Menopause / perimenopause support!

I am just starting this phase and would appreciate any guidance!

Re hot flashes/night sweats, I'll quote myself from the other peri thread:

https://community.myfitnesspal.com/en/discussion/comment/46774162/#Comment_46774162

I'm 55 and still have yet to have a hot flash, but am always hot. This was not a problem when I controlled the thermostat, but now I am living with my 84 year old mother, who is always cold. I just found out Gabapentin can help with night sweats and that SSNRIs can help with peri/menopausal vasomotor symptoms during the day. I was already taking the lowest dose of Cymbalta available, and have just switched to a higher dose, which I think I needed for some mental health issues as well.

Kshama beat me to the NEAT thread (thanks, Kshama!).

On the eating front, I did this (to lose, and now to maintain):

https://community.myfitnesspal.com/en/discussion/10636388/free-customized-personal-weight-loss-eating-plan-not-spam-or-mlm/p1

I'm also vegetarian, but I think that's a complete tangent to weight management, health, or performance. (If anything, it makes those things a tiny bit more difficult, logistically and socially.) Reason for saying that: I was vegetarian all the way through decades in which I was thin and healthy; then fat, evenutally obese and unhealthy (high blood pressure, high cholesterol, and many other things, including cancer that's more common among obese women); then athletically very active (but still high BP/Cho) for over a decade; and finally thin again.

On the exercise front, I didn't much change my exercise routine to lose weight, since I was already active - had been since my mid-40s, starting after cancer treatment as part of recovering; I was already menopausal at that point. During loss, I did make it a point to be a little more consistent with strength training, something I'd done before off and on, but that I tend to be flaky and inconsistent about because I don't enjoy it.

I do have major sleep problems, not sure whether from menopause or chemotherapy. I've tried pretty much everything, and have been treated for sleep apnea. I still have significant, disruptive sleep interruption insomnia: I go to sleep easily, wake up multiple times a night, go right back to sleep. It's not restful. There are various things that helped a little, a lot that helped not at all. The only thing that helped remotely significantly was a few sessions of hypnotherapy from a credentialed psychologist. That got me from longest sleep interval being 60-90 minutes, to often getting one block of 3 hours, and occasionally as many as 5 hours.

My background story, as context: Chemotherapy put me into menopause, hard stop, right around my 45th birthday. Then I took anti-estrogen drugs for 7.5 years. Those drugs, speaking loosely, create a sort of hyper-menopausal state, making the menopausal symptoms worse than average for many who need to take them. (They're part of what kept me alive after stage III locally advanced breast cancer, so I'm grateful: Alive is a good start on the rest of my day.)

At the time of cancer treatment, I was in terrible physical condition, very sedentary, depleted by a very bad few years right before that (widowed, deaths of other family members, stressful career with long hours, etc). After cancer treatment, I gradually became more active, to try to recover strength and energy. Eventually, I was even competing as an athlete, not always unsuccessfully . . . but I stayed class 1 obese for another decade plus, despite working out pretty intensely 6 days most weeks.

At age 59, I committed to lose weight, and was at a healthy weight by around my 60th birthday. I'm maintaining now, age 66, 5'5", up and down a bit within the healthy range, but considering goal to be mid-120s pounds, and currently thereabouts. I'm still pretty athletically active, though no longer competing (I think 😉).

I posted a thread about how my loose skin (and body generally) looked after a few years in maintenance. Be forewarned: I wasn't trying to look my inspirational best (by managing clothes, poses, lighting, etc.), I was trying to be brutally honest. If you aren't up for that, don't go there

https://community.myfitnesspal.com/en/discussion/10809632/loose-skin-50lbs-loss-at-60-4-years-m.aintenance#latest

I'm a little prickly about the "menopause as weight loss/fitness doom" idea. Weight management and fitness improvement is challenging for nearly everyone, though the details differ. Sympathy is one kind of support, but "oh, the difficulty" or "woe is me" are not action plans. When I'm dissatisfied with a state of affairs, I personally prefer an action plan (or action ideas) to commiseration. For my personality type, commiseration can just get me dug in deeper to feeling disempowered and discouraged, maybe even cozy in the thought that there's no alternative to my unfortunate state.

I feel like there are some common (not universal) patterns among women of menopausal age and beyond, that can potentially contribute to where we find ourselves in these years, that are underappreciated in their impact on on weight, fitness, and body composition. These include common tendencies to be better caregivers to ourselves than to others; to have come up when athleticism among young women was less encouraged (pre Title IX in the US, for example) and maybe even discouraged; perhaps to have gone through multiple cycles of extreme yo-yo dieting; and often to have activity patterns that subtly and gradually shift in a less active direction as we age.

I also see some tendency, among women my age I know in real life, to have unrealistically low expectations of ourselves, and to be self-deprecating. I can remember being at dinner with a group of friends (6-8 women around my age), when one of them said with complete seriousness "of course, we can't lose weight at our age" and everyone else nodded sadly, equally seriously.

A first step toward losing weight and improving fitness is believing it's possible, and that we as individuals are capable of it. Because we are.

/curmudgeon /manifesto

I said something similar on another thread recently was accused of being non-supportive. 🤷‍♀️ I'd like to help, sincerely . . . but since the support I personally want is action steps or relevant science references, that's mostly what I try to offer.

There are mixed results, but a few studies suggest that strength training may have extra benefits for post-menopausal women (with results like reduced central adiposity, which is researcher-speak for less belly fat). This is one example, but there are others:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005909/

This one may be unpopular, though I find it hopeful: It suggests that "metabolism" is pretty constant in adults from 20-60:

https://www.science.org/doi/10.1126/science.abe5017

From separate sources, I understand that there as some exercise interventions that can sustain youthful "metabolism" longer (blah blah blah telomeres, mitochondria, blah blah blah). For those, I don't have easy links, but the general idea is that including some higher intensity in one's exercise mix - once fit enough to do it without problems - has some of those effects.

ythannah wrote: »

So building muscle and preserving bone density have been major aspects for me.

I've had hot flashes and deplorable sleep now for 10 years because my doctor doesn't "believe in" HRT, and I find this a bit annoying because I've been pretty miserable and I think something should have been done medically in terms of osteoporosis prevention. I've recently been found to have degenerative disease in my mid-thoracic spine despite the weight lifting and I'm now awaiting a full bone scan. (Okay, I'm actually super freaking angry that I've had this much deterioration already when it should have been addressed as a concern years ago)

Sounds like you need a new doctor !

amfmmama wrote: »

ythannah wrote: »

So building muscle and preserving bone density have been major aspects for me.

I've had hot flashes and deplorable sleep now for 10 years because my doctor doesn't "believe in" HRT, and I find this a bit annoying because I've been pretty miserable and I think something should have been done medically in terms of osteoporosis prevention. I've recently been found to have degenerative disease in my mid-thoracic spine despite the weight lifting and I'm now awaiting a full bone scan. (Okay, I'm actually super freaking angry that I've had this much deterioration already when it should have been addressed as a concern years ago)

Sounds like you need a new doctor !

Trust me, if that was possible I would have cut her loose years ago but we have an ongoing shortage of GPs and tens of thousands of people who don't even have a family doc. I've had better luck with the other doctors at the clinic by showing up at the walk-in (although there's always a chance I'll end up with my own anyway) but there hasn't really been a walk-in since Covid.