biological process that happens to every woman when their hormone levels start to fluctuate and drop. Peri-menopause symptoms can start in the mid to late 30’s and menopause symptoms can start anywhere from ages 40 to 55. The symptoms can initially be difficult for women to identify and understand because menopause is unique to every woman and hormone levels fluctuate. Therefore the symptoms will come and go gradually get stronger and more frequent over time. 90% of women experience symptoms, which can go on for months or even years. Women have oestrogen receptors in every cell in their body and when oestrogen levels fluctuate it is felt everywhere.
Symptoms can include: forgetting names, becoming terrified of making a mistake at work, weight gain and difficulty losing the extra weight, feeling tense and nervous, feeling irritable and unhappy, aching joints and muscles, feeling over whelmed and crying for no reason, breathing difficulties, numbness, migraines and headaches, loss of energy and loss of interest in most things, difficulty concentrating, difficulty sleeping, hair loss, dry skin, feeling hot, feeling faint or dizzy, the dreaded brain fog and more.
These symptoms affect many millions of women every single day and in a recent study
10% of women in the UK said they left their jobs due to menopause.
If you feel concerned about your health and well being then make an appointment with your Doctor, explain how you are feeling and ask if it could be fluctuating hormones. Your Doctor can suggest a range of options including hormone replacement therapy. (HRT)
WHAT IS HRT?
HRT - Hormone Replacement Therapy - is a treatment to replace the hormones that you are deficient in, as a result HRT vastly improves your symptoms and protects against long term health risks associated with hormone deficiency including osteoporosis, cardiovascular disease, diabetes and dementia.
HRT always contains oestrogen and can also contain a form of progesterone. The most common type of oestrogen prescribed today is 17 beta-estradiol. It is available as a patch, gel or spray and is derived from the yam (a root vegetable). It is known as ‘body identical oestrogen’ because it has the same molecular structure as that produced naturally by your body. HRT can be started during perimenopause and menopause. The way you take this and the amount you take can be tailored by your GP to what works out as being the best fit for you.
Additionally, only 14% of women in the UK are on Hormone Replacement Therapy (HRT), possibly due to the perceived risk of breast cancer. A 2002 study by the Women’s Health Initiative claimed HRT was associated with an increased risk of breast cancer and cardiovascular disease. Fortunately this study has since been re-examined, and new research shows that, for most women, the benefits of HRT outweigh the risks. It’s also important to remember that the type of HRT used in this study is not usually prescribed today in the UK. Transdermal HRT can be much safer to use and not only helps to alleviate many of the symptoms of menopause it can also help to protect against heart disease, loss of bone density and even dementia. A diet rich in phyto oestrogens and regular exercise such as yoga and swimming can also help alleviate some of the symptoms of menopause. Alas many Doctors and healthcare professionals in the UK have still not yet received menopause training therefore when women present with symptoms they are frequently misdiagnosed and not given the correct treatment.
MENO FRIENDLY WORK PLACE
Simple steps make all the difference
In 2022 only 25% of UK companies and organisations had a menopause policy in place. Employers can take steps to create a menopause friendly work environment by implementing a menopause policy to protect and support their staff. Such as staff training to raise awareness of the symptoms, flexible working, fans, air conditioning, adjustable lighting, leave policy, a private rest space, access to a fridge and cold water, appointing a Menopause Mentor and or support group for women to share experiences and best practice, proactively ask staff what else may be needed, communication with all staff to normalise menopause, zero tolerance of any harassment, correct use of language avoid words like 'the curse' or 'the change' or 'fat shaming', healthy snacks. Encourage Yoga and Swimming with a company membership. These steps will help to contribute to a menopause friendly environment and in turn will maintain productivity, reduce absenteeism and support women to flourish in their careers.
NUTRITION FOR MENOPAUSE
Although you cannot control when you may experience symptoms of perimenopause or menopause you can control your diet. A balanced diet will help to strengthen your bones, improve your cardiovascular system and regulate your mood. Menopause can lead to significant changes in your metabolism and your body responds to falling oestrogen levels by trying to build up a reserve of oestrogen in the fat cells. What you eat during this stage in your life will have a direct affect on how your body and mind will deal with the challenges of the changes brought on by menopause and will impact on your future health.
Calcium - helps to maintain your bones and 99% of Calcium in your body is stored in your bones. Women aged - 18- 65 require around 700mg of Calcium per day. Good sources of Calcium include milk, cheese, yogurt, leafy green vegetables, broccoli, soya beans, nuts and fish.
Vitamin D - aids Calcium absorption therefore supports strong bones. You need about 10 micrograms per day and the best source is sunlight on your skin, so try to include a walk outside every day for around 30 minutes to 1 hour. Food sources of Vitamin D include egg yolk, mushrooms, meat, animal fat, liver, kidney and oily fish such as mackerel and salmon. People living in the far northern hemisphere have less daylight in the winter and many benefit from a Vitamin D supplement.
Magnesium - is a mineral used throughout the body including our brain and muscles, it also works with Calcium to produce strong bones. Many women find they sleep better when they take a Magnesium supplement. You need around 270mg of Magnesium per day. Good food sources include green leafy vegetables, nuts, seeds, squash, wholegrains, legumes and pulses. Alcohol, caffeine and antibiotics can all affect Magnesium absorption. Magnesium oral supplements, sprays and creams are also available.
Low Gi Foods - these are foods which are digested more slowly and therefore release sugar more slowly into the bloodstream. This helps to stabilise energy levels, blood sugar and moods. Low GI food include - whole grain bread, brown rice, sweet potatoes, beans and bulgur wheat.
Omega 3 - these cannot be made by your body and therefore come from your food alone, they help with mood, circulation and are anti inflammatory. Good food sources include - oily fish eg mackerel and salmon, vegetable oils such as flaxseed and rapeseed, walnuts, pecans, hazelnuts and green leafy vegetables.
Good Gut Health - in order to benefit from nutrition our gastrointestinal system must be able to extract the vital nutrients and energy from the food we eat. Because each cell in your body contains oestrogen receptors including those in your gut and brain, when levels of oestrogen fluctuate through your menopause journey it can impact gut function. Ways you can support your gut health include:
Eat foods that promote good bacteria - these include prebiotic food such as onions, leeks, garlic, asparagus, artichoke, chicory, and banana. Fermented foods such as live yogurt, kimchi, sauerkraut, kombucha, live apple cider vinegar.
Alcohol - alas this is a trigger for menopausal women and can increase the severity of hot flushes, headaches, poor quality sleep, night sweats and brain fog. As you age your body holds less water and is therefore unable to dilute the amount of alcohol you may have been able to consume in your past without any side effects. Kombucha offers a good alternative to alcohol.
ALTERNATIVE HERBAL MEDICINES
In addition you may wish to explore alternative herbal medicines, these can include:
Soy - Increasing your phytoestrogen (plant based oestrogen) from sources such as soya supplements, soya food products include milk, yogurt, tempeh and tofu. This can help to reduce night sweats and hot flashes.
St Johns Wort can help to reduce anxiety, this can be taken as a tablet, tincture or tea.
Black Cohosh is most commonly used for menopausal symptoms, including hot flashes (also called hot flushes) and night sweats (together known as vasomotor symptoms), vaginal dryness, heart palpitations, tinnitus, vertigo, sleep disturbances, nervousness, and irritability
If you are on any medication is it important to consult your Doctor before taking any herbal medicine.
YOGA TOOLS AND TECHNIQUES
Yoga is a holistic treatment that can be used at all stages of your menopause journey. It is a wonderful way to de-stress and become energised.
Pranayama (breathing) techniques offer a wide selection of tools that can have a quick and effective impact on whatever you may be experiencing. Alternate nostril breathing will balance your parasympathetic and sympathetic nervous systems, bringing you into a state of being calm and in control whilst Chitale breathing will cool you down when you are feeling hot. You can use these throughout the day as required and at night if you are suffering with night sweats and poor sleep patterns.
The asanas (postures) will strengthen your bones, skin, heart, lungs and muscles. You can use asanas that focus on core strength and those that will strengthen your pelvic floor. Many asanas will help you to balance your hormones. You can practise yoga in a slow and relaxed way to help release any tension build up in your body. Asanas will also help to reduce fluid retention and bloating.
Meditation will bring you peace and help you to deal with brain fog by exercising your ability to focus, manage your thoughts and to stay calm yet alert.
Your yoga practice will create a calm space in your busy life for you to connect with yourself, your mind and your body. It will help you to process how you feel each day and record the changes that you are going through.
Try to do your home practice every morning if you can and or attend a class once a week.
CLOTHING AND BEDDING
Night sweats are very common and can last for years. They happen very quickly and you can experience them multiple times though the night. Put a light weight duvet on the bed even in winter, add a light weight cover. If you sleep with your partner you can try a heavier cover on their side of the bed. If possible have a second bed ready for you or your partner to use at night when you are hot and to give you and your partner a good night sleep. Fill a water bottle with cold water and use it to help you cool down, have a fan next to the bed and use it as required. Wear loose thin woven cotton night gowns of pyjamas to sleep in that can be quick to change and quick to wash. Night sweats result in poor quality sleep therefore invest in a luxurious silk eye mask to cut out light when you are catching up on sleep.
Wear loose comfortable cotton or cashmere clothing in layers that can be removed or added as needed. Tops with short sleeves or off the shoulder/holes in the shoulders are great for releasing heat. Wear loose yoga pants and tops for your yoga practice, anything directly next to the skin can increase temperature and lead to discomfort. Wear open sandals to release heat through your feet.