Menopause Management

A Prescription for Health in Menopause

The best approach to menopause is to follow a healthy regimen. That includes dealing with smoking, nutrition, exercise, weight management, and stress reduction.

Smoking

Smoking is a leading cause of preventable illness and premature death. It increases the risk for heart and lung disease and osteoporosis, as well as lung and cervical cancer. It increases the risk for Alzheimer's disease. Smokers also may experience menopause up to two years earlier than nonsmokers. Your health care provider can offer help to quit smoking.

Nutrition

A healthy diet is one low in saturated fat and high in whole grains, fruits, vegetables, and plenty of water. If you are in perimenopause or beyond, however, you have special concerns: Both heart disease and osteoporosis are greatly affected by diet.

You can lower your risk for heart disease by using little or no cholesterol or animal fat. Olive and canola oil are good alternatives. You also should avoid hydrogenated oils such as those found in some peanut butters and margarine. Eating fruits and vegetables and soy foods, such as soy milk and tofu, can help lower cholesterol levels. The use of soy products to treat symptoms of menopause is controversial. While it may improve symptoms for some women, the phytoestrogens (plant estrogens) that may help relieve hot flashes also may increase the risk of breast cancer.

You can help prevent osteoporosis by getting an adequate amount of calcium as a teen and young adult. This period is when bone mass and bone strength are built, reaching a peak during a woman's 20s. As you reach menopause, it is still important to consume adequate calcium. The National Institutes of Health recommends that women after menopause get 1,200 mg of calcium per day. Calcium, whether from food or supplements, is absorbed best by the body when it is taken several times a day in amounts of 500 mg or less, but taking it all at once is better than not taking it at all. If you take supplements, be sure they have the USP (United States Pharmacopeia) symbol as a guarantee of purity. Calcium carbonate supplements are best absorbed with food; calcium citrate is well absorbed any time.

Calcium is found in dairy products, such as milk, yogurt and cheese. It also is found in sardines, canned salmon and sardines with bones and green leafy vegetables. It is preferable to eat dairy products low in fat. Caffeine interferes with calcium absorption.

Vitamin D is important to help the body absorb calcium. Vitamin D is made in the skin when it is exposed to sunlight. The amount of vitamin D made in the skin depends on the time of day, season, latitude, and your skin color. These factors can decrease the amount of vitamin D made by the skin: sunscreen, advancing age, window glass, clothing, and air pollution. The general amount of sun you need for vitamin D production is 10 to 15 minutes of exposure to arms, hands and face at least two times a week without a sunscreen. Certain foods such as fortified milk, liver and tuna contain vitamin D. The Office of Dietary Supplements says that a woman age 51 to 70 needs 400 IU of vitamin D daily; a woman 71 and older needs 600 IU daily.

Weight management

As you age, your body requires less energy because you may become less physically active and you lose lean body mass. It is not uncommon for women in midlife to gain two pounds per year. Being overweight, however, increases the risk for heart disease, diabetes and arthritis.

Maintaining a healthy weight is very important. One way to lose weight is to increase your level of physical activity. Being too thin, however, is not healthy either. Premenopausal women who diet or exercise excessively can become so thin that their menstrual periods stop temporarily because they have such low estrogen levels. This increases the risk for osteoporosis later in life.

Exercise

You can help avoid many common menopausal complaints, as well as future disease, with exercise. Exercise helps you sleep better. Some women report fewer hot flashes when they exercise regularly.

Exercise stimulates production of brain chemicals called endorphins. These have a mood-heightening effect that can last for several hours. Endorphins guard against negative thoughts and combat depression.

A beneficial exercise program includes aerobic, weight-bearing and stretching exercises. Aim for 30 to 60 minutes of moderate-intensity aerobic exercise on most days of the week. Weight-bearing exercise helps build muscle and delays or prevents bone loss. Flexibility exercises help maintain function and improve balance. Climbing and going down stairs helps with both weight control and with exercise.

Talk to your health care provider about the level of exercise appropriate for you.

Stress reduction

Menopause itself does not cause stress. Women in midlife, however, may face many stressors, including children leaving home, aging parents, and widowhood or divorce. Prolonged stress can have a severe impact on health. You should take steps to reduce stress and spend time each day relaxing.

Although studies have shown an association between these lifestyle factors and a reduced risk for Alzheimer’s disease, the National Institutes of Health says that researchers still aren’t sure whether these factors can actually prevent the disease.