Are you dreading the menopause starting or experiencing adverse menopausal symptoms, which are getting you hot under the collar? Then read on sister!

Due to a number of requests I’ve decided to write a blog about ‘the menopause’. This is a subject that really interests me as I am very soon to be on the wrong side of 45! My periods have started to come closer together and I suspect that this is the beginning of the end! So I am keen to make this transition as smoothly as possible.

What is the menopause?

The menopause is when your periods have stopped completely for 12 months – it actually means the end of menstrual periods.

The perimenopause is the period of time leading up to the natural menopause. When you are having periods your ovaries are producing oestrogen, progersterone and eggs. During the perimenopause stage your ovaries gradually produce less of these and eventually the ovaries stop working and your periods stop. You are classed as being postmenopausal if you have not had a period for over 12 months.

At what age do you get the menopause?

Most women will experience a natural menopause when their periods stop around the age of 51 years. Although, there are some women who will experience this many years earlier or later than this time. It is also possible for women to experience a drug or surgery induced menopause, but that is for another blog!

How do you know if you are becoming perimenopausal?

Due to the fluctuation and reduction of oestrogen some women experience unwanted symptoms during the perimenopause and menopause. Such as hot flushes/flashes, sweats, low mood, joint and muscle pain, vaginal dryness, irregular bleeding and low sex drive. This is not an exhaustive list!

It’s difficult to diagnose and UK doctors are now advised to follow recommendations published by the National Institute for Health and Care Excellnece in 2015 (NICE).

Firstly NICE recommend that each woman is treated as an individual in regards tothe diagnosis, investigation and management of the menopause. Which is nice to hear! Then they recommend the following for the diagnosis (WITHOUT laboratory tests) in otherwise healthy women over the age of 45 years with menopausal symptoms:

  • perimenopause based on vasomotor symptoms (such as hot flushes and sweats) and irregular periods
  • menopause in women who have not had a period for at least 12 months and are not using hormonal contraception
  • menopause based on symptoms in women without a uterus.

Will you definitely get adverse symptoms such as hot flushes or mood changes?

Not at all. Each woman will have a different experience. The menopause is a natural biological process and many women do not experience any problems and do not know that they have been perimenopausal until their periods have actually stopped.

Your lifestyle can greatly affect your transition through the menopause. Adverse symptoms are more likely to be experienced by women who smoke, use recreational drugs, drink excessive amounts of alcohol, do not do enough exercise, have a poor diet or have high levels of stress.

The menopause can be seen as a positive journey and for many women it is seen as a time of new beginnings. Women can stop using contraception and this means the removal of the fear of getting pregnant. And in some cultures post menopausal women are respected for their knowledge and their status in their communities change during this time.

Saying that, due to the reduction of oestrogen in your body you do have an increased risk of conditions such as osteoporosis and heart disease.

What can your doctor do for you?

Your doctor can give you information about contraception and when it is safe for you to stop using it. They can also give you the latest information about Hormone Replacement Therapy (HRT) and other prescription drugs that may help you.

Cognitive Behavior Therapy (CBT) can be useful during this time and your doctor can refer you to someone on the NHS.

In some areas there are designated Menopause Clinics run by experienced clinicians. You could ask your Doctor if there is one in your area that you can be referred to.

If you don’t want to go down the HRT route then do still go along and chat to your doctor to ensure that you are having all the tests that you should have. They are really used to women coming to them who do not want to take prescription medication. In a recent UK study 95% of woman said they would try alternative therapies before HRT, so you are not alone!

What can you do for yourself?

  • Have regular shiatsu treatments

There are different adverse menopausal symptoms that Shiatsu can help with. Usually the Kidney meridian will need some attention as Kidney Qi declines during this time. Because this happens the Spleen Qi also slows down because it is no longer needed to supply blood. This is turn causes issues with digestion and explains the tummy weight gain that often happens during the menopause (despite not changing your diet and exercise routine). The liver energy can be blocked and cause mood changes too.

When treating a client with shiatsu I would always take a details history of their medical health, lifestyle and symptoms and treat each person on a case-by-case basis.

I would treat any affected meridians and also focus on some particular acupressure points which have been known to help adverse menopausal symptoms. I would also give lifestyle advice where needed.

Shiatsu as I have mentioned many times before is good for stress and has a calming effect to the nervous system at this time. Often my clients will tell me that they have slept well and feel calmer after having a shiatsu treatment.

These will open up your meridians and help the Qi to flow freely. Remember that blocked meridians can cause imbalances in the body and lead to ill health!  When practicing these stretches it is important to go into them slowly, remember to breath as you do this and take a rest in between each stretch.

Alternatively you may wish to try Yoga, Shakti Dance or Tai Chi which will help keep you flexible too.

  • Do moderate exercise on a regular basis

This can increase your bone density and help protect your bones. It also helps you relax and sleep better too. Things like walking, dancing or swimming are great for this.

  •  Dietary and lifestyle advice

There are certain foods, drinks and substances that can trigger hot flushes. For instance smoking, recreational drugs, black tea, coffee (both caf and decaf), alcohol and spicy foods.

Some women find that restricting greasy and fried foods, preservatives and red meat can also help adverse menopausal symptoms.

As far as what to eat I don’t think it helps to be too prescriptive. Eat a plenty of fruit and vegetables. Warm cooked foods are best for supporting the body during the menopause. So eating grains and cooked vegetables can be beneficial.

There are some foods that when metabolized by your liver can be converted to oestrogen, which is said to help keep your levels raised during and after the menopause. These include plant based foods such as alfafa, parsley, licorice, aniseed, red clover, sage and soya beans.

Ensure that you eat enough calcium rich foods to help your bones such as carob, kelp, sesame seeds, figs, hazel nuts, leafy greens, broccoli, chickpeas and lentils. If you eat animal products you could try dairy products or fish which are also high in bone strengthening calcium.

To further protect your bones and your heart it is recommended that you eat vitamin D rich foods too. Again fish is high in Vitamin D and eggs are also a wonderful source. Getting out in the sun is important as vitamin D is produced in our skin. So they recommend that you expose your face and hands to sunlight on a daily basis, so maybe you can combine this with your exercise and have a daily walk outside. Sadly in the winter the sun is not strong enough to give us enough vitamin D, so it is important to bump your vitamin D intake up with your food. You may even want to consider taking some vitamin D supplements and it would be best to speak to a nutritionist about the most appropriate dosage you need.

  •  Herbal treatments

NICE also reviewed the evidence around herbal supplements. They found some evidence that black cohosh and isoflavones (for example Soy) can help relieve vasomotor symptoms such as night sweats, and hot flushes.

St Johns Wort can also help with vasomotor symptoms, but be careful if you have had, or at a high risk of breast cancer or are taking medication such as hormonal contraceptives , Tamoxifen, anticoagulants or anticonvulsants as there are know interactions with these drugs.

But be warned that the strength, efficacy and safety of herbal preparations vary and again I would recommend getting advice form an nutritionist and doctor where necessary before taking them.

  • Mindfulness based stress reduction

This has been shown to help with the stress and anxiety that is caused by menopausal symptoms. Even doing 5-10 minutes daily can make a difference.

So I think my take away message here is to see the transition through the menopause as a natural biological process and not as an illness. I for one am preparing for it now by nurturing myself and I look forward to the day I don’t have to think about contraception anymore.

Bring it on!