Menopause Treatment
For many women, there is often something more pressing than their own health. This may be work, children, relationships, or someone else’s health. Unless you have had a medical condition it is not uncommon to make it to your mid 30s early 40s without giving too much thought to your health. At this point things often start to change. Sticking to the same diet may no longer maintain the same weight. The same exercises may not produce the same results.The body may start to react differently to alcohol…..and then the symptoms of perimenopause may start to occur.
As previously discussed, while the symptoms of perimenopause/menopause can be quite debilitating, they are also a good reminder to stop and pay attention to one’s own health and wellbeing.
When looking at treating menopause, optimising ones own lifestyle choices can have significant benefits on menopausal symptoms and quality of life.
Lifestyle Changes
Exercise and Healthy eating
While exercising regularly and eating a healthy diet are important at all stages of life, they are even more so during perimenopause/menopause. Obvious benefits include improved mental health, decreased stress, and weight loss/weight management.
If you are carrying extra weight, weight loss itself can significantly decrease menopause symptoms such as hot flushes.
Exercising can additionally directly improve ones mental health and wellbeing, and counter some of the anxiety and depression felt during menopause.
Joint pain and muscle aches and pains can also be decreased by strengthening muscles and weight reduction. Exercise, in particular cardiovascular exercise, lowers blood pressure, improves cardiovascular fitness and decreases the incidence of cardiovascular disease
Strength exercises also protect bones and decrease the risk of Osteoporosis.
Minimising sugar and processed foods, eating lots of vegetables and limiting meat, are just a few things that can be done. Below are a few links outlining some further lifestyle strategies:
Tips for healthy eating:
https://www.jeanhailes.org.au/news/five-dietary-tweaks-for-women-over-50
https://www.menopause.org.au/images/factsheets/Mantaining_Weight_and_Health_0219_V2.pdf
Excellent resource outlining specific strength and weight bearing exercises:
https://healthybonesaustralia.org.au/your-bone-health/exercise-bone-health/
Alcohol reduction
It is not uncommon for a woman’s alcohol consumption to increase in her 40s. Alcohol often provides initial relief from some symptoms of menopause. Unfortunately it has significantly negative effects on both both flushes and mental health, In addition, it can interfere with sleep and cause weight gain. It is often useful to do a trial off alcohol for 2-4 weeks to objectively assess the effect on symptoms. There are a number of helpful online resources including a particularly well designed app called reframe
Smoking cessation
Smoking is associated with earlier onset of menopause. Women who smoke can also experience more severe menopausal symptoms. While quitting smoking an be challenging, there are a number of excellent resources available.The quit foundation is a good place to start, as is having a discussion with your GP.
Stress Reduction
Stress is often under recognised and under acknowledged. Chronic stress can affect mental health and also affect the way a woman experiences menopausal symptoms. Meditation and yoga can provide positive benefits. As can counselling.
Some small trials have suggested menopausal symptom improvement from yoga.
Above is a general list of lifestyle factors. For more specific information and resources please refer to healthy eating/exercise/mediation resources on this site.
Medication
Hormonal Therapy
HRT or now known as MHT (Menopausal Hormone Treatment) has been in and out of favour over the years. Thankfully we now have a lot more information pointing to the value and safety of MHT.We also have newer, safer formulations including patches and gels.While there are some potential risks with MHT, often the benefits outweigh these, particularly if MHT is started within the first 5 years of symptoms.
Benefits
Decrease Vasomotor symptoms : decrease flushes and sweats. Positive effects on sleep.
Improved mood
Bone protection, decrease risk of osteoporosis
Risks
Breast cancer risk increases by 8/10000 women per year
Clots (ie/stroke) risk increases from 1/1000 to 2/1000 women per year. This is less if using topical forms of oestrogen including patches gels.
Topical oestrogen
For women experiencing vaginal or urinary symptoms topical oestrogen can be beneficial.
It can decrease vaginal dryness and make sex less painful. It can also decrease urinary symptoms and the incidence of urinary infections.
Testosterone
Can be used in post menopausal women to help with low libido
Non hormonal treatments
Antidepressant/anti anxiety medication SSRIs/SNRIs- selective serotonin re uptake inhibitors/selective noradrenaline re uptake inhibitors
Anti depressants/anti anxiety medication can significantly decrease symptoms, in particular anxiety and depression and general mood changes. In addition they can decrease hot flushes.
Other treatments
There are a number of other medications that can be used.
There is promising data about the role of yoga, acupuncture, and psychological therapies such as cbt (cognitive behavioural therapy).
Herbal treatments such as femula and Remifemin may also offer some symptom relief.
There are a number of other medications and non pharmaceutical medications more information can be found in the links below.
Seeing your GP can be a good starting point to have a health assessment and explore treatment options. Below are some useful resources
Jean Hailes
An excellent source of information including information sheets and podcasts
https://www.jeanhailes.org.au/health-a-z/menopause
Australian Menopause Society
Excellent information sheets and articles
https://www.menopause.org.au/health-info/fact-sheets/menopause-what-are-the-symptoms