Countdown to Menopause
Six ways to ease perimenopausal symptoms

Bonnie Schiedel

“Many women think menopause is a doorway: they go through it and it’s over,” notes Dr. Marla Shapiro, a Toronto family physician and member of the North American Menopause Society. “But menopause is the period of a woman’s life that begins with the total cessation of menstruation.” It is not a single moment in time; it can represent 30 years of life or more.

Illustration by Belle Mellor/ThreeInABox.com

Perimenopause versus menopause

The transitional phase leading up to menopause is known as perimenopause. On average, it begins in Canadian women around age 45 (although it can range from ages 39 to 51) and tends to last around five years. In this period, aging ovaries produce fluctuating and ultimately declining amounts of the female hormones estrogen and progesterone. As the hormone levels rise and fall, your periods may change — be heavier or lighter and come closer together or further apart.

Hot flashes, night sweats, mood swings and sleep disturbances may also be part of the countdown to the “change of life,” as our grandmothers discreetly called it. A woman is considered to be fully menopausal when she has had no menstrual periods for 12 months.

If you’re struggling with perimenopausal symptoms, your doctor may prescribe medication such as birth control pills, antidepressants or hormone replacement therapy (HRT). But there are also lots of lifestyle choices you can make to ease your passage through perimenopause and into menopause, as well as to reduce the risk of conditions such as osteoporosis and heart disease, to which you become more vulnerable as you age. Try the following doctor-recommended tips.

1. Eat well 
   
   Now’s the time to take charge of your health, and eating better is a good place to start. Choose whole-grain foods, deep-coloured fruits and vegetables and lower-fat dairy products. Include a couple of servings of fish per week. Go easy on red meat and foods that are high in fat, sugar or salt. Limit intake of caffeine, alcohol and spicy foods, which may contribute to hot flashes and sleep disruption. Maintain a healthy weight, too: several studies, one from the University of Michigan, found that obese women were twice as likely as normal-weight women to have earlier, more frequent and severe hot flashes.

2. Consider supplements
   
   One in four Canadian women over the age of 50 has osteoporosis, which means decreased bone mass and deteriorating bone tissue. Calcium and vitamin D help prevent bone loss during perimenopause and menopause. Ask your doctor about taking a daily
   high-quality calcium and vitamin D supplement. 

3. Deal with stress
   
   Chronic stress and anxiety can make hot flashes worse. Take time every day to work on a favourite hobby, laugh or talk with loved ones, breathe deeply and relax with music, yoga or meditation. “Anything that buys you me-time helps deal with stress,” says Shapiro.

4. Get moving
   
   Thirty to 60 minutes of daily exercise will help combat stress, prevent weight gain and ward off heart disease, diabetes, cancer and osteoporosis. Mix cardio and resistance-training activities for heart and bone health, strength, flexibility and endurance. “Exercise has to be a priority because it affects countless aspects of our health,” she says.

5. Set up for sleep
   
   Cool down your bedroom, wear nightclothes in light fabrics that “breathe,” and use layers of bedding that can be removed as needed. A decompressing routine such as reading in bed can help you get to (or back to) sleep, too.

6. Quit smoking and avoid second-hand smoke
   
   Smoking can worsen hot flashes (possibly because nicotine constricts blood vessels) and also affects your medication choices (you can’t take oral contraceptives and you may need a higher dose of estrogen in your HRT). “Smokers tend to go through menopause earlier,” adds Shapiro.

After attending a workshop held by the Calgary Health Region, Brenda Henley, 47, made many of these healthy choices part of her routine. “Knowing what to expect from perimenopause and how to handle it made such a difference to me,” she says. “Making these changes has helped me the best I can be at this stage in my life.”