What is Perimenopause and How Can We Treat the Symptoms? Part 2
In the first part of this topic I talked about the different stages of menopause and their most common symptoms. Here, I like to dive in to talk about the different ways we can combat and treat those symptoms. It is important to know the different options as most of the symptoms will worsen without treatment. Below are just some options or suggestions for you that you can bring it up to your doctor in your next check up. They do not in any way serve as medical advice and always consult your own physician for any personalized medical advice.
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1. Hormone Replacement Therapy (HRT)
Hormone Replacement Therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. (Wikipedia®, March 11 2024) There are a few varieties of treatment available.
2 Ways to take HRT:
Systemic Hormone Therapy: means the product gets into your bloodstream and then travels to the organs and tissues it needs to get to. This therapy not only treats night sweats and hot flashes but may also help protect against bone loss that can occur in early menopause and prevent osteoporosis.
Usually comes in these forms:
Pill - that can be taken by mouth.
Patch - that can stick on to the skin.
Gel - that can be applied to the skin and absorbed.
Spray - that can be applied to the forearm.
Local Hormone Therapy: means you apply the product to a specific area.
Usually comes in these forms:
Cream - that can apply to the vagina.
Ring - that can wear inside the vagina
Tablet - that can be placed inside the vagina and will melt inside
This type of therapy is especially helpful when your main symptom is vaginal dryness. Local therapy tends to come in a much lower dosage. (Cleveland Clinic, March 12 2024)
There are 2 Types of Hormone Replacement Therapy:
Estrogen therapy: This type of therapy contains only estrogen. Health providers would typically recommend estrogen-only therapy to those women who have had a hysterectomy (a surgery to remove the uterus) because it seems to have fewer long-term risks than other therapies which use a combination of hormones.
Combination Therapy: This type of therapy combines doses of estrogen and progesterone may help lower the risk of colon cancer. This type of therapy typically comes in a pill or skin patch, but can also come in:
Implant - small pellets containing bioidentical hormones (hormones similar to human hormones) that are inserted into the fat layer under the skin. This is a non-reversible procedure, and can not be removed once inserted.
IUD - an intrauterine device that can be placed inside the vagina.
Possible health risks of HRT:
Increased risk of uterine cancer for those taking estrogen only therapy when they still have their uterus. Those with uterus intact and take progestin along with estrogen generally show lower risks.
Studies show Increased risk of heart disease if women begin HRT more than 10 years after their menopause symptoms begin. Taking HRT in your 40s or 50s is typically not associated with an increased risk of cardiovascular disease.
Increased risk of blood clots and stroke.
Increased risk of gallbladder disease.
Increased risk of breast cancer with long-term use in some people. Therefore it is crucial to get regular gynecological exams and mammograms to monitor your condition.
Many of these risks also have to do with your overall health and family history of health conditions. Always discuss with your health provider and see if there is a suitable individualized treatment that will minimize your risks and work best for you before you decide and start on any form of therapy.
2. Maintain a Healthy Diet
For women who have reached the menopausal stage of life, a healthy and well balanced diet is important. The National Institutes of Health (NIH) suggests adults between the ages of 19-70 to be intaking 600 international units (IUs) of vitamin D per day. 1000 mg of calcium (for adult women ages 50 and younger) or 1,200 mg of calcium (for women between 51-70 years old) per day. Consult your doctor to see if supplements may be a good option for you.
Add Dairy to Your Diet
Not only will you get calcium and vitamin D from adding dairy to your diet. But dairy products such as milk, yogurt and cheese offer some essential nutrients such as vitamin K and minerals (phosphorus, potassium, and magnesium) that women need to fight bone loss.
Eat Lots of Fruits and Vegetables
Fruits and vegetables are packed with vitamins, minerals, and antioxidants. Research has shown that eating more fruits and vegetables helps with many of the menopause symptoms: reduce hot flashes, better sleep, lower blood pressure, lower rates of depression and heart disease. Heart disease risk tends to increase after menopause due to age, weight gain, and reduced estrogen level factors. Fruits and vegetables are low in calories and can help you feel full, so they’re also great for weight loss and weight maintenance.
A study in 2000 even found that broccoli helped decrease levels of estrogen associated with breast cancer, and increased levels of estrogen that help protect against breast cancer. (Riverside Health System, 2022). Another observational study of 3,236 women ages 50 to 59 found that diets high in fruit and vegetables may lead to less bone breakdown. (Healthline, March 29 2022)
According to Traditional Chinese Medicine (TCM), these fruits are especially helpful for reducing some of menopausal symptoms: lemon, cantaloupe, grapefruit, mulberry, apples, pears, watermelon, apricots and persimmons.
Eat Protein Rich Foods
Protein can help boost muscle mass and bone strength – two things that decline during menopause. Eating protein regularly throughout the day can help prevent and reduce risk of sarcopenia (the loss of muscle mass, strength and function) that occurs with aging and help regulate mood and sleep. In addition, high protein diets can help with weight loss by making you feel full longer and and help increase calorie burn. Some best sources of healthy proteins are meat, fish, eggs, beans and legumes, nuts, and dairy.
Limit Refined Sugar and Processed Foods
Processed foods are typically full of salt and refined sugar, both of which can negatively impact your health. High salt foods can lower a woman’s bone density. Diets high in refined carbohydrates and sugar can cause sharp rises and dips in blood sugar overtime can lead to insulin resistance and type-2 diabetes. Other diseases such as high blood pressure, heart disease, obesity, and mood disorders are also associated with having a high refined carbs and sugar diet.
One study found that diets high in refined carbs may increase the risk of depression in postmenopausal women. Another large observational study found that among women ages 50 to 59, diets high in processed and snack foods were associated with poor bone health. (Healthline, March 29 2022)
Avoid Trigger Foods and Eat More Cooling Foods
Certain foods may trigger your menopausal symptoms: hot flashes, night sweats, and mood changes. These common trigger foods include foods high in sugar, spicy foods, caffeinated drinks, and alcohol. Spicy foods will worsen your hot flashes and blood pressure. Alcohol may interfere with sleep and exacerbate hot flashes, anxiety, and depression symptoms.
According to Traditional Chinese Medicine (TCM), there are some foods that are considered “Cooling foods''. These includes apples, bananas, cucumber, spinach, daikon radish, mung bean, dandelion greens, cabbage, bok choy, cauliflower, broccoli, celery, carrots, romaine lettuce, eggs and green tea may help cool down your body’s internal thermostat. Bitter foods such as kale, watercress, turnips, asparagus and tangerine peel will also help disperse heat, they operate as an internal air conditioner to relieve some of the menopausal symptoms. Eat at least two servings of these a day for your internal air conditioner to kick into action. However, make note that too much cold food inhibits digestion and may lead to diarrhea. (www.pacherbs.com, August 22 2014)
It is helpful to keep a diet diary so you can easily identify which foods help improve and which ones tend to worsen your menopausal symptoms.
Eat Foods that are High in Phytoestrogens
Some believe that phytoestrogen foods help minimize menopausal symptoms. Phytoestrogens are naturally occurring plant compounds that can mimic the effects of estrogen in the body.
Researchers from the Department of Integrated Health at Westminster University polled 1,000 British women ages 45 to 55 and compared their answers to those of women from the U.S., Canada, Japan and China. The conclusion was that Japanese and Chinese women suffer the least amount of menopause symptoms. British women suffer the most and Americans are somewhere in between. What causes this disparity between menopausal women in the East and West? Certainly diet and lifestyle choices may play a key role. (www.pacherbs.com, August 22 2014) The high intake of phytoestrogens in Asian countries is thought to be the reason why menopausal people in these places rarely experience hot flashes. (Healthline, March 27 2024)
Foods rich in phytoestrogens include: soybeans and soy products (tofu, tempeh), flaxseeds, linseeds, sesame seeds, beans, cruciferous vegetables (broccoli, cabbage, collard greens, brussels sprouts), beans (edamame), berries (strawberries, blackberries), peaches, and garlic.
Drink Lots of Water
During menopause, due to decreased estrogen levels, women will experience dryness: dry skin, wrinkles, thinning of skin and hair, itchiness, vaginal dryness. Staying hydrated not only can help relieve some of the discomfort associated with menopause but can also help with critical bodily functions like regulating temperature, lubricating and cushioning joints, and removing waste. According to (Gennev, 2024), the recommended ounces of water per day is your body weight {in pounds (LB)} divided by 2. For example: 150 pound person / 2 = 75 ounces of water per day. In addition, water can help you feel full and slightly increase your metabolism, therefore can help with weight loss and prevent weight gain.
3. Exercise Regularly
Doing regular physical exercise is crucial at any age, but it may offer extra benefit during menopause as it can help women alleviate some of the menopausal symptoms such as hot flashes, regulate mood, and manage weight. Regular exercise has also been linked to many health benefits for menopausal women, including: stronger heart, muscles, joints and bones, improved energy, stamina,and endurance, decreased stress, better sleep, increased metabolism, and better protection against diseases and reduced risk of cancer, heart disease, stroke, high blood pressure, type 2 diabetes, obesity, and osteoporosis.
There is a study in Korea that looked at the effects of a 12 week walking exercise program for a group of 40 menopausal women, and found that the exercise program improved the physical, mental, and overall quality of life of these women. (Healthline, March 29 2022)
The Centers for Disease Control and Prevention (CDC) recommends 150 minutes of moderate-intensity aerobic activity each week for adults up to the age of 65. The CDC also recommends doing at least 2 strength training such as weight training or yoga sessions per week to help increase bone strength and prevent the loss of bone density which may lead to osteoporosis. (Healthline, June 21 2016)
4. My Secret Tips
Besides maintaining a healthy diet and regular exercises, here are a few additions I’m personally doing to combat my early perimenopausal symptoms:
Supplements I’ve incorporated into my diet:
Omega 3 (Can help reduce inflammation, relieve joint pain and stiffness related to menopause arthritis)
Probiotics (Helps with hot flashes, night sweats, sleep quality, mood, vaginal infections, and osteoporosis)
Magnesium (helps lower risk of depression and anxiety, supports bone and heart health, and improve sleep)
Zinc (Helps regulate stress hormone cortisol and stabilize mood fluctuations)
Collagen (helps with skin elasticity, bone density, heart health and circulation, gut health, balance hormones, and weight management)
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What are some of the things you’re doing to combat those menopausal symptoms? Which tip do you think you’ll incorporate into your daily lifestyle? There is so much information packed into this month’s blog. I know it is a lot to digest and hard to remember everything in one go. Feel free to come back to this article whenever you need a refreshment of the materials.
“Wow” Yourself!