Going into the menopause prepared

Menopause can be a daunting time for women with uncertainty around physical and mental symptoms, and weight gain, fatigue and even depression sometimes occurring. For those heading towards or even in that time, there are ways that diet and exercise can help lessen the symptoms and make the whole experience a more manageable one.

Menopause occurs because our ovaries shut down and stop producing sex hormones, primarily oestrogen and progesterone, says Dr Fiona Barry, a member of the Meno Active formulation team at Revive Active. “While the ovaries are the primary site of production for these hormones, they are not the only one. Our adrenal glands, hair follicles, skin, fat cells, muscles and brain, in particular the pineal gland, all produce these hormones, albeit at much lower levels.

“When a woman enters perimenopause in good nutritional, physical and psychological health these sites can increase their production of sex hormones considerably; in the case of the adrenal glands by up to threefold. This just goes to show that it is not our bodies that are incompatible with menopause, it is our lifestyle.”

Dr Barry says that given our current life expectancy, most women will spend at least a third, if not a half, of their life in menopause, therefore it behoves them to prepare for it. “Our bodies are designed to cope well with menopause but our current lifestyle is incongruous with it.”

Menopause symptoms

Symptoms can include the well-known hot flashes, as well as fatigue, weight gain, and some patients have complained of cognitive issues, says Prof Rose Anne Kenny, medical gerontology at Trinity College and St James’s Hospital. “Their memory isn’t as good and that worries them. These are all because of hormonal changes taking place.” Cardiovascular disease increases after menopause. “Doctors aren’t as good at screening women for high blood pressure and cholesterol. It is important for individuals to know – you need to have that checked at regular intervals.”

Loretta Dignam, founder and chief executive of the Menopause Hub, says the decline in oestrogen results in women laying down fat differently. “We lay down ‘brown fat’ or visceral fat, rather than laying down subcutaneous fat which we did pre-menopause. In addition, our metabolism slows down and we need to consume fewer calories.”

Watching the weight

Dignam advises three steps to help manage weight gain. Firstly, keep a food diary. “Identify where you can reduce calories by 500 per day. This is a lifestyle change and we need to reduce our calorie intake forever.” She then recommends increasing the energy output. “Walk more steps per day, to a minimum of 10,000 per day every day. If you are already at 8,000-10,000, increase to 15,000 every day.

“Incorporate daily weight-bearing exercises into your regime every day; using your body weight makes it easier and more convenient – for example, squats, push-ups, and planks.”

Diet and supplemental help

Without a doubt, outside of HRT and even with HRT, research has shown that diet and lifestyle play a major role in helping with menopause, says Brian Fitzpatrick, managing director of Oriel Marine Extracts. “Many of the foods recommended such as healthy leafy greens, berries, seeds, specific dairy and fatty acids such as omega 3s all contribute to a healthy lifestyle but become even more important during menopause due to the body’s need for these key nutrients.

“In many cases due to the quality of food and modern farming practices we need to supplement specific nutrients such as magnesium to achieve the necessary levels of nutrient absorption to make a difference.”

Dignam says given the lack of sunshine in Ireland, a supplement of vitamin D is typically required, with calcium important for bone health, and magnesium for the nervous system and muscles.

Dr Barry says eating a whole food diet is paramount. “My general rule of thumb is if a food comes in any sort of packaging, I’m wary. If it contains more than five ingredients and if any of those ingredients sound like chemicals or you can’t pronounce any of them, don’t consume it.”

Start early

There is no doubt that the better prepared and healthier a woman is going into her menopausal years, the better, says Dr Barry. “Nowadays, most women are entering these years completely depleted. We are the sandwich generation and are often juggling rearing a young family, while caring for elderly parents and holding down a career. This is not conducive to good health. We’re also having children later so many women are surprised when they are vaulted into perimenopause while still holding a baby.

“By the time a woman is 45 she is definitively in perimenopause and so I would be advising that women start taking preparatory steps in their mid to late 30s. Indeed, one in a 100 women go through menopause before the age of 40 so knowing your body, and listening to it, is key.”