Will you recognize your symptoms? How to bring your body under control? What’s the best way to train yourself to stay in good shape?

Menopause is the end of a woman’s menstrual cycles. The term  describe any of the changes you go through just before or after you stop having your period, marking the end of your reproductive years. 

The chinese culture defines this period of a woman life as a “second adolescence”, where the women can take care of herself again and make herself a priority.

 “While you might feel like your body is all over the place, you actually have control over your mindset, your lifestyle, and your environment”  all of which also affect the symptoms that come along with menopause. So I hope this article helps you to understand and  embrace this new period of your life.

How to recognize peri-menopause and menopause symptoms.

The symptoms can appear very early in a woman’s life. We can feel symptoms as soon as 30!! and it can happen anytime between 40 and 60 years old. Every woman is different. But also there’s not a single start or end point of menopause; our biology operates like a continuum. Most of the symptoms or changes are related to the decrease of production of estrogen and progesterone.

They can be consistent or intermittent, intense or barely noticeable. Each woman will be different and there’s not a universal recipe to improve these symptoms. Each woman should experiment  with these solutions to find the one most convenient for her. But first let’s see how to recognize the symptoms of peri and menopause:

1. Your period is less regular (it starts late, or is shorter or longer, heavier or lighter, or absent for a month)

• You begin to have trouble sleeping. 

• Foggy mind, trouble remembering things.

• Depression, emotional flatness, trouble “getting motivated”, sense of being overwhelmed, feeling irritable, or less able to deal with small hassles, feeling more anxious, worried, fearful. Feeling distracted or preoccupied, crying or other emotional outburst that happens more often, more unexpectedly or more intensely. More mood swings or stronger swings. More intensive emotions, positive or negative. Or… everyone around has turned into a jerk. Those symptoms can be also associated with other biopsychosocial shifts that happen during menopause. In this case, consulting a counselor or a coach can be very useful.

• You need to go to the bathroom more often, you get more bladder infections, or have trouble controlling your bladder because your pelvic muscles are weak. You could ask your doctor for some perineal muscle sessions with your physical therapist.

• Your digestion and bowel function: changes in appetite, digestion and bowel function. Heartburn, gas, and constipation more and more frequently. Maybe more food intolerances and sensitivity to meals that you used to eat or drink without any trouble before. A food journal will help you to discover what these foods are. You should note the food and how you feel after. (sleepy, pain in your belly, bloating…) 

Bloating is very common: sugar substitutes and sugar alcohols such as xylithol, mannitol, and sorbitol are significant contributors.

• You have fewer muscles (beginning of sarcopenia) and more fat around your middle and lower belly in particular.

• Hot flashes (feeling extremely warm for a few minutes) and night sweats: They persist for 3-5 years.  They seem to be triggered by sudden dips in estrogen levels.  It seems that Breathing in from the belly while slowly counting to 5, for 5 minutes, helps with the hot flashes and also help lower the blood pressure and decrease anxiety, promote relaxation. Migraines can also be associated.

•  Your risk of chronic disease becomes greater: “Female hormones” lower the risk of some chronic diseases, such as cardiovascular disease, cancer, and others…

1. Dizziness/vertigo, because of changes in how your brain regulates blood pressure. Also may be related to migraines. In this case doing two simple exercises: Eppley maneuver or half-somersault maneuver (Dr. Carol Foster), you can treat your own vertigo. You can find it on youtube.
2. More hair in some places (like on face), and less in others (scalp, lower legs, armpits, pubic region).
3. Pain and inflammation: As estrogen and progesterone decline, you may notice changes in muscle pain arthritis, other types of joint pain or other chronic pains.
4. Sexual function: As those hormones decline, the vaginal and urethral epithelium (lining) thins and become less elastic. Additionally lubrication decreases, so the vagina will be drier. This means that sex can cause burning or itching. Libido fluctuates, many women say they’re having the greatest sex of their life, because they’re so much more confident, experienced, and assertive. Some doctors will prescribe estrogen creams or lubricants to reduce dryness. Or some studies showed that a vaginal cream containing hyaluronic acid was nearly effective as estrogen cream.
5. Skin: It gets drier or oilier as hormones shift. Sometimes you can have a teenager-style acne. Proteins syntheses slows, so you may start to wrinkle and have less collagen. Sometimes changes in your skin pigment.
6. Teeth: gum disease, dry mouth and so on.

Other biopsychosocial factors:

We cannot say that hormone fluctuations are the only reason for all the changes in menopause. There are also other important  life-changes. For example:

The “empty nest” phase: When the kids move out.

Relationship adjustments: Divorce or adapting to new age changes.

Aging parents: They are maybe dealing with health problems or need more of your attention.

Work burnout: difficulty finding joy in our work.

A desire for change: Maybe you can begin another career.

Many women say middle age is a time of empowerment.

During this period some things die, but new things will be born…

Many women they say that they feel more authentic, more free to be themselves, and more courageous.

What can you do to help your body to deal with all these changes in a smooth way?

1. Prioritize quality of nutrition:

Good nutrition can alleviate muscle discomfort of midlife physical changes, and maintain a healthy body composition, digestion and bowel habits. Good nutrition can also reduce inflammation, and decrease disease risks.

Carbohydrates: 1-2 cups of slow digesting, high fiber carbohydrates at most meals. Vegetables and fruits must be present. 

 For athletes, It seems that post-menopausal women have a harder time metabolizing fructose (fruit sugar) than those still in their reproductive years. Less glucose is converted into glucose and available for energy. Athletes can report GI issues, cramping, and bloating. If you’re competing, avoid fructose before trainings or competitions.

Proteins: At least 1 palm-sized portion of protein at most meals. Some authors suggested Leucine rich proteins for this period. It seems that the more Leucine you get into your system, the faster the tissue levels rise and the more quickly your muscles get the signal to repair and grow. Riches sources of leucine are; spiruline, poultry, meat, soy, fish, beans and nuts.

Phytoestrogens: The research suggest that the phytoestrogens in food (soy) may help with hot flashes, though it is still very controversial. Feel free to experiment yourself eating more miso, tempeh, edamame…

Hydration: Drink plenty of water and moderate your salt intake to have better skin, reduce water retention, and breast tenderness.

Vitamin D: Some research suggest that it can lessen perimenopausal and menopausal symptoms, and also maintain bone health.

Caffeine: coffee, tea, energy drinks, dark chocolate or some medication as (painkillers) exacerbate some breast tenderness or migraines. Try to reduce caffeine intake.

Flaxseeds: they are rich in lignans. Lignans can be converted to weak estrogens which may help reduce menopausal symptoms.

Omega-3 fatty acids (2-6 grams a day) may help with hot flashes, depression symptoms, and memory decline and skin changes.

Iron: If you stopped menstruating, you’ll need less iron (about 8 mg a day).

Calcium: For bone health, calcium must be increased about 1200mg/day. Cooked dark leafy, dairy products, canned salmon or sardines or calcium fortified foods.

Magnesium: Important for calcium metabolism (200-400mg). May also alleviate hormones related cramps and migraines.

• Approach alcohol intake mindfully: limiting alcohol consumption may help reduce inflammation, as well as your risk of breast cancer and other diseases. You can experiment with what happens when you stop drinking alcohol for a week or two…Try the experiment.
• Commit to regular exercise that you truly enjoy: Moving at moderate intensity (2-4 times per week for 30-60 minutes) seems to help with cramps associated with changes in menstrual cycle and inflammation. Here are some guidelines to consider when exercising during menopause:
• Recognize that you’ll need more recovery if you do an intense workout
• Keep your joints lubricated and flexible: Do a good warm-up and include joint mobility
• Resistance training 2-3 times a week to keep bones and muscles strong
• Start where you are. Begin slowly. Chose your activity.
• Consider making it social. It is easy to stick when you have accountability support.
• Keep it cool! In a cold place and drink cool fluids
• Consult with a physical therapist specialized in pelvic floor if you’re leaking urine during squats, jumping or other movements or having pelvic pain underload.
• If you have a personal trainer, make sure they understand how to train a body at midlife.
• Have fun. Look for the activity you that you really enjoy.

• Practice self -compassion, especially when it comes to your body

It’s ok to feel frustrated, angry or sad when you experience all these types of changes. Define what health and fitness mean now for you. Be realistic with your new activities and expectations. Approach these goals with self-compassion rather than self-criticism.

• Prioritize and schedule recovery and sleep

Between 40-60 percent of women going through menopause have poor sleep quality or insomnia. Lower estrogen means that your body lowers the capacity to deal with stress. There are many good stressors for our body (exercise, learning, and change) but they only make us stronger if we give ourselves the chance to recover from them.

Not getting enough recovery and sleep can also contribute to pain, inflammation and age-related skin changes.

To improve your sleep you can:

Drink a big glass of cold water 30 min before going to sleep. Keep your bedroom at a cool temperature

See what you can do to reduce hot flashes. 

Reduce your alcohol and caffeine in-take

Take a Valerian root infusion or capsules (400mg) or drink cherry tart juice (increase the body natural production of melatonin). 

Black cohosh, plant native to north America, can be beneficial in improving sleep quality by reducing hot flashes.

If sleep issues still continue, try the smallest effective dose of melatonin: 0.3 to 1.0 milligram 30 minutes before bed.

Establish a regular bedtime, eliminate light and screens from your bedroom

Practice a good sleep hygiene 

See a therapist who specializes in sleep (sometimes behavior therapy or hypnosis designed for insomnia can be effective).

Experiment with natural remedies like valerian root, tart cherry juice and isoflavones from soy may help.

Talk to your doctor, HRT or low dose of SSRIs can help.

Get a massage or take a warm bath to relax

Many women opt for a separate bedroom to avoid the snoring of their partner.

Good sleep is important but also make a break off from the gym and walk or practice meditation, stretching, foam roller, tai chi. Every month schedule a “recovery week”.

• Manage your stress

Consider which relationships are serving you right now and which are not so healthy. Be open to a new version of yourself and new ways of relating.

Menopause can be a gift, nature is kind of telling us: “now is time for you”

What to do now?

Menopause is a normal, inevitable, adaptive stage of womanhood. First, Accept it!!

you’re considering small changes to feel better, pick one at the same time, practice this change consistently, then add more when/if you feel ready.

Keep a journal of your experience, you are the expert on you.

Practice the non-judgemental observation of your body and just note what’s happening, record what’s coming up.

Use your emotions as tools to learn more about yourself, and create a life that feels good for you.

Talk to other women, your mom, a friend…about their experiences. You’ll have practical advice and emotional support.

You’re allowed to not care about whatever you don’t want to care about anymore.

Assemble your support team: Physical therapist, coach, therapist, naturopath, nutritionist, or dietician…

What is the best way of training midlife women and why? 

Women during menopause have a higher core temperature than younger women. So before exercise, two strategies are important: precooling (drinking an icy glass of water) and Hydrating (adding 1/16 teaspoon of salt to water)

High intensity power training is really important once you hit menopause to prevent muscle loss and weakness with age.

Resistance training is important to maintain your muscle mass and fight against sarcopenia, and also to maintain your bone mass.

Some research studies show that HIIT is an effective training for post- menopause women

For example, in one study we compared the effects of classical aerobic training (MICT) of 40 minutes at 55%-60% of peak power output with HIIT (60 × 8 s at 80%-90% of peak HR, 12 s active recovery), and HIIT + Resistance Training (HIIT + 8 whole-body exercises: 1 set of 8-12 repetitions). 

It seems that HIIT + RT and endurance (MICT)  is recommended to reduce weight but HIIT was more effective than MICT in reducing abdominal/visceral fat mass. RT in addition did not potentiate this effect but increased the percentage of muscle mass programs in non-dieting overweight/ obese post-menopausal women.

In another study, comparing HIIT and endurance programs in obese menopausal women,participants in the HIIT group lost twice as much weight as those in the Endurance group (8.7% vs 4.3% of initial body weight), and lost an additional 6 in. of body mass. In addition, only the HIIT group significantly changed fat mass, body mass index, and fat-free mass (Ps < 0.04). These findings support the feasibility and potential effectiveness of HIIT for weight loss and body composition changes in obese menopausal women and indicate that additional investigation of this approach is warranted to reduce postmenopausal chronic disease risk.

Krista Scott-Dixon and all. Precisionnutrition.com Infograf: What’s happening with my body?

Stacy T. Sims, “ROAR” 2016