What can make menopause easy to sail through?

I’ve just hit 50 and have begun perimenopause. While I’m largely symptom free but was chatting to my doctor about it anyway as a number of my friends are having problems. She said that the fitter and healthier you are, the milder your symptoms are likely to be and she is unsurprised that I, as a distance runner, seem to be sailing through so far.

So another great reason to get super fit and healthy.

I'd vote also that the best one can do is pursue good overall nutrition fairly consistently, strength and cardiovascular exercise regularly, and implement other measures that promote thriving good health (like moderating alcohol intake, among other things).

There's no panacea there, though. Some of the severity or nature of menopause symptoms may be genetic, even, I don't know.

I feel like the horror of menopause is being hyped a lot nowadays, mostly by people who want to sell us a "solution" (diet, exercise programs, supplements or whatever) or at least rent our eyeballs for their content so that they can earn advertising revenue. If we get sucked into that beyond what's realistic (for us personally) . . . well, self-fulfilling prophecy can be a thing that happens. Yes, there can be severe symptoms for some women, but also there can be few or no symptoms for others.

There's recent research suggesting that our metabolic rate (base calorie expenditure, loosely) is quite steady from our 20s into our 60s. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370708/)

What does happen over those years, though - for many of us, unless we take steps to counter it - is gradual muscle loss (from under-use and insufficient nutrition, especially protein), and gradually less active lifestyle (more the daily life humdrum vs. intentional exercise). Many even become more food-focused as well as less active in social lifes (think about those potentially more centered on dinner parties and theaters and such as we age, less on clubbing/dancing/recreational games or sports we may've done in youth).

IMO, the weight management consequences with aging are more about those things, less about menopause per se.

There are various non-HRT ways to deal with menopause symptoms if or as they occur. That's the focus that makes most sense to me: Keeping an open mind, staying healthy and fit, and seeing what comes . . . then dealing with symptoms.

There's no point IMO in catastrophizing about menopause per se: It's coming, if we're lucky to live long enough. That's unchangeable. We have control over our nutrition and fitness in the lead up. We have control over our daily life activity level. Once in menopause, if we have symptoms, there are a diversity of ways to deal with them.

If you want specific ideas for addressing certain symptoms, I'm willing to comment on specific questions. I'm not enthusiastic about typing out a laundry list of things that might happen symptomatically, and what to do about them. That's a long list, and speculative. Some women have many symptoms, some have few, and which ones a woman has will differ.

My background includes a lot of discussion with other women (and medical professionals) about menopause symptoms and non-HRT ways to improve them. Here's why: I was put in menopause early and quickly in my late 40s by chemotherapy for breast cancer.

My cancer was estrogen fed, so I also took a couple of different kinds of anti-estrogen medications for 7.5 years after that. Those medications in some respects create a sort of hyper-menopausal state (by blocking creation or uptake of estrogen that's created in other tissues beyond the ovaries (like adrenals and fat cells). Because of the estrogen-fed tumors I had, HRT was and is completely out of the question.

Because of my cancer, I was active in a breast cancer support group, and trained as a volunteer peer support person for women in similar circumstances. That including education and many, many discussions about strategies for mitigating menopause symptoms other than HRT, since for many of us HRT was a big "NO".

Good health is worth pursuing for a variety of reasons. Beyond that, I don't think there's much a person can do in advance to affect menopausal symptoms. I don't see the point - beyond that - in worrying now about troubles that may arise in the future . . . but maybe that's just me.

Best wishes!

COGypsy wrote: »

Ditto on the symptoms being different for everyone. I had night sweats and absolute rage, but was much more bothered by heart palpitations and the body/foot pain. My biggest suggestions are learning about the less well-known symptoms and take action sooner rather than later if they pop up. I'm on HRT now and it eliminated the majority of my symptoms in a matter of days. I also take a supplement for night sweats and between the two, life is much more manageable.

I know some people prefer a more "natural" approach (although I'd say replacing the hormones that already exist in your body isn't unnatural) but I doubt just a supplement or two would have done the job and certainly not done it so quickly. Plus I realized that in the end, I wasn't going to get a prize for white-knuckling my way through multiple YEARS of misery. I also don't have any factors that would make HRT more risky, so patch and pills was an easy choice to make.

I wanted - and hoped - not to need HRT, as my mum didn’t. She had hot flushes and some rage but otherwise was pretty unbothered by it. I could cope with the night sweats and hot flushes (although the interrupted sleep was getting to me). But my issue - and whilst this isn’t usual it isn’t apparently rare - was the bleeding. Like crime scene periods, where I couldn’t commute to work, couldn’t plan time away, was badly anaemic and felt so poorly. My periods lasted 10 days and my cycle 14-18. So the most I managed for TWO YEARS was 8 days in a row without bleeding. Hence the inappropriate thoughts - I could no longer cope.

HRT is not for everyone, I had to undergo extensive (paid for) testing before I got a prescription owing to an endocrine cancer: but good grief it’s changed my life. I am no longer ill, I can leave the house, I don’t have to change my bedding twice a night, I’m not spending the equivalent of a mortgage on sanitary products - the list goes on.

So no, HRT is not the only way, it’s not always needed or wanted or suitable, but for those who cannot cope, it can life changing.

claireychn074 wrote: »

COGypsy wrote: »

Ditto on the symptoms being different for everyone. I had night sweats and absolute rage, but was much more bothered by heart palpitations and the body/foot pain. My biggest suggestions are learning about the less well-known symptoms and take action sooner rather than later if they pop up. I'm on HRT now and it eliminated the majority of my symptoms in a matter of days. I also take a supplement for night sweats and between the two, life is much more manageable.

I know some people prefer a more "natural" approach (although I'd say replacing the hormones that already exist in your body isn't unnatural) but I doubt just a supplement or two would have done the job and certainly not done it so quickly. Plus I realized that in the end, I wasn't going to get a prize for white-knuckling my way through multiple YEARS of misery. I also don't have any factors that would make HRT more risky, so patch and pills was an easy choice to make.

I wanted - and hoped - not to need HRT, as my mum didn’t. She had hot flushes and some rage but otherwise was pretty unbothered by it. I could cope with the night sweats and hot flushes (although the interrupted sleep was getting to me). But my issue - and whilst this isn’t usual it isn’t apparently rare - was the bleeding. Like crime scene periods, where I couldn’t commute to work, couldn’t plan time away, was badly anaemic and felt so poorly. My periods lasted 10 days and my cycle 14-18. So the most I managed for TWO YEARS was 8 days in a row without bleeding. Hence the inappropriate thoughts - I could no longer cope.

HRT is not for everyone, I had to undergo extensive (paid for) testing before I got a prescription owing to an endocrine cancer: but good grief it’s changed my life. I am no longer ill, I can leave the house, I don’t have to change my bedding twice a night, I’m not spending the equivalent of a mortgage on sanitary products - the list goes on.

So no, HRT is not the only way, it’s not always needed or wanted or suitable, but for those who cannot cope, it can life changing.

I'm actually getting a hysterectomy in September for the non-stop bleeding. I've been at the point where I literally wear Depends instead of a pad. My record so far is a 37 day period. That's from fibroids that have grown into the muscle of the uterus though. The fibroid symptoms got worse when I started peri and HRT doesn't seem to have had much effect one way or the other, so it's time for the whole mess to go! So I completely empathize with you on that front. I'm glad the HRT stopped all of that and that you're doing so much better! I can't wait to feel the same way.

spiriteagle99 wrote: »

My mother had a very mild menopause so when the time came, I wasn't surprised that I also had a very mild menopause. I think the fact that I was hiking every week helped, but genetics definitely did. I never had hot flashes, just an occasional 'warmish flash' where I would ask my husband, "Is it warm here?" and he would usually say yes. I never had heavy bleeding. Instead, for the last 4 years I bled one day every 9-12 months, usually for less than an hour. I didn't get more emotional. I lost weight (by choice) fairly easily by cutting my food. I know I was lucky or maybe I accidentally did something right. Bottom line, you don't know that your experience will be a bad one. Stay active, eat as healthy as you can, and try to keep a good attitude. It can't hurt and it might help.

I think this is a really important post: for all of those reading some of the horror stories about uncontrolled bleeding (me) and mood swings (fortunately not me), not everyone has it. As @AnnPT77 said unthread, the media likes to hype up the negative aspects of menopause but some people will just meander through it - it isn’t a life sentence doesn’t mean everyone will suffer.

The key is getting support if you need it and seeing different doctors until you find one who will listen and understand. GPs still aren’t taught much about menopause so they will do their best but they aren’t specialists.

This is a prosaic suggestion but I also found being open and honest really helpful. I told my boss, who was great and said if I needed to be late / just couldn’t come into the office to let him know, and I told the team I manage. I kept it light (didn’t go into the details) but just explained I might have to leave work suddenly some days. That led to quite a few people approaching me privately to tell me they were going through similar stuff - or their partners were - but they’d not felt comfortable speaking up. I understand not everyone will want to do that, but TBH it was kind of public given I’d arrived at work and had to go straight in to clean up and change so many times.