We want to take away some of the stigma still attached to the subject of the menopause and provide some clear information about what is going on in a woman’s body during this time of natural transition.
When we are young, we are educated about the menstrual cycle and learn about periods, but we are never told what happens when women reach the point that their periods stop. There is still little information out there about the effects of menopause on the body, what can be expected and what women can do to manage or lessen any symptoms they may experience.
The information available is often unclear or unhelpful, so we hope to break the taboo and provide some clear facts and advice to support women on this journey.
Quick facts about menopause
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- Menopause is the time in a woman’s life when she stops menstruating and can no longer get pregnant naturally.
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- Sometimes periods stop abruptly but generally they become less frequent over the months or years before they cease altogether.
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- The time leading up to menopause, when periods are changing in frequency, is known as perimenopause.
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- The day a woman has not had a period for twelve months is menopause, and after that, she is post-menopausal.
- Generally, the term menopausal is used to refer to the time when there are symptoms occurring.
What causes menopause?
The menopause is a natural part of ageing that occurs as a woman’s oestrogen levels decline, usually between 45 and 55 years of age. The ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.
The average age of natural menopause is 51 in the UK. 80% of women reach menopause by age 54.[1]
What is happening to me?
The menopause is a different experience for every woman. Some glide through this transition with few effects, while others feel like a tsunami has hit them and no longer recognise their own bodies.
Menopause is the point in a woman’s life when she has had no periods for 12 consecutive months and this cannot be explained by any other health-related or physiological factors.
The period of change leading up to the menopause, known as the perimenopause, can last between five to ten years (varying from woman to woman) until the cessation of periods.
Perimenopause can start from the early 40s for a lot of women, and most certainly from 45 for most women. Changes can start occurring that are confusing and many women do not recognise these as signs of perimenopause.
What can I expect during the menopause?
Symptoms that may be experienced during the perimenopause and for several years after menopause has occurred include:
| Hot flushes | Depression or low moods | Dizziness |
| Night sweats | Anxiety | Incontinence |
| Insomnia/ difficulty sleeping | Mood swings | Bloating |
| Irregular periods | Irritability | Allergies |
| Unusually light or heavy periods | Panic disorder | Recurrent urinary tract infections (UTIs) |
| Fatigue | Headaches | Palpitations |
| Difficulty concentrating | Joint pain | Itchy skin |
| Short term memory loss | Breast pain | Digestive problems |
| Changes in odour | Osteoporosis | Vaginal dryness |
| Loss of libido | Muscle tension | Reduced muscle mass |
| Weight gain | Hair loss | Brittle nails |
The duration and severity of menopausal symptoms varies from woman to woman. Some women experience lots of these effects, while others experience just one or two but extremely intensely.
Going through the perimenopause some women just don’t feel like themselves, which can have a huge effect on their motivation. They may feel fatigued some days and on top of the world on other days. It is therefore really important that women listen to their bodies and adjust their training and diets to suit the changes they are going through.
On average, most symptoms last around four years. However, around one in ten women experiences them for up to twelve years.[2]
Other terms to consider
Premature ovarian insufficiency (POI), or early menopause, is when a woman experiences the menopause (periods stopping) before the age of 45. Around 1 in 100 women experience premature ovarian insufficiency.
Once menopause has occurred (periods have stopped for 12 months) a woman then becomes post-menopausal (for the rest of her life).
Medically-induced menopause is menopause caused by treatments such as chemotherapy or hysterectomy.
What causes the symptoms of menopause?
Menopausal symptoms are caused by hormonal changes occurring in a woman’s body. The ovaries produce oestrogen and progesterone – the two key hormones that control the menstrual cycle and fertility.
Oestrogen nourishes the tissues of the body with blood, regulates cholesterol, and keeps organs like the brain, liver and heart healthy. Progesterone helps control blood sugar levels and plays a crucial role in achieving and maintaining pregnancy.
When ovulation stops, the fatty tissue, breast tissue, adrenals and liver take over the production of these hormones, with lower levels being produced. When the amounts of these hormones being produced starts to decline, changes in the body start to occur.
Testosterone plays a key role in oestrogen production, supports bone density, helps to improve cognitive function and contributes to libido. It also declines with age and by menopause the level of testosterone is at half its peak (which occurs during a woman’s twenties).
Possible health impacts of menopause
Menopause can increase a woman’s risk of developing conditions, such as:
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- Cardiovascular disease
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- Bone disease
During perimenopause and menopause the risk of cardiovascular disease increases due to the falling levels of oestrogen in the body. Oestrogen helps to protect the heart and blood vessels so declining levels increase the risk of coronary heart disease and circulatory conditions, such as a stroke.
Maintaining a healthy body weight, avoiding or quitting smoking, regular exercise and a healthy diet will all help to reduce the risk of these conditions occurring.
Another increased risk during and after menopause is bone disease. In general, women begin to lose 0.5-1% of their bone mineral density (BMD) per year from their 30s and 40s. However, a woman may experience up to a 3% BMD loss per year if they are leading a sedentary lifestyle during and after the menopause.
Women can lose up to 20% of their bone density in the 5-7 years after the menopause. This bone density loss can lead to osteopenia and osteoporosis.
Osteopenia is a medical condition in which the protein and mineral content of bone tissue is reduced, but less severely than in osteoporosis.
Osteoporosis is a medical condition in which the bones become brittle and fragile from loss of tissue. Osteoporosis is the most common bone disorder and can lead to a poor quality of life.
The good news is that there are preventative measures women can take against these conditions during the menopause and even before they begin experiencing symptoms of menopause. Exercise, in particular strength training, and good nutrition are both extremely beneficial in preventing bone density loss but we’ll take a look at this in more detail further on.
What can I do to manage the symptoms of menopause?
As we already mentioned, some common symptoms of menopause include hot flushes, difficulty sleeping, low mood and anxiety, reduced libido, headaches, loss of concentration, joint stiffness, aches and pains, and reduced muscle mass.
As a result, the menopause can be a pretty unpleasant time for many women. However, some simple lifestyle changes can help to ease the symptoms or at least provide a way of coping with them.
Nutrition plays a major role in how we cope with many things, including illness, mental health and general wellbeing. And its role during the menopause is just as important.
Nutrition
The menopause is a time when the female body is already under stress, due to the many changes occurring, so good nutrition will help to keep it healthy and strong.
Weight gain is often reported as being common during and after the menopause. This might be attributable to the hormonal changes going on at this time but it is also likely to be related to general aging and lifestyle factors so a healthy diet is important.
During the menopause the right nutrition can also help to retain muscle, boost mood, counter the effects of lack of sleep and other common symptoms.
Good nutrition includes eating the right balance of macronutrients (proteins, carbohydrates and fats) and plenty of fruit and vegetables to provide the vitamins and minerals the body needs.
Protein
Protein is particularly important because it helps to build and maintain muscle. It also makes you feel fuller for longer, which can help with weight control. Good sources of protein include:
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- Meat
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- Fish
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- Eggs
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- Whey protein powder
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- Greek yoghurt
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- Tofu
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- Beans and pulses
It is best to spread protein intake throughout the day, rather than having a large amount once a day. Aiming for 20-30g of protein in each meal is ideal. This would look like:
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- A palm size portion of meat of fish
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- 2-3 eggs
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- 1 scoop of protein powder
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- Around 200g/ 1 cup of cooked lentils
While increasing protein intake during the menopause women can also look to reduce their carb intake and pack meals with extra vegetables to help boost health, digestion, immune function, and weight loss.
Healthy fats
Healthy fats are super important for women at this time of life, as they provide energy and vital nutrients for producing hormones, transporting and using vitamins, and building healthy cells.
Healthy fats in appropriate portion sizes include:
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- Half an avocado
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- A tablespoon of olive oil
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- 1 tablespoon of coconut oil
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- 1 fillet of salmon or mackerel
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- 25g walnuts or almonds
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- 2-3 Brazil nuts
Menopausal women should aim to eat one to three servings of healthy fats every day but watch out for portion size, in order to control calorie intake.
Carbohydrates
Should you cut out carbs altogether? The answer is no, carbs are not bad for you and they won’t cause you to gain fat if you stay on track with your daily calorie allowance.
However, carbs can lead to water retention, which can affect the number on the scales even when you are not gaining fat. What is important when it comes to carbs and all the hormonal changes that are going on during the menopause is the quality and quantity that you are consuming.
The kinds of carbohydrates that could be included in the diet are:
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- Oats
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- Potatoes
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- Sweet potatoes
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- Quinoa
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- Lentils
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- Beans and pulses
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- Wholemeal bread
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- Wholegrain or basmati rice
All these carbohydrates provide nutrients and fibre, both of which are important for gut health. White pasta and rice are not ‘bad’ carbohydrates, as long as you don’t overload on them – they still contain some fibre and small amounts of vitamins and minerals, just less nutritional value than some of the other options mentioned.
Opting for some of the ‘healthier’ carbohydrates will be more beneficial for overall health and also helpful for weight loss.
Sticking to 1-2 servings of quality, slow-release carbs per day, with 2-3 servings of healthy fats and plenty of protein and vegetables, is generally a good approach to diet during the menopause, although every woman’s body, and therefore requirements, differ slightly.
Fruit and vegetables
Fruit and vegetables are actually classed as carbohydrates but they are so beneficial during the menopause that we are going to look at them separately.
The more fruit and veg you eat, the better. Aiming for a variety of colours of both fruit and vegetables will ensure that your diet is nutrient, vitamin and mineral dense.
Lightly cooking vegetables, such as steaming them, is the best way to retain nutrients and make them easy for the body to digest. Overcook them and they lose some of those lovely nutrients, and let’s face it, who likes soggy veg anyway?!
Essential nutrients during the menopause
The health and strength of our bones relies on a steady stream of nutrients from a balanced diet, most importantly calcium and Vitamin D. Calcium is not made in the body and must be absorbed from food.
Oestrogen is responsible for the absorption of calcium, so during and after the menopause women have a reduced ability to absorb it. It is therefore very important to include plenty of calcium in the diet. Sources of calcium include:
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- Milk, cheese and other dairy foods
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- Green leafy vegetables, such as broccoli, cabbage and okra, but not spinach
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- Soya beans
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- Tofu
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- Soya drinks with added calcium
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- Nuts
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- Bread and anything made with fortified flour
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- Fish that contain bones you eat, such as sardines and pilchards
Vitamin D is essential in helping the body absorb and use calcium. After the menopause, the risk of osteoporosis significantly increases. Therefore, maintaining bone health is important. Vitamin D also helps to protect brain health, immune system function, mood and energy levels.
We get Vitamin D from sunlight but living in Britain means that we don’t necessarily get enough all year round. As a result, we must try to get enough Vitamin D through our diet and possibly taking a supplement. Foods that provide Vitamin D include:
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- Fatty fish, such as tuna, mackerel and salmon
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- Foods fortified with Vitamin D, like some dairy products, orange juice, soy milk, and cereals
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- Cheese
Omega 3 is important for maintaining healthy joints, reducing long-term risk of heart or brain disease, boosting mood, energy and weight loss efforts. Oily fish contains Omega 3 but unless you eat at least two to three portions per week it is a good idea to take a supplement.
Magnesium
Migraines, aching muscles and trouble sleeping are all commonly reported effects of the menopause but getting enough magnesium can help. The foods that provide magnesium include:
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- Dark green vegetables
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- Nuts
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- Seeds
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- Figs
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- Avocados
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- Bananas
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- Raspberries
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- Beans and chickpeas
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- Oily fish
Taking a magnesium supplement can also be worthwhile, especially taking it before bed if difficulty sleeping is an issue.
Exercise – strong body, healthy mind
Can exercise help during the menopause? Yes, it can help in many ways. Not only will it help to reduce or even alleviate symptoms such as anxiety, low mood, poor sleep and weight gain but it will also help protect against conditions such as heart disease, osteopenia, osteoporosis and type 2 diabetes occurring.
Any exercise is beneficial but weight bearing exercise, such as strength training (lifting weights) is by far the best form of exercise to undertake.
As we get older, we lose muscle, and the rate of loss increases after menopause. Focusing on exercises that build muscle will help to decrease losses in bone mineral density and reduce the risk of developing osteopenia – basically, muscles that are lifting weights pull on bones and help them to get stronger.
Strength training will also help to maintain lean body mass and keep weight under control. The more muscle you have, the more calories you burn! Plus, getting strong physically makes you feel strong mentally, and therefore more prepared to deal with any of the challenges that menopause may throw at you.
As well as lifting weights, any exercise where your legs and feet support your weight is good for keeping bones strong. Walking is one of the easiest forms of this and walking outside daily has been shown to boost mental and physical health.
Tracking your daily steps can help you to stay active and hit targets to help with weight control. Walking and general activity is good for overall wellbeing and can improve the quality of sleep, reduce stress and anxiety, and help alleviate symptoms of depression.
Yoga and meditation are also excellent ways to stay fit and look after your mental health. Other exercise options include running, skipping, dancing, hiking and swimming.
Basically, finding something you enjoy and making it a regular part of your life will go a long way to help with both the physical and mental symptoms that you might experience during the menopause.
Exercise quick facts:
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- Strength training helps to build muscle and protect bones
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- Strength training helps to maintain lean body mass and control weight
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- Strength training helps with pain tolerance and sleep quality
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- Strength training makes you feel strong both physically and mentally
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- Daily walks help to maintain heart health, mental health and weight
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- Yoga and meditation can help with mental wellbeing by reducing stress and anxiety, and boosting mood
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- Any form of exercise is good – find something you love!
Other effects of menopause and how to deal with them
Hot flushes are synonymous with the menopause. If you even mention feeling hot at this time of life people assume you are menopausal! Unfortunately, this is for good reason, as hot flushes are one of the most commonly reported symptoms that women suffer. They are thought to be caused by the falling levels of oestrogen creating a hormonal imbalance in the hypothalamus (the body’s thermostat).
If you experience hot flushes or night sweats some simple measures may help, such as exercising regularly, losing weight if you are overweight, wearing light clothing, having a cold drink when you feel one starting, reducing stress levels, and avoiding potential triggers, such as spicy food, caffeine and alcohol.
Many women experience severe mood changes, low mood and anxiety during menopause. Getting plenty of rest, exercising regularly and trying to reduce stress levels through activities such as yoga can help. If you feel depressed a trip to your GP is advisable as anti-depressants may help in some cases.
It is not uncommon for women to experience a loss of sexual desire during menopause, although this isn’t always the case. Vaginal dryness and discomfort during sex is another common effect of menopause but there are treatments available from your GP and lubricants that can help with this. Don’t feel shy to ask your GP or pharmacist for advice.
Another common effect of menopause is insomnia or poor sleep. Sometimes falling asleep is the hard part, and at other times it is waking in the night and being unable to get back to sleep. Either way, disrupted or poor-quality sleep can make you feel lethargic and irritable during the daytime.
Some tips for improving sleep include regular exercise, keeping your bedroom cool, taking a magnesium citrate supplement before bed, eating slow release carbs in your evening meal or a small bowl of oats before bed to boost serotonin levels, and minimising stress. Also, avoiding the use of your phone or any electronic devices for at least an hour before bed is recommended.
Summary
When we talk about ‘menopause’ we are including each stage of menopause, unless specified – perimenopause, menopause (the day when a woman has not had a period for twelve consecutive months), and the post-menopausal phase.
We want to break any stigma surrounding menopause and its possible effects on women. At PP we are here to support you on this journey in whichever way we can. We are not here to judge and will always be available to give advice and help where needed. Please feel that you can come and talk to any of our trainers, who have all been educated about menopause and what it can mean for women. If you feel you need to change your training to suit this time of life for you, come and talk to us.
While menopause is a different journey for every woman, good nutrition and exercise – in particular strength training – will help to ease any symptoms you may experience and protect the body against the effects of menopause and general aging.
Diets that promote weight control and increased muscle mass are best during the menopause so our nutrition tips include:
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- Eat protein in each meal to stay full for longer and encourage your body to keep hold of muscle.
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- Reduce carbohydrates and pack meals full of extra vegetables to boost health, digestion, immune function and weight control.
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- Eat healthy fats for energy and vital nutrients for hormones.
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- Reduce processed and high-sugar foods in your diet to help control blood sugar levels.
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- Take Vitamin D and Omega 3 supplements for energy, brain function, and heart health.
Our exercise tips include:
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- Add a daily walk outside into your routine to boost mental health, maintain bone density and protect against many of the effects of menopause.
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- Continue (or start) strength training, as this is the best possible form of exercise to build muscle mass, protect bones, keep weight down, feel strong and boost mental wellbeing.
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- Try yoga or meditation to help with symptoms of stress and anxiety.
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- Find a sport or an exercise class that you love and stick with it. Any exercise or activity will go some way to help fight the effects of aging and the symptoms of the menopause.
Conclusion
Menopause is a transition, rather than a stopping point. Some women experiencing menopause actually find renewed energy and freedom. For others, menopause is a mixed bag of emotions and symptoms – some days they feel on top of the world, while others are a real struggle – both physically and mentally. There might be weeks, months or even years that are hard but there are ways to get through the tough times with the right support and information.
As every woman experiences menopause differently, there is no one-size-fits-all solution to alleviate any negative effects it may have on their lives. There are however, plenty of things all women can do to smooth the path a little, such as forming good nutrition and exercise habits.
Menopause doesn’t have to be a miserable time of life. Approach it with the right mindset, take action to protect yourself against its possible effects and listen to your body. Make changes that feel right for you. Eat well, exercise regularly, be kind to yourself, and if you need help, don’t be afraid to ask for it.
Women can still get fitter, stronger, healthier and happier during and after this phase of life. And don’t forget the many positives that come out of it. Just think, no more period pain, no more periods. Many women really find themselves at this time of life and discover a whole new sense of confidence and empowerment.
[1] https://www.nhs.uk/conditions/menopause/
[2] https://www.nhs.uk/conditions/menopause/symptoms/
