Managing Menopause

Menopause is the time in a woman’s life when her reproductive capacity has ended and she no longer passes eggs out of her ovaries or creates a lining in her uterus for one of those eggs to grow in, should it be fertilized. There is a great deal of attention paid to this transition for women, which leads us to think of it as a medical event rather than what it really is: a normal passage into the next phase of a woman’s life.

This midlife transition for women has gone from being an uncomfortable subject enshrouded in secrecy to being the very public basis for jokes and off-handed references. Every woman who lives through her 50’s will go through menopause, though, interestingly, women’s experience of it varies. Some women barely notice anything beyond the absence of their menstrual period, while others are plagued by uncomfortable and distressing symptoms. Some of this may be genetic. Asian women, for example, tend not to have hot flashes as much as Caucasian women do. Over the past several years, we have begun to look anew at what menopause is like for different women around the world and we have discovered that there are aspects of it that women can impact if they are well-informed.

The average age of menopause in the United States is 51 years, though the normal span is from early 40’s to late 50’s. Women who smoke or are very thin may have menopause earlier than other women. Along with the cessation of menstrual periods, other changes occur in women’s bodies. In fact, these changes begin to appear in the years or months before menstruation stops, and many continue for a while afterwards. Understanding the processes in the body, and learning how to adapt to these shifts can make this stage of life easier to move through and can set the stage for better health in the postmenopausal years.

Although we mark menopause from the time a woman has not had a period for 12 months, the years before that, referred to as “perimenopause,” are often marked by the beginning of hot flashes, sleep disturbances, sexual dysfunction, and mood changes. Research shows that regular exercise during menopause can reduce symptoms.

Studies show that the best exercise plan during and after menopause is relatively high-intensity physical activity performed several days per week. That said, what matters most is participation in an exercise program that you can be consistent with. Exercise has been shown, among other benefits, to be correlated with decreased levels of stress and improved quality of life.

Once a woman is fully in menopause, her body is producing markedly less estrogen and progesterone. At this time, several health issues become much more of a concern. Among these are bone density, heart disease, weight maintenance, and mental health. Fortunately, women can impact their likelihood of encountering these health challenges. Below are some suggestions for addressing these major issues.

Bone up! Our bones are constantly being remodeled. On a cellular level, they are broken down and rebuilt constantly. At menopause, bones begin to break down faster than they are rebuilding. This is the basis of osteoporosis which puts women at risk for fractures. Weight bearing exercise is essential to keep bones strong. Taking Calcium supplements and Vitamin D can help, too, as does eliminating soft drinks.

Keep the beat! At menopause women’s rate of heart disease catches up with men’s risk. Aerobic exercise and low fat diets have a big impact on heart health.

Choose the right “weight”. As metabolism slows with the hormone changes, it becomes very easy for women to gain weight. The deposition of fat, especially in the abdomen, is linked with many serious diseases. Keeping strong helps keep your metabolism up, and burning calories with moderate levels of exercise will keep those extra pounds off.

Let the good times roll! Studies show that depression and difficulty concentrating are common in perimenopausal women. Both of these can arise from many factors. While exercise is not a cure, it has been shown to help reduce the severity of both depression and cognitive impairments. Getting involved in meaningful projects, learning new skills, and developing healthy approaches to handling stress are all ways to enhance mental health.

Written by Peg Maas, PT
Physical Therapist, Seattle Athletic Club Northgate