Menopause. It basically just sucks. Except for finally being able to stop family planning or wondering if that missed period is a “happy accident” or just from stress, there is not too much that is pleasant about having to go through a physical, emotional, and hormonal (abrupt) change on nature’s clock. One thing I often hear is “I just figured this was normal and I have to deal with it, is that not true?” There’s a few things that can help before you see your doc, and a few things you should definitely see your doctor for.
Hot flashes/ Night sweats: One of my favorite scenes in any episode of Sex and the City is when Samantha Jones, who is going through menopause after having breast cancer, rips her wig off at a fancy luncheon and goes, “To hell with it.” Menopause is hot. It can be 40 degrees outside, and the body just doesn’t get the memo, and you’re sweating and your face is red. Basically not a pleasant feeling. The first thing we recommend (and I promise, it can work), is changing diet and increasing exercise. Avoiding caffeine, alcohol, spicy foods (yes. All the good stuff) and drinking more water can reduce hot flashes and night sweats. Also, exercising helps to reset the thermoregulatory system, especially cardio. If these aren’t cutting it, trying a low dose antidepressant can also send signals to the brain to control the body’s temperature better.
Weight gain: After menopause, because of the drop in hormones, the body changes. Try as you may, a little extra stuffing appears in the dreaded midsection. Although I think the first step is embracing the shape, and learning to love whatever body you live in, I also recognize this is super hard to watch happen. Good old fashioned diet and exercise can help curb some of these changes. Avoiding carbs (bread, sugar, fruit, rice) and increasing cardio can control the amount of weight gain. There are other options, such as liposuction or newer machines that can freeze the fat away to help kick start the process.
Painful sex: So you don’t have to worry about getting pregnant, but it’s so uncomfortable what’s the point?? After estrogen levels take a little nose dive, the vaginal walls become less lubricated, making sex more painful. One of my favorite pieces of advice for post-menopausal women is olive oil. Incorporate this into foreplay with your significant other and it can help reduce friction and stimulate natural lubrication. Disclaimer: Olive oil
should NOT be used with condoms as it reduces their efficacy. If you are using condoms to protect yourself against STDs (because yes, STDs do not discriminate and anybody of any age can get them!! Use condoms if you are not monogamous or you are with a new partner!), you should use only water based lubricants, not oil based. Vaginal rejuvenation is also a feasible option, and although it is not covered by insurance, it can help increase blood flow to the vaginal tissue, making sex less painful.
Hormone replacement therapy something a lot of women have questions about. It can be a great therapy for those that do not find relief from any of these other options, however it is associated with its own risks and this should be a discussion with your physician about a risk/ benefit analysis. There are different modes of treatment (pills, gels, patches, rings) and it is possible to find one that works best for you.
A final note. There are a LOOOOOT of internet/ drugstore/ over the counter magic pills that prey on women looking for some relief. The majority of these seemingly harmless “vitamins” have NOT been tested by the FDA, and there is no regulation to determine safe doses or risks associated with them. I counsel my women that these meds are in the “take at your own risk” category.
Some things you always want to discuss with a physician. Any bleeding post menopause, increases in bloating, GI symptoms, constipation/ diarrhea, bleeding after sex, pelvic pain or cramping. Menopause isn’t fun, it is a shock to the system, and it is definitely a change. But with some of these tips and tricks, hopefully the transition can be a bit less abrupt and we can slide into the golden years feeling good.