Managing Menopausal Symptoms the Natural Way
Menopause is an inevitable and natural transition that all women will experience, typically in their 40s or 50s. It is defined as the time when a women has not had a period for 12 months; the average age in the UK is 51, after which you are classed as post-menopausal. The build up to menopause, and often the time when women experience the most intense symptoms is called peri-menopause, where your periods may become lighter and less frequent or contrastingly, heavier and more frequent. If you are still bleeding you are classed as peri-menopausal and the symptoms associated with peri-menopause can last anything from 2 to 10 years or beyond.
Why do women experience menopause?
Women are born with every egg they will ever have which are impacted upon by their mother, their grandmother and exposure to physiological or emotional changes during childhood, puberty and adulthood. In fact, every female foetus developed all the eggs she will ever have whilst she was inside her mother's womb. This means that all female eggs start life inside their grandmother! If a woman's grandmother experienced severe nutritional deficiency, for example, then her granddaughter's eggs could have become affected and in turn her ovarian reserve.
Women are born with approximately 1-2 million eggs which deplete over time, speeding up after the age of 35 and more so post 40 years old. The decline in ovarian reserve (the reproductive potential remaining based on the count and quality of eggs) can fluctuate and it is not a steady reduction, meaning the menstrual cycle and the peri-menopausal symptoms will fluctuate alongside this. As the eggs decline, the hormone levels produced in the ovaries, progesterone and oestrogen, also gradually fall, eventually leading to menopause.
What is the impact of menopause?
75% of women say that menopause has caused them to change their lives, with 50% saying that is has had a negative impact. Yet, despite this, a third say they have not tried anything to help their symptoms.* This may be because menopause is still seen as a taboo subject in the UK and is something which women and men don't feel comfortable talking about. Many women experiencing peri-menopause or menopausal symptoms are employed and may need time off work to deal with varying symptoms yet are not comfortable explaining the real reason behind taking time off. 38% of partners feel they do not understand enough about what women are going through therefore feel helpless in how best to support them, hence impacting on relationships*.
What are the symptoms?
Symptoms will vary greatly and all women will go through their own experience, often not recognising many of the symptoms as a result of peri-menopause. The lowered levels of oestrogen and progesterone affect all body systems and will cause changes in the ovaries, brain, breasts, skin, bones, glands, urinary system, digestive system etc. Some women may experience no symptoms at all whilst others may experience some symptoms for only a few months. Alternatively, some women could suffer from a whole host of symptoms which last for many years even after their final period. It is important to remember that changing hormone levels do fluctuate over time so women may have phases of more intense symptoms and others where they experience nothing at all. According to Menopause Now there are 34 common symptoms of menopause:
How can you manage symptoms naturally?
Below I will go into more detail about some of the main symptoms and offer ways in which you can help alleviate them.
Menstrual Cycle Changes
Irregular periods are often one of the first signs women notice when starting to reach peri-menopause, lasting anything from 3 to 10 years before their periods cease altogether. As previously mentioned, cycles may become either shorter or indeed longer or fluctuate between the two. Bleeds may become either lighter or heavier, sometimes resulting in flooding as eggs may not be released every month, yet, the next month two may be released. This is also why there is an increased chance of older women having twins should the eggs be fertilised. PMS symptoms may be heightened and this is particularly more likely if you experienced intensified PMS symptoms earlier in life.
Self help recommendations
Inactivity and stress can exacerbate symptoms so getting more exercise like yoga or practising meditation or mindfulness could help
Too much caffeine and alcohol can also exacerbate symptoms so it's best to limit intake whilst increasing the intake of complex carbs, fruit, vegetables and water to help balance the body
Getting a good night's sleep is important for the body to function well
Investigating natural supplements such as black cohosh, ginseng and Macafem which could help
Reflexology can help balance the hormones, normalise cycles and reduce PMS symptoms
Hot Flushes / Night Sweats
Hot flushes are the most common symptom of menopause and affect 4 out of 5 of every woman, whilst for 1 in 5 they are severe and frequent. They are caused by the desensitization of the thermo-regulatory system due to the changes in oestrogen levels. Small changes in heat, food and drink intake or psychological /emotional responses can trigger flushes. The alteration of the thermo-regulatory system can be permanent and for some women they may even experience hot flushes post menopause, even into their 80s. Hot flushes tend to come on suddenly, throughout the day, lasting from 3 to 30 minutes and can affect just the chest/face or the whole body. They can be associated with symptoms such as light-headedness, dizziness, sweating, anxiety, headaches and heart palpitations. Night sweats are also very common and very troublesome causing many women to wake each night drenched in sweat, feeling sudden and intense heat, chills, irregular heartbeat and headaches. This interruption in sleep can have a huge impact on a woman's daily activities and could result in insomnia, trouble concentrating, irritability, exhaustion and heightened levels of stress.
Hot flushes and night sweats tend to be affected by being overweight, smoking, caffeine, stress, spicy food, sugar, alcohol especially wine, monosodium glutamate, certain medications such as blood pressure medication and diet pills.
Self help recommendations
By making some small lifestyle changes there are a few ways you can help try to manage the symptoms or even reduce them. In the first instance it would make sense to avoid any of the triggers above. Additionally the following suggestions can help:
Wearing natural fibres such as cotton, wool and linen plus wearing layers that can easily be removed.
Consider using airconditioning, fans including handheld personal fans or opening windows in the bedroom at night.
Using a duvet with a low tog value could be helpful as well as cotton or linen sheets - some are specifically designed to expel heat.
Using a cooling gel pad or hot water bottle filled with cold water in the bed to cool it down
Warm baths with lavender or chamomile as a sedative can help cool you down
Using a face water spray
Having a cold shower
Managing stress and anxiety levels
Going for a walk
Taking up meditation, yoga or thai chi
Practising slow and diaphragmatic breathing
Aiming for Vit E intake of 800mg a day
Vit Bg (Folic Acid) has been proven to reduce frequency, severity and duration of hot flashes
Investigating natural supplements such as black cohosh, flaxeed and Macafem
Using Reflexology to help manage hormone levels, stress and anxiety
Mood Swings, irritability, anger, anxiety and depression
As oestrogen plays a major role in the brain's production of serotonin, lowered levels of oestrogen will impact serotonin levels thereby resulting in mood changes. Not all women will experience mood swings but they do tend to be a very common symptom and they can be detrimental to home and family life. Typically if you experienced mood swings, anxiety or depression as part of PMS symptoms in the past or during post partum, then you are more likely to suffer when you are peri-menopausal. Symptoms can be extreme and even uncontrollable at times, causing women to feel out of control or overwhelmed and not like themselves. Anxiety and depression levels tend to be impacted by life stresses, sleep problems, worries about body image and aging, decreased sense of well-being, over or under eating or feelings of worthlessness.
Self help recommendations
Talking to family or friends about what you are going through can be a great way to get things off your chest
Going for a walk
Practising slow and diaphragmatic breathing
Exercising regularly to boost serotonin levels
Practising yoga, thai chi or meditation
Using a relaxation app such as Headspace or Calm
Using lavender or chamomile in a warm bath
Eating dark chocolate for a quick boost in serotonin and mood levels
Eating foods rich in phytoestrogens and Vit E such as soy, wholegrains and fish
Investigating natural supplements such as black cohosh, Macafem, ginseng, St John's Wort
Getting a good night's sleep
Using Reflexology to help manage hormone levels, relaxation, stress and anxiety
Medical help and support may be necessary if symptoms are severe
Insomnia or Sleep Disorders
Poor sleep could be as a result of night sweats but many women find they have more unsettled nights when they are peri-menopausal, regardless of night sweats. Insomnia is often caused by the reduction in progesterone levels due to a reduction in ovulation. Progesterone increases levels of the neurotransmitter GABA in the brain, which in turn boosts sleep, so if progesterone levels are reduced then GABA is reduced and sleep is affected. Other peri-menopausal symptoms may also affect a woman's sleep such as anxiety, stress, aching joints, mood fluctuations and an irritable bladder. Lack of sleep will have a knock on effect in the daytime often resulting in poor concentration and irritability, depression, poor performance at work, fatigue as well as a lowered immune system.
Self help recommendations
Developing a good bedtime routine is paramount by winding down and only going to bed when sleepy
Ensuring to only sleep in the bedroom and make sure it is not too hot/cold, quiet and dark
Don't use devices or watch TV for an hour before bed and try not to use these in the bedroom
Having a warm bath with lavender or chamomile
Getting up at the same time each morning
Only taking naps before 3pm
Exercise daily but not past 6pm
Practising slow and diaphragmatic breathing
Practising yoga, thai chi or meditation
Limiting fluid intake in the evening and avoiding caffeine, nicotine, alcohol and heavy food post 6pm
Playing some relaxation music or using an app such as Headspace or Calm
Using Night Time Bach Flower Rescue Remedy - 4 drops every hour from 6pm until bedtime
Look into supplements such as magnesium, black cohosh, Macafem,soy
Using Reflexology to help manage hormone levels, relaxation, stress and anxiety
Palpitations
Heart palpitations are when the heart beats faster or more forcefully than usual and can be an unpleasant and unsettling experience. They are caused by the lowering oestrogen and progesterone levels and could be accompanied by other symptoms such as chest discomfort, shortness of breath, feelings of panic or anxiety, dizziness and weakness. It is important to be checked for any thyroid issues, anaemia (particularly if heavy bleeding or flooding occurs) or if there is severe chest, neck, back or jaw pain and if they last for more than 5 minutes ensure to seek medical advice.
Self help recommendations
Reduce alcohol and caffeine intake
Stop smoking
Manage stress and anxiety levels
Practise slow and diaphragmatic breathing daily but also during an attack
Practise yoga, thai chi or meditation
Change your diet to avoid sugar, spicy food, carbohydrates and MSG
Review medications e.g. ephedrine in decogestants can make them worse
Use Bach Flower Rescue Remedy across the day
Look into natural supplements such as black cohosh, Macafem, dong quai
Use Reflexology to help manage hormone levels, circulatory system, relaxation, stress and anxiety
Muscle and Joint Aches and Pains
Hormonal fluctuations, particularly lowered levels of oestrogen, can result in increased stiffness or joint pain as well as an increased risk of injury and inflammation. These aches and pains can be very unpleasant and make the most simple of tasks arduous or even unbearable. The most common areas affected are the neck, shoulders, hands, elbows, knees, hips, legs and back. Muscle and joint aches and pains are often not attributed to menopause as they are a lesser known yet common symptom.
Self help recommendations
Keeping active is important such as walking, practising yoga or swimming
Doing some simple stretches or seeing a physical therapist
Making sure to take a break and not to overdo any exercises
Using Biofreeze
Using Icepacks or gel packs
Investigating natural supplements such as black cohosh, Macafem,ginseng
Using Reflexology to help manage hormone levels, increase circulation and reduce pain
Bladder and Vaginal Atrophy
Oestrogen helps to produce cervical mucous during the reproductive years and it is this cervical mucous which keeps the vaginal tissues elastic, whilst in turn supporting bladder function. Symptoms of vaginal dryness can range in severity from mild and slight irritation to extreme disruptiveness. As the oestrogen levels decrease, the vaginal tissue thins and can tear, sex can become painful and libido decreases. Women may experience itching, burning, stinging, irritation, frequent urination or urgency, UTIs tend to increase and discomfort wearing knickers. Stress, anxiety and depression can make the symptoms worse. It's common for women to feel that these symptoms affect the way they feel about themselves, about sex and about life in general.
Self help recommendations
Wearing cotton underwear can be helpful
Using Vit E, PH balanced lubricant (such as Yes or Sylk) during sex and vaginal moisturisers can help improve sexual comfort
Topical oestrogen can help
Ellamuselle supplement could be useful
Natural supplements such as soy, ginseng and Macafem could help
Reflexology can help flush out toxins and rebalance the hormones
Headaches and Migraines
Headaches and migraines can be very debilitating during peri-menopause. They are caused by the fluctuating oestrogen and progesterone levels and are more likely to occur if they were a symptom of PMS. Triggers can include bright lights, loud noises, strong smells, changes in the weather, alcohol, caffeine, sleep and stress. Some foods can also be triggers e.g. those that include MSG, nitrates (hot dogs, luncheon meat) and tyramine (aged cheeses, soya products, smoked fish).
Self help recommendations
Avoid dietry or environmental triggers as much as possible. You may need to do a headache/migraine diary to identify what the triggers are.
Don't overuse paracetamol (even as much as 2-3x per week) as this can cause headaches to increase
If there are any additional symptoms such as dizziness, changes in vision or muscle weakness make sure you see your GP
Get your eyes tested as eye strain can cause headaches although typically it's not your eyes if you wake with a headache
Manage stress and anxiety levels
Practise slow and diaphragmatic breathing
Practise yoga, thai chi or meditation
Use self massage techniques if you have the onset of a headache and head/neck stretches
Investigate natural supplements such as black cohosh, Macafem and red clover
Use Reflexology to help rebalance the hormones and reduce pain
Skin/Nail/Hair Changes
Skin elasticity reduces as oestrogen levels fall which means it is less able to retain fluid, resulting in the likelihood that it is more prone to injury. Women may find their skin thins and they have an increase in bruising as well as being more prone to sun damage and skin cancers. Nails may become brittle and hair can become drier, lose its shine and start to fall out more readily.
Self help recommendations
Some lifestyle changes may help including looking into diet such as increasing protein intake
Taking Vit D and Iron may help
Helping to reduce stress through yoga, thai chi or meditation could be useful
Investigating natural supplements such as black cohosh, soy and macafem
Rebalancing the hormones through Reflexology
What are the medical treatment options and should you consider them?
There are various medical treatment options which could be considered, particularly for more severe symptoms, although, there are various pros and cons that should be taken into account. Many women find that natural methods can be just as useful as medical ones, with fewer to no side effects.
HRT - Hormone Replacement Therapy
Probably the most widely known medical treatment and often offered as a "magical cure". However, it is important to know the pros and cons so that you can judge for yourself whether it is right for you. There are many forms - implants, patches, tablets, creams, gels, pumps, sprays and suppositories which provide supplemental progesterone, testosterone and oestrogen, although some are oestrogen only. Each option is personalised for the individual to support their menopausal symptoms and can protect against a wide range of age related symptoms including heart disease, dementia and osteoporosis. HRT can reduce the symptoms many menopausal women face and it can make a significant difference in some women's lives, However, there are a number of risks meaning it should be avoided by those with a history of breast, ovarian and endometrial cancer, unexplained vaginal bleeding and blood clots. There are also various side effects reported from taking HRT, for example, leg cramps, breast tenderness, headaches, nausea, fluid retention, mood swings, depression, lower abominable pain and acne,
Anti-depressants / SSRIs / SNRIs
Low doseage SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Selevtive Seratonin Noradrenaline Reuptake Inhibitors) are typically offered to help with vasomotor symptoms such as hot flushes and night sweats as an alternative to HRT. In turn, as women may be less affected during the night from a reduction in night sweats, they may also have an improved quality of sleep. However, as many women may suffer additional symptoms to the hot flushes/night sweats then this may not be the best option. There are also many side effects associated with anti-depressants such as nausea, restlessness, dry mouth, insomnia etc.
Progesterone
Progesterone is sometimes offered as a way to help women who suffer with heavy bleeding or flooding. It can also be used as contraception for those who are still bleeding and who don't want to conceive. If women have an oestrogen dominance, progesterone may be offered to balance this. It could also help the frequency and severity of hot flushes or night sweats although there is only limited evidence to suggest this is the case.
Topical Oestrogen
Topical oestrogen gels or creams are a way of getting oestrogen into the bloodstream by directly being rubbed into the skin on either the vagina, arms or legs. They are typically used for women with vaginal atrophy and can be more potent in alleviating symptoms than oral oestrogen. They could potentially also be safer for those with liver or cholesterol problems although this is not widely evidenced.
Mirena Coil
Whilst the Mirena Coil may prevent heavy bleeding during peri-menopause, it doesn't delay the onset. It also won't help with any symptoms that occur due to decreased levels of oestrogen such as hot flushes and insomnia as there is no oestrogen in it. It may help with symptoms that occur due to decreased progesterone, however, as it contains progesterone it may also cause additional symptoms such as breast tenderness, headaches, cramping and pelvic pain. The coil can be useful as a method of contraception during peri-menopause and can be used as a method to protect the uterus if oestrogen is being taken,
Oral Contraceptive Pill
OCPs could help manage menopausal symptoms by providing both oestrogen and progesterone thus balancing fluctuating hormones and therefore resulting in reduced symptoms. OCPs can also regulate and reduce bleeding whilst helping maintain bone health and strength. OCPs can also be used as contraception and should be used until 12 months post the final bleed - however, it can be difficult to know when this may be as it can create withdrawal bleeds. Therefore, progesterone only pills may be more useful in this situation.
Hopefully this article helps to explain some of the symptoms women face when going through peri-menopause and menopause whilst offering a plethora of useful self-help techniques to manage menopause the natural way.
Abi Brazil is a Level 5 Clinical Reflexologist with specialist training in Women's Health from puberty, Fertility, Pregnancy through to Menopause. She is based in Whetstone and Crouch End, North London plus offers mobile visits.
website: www.reflexologyroomlondon.co.uk
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