Menopause is an important life stage that every woman will have to go through eventually. This experience varies for each woman; some find this period of time challenging while others find that it does not affect them as much. However, no matter how much it affects the lives of these women; there are ways for them to manage this time in life better.

Hormone Replacement Therapy
At the menopausal stage, a woman's body produces less estrogen and progesterone which can cause symptoms and discomfort. Hormone Replacement Therapy (HRT) replaces these hormones in the body and aims to counter these symptoms. The synthetic estrogen or combined estrogen and progesterone hormones found in HRT are usually prescribed in the form of tablets, skin patches, vaginal preparations, implants and nasal spray.

Although HRT is the most common medical treatment, it is not meant for everyone. Women who have a history of cancer, experienced vaginal bleeding or blood clotting problems are advised against HRT. Those who are susceptible may also experience some side-effects of the therapy, which include skin irritation, bloating, nausea and headaches.


HRT Benefits
HRT helps to relieve hot flushes and night sweats, allowing women in the menopausal stage to sleep better. Using HRT also promotes the growth of the vaginal lining; this in turn reduces vaginal dryness and relieves further discomfort such as itching.

These are the short-term benefits of HRT and many studies ended prematurely when the results illustrated that the risks of HRT outweighs the benefits.


HRT Risks
Even though HRT is able to relieve some of the symptoms of menopause, it may not be the right choice as it increases the likelihood of getting some potentially serious conditions.

A Women's Health Initiative Hormone Trial in 2002, designed to assess the risks and benefits of HRT in more than 27,000 women, has shown associations to significant increases in the risk of stroke (41%), heart attack (29%), cardiovascular disease (22%), thrombosis (20%) and breast cancer (26%).


Heart Disease and Stroke
Heart disease and stroke normally occur due to the build-up of fatty deposits in blood vessels or by the presence of blood clots in the arteries. HRT was believed to prevent heart disease as it has favorable effects on fat levels in blood. However, recent studies proved otherwise and HRT may increase the risk of heart disease in the first year of use. Women on HRT were also found to have a higher chance of suffering from stroke.
Breast Cancer
The long-term use of HRT may increase the risk of breast cancer. However, it was found that estrogen-only HRT causes a smaller increase in the risk of breast cancer when compared to combined HRT. In addition, women who consume combined HRT may suffer from breast cancer growth of a slightly larger size.

The risk of breast cancer is noted to increase after the first year of using HRT. The longer HRT is used, the higher the risk of breast cancer. Hence, long-term use of HRT is not recommended and this risk will start to decline when HRT is stopped.
Blood Clots
HRT is found to raise the risk of blood clots (thrombosis). Harmful blood clots restrict bleeding when injured and may be formed in the veins. The veins in the calf are amongst the most common places where blood clots tend to occur. This will cause the legs to be red, swollen and painful. This is known as venous thrombosis (sometimes called deep vein thrombosis or DVT).

Another area where blood clots may be present is in the lungs and is especially prone to women on long-term HRT. Blood clots that lodge in the lungs pose as an obstruction and may cause breathlessness or sharp pains in the chest. This may lead to collapse or fainting. At times blood clots may cause serious problems and in some cases, it may even be fatal.
Complimentary and Alternative Remedies
Other than HRT, there are also other alternative options available to manage menopause. Botanical products from natural sources are popular in the field of relieving menopausal symptoms. They are normally made available in the form of pills and creams.

Nutrafem by Bionutra is a natural botanical supplement for menopausal women. Made from extracts of various botanical products, Nutrafem is designed to complement the female hormone estrogen action in your body. Know more about Nutrafem.

Healthy Lifestyle
A healthy lifestyle can help women manage menopause better.


Diet
A balanced diet that includes carbohydrates, proteins, fats and fibre, and packed with minerals and vitamins, is very important during menopause. Minerals are vital for healthy bones and normal cell function. Vitamins help drive cellular activity, producing more energy. Fruits that are high in potassium such as melons, bananas and citrus fruits will help to balance sodium levels and defend against water retention.

Menopausal women are recommended to eat foods that are rich in vitamin C, E and calcium. Choose dairy products which are low in fat but high in calcium such as low fat milk, cheese and yoghurt to improve bone health. Foods which are rich in phytoestrogens are also beneficial. Choose from whole wheat, barley, oats, carrots, onions, cucumbers, cabbages, potatoes, pomegranates, apples, citrus fruits, green tea, soybeans and garlic.

Drinking plenty of water and having regular meals helps to stabilise blood sugar levels. Maintaining a healthy diet will not only help women to manage menopausal symptoms better, but will also contribute to better health.
Regular Exercise
Exercise improves blood circulation, enabling more nutrients and oxygen to reach your cells. It also helps to strengthen bones, relieve stress and promote sleep.

Try to exercise at least three times a week, one hour for each session. For a balanced workout, include aerobic, weight-bearing and stretching exercises into your exercise routine.

Regular exercise gradually strengthen the lungs, digestive tract, nervous system, and control body fat; thus decelerating the aging process. It also helps individuals to cope better with stress in the everyday lives.

Women in their menopausal years can benefit from various exercises:

General Fitness
General exercise are exercises that can be done while carrying out daily tasks. For instance, women in their menopausal years can take the stairs instead of the elevator as it promotes mobility and decreases stiffness. Other forms of exercise that can be done regularly include daily walking and brisk walking. It is recommended that women start their day by doing a short morning walk, however if this is not possible, walking whenever there is a chance to will be good too. Such exercises help keep bones healthy and maintain good balance as one age.

Kegel Exercise
Kegel exercise is an effective method of countering incontinence by strengthening the pelvic muscles. In addition it can also enhance sexual satisfaction. Kegel exercises are not hard to do at all, women just need to contract their pelvic floor muscles for a second and release it completely. Repeat 10 times for each set. For a more effective result, do up to 20 sets a day.

I DON'T KNOW WHERE MY PELVIC MUSCLES ARE!

Try to stop the flow of urine the next time you visit the bathroom.
The muscles you contract are your pelvic muscles.

Not only is it simple, but this exercise can be done anywhere and at any time. It can be done in the bus, in the car, while waiting in line at the supermarket or even in the shower.

Yoga
Due to the rapid fluctuation of hormone levels in a menopausal woman's body, exercise that could balance the body and mind such as yoga can be particularly helpful.

Yoga gives women a positively empowered attitude and while meditation helps rejuvenate the mind. Women will be able to have a better outlook on life when they are more at ease and have a better sense of well-being. As one of the popular methods of relaxation, meditation helps ease the tension and improve the energy level of the individual. Being more relaxed promotes regular sleep patterns, and this will help to overcome the menopausal symptom of occasional sleeplessness. Some yoga poses ay fall under the weight-bearing category and are great for strengthening muscles.



Pilates
Pilates improves flexibility, balance, and body awareness. In addition to that, it also helps to tone and strengthen the muscles and gain better muscular control. Women who adopted pilates as part of their fitness regime found that they not only feel stronger, but also more graceful, peaceful and confident.



Leisure
A variety of leisure activities will help women to keep active and alert. It also builds confidence and at the same time women can widen the circle of friends, giving themselves more options of social and emotional support enhancing their quality of life.

Dancing is one of the more popular activities that have been taken up by mature individuals in recent years. Perhaps because it is fun, easy and conveniently available and thus it has more benefits compared to traveling and other leisure activities. Therefore, it is not surprising to see more organisers for such activities like your local community centre; and if you are concerned that you are out of the league, not to worry as there is always be a beginners’ class. So get your heels or boots and boogie woogie!
Emotional Support
Not all will embrace menopause with a sense of freedom. With so many changes going on in the body of women in the menopausal stage, it is not surprising that these women are emotionally affected as well. Some women are more concerned about aging once they reach menopause, and some may develop a lower self-esteem as they begin to dwell on what they may have failed to achieve instead of focusing on what they have accomplished so far. This in turn makes them more vulnerable to depression, anxiety and increased health problems. Seeking emotional support from family and friends or joining support groups can also help the well-being of women in their menopausal years.


Support Groups
Joining support groups may help women who are going through this transition in life. Having experienced the physical, emotional, and relational effects of menopause, the support group has a better understanding of the situation. Thus, they not only would be able to provide more information on menopause and ways of coping with the changes they are experiencing, but it also gives these women a chance to interact with one another, reinforcing emotional support. They will then gain a better perspective of themselves, their feelings and to make sense of what is going on in their lives.


Family and Friends
Some women find this transition frustrating; and this may cause a strain in relationships. This may be a result of changing family relationships with their partners, children, parents and even friends. Therefore it is important for these women to talk to their family and friends regarding the transition in life they are going through. This helps the people around her to understand more about the changes, and in turn, adjust their expectations in the relationship. Supportive family and friends will help women who are going through the transition to cope with the life transition better, and being around people who constantly interact with her to learn more about menopause will prepare them for the changes.



Other Healthy Choices
To manage menopause more effectively, you should:
- Avoid smoking;
- Think positively;
- Have a Pap Smear Test (every 2-3 years);
- Go for regular Mammogram (every 1-2 years); and
- Take the Bone Mass Density Tests if you think you are at risk for osteoporosis.



Other Measures
In order to reduce the symptoms of menopause, women going through this phase must first identify the symptoms. Although women often feel helpless or depressed when they are going through this transition, there are actually simple things that can help to mitigate the effects of menopause.

Hot Flushes / Night Sweats
Cause Response of pituitary gland to the falling estrogen levels
Remedies Keep cool with the fan or air-conditioning
Keep a diary of hot flushes to identify timing and triggers
Avoid stressful situations
Take anti-oxidants and botanical supplements
Joint Pain
Cause Hormonal level changes
Remedies Take calcium or magnesium supplements
Take foods rich in omega-3 such as fish
Try Massages
Fatigue
Cause Loss of bodily fluids and disrupted sleep
Remedies Consume foods rich in vitamin B complex, potassium,
magnesium, iron, iodine and chromium
Sleep Disruption
Cause Night Sweats
Remedies Consume foods rich in melatonin like bananas, oats, tomatoes
Regular Exercise
Comfortable sleeping environment with minimal noise and
cool colours

Keep to a fixed bedtime
Relax before bedtime
Mood Swings
Cause Fluctuating hormonal levels
Remedies Gain a deeper understanding of menopause and its changes
Communicate your frustrations with your loved ones
Share your challenges, express your emotions
Counseling
Vaginal Dryness
Cause Reduced secretion of cervical mucus
Remedies Stay sexually active
Perform Kegel exercises
Use a lubricant
Memory Problem
Cause Declining estrogen affecting memory function
Remedies Increase water intake
Eat nutritious meals
Use your memory more often to sharpen your recall
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