Oestrogen and progesterone are pivotal hormones in the female body, responsible for regulating the menstrual cycle and supporting pregnancy. However, during perimenopause, your ovaries shrink, and the amount of progesterone and oestrogen they produce declines. Eventually, your body stops releasing eggs and your periods stop altogether. After 12 consecutive months without a period, you are classed as being in menopause.
Menopause is a distinct life stage for women, marking the end of their reproductive years. It brings with it a range of physical and emotional changes that can take time to acclimatise to. The fluctuating and then reduced oestrogen and progesterone in the body cause a variety of menopause symptoms, including hot flushes, night sweats, vaginal dryness and brain fog. These can be difficult to deal with and impact your day-to-day life.
Fortunately, there are a variety of things to help with menopause that you can try if you’re struggling with its symptoms.
Hormone Replacement Therapy (HRT)
HRT is the most common treatment for managing menopause. Body-identical HRT uses oestrogen, progesterone and sometimes testosterone to replenish the hormones that are now at low levels in your body.
It’s a safe and effective treatment for menopause symptoms, with the benefits of HRT outweighing any HRT risks in most cases. It can help dramatically with joint pain, mood swings, vaginal dryness, hot flushes and night sweats in menopause, and may also reduce your risks of hormone-related health problems including osteoporosis and heart disease as an added benefit.
There are some side effects of HRT, such as headache and nausea, but it’s common to experience few or no side effects, with most disappearing within the first three months of treatment.
There are different forms of systemic ( in the whole body) and localised ( to the vagina) HRT including:
- Tablets
- Patches
- Gel
- Spray
- Vaginal rings
- Pessaries
- Cream
They can contain oestrogen, progesterone or both (combined HRT) and their regimen can vary. Some HRT must be taken daily (continuous HRT), while others are taken in a cycle (sequential HRT).
Cognitive Behavioural Therapy (CBT) and other therapies
CBT for menopause is a form of talking therapy that focuses on the link between physical symptoms, feelings, and actions. It can help you to manage anxiety, depression, and stress as well as other menopausal symptoms including insomnia, hot flushes and palpitations. It does this by encouraging you to examine your thoughts and behaviours and develop new ways of thinking to create more positive patterns.
There are other therapies which are also useful for dealing with menopause, particularly for the emotional and cognitive changes that can occur.
Counselling provides you with a safe space to talk about how menopause is impacting your life. Mindfulness practices help you to acknowledge current challenges by taking a step back from them, appreciate the positives in your life and find ways to ground yourself. Using these techniques can make you feel calmer and less overwhelmed, which in turn, can reduce physical menopause symptoms as well.
Prescription medication and over-the-counter products
While HRT is the most commonly prescribed treatment for coping with menopause symptoms, there are other medications and over-the-counter products that may be helpful including:
- Veozah: A hormone-free medication that is licensed for alleviating the vasomotor symptoms of menopause such as hot flushes and night sweats.
- Beta-blockers: Beta-blockers work by slowing the heart rate down. Due to this, they can sometimes be prescribed to manage menopausal vasomotor symptoms.
- Oxybuynin: Most frequently used to treat an overactive bladder, oxybuynin has been shown to relieve hot flushes and night sweats in nearly 40% of menopausal women.
- Antidepressants: Low-dose antidepressants can reduce hot flushes and help alleviate mood swings or depression linked to menopause.
- Lubricants: They provide relief from vaginal dryness, making sexual activity more comfortable during menopause.
- Vaginal moisturisers: These are different from topical vaginal oestrogens. These hormone-free creams or gels are applied into the vagina to restore moisture and reduce discomfort, and itching.
- Skincare: Menopause can affect skin elasticity and hydration, so you may need to adjust your skincare routine to include products that can help improve moisture retention, soothe the skin, and reduce signs of aging.
- Women’s health physiotherapy: Urinary incontinence is a common issue during menopause due to weakened pelvic muscles. Physiotherapy can help with tailored exercise to improve muscle strength.
- Clonidine: This medication helps manage menopause symptoms, particularly migraine headaches and hot flashes, by reducing blood pressure.
Natural remedies
If you cannot take HRT or don't want to use a hormone-based treatment, you might want to explore herbal remedies for menopause. The effectiveness and safety of herbal remedies are not as regulated as it is for HRT, but some women have found the following helpful in dealing with menopause symptoms:
- Black cohosh: This herbal remedy is commonly used to reduce hot flushes and night sweats.
- St John’s wort: Known for its mood-enhancing properties, it may help alleviate mild depression, anxiety, and mood swings often experienced during menopause.
- Phytoestrogens: Found in red clover and foods like soy, these plant-based compounds mimic oestrogen and may help balance hormone levels, reducing menopause symptoms like hot flushes.
- Gamma Linolenic Acid (GLA): An omega-6 fatty acid found in evening primrose and starflower oil, GLA may help reduce breast tenderness and inflammation linked to hormonal changes and be beneficial in reducing the risk of cardiovascular disease.
- Folate: This B vitamin supports energy levels and cognitive function and may help alleviate mood swings, hot flashes, and fatigue during menopause.
Holistic treatments
Holistic treatments focus on the well-being of the whole person, addressing both physical and emotional aspects of health. For managing menopause symptoms, these approaches consider the mind-body connection, offering relief from physical discomfort while also helping women manage stress, improve their mood, and foster a positive outlook on life.
- Yoga for menopause: Yoga supports flexibility, strengthens muscles, and helps balance hormones, while also promoting relaxation and reducing stress, which can improve mood and mental clarity, as well as reduce hot flushes and night sweats.
- Reflexology for menopause: This therapy stimulates pressure points on the feet and hands that correspond to various organs, which can help relieve physical symptoms like hot flushes and promote a sense of calm and well-being.
- Cold water swimming during menopause: Cold water immersion can improve circulation, reduce inflammation, and help with joint pain or hot flashes, while also boosting mood and energy levels.
- Acupuncture and menopause: This traditional Chinese medicine technique uses fine needles to stimulate specific points on the body, which can help regulate hormones, relieve pain, and reduce the intensity of menopausal symptoms like hot flashes and insomnia.
Exercise and nutrition
What we eat has a significant impact on our health and how we feel. Adopting a varied menopause diet that is rich in vitamins and minerals can not only improve menopause symptoms but can also help protect you against future health problems. When eating during perimenopause and menopause, be sure to include:
- Protein: From lean meat, oily fish and non-meat sources including tofu, nuts and beans.
- Low glycemic index carbohydrates: including wholemeal bread, sweet potatoes, wholegrain pasta, cereals and grains.
- Calcium: To help protect against osteoporosis, include dairy products, leafy greens, small fish with bones, beans and lentils in your diet.
- Fruits and vegetables: Are packed with important vitamins and minerals. Aim for a minimum of five portions a day – the more varied the better.
- Water and fluids: Staying hydrated is important so try to drink at least two litres of water per day.
Exercise is also great for managing menopause symptoms, improving your mood and increasing your strength. Any exercise is beneficial but try to do a range including:
- Cardiovascular exercises such as dancing, cycling and running
- Strength exercises including bodyweight exercises, lifting weights, yoga and resistance training
- Balance and mobility exercises like yoga, pilates and Tai chi
Other lifestyle changes
Ultimately, any behaviour or action that contributes to overall well-being has the potential to help you cope with menopause symptoms. Other lifestyle changes that may be beneficial include:
- Talking to friends and family
- Stopping smoking
- Limiting caffeine
- Avoiding spicy foods
- Reducing or avoiding alcohol intake
- Wearing loose clothing made of natural fibres
- Maintaining a healthy BMI
If you want to know more about managing menopause, speaking to a professional about your personal symptoms and experiences can be really helpful. Which doctor to consult for menopause is a personal choice, but an experienced menopause doctor will understand what you’re going through and be able to provide you with tailored advice and support. At Menopause Care, we have a team ready to help you. To get started, book a consultation with a menopause doctor.
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