Normal is a very difficult thing to define, mostly because we are all individual and respond differently not just to the symptoms but to the whole cycle of menopause itself.
This can be a time of mixed emotions too. While some women welcome the end of their menstrual cycle, menopause can also bring some unwelcome reactions to this major change in life and the symptoms along with it.
The good news is that there are plenty of ways to manage the physical and emotional changes that occur during this time.
Here are six symptoms of menopause that you don’t have to accept as your new normal.
1. Painful sex
Sex itself can bring definite changes at menopause and these are not just physical but also emotional as the attendant stresses may mean you have less interest in sex ,and possibly find your libido much reduced due to discomfort or changes in your relationship.
During this transition to menopause, it’s not uncommon to have pain before, during, or right after sexual intercourse. The intensity can vary from pain only at penetration, to a deep burning or throbbing sensation that lasts for hours after penetration.
Menopause is associated with vulvar and vaginal atrophy (VVA), a condition that causes dryness and thinning of the vaginal walls due to a drop in oestrogen. Both dryness and thinning can make penetration and sex uncomfortable.
Solutions: You can make adjustments to your sex life. More foreplay can stimulate natural lubrication and lead to less pain and more enjoyment during sex. This involves more touching, cuddling, or kissing before actual penetration.
Using over-the-counter vaginal lubrication can make sex more comfortable and many women find using the bioidentical creams vaginally also makes a difference.
If you’re still experiencing pain, talk to your doctor as if you are suffering from vaginal atrophy this will normally require additional oestrogen in the form of a cream or suppositories and can be used alongside bioidentical progesterone to keep your hormones balanced.
2. Hot flushes
These most commonly begin at peri/menopause, due to hormonal changes as both oestrogen and progesterone levels decline.
Hot flushes can feel like sudden warmth or heat spreading over your body that mostly affects your upper body and face. Signs include facial flushing or redness, excessive perspiration, and a rapid heartbeat.
Their frequency and intensity varies from woman to woman and can change in severity during menopause itself from light flushes to frequent attacks and night sweats which affect your sleep.
Some may experience them just for a year or so, but some women can continue to experience them for more than 10 years.
Solutions: It is the declining levels of hormones behind this unpleasant symptom, rebalancing with either progesterone – as that falls faster than your oestrogen levels – or if your symptoms are severe with a combined cream that has both progesterone and natural oestrogens can be a solution for many women.
Many doctors will prescribe either HRT or more frequently, given some of the health risks associated with it, they are turning to drugs such as antidepressants.
A priority has got to be finding ways to keep yourself cool, and that may mean switching your clothing to a looser fit and bedding for something lightweight and natural, and keeping your bedroom as cool as you can.
You may also find relief from drinking cold water at the onset of a hot flush, sleeping under a fan, and losing weight may also improve hot flushes in some women.
Some women have reported that using just a dab of bioidentical progesterone cream on the inside of the wrist can often stop a flush as it is starting, or reduce it in severity.
3. Mood changes
Mood changes from fluctuating hormone levels are a common occurrence during your menstrual cycle and similarly, you may experience irritability, fatigue, or sadness during menopause.
As menopause can also bring its own stresses, in terms of your changing health, your increased hormonal symptoms and the emotional effects of any relationship difficulties as these will all play their part.
Solutions: Simple lifestyle changes can help you manage your moods and if you can keep a mood diary it will help you identify what your triggers are, and find strategies to help you cope with it.
Reduce stress by setting limits for yourself and saying no if you’re feeling overwhelmed. Relaxation techniques like deep breathing exercises and meditation may also help.
Although it can be difficult if you are finding your sleep is being affected by your flushes or night sweats it is important to try to get at least seven to eight hours of sleep at night as poor sleep will affect your mood too.
The benefits of regular exercise can also help improve your mood by stimulating the production of endorphins or “feel good” hormones. It does not have to be complicated, going for a walk works well as does any activity you find pleasurable whether that’s gardening or dancing or yoga.
If your mood doesn’t seem to improve, and you’re experiencing symptoms of depression or anxiety, talk to a professional or your doctor.
If the root of your depression is hormonal you could benefit from a combination cream using both progesterone and natural oestrogens as this has been found to be effective by Dr Jeffrey Dach in the United States.
Trouble sleeping is another common symptom of menopause. Although the reasons vary, you may experience insomnia due to a drop in oestrogen and lower levels of the hormone progesterone may also affect falling and staying asleep.
You can look at the solutions suggested on the hot flushes, but you can also take steps to improve your sleep routine.
Solutions: although when you are lacking in sleep you are tempted to take a quick nap, try to avoid taking naps during the day, especially in the late afternoon or close to bedtime.
Also, avoid drinking alcohol, having caffeinated drinks, or eating before bedtime as these can all stimulate you. If you tend to have a heavy meal in the evening, your digestive system will also be working hard and this can prevent you having a peaceful night.
Although it is very common now to have electronic devices in the bedroom such as our TV, laptop and phone, they are also not helpful when trying to have a restful night. Limiting screen time before bed can help you fall asleep faster, too.
5. Urinary incontinence
A decrease in oestrogen during menopause may weaken your urethra. As a result, you may leak urine when sneezing, laughing, or coughing. Some women may have difficulty holding their urine and find themselves rushing to the bathroom.
Solutions: One way to reduce this from happening is to try Kegel exercises to strengthen your pelvic floor muscles. This can give you more control over your bladder function. Kegel exercises involve tightening and relaxing your pelvic muscles repeatedly – but not when you are actually urinating – and you will find plenty of information on how to perform them on the internet.
Until incontinence improves, you can wear pads specifically for bladder leakage. Also, avoid any liquid that increases the urgency to urinate, such as caffeinated drinks.
Excess weight can put pressure on your bladder, so losing weight may improve urinary incontinence in some women.
Memory problems and trouble focusing can develop during menopause and commonly known as brain fog/freeze.
These problems may be related to hormone issues such as lack of sleep and conditions like depression and anxiety. So, effectively treating these may gradually improve cognitive function and once you can identify and start helping any of these you will be beginning to help yourself.
Solutions: It definitely helps to keep your mind engaged so activities that stimulate the brain, like crossword puzzles, quizzes and learning a new skill all help.
Most important is to stay active socially whether in person, by phone or online as contact with others will keep you more engaged and stimulated.
However, if your memory problems don’t improve, or are affecting your day-to-day life, talk to your doctor.
Depending on the severity of your symptoms, menopause can have a negative impact on the quality of your life, but how you approach it can make all the difference.
You can’t change menopause itself, but you can manage difficult or unpleasant symptoms. The sooner you can take action to get relief from symptoms like hot flushes and insomnia, the easier it will be stay in control and have an easier transition through the menopause journey.
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