How to Get Through Menopause More Comfortably

Menopause is a significant and inevitable health journey for anyone with ovaries and a uterus — about half the population. Yet most people go through menopause without knowing that there are things you can do and treatments you can try to improve your quality of life.

When people talk about “going through menopause,” they’re usually referring to the middle to late stages of perimenopause, a period that typically includes the last reproductive years during which the ovaries begin to produce less and less estrogen and progesterone. Irregular or declining hormone levels during this time can cause symptoms such as hot flashes, urinary and vaginal problems, changes in menstrual cycles, mood swings, and brain fog.

Once the body stops producing progesterone and estrogen altogether, menstruation stops. You are fully “in menopause” or postmenopausal when you have not had a period for a full year. The average age of menopause in the U.S. is 51, and Perimenopause usually begins in your 40s.

Despite being an unavoidable health event that affects multiple body systems, the embarrassment surrounding reproductive health conversations and confusion over the use of the first-line treatment for menopause — estrogen therapy — has left many people in the dark. In recent months, celebrities including Halle Berry And Naomi Watts have called for reducing the stigma surrounding menopause and increasing awareness of it.

To get the full picture, we spoke to experts about how to recognize the signs of perimenopause, when to see the doctor, what foods to incorporate into your diet, and more tips for getting through your period as comfortably as possible.

Step 1: Recognize the early signs of perimenopause

For most people, perimenopause begins in their 40s, although it can begin as early as a person’s mid-30s or as late as their mid-50s. How long you experience symptoms also varies, as some people are in perimenopause for several years, while others are in it for only a few months.

Perimenopause can occur stageswith symptoms becoming more noticeable towards the end, when less estrogen is produced. However, the first signs of perimenopause are usually seen in the menstrual cycle.

Your menstrual cycles become shorter

According to Doctor Natalie CrawfordAccording to Crawford, a fertility doctor and co-founder of Fora Fertility in Texas, one of the first signs of perimenopause is that someone is likely to have shorter menstrual cycles than normal. (For example, someone who has always averaged 28 or 29 days of menstruation may now normally have periods of 24 or 25 days.) According to Crawford, this is because there are fewer and fewer eggs in the “vault” (your ovaries). These naturally deplete over time, but they start to become fewer and fewer toward the end of your reproductive years.

“As the vault empties, you have a clinically low threshold and you start to see these menstrual changes,” Crawford explained. However, factors such as being on birth control that suppresses ovulation or not knowing the timing of your “normal” cycle can make this telltale sign a little trickier to spot, Crawford said.

That’s why the major changes in the menstrual cycle that occur as perimenopause progresses are often the first signs people report to their doctor.

Your menstrual cycle becomes irregular and longer

Periods often become irregular and longer because your body ovulates less easily and less often. The Mayo Clinic describes irregular periods as the “feature” of perimenopause.

“Your period gets weird, it comes less often, and then you think, ‘Is that it?’” says Dr. Sophia Yen, co-founder and medical director of Pandia Healtha telemedicine company for reproductive and hormonal health. Someone can go months without a period, think they’re finally in menopause, and then get a period again, she explained.

“It’s just very stressful for a lot of women,” she added.

You may also experience “flooding,” which Yen described as the very, very heavy bleeding that people often experience in perimenopause. “Spotting,” or light bleeding outside of the menstrual part of your cycle, may also occur.

You have symptoms of low estrogen

Vaginal dryness, urinary tract infections and pain, sleep problems and the infamous “hot flashes” are signs of low estrogen and signs of perimenopauseaccording to the American College of Obstetricians and Gynecologists.

Step 2: Tell your doctor about your symptoms and ask about estrogen therapy

Your menstrual cycle is a window into your overall health — not just your reproductive organs. So even if you’re in your 40s and you think your irregular periods are related to perimenopause, it’s important to rule out a thyroid problem, nutritional deficiency, or other ailment.

“You want to make sure the change isn’t caused by a different hormone system,” Crawford says.

But if you’re in perimenopause, there are treatments available to help ease your symptoms and you don’t have to suffer through them. The best one is probably estrogen therapy. Not only does estrogen help with hot flashes and vaginal and urinary symptoms, it can also help reduce your risk of osteoporosis and relieve some of the mental symptoms associated with falling estrogen levels, such as brain fog or depression.

“Estrogen is good for the blood, the brain and the bones,” Yen said.

Different types of estrogen therapy

Estrogen therapy, or hormone replacement therapy, has gotten a bad rap because of a large study that has been heavily criticized and is now largely seen as flawed. While it’s not right for everyone, hormone therapy is considered an effective and safe treatment for many, relieving symptoms like hot flashes, night sweats, and vaginal dryness, especially when started at a younger age rather than many years after menopause.

Systemic estrogen therapy is given to the whole body as a pill, patch or gel, while local estrogen therapy in the form of a cream, ring or tablet can treat vaginal dryness. Progestin is also sometimes given as a combination therapy.

The important thing is that you don’t have to wait until your period has officially stopped and you’re postmenopausal to ask about estrogen or hormone therapy. In fact, Yen says it’s in your best interest to ask and start earlier in your perimenopausal journey, as long as it’s is considered safe based on your medical history.

“The way I look at menopause is that I run out of gas,” and estrogen is the gas, Yen explained. Instead of waiting until the tank is completely empty, Yen said some people can even use contraception as a way to stabilize the hormone levels that go up and down during perimenopause. Then when menopause hits, you can switch to the stronger stuff (hormone replacement therapy).

As always, your doctor can help you determine which therapy is best for you based on your medical history, risks, and current menopausal or perimenopausal symptoms.

Step 3: Eat the right nutrients and consider phytoestrogen foods

According to Johns Hopkins Medicine, your daily calcium intake goes from 1,000 mg of calcium per day to 1,200 mg once you go through menopause. Again, this is due to the lack of estrogen. You should also make sure you are getting enough vitamin D, as this helps with bone health.

If a balanced diet isn’t enough, you may want to consider a supplement or multivitamin that’s specifically formulated for women 50 and older. However, because too much vitamin D or calcium can cause problems, it’s best to discuss any plans for a supplement or daily vitamin with your doctor to make sure you choose the right one for your needs.

In addition to the basics for healthy bones (get enough vitamin D and calcium), there may be other ways you can eat to prepare yourself for a healthier transition into menopause. Hormonal changes that come with menopause can put you at higher risk for chronic health conditions, such as heart diseaseLimiting your sugar intake and choosing unprocessed, nutritious foods will have a positive impact on your overall health.

And according to information from Zoea company that focuses on nutritional science, some foods notorious for being “heart healthy,” such as the Mediterranean diet, may also help reduce menopausal symptoms, such as hot flashes. compared to people who don’t following a diet that is focused on plants.

Moreover, foods containing phytoestrogens may help stabilize hormones and estrogen levels. According to the Cleveland ClinicSome foods that contain phytoestrogens include:

• Soy products, including soy milk and tofu
• Berries
• Oats and barley
• Carrots
• Apples
• Wheat
• Lentils
• Dried beans
• Sesame seeds
• Rice
• Alfalfa

Step 4: Adjust your workout routine

Physical activity is important at all stages of life, including perimenopause and menopause. For menopausal women, however, the focus is not on aerobic exercise but on muscle-building exercises, Yen says, because this can help with bone strength.

As you get older, you can modify or increase the intensity of your workouts to meet your body’s needs with cardio, strength training, and exercises to improve your balance.

Step 5: Try to make your sleep as optimal as possible

Many people report sleep disturbance as a major symptom of perimenopause and menopause. For those who experience hot flashes (about 75% of women at some point), they are often worse at night. Hormonal fluctuations can lead to restlessness and contribute to night sweats. Hormonal therapy can improve sleep for some people.

For general tips on sleeping cool, practice good sleep hygiene by avoiding or limiting caffeine and alcohol, sticking to a sleep schedule, and keeping your bedroom temperature cool. You can also invest in cooling sheets or a cooling mattress pad.

However, it may be changes in the brain related to night sweats, rather than the heat itself. keep people awakeaccording to Johns Hopkins Medicine. Also, declining hormone levels can increase your risk of sleep apnea — a major sleep disruption. If you’re having trouble sleeping at night, talk to a doctor and advocate for yourself and how you’re feeling. If your concerns aren’t addressed by your primary care doctor, find someone who specializes in women’s health. You can also find a menopause doctor near you.