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The emotional roller coaster of menopause: How to ease the ride

By CLAUDIA BERMUDEZ-HYUN, The Philippine STAR Published Jun 21, 2022 5:00 am

Most of us would agree that menopause is no picnic.

The stigma of menopause, its association with hysteria and incompetence, the shame of aging and the taboo of revealing menopausal symptoms — all these compound the distress and struggle.

Some women breeze through this natural process with mild to no symptoms and others are highly affected by the side effects, the shift in hormones, mood swings, hot flashes, brain fog, sleep disruptions, anxiety and weight gain.

In addition to the above, recent headlines from The European Society of Cardiology (May 2022) show that levels of bad cholesterol that rise during menopause predispose women to heart disease. Yet one more thing to look out for.

Weight gain: The hormonal changes of menopause might make you more likely to gain weight around your abdomen than around your hips and thighs. Opt for low-carb, low-sugar intake at this time.

It feels like some sort of payback for all those free, fun, fertile and frolicking childbearing years.

So what exactly happens to our bodies during this time?

In normal circumstances, this transition occurs between the age of 48 to 53 and it is mainly due to an eminent production decline in your ovaries of both estrogen and progesterone. Perimenopause is the time when your menstrual cycle begins to be disrupted: you skip a period for few months or you get it twice in six weeks. In other words, the expected 28 monthly cycles of the last 35 years are no longer happening. Once you have had 12 full months of no periods, menopause has officially set in but those “killer” side effects can carry over for six to seven years.

Age and symptoms are usually enough for women to know the transition has started. Having said that, your medical practitioner can tell you at what stage you are in, by checking your levels of Follicle-Stimulating Hormone (FSH), and estrogen through a simple blood test.

What can you do to make this natural biological process easier and curb some of the side effects mentioned?

“Menopause is unavoidable but it is possible that the negative metabolite shift can be diminished by eating healthily and being physically active,” said study author Dr. Eija K. Laakkonen of the University of Jyväskylä in Finland. “In particular, women should pay attention to the quality of fat in their diet and getting sufficient exercise to maintain cardiorespiratory fitness. “

Let’s start addressing the four pillars that will give you stability to face the side effects of menopause.

Decide what time you will sleep nightly and stick to it.

Sleep. Understand that the main pillar of wellness at any time in life is good sleep. Getting this right should be your main priority so the rest can fall into place. Create a routine around bedtime to get the hours you need to function properly. Turn off electronics and mentally prepare yourself for bed by reducing exposure to light and noise using an eye mask and earplugs. Decide what time you will sleep nightly and stick to it. Try restorative activities before bedtime: brew a cup of camomile or mint tea, meditate or read a few pages of a book. These will all help you establish your Circadian rhythm. If you are having trouble falling asleep, try melatonin or a mild sleeping aid to clock in those seven to eight hours daily. Top up with a short nap in the afternoon if you feel your rest was not fully completed the night before. Basta, do whatever it takes, within reason, to get this crucial, physical and mental need met.

Try cold summer soups like gazpacho or chilled cucumber or pumpkin soups. They are low in calories, rich in flavor and fiber and full of vitamins and minerals.

Diet. Diet and mental health are more closely intertwined than you may think. When it comes to food intake, fresh, and if possible organic, produce is the way to go. Opt for wholefood meals that balance protein, carbs and fiber. Lowering carb intake and foods high in fat is wise as your metabolism is slowing down and it is more difficult to burn any extra weight gained in these years. Watch your intake of trans fats and sugar carefully for the obvious calories and most importantly the insulin spikes.

Discover summer recipes like gazpacho, vichysoisse, chilled cucumber or pumpkin soups. They are low in calories, highly satisfying and rich in both fiber and vitamins.

Remember that menopause is not an illness. It’s a natural part of a woman’s life that can be looked at as a marker of “moving on” to a next stage.

Increase your intake of Omega-3 fats found in olive oil, fish, and nuts.

Dehydration can make you more susceptible to menopause symptoms. Have a bottle of water with you at all times and refill it as often as possible as you go through your day trying to consume at least 2.5 liters daily.

Vitamins and minerals that are depleting at this stage are mainly vitamin D, iron and calcium. Brittle bones are connected with low estrogen, so check with your GP if you are low on any of these and if you can take supplements to compensate for the lack.

Weightlifting: Women in their late and early 50s should try lifting weights and doing other strength training exercises if they want to kick menopause symptoms and prevent osteoporosis-related fractures. 

Exercise. During this time especially, movement is pivotal when it comes to improving both your physical and psychological states. Moderate exercise four to five times per week can help with mood swings, hot flashes and anxiety. Exercise releases the feel-good hormones known as endorphins and boosts serotonin levels. Carve out 30 minutes a day for a cardio walk, yoga or weight training to build lost muscle tone. I know it may sound like sweating is the last thing you want to purposely do, but believe me, it will help curb the mood swings and burn calories.

Mindfulness: Researchers at Mayo Clinic discovered that being mindful may be especially helpful for menopausal women struggling with irritability, anxiety and depression.

Mindfulness. A calm and positive mind will help you surf the waves better. Learn breath and meditation exercises. Researchers at Mayo Clinic report that being mindful may be especially helpful for menopausal women struggling with irritability, anxiety and depression. Find a quiet and cool corner at home or work to sit and find your “center” for 10-15 minutes daily. It’s all about creating a habit and making it part of your routine by practicing it daily.

Now let’s talk about dealing with the most common side effects:

Hot flushes: During the day, wear light clothes and natural-made fabrics and carry a paypay or abaniko in your bag at all times; keep hydrated and stay indoors in the hottest hours of the day. 

Hot flashes. Studies estimate that 85 percent of menopausal women experience hot flashes, and some suffer from them more frequently in the middle of the night or in certain situations. Hot flashes are quick bursts of heat and often accompanied by rapid heartbeat and drenching sweat that can last anywhere from 30 seconds to five minutes. These infamous heat waves are the most unwelcome and uninvited visitors, with no sense of appropriate timing.

For starters, avoid any type of spicy foods or stimulants such as coffee, alcohol or smoking. These will increase the intensity.

Opt for cool showers before bed to lower body temperature and help with the night sweats. Try using those satin sheets you never dared buying (this is the time!) as the mix of fibers will keep you body temperature lower. If the heat is unbearable, research on purchasing a cooling blanket or, better yet, a temperature-controlled mattress. There are many available options in the market. Look at Chillsleep.com and Eightsleep.com as my recommended choices.

During the day wear light clothes made of natural fabrics, carry a paypay or abaniko in your bag at all times, keep hydrated and stay indoors at the hottest hours of the day.

Making waves: Water is your best friend at this time for its cooling  and invigorating  properties. A late-afternoon or evening swim will lower your body temperature by a few degrees and allow you to sleep better.

The regular practice of Cold Water Immersion (CWI) is particularly good for women going through menopause, according to studies being carried out. Women report that hot flashes and night sweats diminished since they began soaking in a 12° to 15° Celsius tub periodically. You can set this up if you have a bathtub at home or an inflatable pool. It is also beneficial for weight management, circulation and heart health. Alternatively, a late afternoon or early evening dip in a swimming pool or in the sea can do the trick as well.

Mood swings: These are tricky and highly destabilizing. Reactivity and emotional meltdowns over seemingly small things are common.  

Mood swings. These are tricky and highly destabilizing. Reactivity and emotional meltdowns for seemingly small things are common. Anger, and often rage, set in with the hormonal shifts and it can be a spiral. Unlike anger, it’s hard to tame rage by sheer willpower or attempting to alter your behavior. So, be patient with yourself and recognize the reasons why you’re feeling this way. Be open with loved ones, let them know what you’re going through and have honest conversations about what you need during this time so they can be aware of your changing moods. Remember, the negative emotions you may be feeling during this transition are not your fault and you will not feel this way forever. Forgive yourself. You are entitled to your emotions.  Observe what are the common triggers and try to avoid being in those situations as much as possible.

Dry skin. Your skin and hair in general will feel drier. Find a richer moisturizing lotion for face and body. Stay away from anything mentholated as it will add heat to your body and you don’t need more of that.

Find activities that bring you joy and positive feelings such as gardening, painting or writing. This is a perfect time for introspection and a deeper connection with yourself.

Productive outlets. Find activities that bring you joy and positive feelings, such as gardening, painting or writing. This is a perfect time for introspection and a deeper connection with yourself.

Therapy. Seek out a therapist if you need some extra support. Ideally, one that is experienced in menopause and midlife. Having a professional guide you through this stage can be highly beneficial for the anxiety or depression feelings that might accompany some women. Your girlfriends are your best supporters during these times, so don’t forget to tap into that resource for comfort, company and feedback. Don’t suffer through this alone.

Medically, there are many options to assist you through this process. Consider online research and consult your doctor on the following:

Hormonal Replacement Therapy. Consider using a topical estrogen in either cream or tablet form if you are experiencing intimate dryness and discomfort.

Low dose anti-depressants (SSRIs) and Gabapentin can help manage hot flashes.

Remember that menopause is not an illness. It’s a natural part of a woman’s life that can be looked at as a marker of “moving on” to a next stage, a time of new beginnings and renewed libido. For many women it’s a “rite of passage” involving both social and psychic transformations whereby a sense of self emerges. Embrace this time with awareness. Though its symptoms can be difficult to deal with, consuming the right foods and exercising regularly will help alleviate and often prevent them all together.

The more positivity and awareness you pour into this life transition, the smoother the ride can be.