For many women, the Davina Mccall menopause doc, Sex, Myths and Menopause which aired in May 2022 was a lifeline.The documentary reassured women they weren’t hurtling at breakneck speed into old age, dementia and illness. The good times weren’t quite over yet, they were experiencing perfectly natural perimenopause and menopause symptoms. Their body was just putting them through a transition which changed their physiology like puberty and pregnancy. Just that the menopausal transition wasn’t talked about or taught in school.
For other women, the documentary was an alarming preview of how hormones could destabilise the lifestyles, relationships and careers they had spent years building. Hot flashes, mood changes, vaginal dryness and the loss of bladder control. They needed to get clued up and seek medical advice so they could make some decisions on how they were going to handle it when it was their time.
In this article we’ll cover the menopause basics of hormones, the different stages of menopause, estrogen ( oestrogen ), symptoms, hormone therapy, health risks associated with menopause and what you can do to make sure your menopause experience is as good as it can be for you.Menopause isn't the end of your career or your plans - with a few tweaks and adjustments you'll be right back in the driving seat.
- Female Biology: The ovaries, fertility and menstrual cycles
- Hello ( And Goodbye ) Hormones
- Oestrogen ( Estrogen) is A Big Deal for Women
- Menopause And Female Health
- Signs and Symptoms of Menopause & Perimenopause
- Does Menopause Cause Weight Gain?
- Meal Replacements for Menopause - How They Work
- Pros and Cons of Hormone Replacement Therapy
- Natural Menopause - Menopausal Transition Without HRT
- The Menopause Diet
Female Biology: The ovaries, fertility and menstrual cycles
A female is born with all the eggs she will ever have, around 2 million which die off each month in their thousands from her birth until puberty when the rate of loss slows . At puberty the pituitary gland in the female brain releases follicle stimulating hormone ( FSH) which signals the ovaries to ripen an egg within a follicle.
The follicle produces oestrogen ( a form of oestrogen called estradiol) to prepare for a potential pregnancy by thickening the lining of the womb. Luteinising hormone ( LH), also from the pituitary gland signals the ovaries to release an egg into the fallopian tubes. If her eggs aren't fertilised through sexual intercourse the lining of the womb is discarded as menstrual blood and tissue.
A woman’s menstrual cycle ( period) generally falls between 24 to 38 days. Estrogen (oestrogen) , progesterone and testosterone levels change during the monthly causing temporary symptoms. These can include headaches, abdominal cramps, irritability, gastrointestinal issues, tiredness, water retention and breakouts. AKA premenstrual syndrome or PMT.
Hormones also play a massive part in maintaining a woman's overall health. They help to protect her heart, maintain her muscle mass, balance her metabolism and manage her physical and mental stress. They keep her hair full bodied and shiny, her skin plump and moisturised and her memory and concentration skills sharp.
When the ovaries start to decrease their levels of hormone production you’re going to experience menopause symptoms directly related to their decline. Unfortunately you can’t know in advance what symptoms you’ll need to deal with. Every woman's symptoms will be unique but if you get familiar with what hormones do and are able to spot emerging symptoms then you’re well armed to make your own decisions on how to handle them. So let’s get you caught up, shall we?
Hello ( And Goodbye ) Hormones
Women have three major sex hormones produced by their ovaries which are oestrogen, progesterone and testosterone, typically regarded as a male hormone but produced at levels of up to four times more than estrogen when women are younger!
The ovaries produce your main source of estrogen before menopause supported by the adrenal glands and fat cells - where estrogen is also able to be accessed albeit in a weaker form. Oestrogen is responsible for the sexual development of female characteristics such as breast formation and widening of hips. It regulates the thickening of the uterine lining and the menstrual cycle which supports fertility and pregnancy. Oestrogen stimulates the mood boosting chemical serotonin and is involved in the production of ‘feel good’ endorphins.
Often referred to as the pregnancy hormone, progesterone is also secreted by the ovaries, maintains the lining of the womb and supports the body in the early stages of pregnancy.
Progesterone helps to balance estrogen and also starts to decline during perimenopause. Progesterone is the hormone which helps us to relax mentally and physically so we can get essential downtime. During Perimenopause and Menopause, in response to declining Progesterone levels cortisol and adrenaline are released which can heighten anxiety levels. How to Recognise and Manage Menopause Anxiety
Testosterone is produced in a woman's ovaries and adrenal glands and plays an important role in many aspects of women’s health including libido, sexual arousal, bone strength, cognitive function, energy and cardiovascular health. Testosterone supports the libido by increasing dopamine levels and is a vital hormone when it comes to a woman's retentive memory and concentration levels.
Oestrogen (Estrogen) is a really big deal for women
The role of oestrogen keeps a woman's body and brain balanced, it isn't just for making babies. Reproductive hormones which include oestrogen do a lot more than manage menstrual cycles and dictate when periods stop.
Oestrogen is multi dimensional in its forms and production levels vary throughout a woman's life. There are oestrogen receptors all over a woman's body which help to regulate how her body works. The main types of estrogen at work in a woman's lifetime are estradiol, estrone and estriol. When the ovaries stop producing enough oestrogen women experience menopause.
Estradiol - abundant and concentrated
Estradiol is the most abundant , concentrated form of oestrogen produced by the ovaries. It is the dominant oestrogen involved in breast development, the widening of the hips and also manages the distribution of fat - relegating it to the hips and thighs during childbearing years. Estradiol is made in the follicles of the ovaries , the adrenal glands, fat cells , breasts, liver and brain. In menopause the ovaries stop producing high amounts of estradiol decreasing output and dwindling to a trickle in a woman’s post menopause phase.
Estrone - higher in menopausal women
Estrone is a weaker form of oestrogen and is found in higher quantities in menopausal women. It is produced mainly in the ovaries, adrenal glands and fat tissue and can be converted into the more powerful version of oestrogen - estradiol. It can also be made in the laboratory. Not much is understood about how and when estrone is controlled but it is thought in premenopausal women, around half of estrone is produced by the ovaries. The remaining 50% is produced by the adrenal glands and fat , which are also the sources of estrone in men and children. Estrone may act as a back up oestrogen, and converted into estradiol by the body when it needs more.
Estriol - good for bones and heart health
Estriol, most active around pregnancy, is derived from estradiol, exists in a woman's body during her lifetime and levels rise and fall throughout the day. Studies suggest it can help to reduce perimenopause and menopause symptoms of vaginal dryness, poor bone density and hot flashes.
Estriol is the weakest form of estrogen. It's produced in small amounts by the ovaries and placenta (the organ that connects the foetus to the uterine lining) during pregnancy. While all three forms of estrogen are important, estriol is the most important estrogen for maintaining bone density, regulating the menstrual cycle / reproductive system and protecting a woman against cardiovascular disease.
Menopause and Your Health
Oestrogen ( estrogen), as well as playing a major part in a woman's reproductive system, also has a significant role in protecting her health. There are oestrogen receptors all over the body which help to keep functions of body and brain in working order. When levels start to take a nosedive there are serious ramifications - including an increase in the risk of certain health conditions.
Oestrogen helps to protect the heart
Heart disease includes conditions that block or narrow blood vessels which can lead to a heart attack, a stroke or angina and other conditions that affect your heart's muscle, valves or cause abnormal rhythms. Diabetes, high blood pressure and high cholesterol are precursors to developing heart problems. Estrogen helps to reduce the high risk factor for women by keeping veins free from fatty plaque deposits and working on the cells that line the arteries.Women who experience lower levels of estrogen due to early menopause have a higher risk of premature Coronary Heart Disease
Oestrogen supports brain health
Oestrogen affects how a woman's brain works and regulates glucose which is fuel for the brain. Brain blood flow and circulation is also part of oestrogen's job, ensuring the brain has enough oxygen and cell building nutrients to function well, and is a powerful ally in preventing neurological degeneration by boosting the immune system. It encourages the growth of neutrons and the communication between them. Researchers think oestrogen may cause the body to make more antioxidants, protecting brain cells from damage. Dementia affects more women than men and it is thought that hormones may play a role in this.
Hot flashes are thought to be a consequence of the brain's internal thermometer being disrupted due to changes in hormone levels.
Oestrogen helps to manage sugar metabolism
Diabetes is one of the leading causes of preventable sight loss in the UK. Estrogen also plays a part in protecting against Type-2 Diabetes by helping to manage blood sugars. ZOE researchers found key differences in post eating inflammation and blood sugar in post menopausal women. Their ability to bring down sugar surges after eating is less efficient when estrogen levels start to fall.
Oestrogen Helps To Protects Against Inflammation
Inflammation is the immune system's response to infection or injury. It causes temporary swelling and can help the body deal with invading germs. Longer term non localised inflammation however, can be harmful changing cells and increasing the risk of disease. A drop in bone density and aching joints is very common for women in menopause. Lower inflammation means less joint pain and discomfort from arthritis.
Oestrogen supports eye health
Eye health also depends on oestrogen levels to stop the eyes drying out ( the lens of the eye is populated with more than one oestrogen receptor) and can reduce the occurrence of cataracts and macular degeneration.
Oestrogen helps to build bones
Osteoporosis and broken bones are more common in women than in men.One of estrogens most important jobs is keeping bones strong by supporting the growth of new bone faster than the breakdown of old bone ( bones constantly renew themselves over 3-9 months) Bones lose strength at a faster rate after menopause. One in 2 women over the age of 50 will break a bone because of osteoporosis. If you have a premature menopause or early menopause you are more likely to develop osteoporosis and have weaker bones as you age.
Low Oestrogen Symptoms
As a woman ages the hormones estrogen, progesterone and testosterone start to become less dependable and the ovaries stop releasing eggs. They steadily decline as time goes on and this causes both physical and mental changes which women experience as perimenopause symptoms and symptoms of menopause. Signs and symptoms of low oestrogen range between 34 and 45 depending on what sources you read! They include
- Hot flashes - sudden feeling of warmth and redness on the face, neck and chest
- Irregular periods - missed, lighter, longer or heavier periods
- Heightened anxiety - feeling more tense/ frightened with no good reason
- Breast tenderness - can include burning, soreness or burning sensations
- Change in body shape - a thickening midsection
- An increase in abdominal and visceral fat
- Changes in gut biome - a reduction in the diversity of the gut flora
- Night sweats - you awake to soaked night clothes and bedding
- Constipation - bowel movements are no longer regular
- Tingling and numbness - usually hands, arms, feet and legs
- Restless legs - jerking movements of the legs experienced at nightime
- Joint pain - as hormonal management of inflammation reduces
- Decline in oral health - bleeding gums and bad breath
- Mood changes - emotional symptoms
- Depression and low moods - a possible risk of declining hormones
- Lines and wrinkles - collagen decreases as estrogen levels decline
- Low libido - less interest in sex, difficult to become aroused
- Declining bone health - bones can become fragile
- Vaginal dryness - can make sex painful, cause itching and discomfort
- Thinning hair / hair loss - most women will experience general hair thinning
- Dry itchy skin - natural oils in skin decrease with estrogen levels
- Midlife acne - around the jawline, on the face, chest and back
- Urinary tract infections - the vagina and bladder
- Urinary incontinence - lack of bladder control
- Painful intercourse - drier skin, loss of elasticity and muscle tone
- Brain Fog - memory problems, poor concentration levels
- Insomnia - sleep patterns are disrupted and affected by other symptoms
- Cardiovascular diseases - higher blood pressure and less flexible arteries
Unfortunately, many women in midlife can also experience autoimmune disease such as hypothyroidism or Hashimoto's thyroiditis symptoms which also share a lot of symptoms with menopause.
Perimenopause Symptoms - Bleeding between periods
On average, a woman enters perimenopause when she in in her mid to late 40's. Primary ovarian insufficiency or early menopause can also occur at this time, when periods stop altogether before the age of 45.
A woman still has periods during perimenopause, although they start to become less predictable, she can still produce eggs and she is still has enough reproductive hormones to get pregnant.
Symptoms of hormonal instability can creep in unnoticed as her ovaries production of progesterone, estrogen and testosterone levels start to become less reliable. As progesterone declines, mood changes can manifest, hot flashes can begin and those who experience symptoms of PMS may find this becoming worse, with unpredictable and uncharacteristic bouts of rage and anger.
Heart palpitations and arrhythmias due to the drop in ovarian oestrogen may manifest. Although these can be a little frightening, heart palpitations in perimenopause are generally none threatening, but you should seek medical advice if you’re overly worried about them.
A woman still has periods during perimenopause, although they start to become less predictable, she can still produce eggs and she is still able to get pregnant.
It is extremely common for women to experience bleeding between periods , missing and spaced periods which can easily be dismissed, put down to stress, being overworked or fatigue. Other women can experience heavy bleeding between periods or heavier periods in general which can last longer than their normal menstrual periods as they come to the end of perimenopause.
What are heavy periods?
Heavy periods are when
- You bleed through clothing
- You pass large blood clots
- You have to use tampons and towels at the same time
- You frequently have to change your sanitary protection
- Your periods prevent you from doing what you want
Super soaking events
Some women report'super soaking' events. When this occurs a woman has a sudden and very heavy bleed which soaks through sanitary protection, underwear and clothing and can be accompanied by dizziness and nausea.Bleeds can include large blood clots which can be very distressing.Super important to keep iron levels up to compensate.
If you're suffering from heavy bleeding Should you consider the Mirena in perimenopause? may be worth a read. The Mirena is often recommended by healthcare providers as a solution for birth control and to manage excessive bleeding.
Brain Fog, Bloating and Broken Sleep
Brain fog is a very common perimenopause symptom and a symptom when women experience menopause. Poor memory and concentration levels may have you forgetting names, meetings and usually all too familiar phrases and details. Many women put this down to getting older but it’s not always the case. If you’re in your mid to late 40’s it could be hormone related. The average age when hormones change is around 47. Learn more about tacking menopause brain fog.
Bloating in menopause
Bloating is where you feel full and uncomfortable and can be down to your hormones and the effect on your digestion and not because you’ve eaten more than you should. Progesterone helps the body to relax and too much progesterone - when it upsets the delicate balance with oestrogen, can slow things down too much, including your digestion. Oestrogen can cause water retention which can also contribute to belly bloating.
Perimenopause sleep problems
Hot flashes, breast tenderness, and sleep disturbances are symptoms women can experience through perimenopause. For some, the lack of sleep or broken sleep can become quite debilitating and make their usual work and family commitments much harder to manage as well as have a detrimental effect on their health.
Symptoms of menopause
The menopause transition is the stage between your last period and up to 12 months when your menstrual periods are absent. The average age for menopause in the UK is 51. Premature menopause, early menopause or primary ovarian insufficiency is when a women's periods stop before the age of 45.
Common perimenopause symptoms of heavy bleeding, mood swings and heart palpitations may start to wane, but most women will start to experience additional new symptoms of menopause. Many women experience hot flashes for years - in their perimenopause, menopause and post menopause phases.
Unless on hormone therapy, women experience menopausal symptoms which include anxiety, urinary incontinence, dryness in and around the vagina, hot flashes and nocturnal sweating called night sweats, a weakening of pelvic floor muscles, less pleasurable sexual intercourse, memory issues, joint pains and dryer, itchy skin. Hair can start to become less lustrous and lose body while individual hair strands can become a lot finer. Hair loss can also be a consequence of the lower levels of estrogen.
Poor memory and concentration menopause symptoms may persist, skin becomes less plump and moisturised, Lines may become more noticeable as collagen levels drop without the support of adequate oestrogen.
A change in a woman's body shape is common in this phase. Women in mid life tend to be less active than their pre menopause versions. Life tends to be very busy with senior careers, teenaged children and ageing parents. Free time is scarce. As we age, natural changes in body composition means more fat is stored and muscle mass decreases. Fat is bulkier than muscle which is one way body shape can change, less definition and softer lines. The body also changes WHERE it stores fat - building up fat reserves around the midsection
Low estrogen can cause the skin inside the vagina and around the vulva to lose it's natural lubrication and elasticity, sometimes referred to as vaginal atrophy. There is an increased risk of a drop in sexual desire due to testosterone levels dropping with around 50% of women losing interest in sex. They find it much harder to become aroused and the decrease in natural lubrication can make sexual intercourse painful.
Post Menopause Symptoms
The post menopause stage starts when 12 months without a menstrual period have passed. Postmenopausal women can continue to experience the same symptoms of anxiety, low mood, poor memory, joint pain, breast soreness, difficulty sleeping, hot flashes, night sweats, itchy skin, changes in body odour and restless legs.
As she gets into her sixties she can lose muscle, vaginal, urinary, hair and skin symptoms can persist and get more severe (unless a woman is taking hormone therapy or supplementation to manage menopause symptoms) Muscle and joint pain symptoms may get worse and with those an increased risk of osteoporosis.
Does Menopause Cause Weight Gain?
Obesity is a health problem globally, worldwide obesity has tripled since 1975 and in England in a 2021 Health Survey 26% of adults were obese. In adults being overweight and obese is connected to life limiting conditions such as Type 2 Diabetes and heart disease.
When menopause occurs, the symptoms, too often misunderstood and overwhelming, can throw women's lives off course. Anxiety, fatigue, low moods, changes in body shape, lack of sleep, digestive issues and stressful work and home lives means gaining weight in menopause is common for many women.
Gaining weight in menopause, if it happens, can be addressed, BUT the tactics you used when you were younger may no longer yield the same results due to hormonal changes. The way you used to eat, exercise or drink may no longer be an option if you want to remain a healthy weight. You'll need to re-evaluate your lifestyle factors and work out what works for you at this stage of life.
Hormones and body fat
When the ovaries don't make as much estrodial the body uses the estrogen produced by the adrenal glands and fat cells ( estrone) and convert it to estradiol to make up for the drop in production from the ovaries. But what if the adrenals aren't playing their part in propping up supply?
Cortisol is produced by the adrenal glands. If the adrenals are under pressure to produce cortisol as a response to stress they can’t be relied on for estrogen replacement which leaves the body relying on fat cells. A way for the body to get more of the hormone from fat cells is to increase fat cells. Cortisol encourages abdominal fast deposition which is another reason stressed out women in their 40s and 50’s can gain weight around their middle. Stress really isn't your friend ladies.
Body weight is also affected by a drop in the naturally occurring sex hormone testosterone. A woman at 40 has half of the level of testosterone a women has at 20. Lower testosterone levels can affect your metabolism, lean muscle mass and energy levels. Testosterone can also affect your sexual desire, ability to become aroused and decrease your bone strength which is why it is sometimes replaced as part of a HRT routine. Testosterone gel for women can be a menopause game changer.
Why Measure Waist Size?
The drop in hormones and slowing of the metabolism means the body's calorie needs may need to be re-evaluated. Women in midlife have many demands on their time from both work and family and life although more busy is physically often less active. If the body is being fed the same diet and calorie level as when it had more muscle mass, a faster metabolism and was engaged in more activity, the excess calories will be stored as fat and weight will increase.
NICE, The National Institute For Health Care Excellence updated it’s guidelines in 2022 to encourage people to keep the size of their waist to less than half their height to keep weight gain in check. Using the waist-to-height ratio along with Body Mass Index ( BMI), can help to provide a practical estimate of central adiposity, or abdominal fat and help to predict health risks, such as hypertension, type 2 diabetes and heart conditions.Healthcare providers will often offer free BMI tests to help you find out where you are on the scale
How To Measure Waist Size
- Place a tape measure around your middle halfway between the bottom of your ribs and the top of your hips - which should be just above your belly button.
- Pull the tape measure so it’s taut but isn't digging into the skin.
- Breathe normally, no ‘sucking it in’ and take your measurement.
If your waist measurement is more than half of your height then working on getting your abdominal fat down is recommended. Losing abdominal fat will help to decrease long term health risks and help to regain your energy and confidence. Research studies have shown blood sugar and cholesterol levels increase in some menopausal women which increase the risk of developing type 2 diabetes and cardiovascular disease. Data suggests this has nothing to do with age and everything to do with the decrease in hormones.
Body Mass Index Benchmarks
Body Mass Index uses your height and weight to indicate whether your weight is healthy. A healthy weight won't increase your risk of developing chronic diseases.
What to Eat During Menopause To Lose Weight
Meal replacement shakes have been used successfully along with a healthy diet to simplify weight loss by substituting solid food with controlled calories and essential vitamins and nutrients in a liquid form.
To protect consumers, there are regulations set by the European Food Safety Authority on exactly what nutrients meal replacement shakes need to contain to be a substitute for real food. There are also conditions for health claims related to meal replacement shakes for weight control which are based on scientific substantiation - generally accepted scientific evidence.
There is conflicting advice on how many calories are needed to maintain a healthy weight. The recommended daily calories are 2,500 for men and 2,000 for women. Women in menopause are advised by the NHS to decrease calories by 200 per day to avoid excess weight as metabolic rate slows down with age. However, calories consumed is not all you need to achieve a healthy weight.Lifestyle and exercise are also important.
NHS England in a 2020 pilot used very low calorie meal replacement shakes to help people with diabetes lose weight with the aim of trying to reverse diabetes. People on the study were also encouraged to increase their activity levels which saw them lose on average 7.2kg in 4 weeks and carry on losing weight in the next 3 months and keep it off in the following months.
Eve Biology Meal Replacement Shakes help women 45+ reclaim their confidence, energy and clarity with a low calorie formula which controls weight and targets menopause symptoms. Read more on how it works see The menopause diet 5 day plan to lose weight. or Guide to Meal Replacement Shakes
Treating Menopause Symptoms
Taking HRT is a personal decision women need to make for themselves and requires a conversation with your doctor or healthcare provider. Replacing lost hormones improves menopause symptoms and can protect long term health. Hormone therapy can be started during the perimenopause phase or the menopause phase depending on symptoms, your family history and the advice of your doctor or healthcare provider.
Hormone replacement therapy always involves taking oestrogen, some hormone therapy contains an oestrogen and progesterone mix and for some it can also include testosterone which is used simultaneously in a cream form rubbed on the skin.The most common form of oestrogen prescribed is 17 beta-estrodial,a body identical oestrogen derived from yams.
Hormone replacement therapy can be taken as pills, as a patch applied to the skin, a spray or a gel and can address common symptoms of hot flashes, night sweats and vaginal dryness. It can also help to protect against osteoporosis and cardiovascular disease.
Women who have had a hysterectomy and no longer have a uterus will be prescribed estrogen only hormone replacement therapy. Women who still have a uterus will need progesterone or progestogen as well as oestrogen to protect the uterine lining.
Is Hormone Replacement therapy right for you?
There are various factors which will be taken into consideration when you and your medical professional review if hormone replacement therapy is right for you. Age, medical history- particularly if you have had breast cancer or uterine cancer, menopause symptoms, birth control and lifestyle will all be considered when deciding which type of hormone therapy regime would work best for you.
The Pros and Cons of Hormone Replacement Therapy
Relief of symptoms
Dr Lousie Newson, considered by many to be the leading menopause doctor in the UK when it comes to menopause faqs, in her book - Preparing for the Perimenopause and Menopause gives a timeline of the benefits to expect if you start HRT
Getting your hormone levels back up will ease symptoms and sometimes stop them altogether. 'Once you start taking HRT hot flashes hot flushes and night sweats will abate over a matter of weeks although symptoms related to vagina and urinary tract can take up to a year. Risks of hormone related health issues like heart disease and osteoporosis will be reduced over time.' Hormone replacement therapy has also shown a drop in women's risk of dementia. Local oestrogen in a pessary form can help to relieve vaginal dryness.Results are best experienced after 2 weeks of daily doses and then twice weekly doses ongoing.
HRT and breast cancer
According to Cancer Research UK, HRT does increase the risk of breast cancer however the risks are small and for most women the benefits outweigh the risks. Using estrogen only HRT holds less risk than using combined HRT which uses both estrogen and progestogen.
The Women's Health Initiative research presented in December 2019 at the San Antonio breast Cancer Symposium suggested estrogen-only hormone replacement therapy seemed to lower breast cancer risk, while combination hormone replacement therapy increased risk.“Long-term influence of estrogen plus progestin and estrogen alone use on breast cancer incidence: The Women's Health Initiative randomized trials.”
The Women’s Health Initiative Clinical Trial and the Women’s Health Initiative Observational Study are commonly called the WHI. The two studies are based on information from more than 161,608 postmenopausal women who were ages 50 to 79 when they were recruited between 1993 to 1998. The goal of the WHI is to find any links between diet, health and lifestyle and health problems.
HRT and blood clots
A study by the British Medical Journal found that women Taking combined HRT in tablet form carries an increased risk of developing blood clots. HRT taken through the skin as patches, creams or gels has a reduced risk of blood clots.
HRT and cognitive health
Even women using the older oral combined HRT showed a 42 per reduced risk of neuro-degenerative diseases like Alzheimer’s and Parkinson’s Disease, but women on transdermal estrogen had a 73 per cent reduction in dementia, and a 55 per cent reduction in Multiple Sclerosis compared to women not using HRT. The longer women stayed on HRT, the better the results.
How long after starting hrt do you feel a difference?
It takes a few weeks until you feel the benefits of hrt and up to three months to feel its full benefits.You'll need regular consultations to check you're on the right level hrt as your hormones decrease over time and symptoms may reappear.
How to stop hrt patches falling off?
The adhesive used to bond hrt patches to your skin can become less dependent in very warm or humid conditions, or when they're continually being caught on clothing. Before you apply your patch make sure there is no residual glue from previous patches on your skin, that it's clean and dry. Once you've laid the patch on your skin make sure there are no creases or air pockets. When temperatures are high you can use medical tape on top of your patch to secure it or waterproof plasters also work well.
Natural Menopause without Hormone Replacement Therapy (HRT)
Some women choose to experience the menopause without hormone replacement therapy, embracing their ageing process and the natural transition their bodies are making. Focusing on exercise, natural supplements and a healthy diet can help to minimise symptoms and manage weight.
These can include
- Eating less red meat to protect heart health, keep cholesterol low and decrease the risk of heart disease
- Knowing how many calories their body needs to avoid becoming overweight
- Embracing more plant based diet days to help to control weight and decrease symptoms
- Increasing dietary fibre to combat constipation, bloating and to increase gut health which will improve hormone regulation.
- Eating a wider variety of fruit and vegetables to boost nutrient intake
- Decreasing coffee and alcohol to aid better sleep and help to minimise hot flashes.
- Using intimate moisturisers to keep vaginal tissue less dry
- More exercise to offset lean muscle mass loss and to counteract a slower metabolism
A Diet Plan For Menopause
Diet and exercise can help to manage symptoms caused when oestrogen levels fall. During menopause, as muscle mass decreases you may need to review portion sizes and how many calories you need. You may also need to review the types of food you’re eating - address some habits which no longer serve you.
- Minimise caffeine and alcohol - stimulants which can affect your existing hormone function and trigger insulin as well as disrupt your sleep patterns and contribute to mood swings even more than your hormone depletion is doing alone. Try to avoid processed foods which contain excess salt which can cause bloating.
- Balance blood sugar - try to avoid over sweet things which can spike blood sugar. Women in menopause have been found to carry more sugar in their blood which can increase their risk of type 2 diabetes.
- Aim for two portions of oily fish per week to support brain health or consider supplementing with omega 3.
- Aim to hit your daily 30g recommended fibre goal by introducing more vegetables, fruit, whole grain cereals and beans which will also boost vitamins and heart protecting antioxidants.
- Increasing exercise can help with weight gain and can also help to address osteoporosis risks. Resistance activities, such as using weights or bodyweight exercise can help to both preserve and build bone and muscle mass.
- Walking and meditation can help to manage stress and anxiety by controlling cortisol levels as well as protect the heart.
Menopause Vitamins and Supplements
Menopause vitamins and supplements can help to ease the symptoms of menopause. Magnesium can help to support heart health and decrease blood pressure. The British Heart Foundation lists high blood pressure as one of the risk factors of developing heart disease. Being overweight, smoking, having high cholesterol and not being active enough are also listed by healthcare providers so get moving ladies
Bone building vitamins and minerals
Vitamin B12 supports good health and energy output as well as helping the body to form red blood cells. Vitamin K supports bone density, which is super important as women's risk of bone breakages and fractures can increase with the decline in estrogen. Calcium is also essential to slow down bone loss and decrease a woman's risk factors of osteoporosis.Ensure your Vitamin D is optimal as it's vital for the absorption of calcium.
Phytoestrogens food which can mimic estrogen
Phytoestrogens are plant based supplements which mimic estrogen in the body and can help to ease menopause symptoms by tricking the body into thinking it has higher levels of estrogen. Rich sources of isoflavones include Red Clover, Flaxseeds. Tofu, Soy beans, Edamame beans and Sesame seeds. Some fruits and vegetables contain phytoestrogens including, raspberries, cranberries, strawberries, broccoli, cauliflower, cabbage and brussel sprouts.
Adaptogens for stress management
Adaptogens such as Ashwagandha, Holy Basil, Cordyceps and Turmeric are herbs have a healing and supportive effect on the body and can help to ease menopausal symptoms such as hot flashes. Ashwagandha KSM66 has been clinically proven to help the body manage stress and lower cortisol levels which are harmful to health when elevated for long periods.
Protein to support muscle mass
Muscle mass declines during menopause and protein is essential for building it back up. Protein supports the immune system, keeps bones strong and staves off hunger pangs which can contribute to overeating and putting on weight.
You are probably eating too much protein. In the UK people consume twice as much protein as they need. The guidelines for protein consumption is 0.75g of protein per kg bodyweight per day for average weight adults.
Pea protein is an excellent source of branched-chain amino acids, especially arginine, which promotes healthy blood flow and heart health and leucine, isoleucine, and valine, stimulating muscle growth. Oestrogen protects heart health by preventing the build up of fatty plaque in arteries and keeping cholesterol levels in check. There is a higher risk of cardiovascular disease in menopausal women due to lower levels of estrogen ) Pea protein contains all nine essential amino acids that your body cannot create and needs to get from food. Hydrolysed pea protein contains 80% highly soluble protein and is easy to digest and absorb.
It is important to speak to your doctor and review your health history before taking any vitamins or supplements, as they may interact with other medications you are taking.
The Bottom Line
The natural hormone recalibration your body goes through from your mid to late forties and onwards is far reaching. The natural decline of ovarian hormones can cause both mental and physical symptoms which can affect everyday life and last for years and increase your health risks. Whether you choose to go onto HRT to replace lost hormones or let nature take it’s course you have the power to experience the best menopause experience you can.
Review your calorie intake and decrease sugar and saturated fat to decrease excess weight. The way your body works is a little different with lower hormone levels and you need to adapt. Your risk of Type 2 Diabetes and Heart Disease both increase if you’re overweight.
A few times a week use vigorous exercise to get your blood pumping and support your heart health. Be active every day. Brisk, short walks can help to manage anxiety levels and alleviate mood. Longer walks can help burn fat and tone muscles.
Resistance exercises can help to strengthen muscles and keep bones strong -osteoporosis is common in menopausal women. Hand weights, body weight and exercise bands all work well!
Fibre is great for your gut and will help to support immunity levels and overall health while vitamins and supplements can support energy levels, anxiety, brain fog and cognitive health.