If we live long enough, it happens to 50% of us - it is, of course, the menopause. Not everyone gets hot flushes, night sweats and vaginal dryness, and some women breeze through this natural phase in their lives - but some of us need a little extra help.
The average age to go through the menopause is 52 - but of course most women aren't average! Anything from 45-55 is 'normal'. About 80% of women get hot flushes and night sweats, which last seven years on average. Statistically, the most effective way to banish hot flushes is hormone replacement therapy (HRT). This does increase your risk of breast cancer, but the risk is small if you just take HRT for a few years and it drops when you stop it.
Other common problems associated with the menopause include vaginal dryness, mood changes, loss of sex drive, and bladder problems. Again, you don't have to suffer in silence - there are lots of solutions out there.
If you prefer to avoid HRT, there are plenty of non-drug alternatives. Lifestyle changes, such as avoiding caffeine, keeping your bedclothes light and wearing breathable clothes (ideally in layers, so you can whip off a layer when needed) may be enough. Increasing the soya in your diet may well protect against hot flushes, because of the phyto-oestrogen it contains, which has a similar chemical structure to oestrogen. While it's thought to be the oestrogen in HRT that contributes to the increased risk of breast cancer, the same doesn't seem to be true of phyto-oestrogens in soya - in fact, some studies have suggested that even among breast cancer survivors, eating soya isn't associated with an increased risk of recurrence or progression.
Prevent weight gain
Lots of my patients complain that they gain weight after the menopause. Some women do, but it isn't inevitable. At around the age of the menopause, you may become less physically active. This can lead to weight gain, but it also reduces the firmness of your muscles, making it feel as if you've put on more weight. As you get older, your metabolism slows down, often because you're less active in your day-to-day activities (as opposed to doing less 'formal' exercise). This means you burn fewer calories, making it easier to pile on the pounds. And there's no doubt that some women are more prone to gaining weight around their midriffs after the menopause.
It can be hard to exercise if you're suffering from hot flushes, but it's more important than ever after the menopause. It helps keep weight down, tone your muscles, improve balance and guard against osteoporosis. Swimming is great for keeping you cool but it's not weight-bearing exercise, which is important for keeping bones strong. But don't worry - you don't have to sweat in body-hugging lycra to get fit. Try alternating swimming with any other aerobic exercise (the kind that makes your heart and breathing rate rise a bit) - brisk walking, tennis, keep fit classes or dancing all count. Find an exercise buddy to reduce the chance of giving up when life is too busy, or join a rambling club to meet new friends and take in our glorious countryside too.
Keep your bones strong
Bone health is key after the menopause. You can't feel it, but your bones become less strong from your 40s or even sooner, and this process speeds up after the menopause. This puts you at higher risk of breaking a bone due to osteoporosis. Regular exercise; avoiding smoking and excess alcohol; taking a daily 10 microgram vitamin D supplement; and increasing the calcium in your diet (dairy products, tinned fish with bones and green leafy vegetables are all good sources) will help.
Other risk factors for your bones include going through the menopause before the age of 45; taking regular steroid tablets; having rheumatoid arthritis or bowel disease (coeliac or Crohn's disease); being very immobile; having osteoporosis in the family and being very underweight. HRT protects against osteoporosis. If you reach menopause below 45, speak with your GP - you should take HRT until you're at least 50 to protect your bones.
After the menopause, lower levels of the female hormone oestrogen mean you make less collagen, making you more prone to wrinkles and a sagging jawline. Protect your skin from the sun more carefully than ever; opt for a hydrating moisturiser rather than soap, which can dry skin out; avoid long hot baths; be liberal with body moisturisers (apply while skin is damp); pay special attention to hands; and choose a facial moisturiser designed for mature skin.
Thinning hair is a fact of life for some women as they get older, and it can run in families. It's worth making sure you have enough protein and iron in your diet - being short of either of these can affect your hair quality. Avoid strong bleaches and perming lotions, which can damage your hair - but a regular shampoo and blow-dry, or even giving your natural colour a helping hand with hair dye (don't worry, we won't tell!) is absolutely fine.
With thanks to 'My Weekly' where this article was originally published.
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