I have been sporty all my life and for some reason I imagined I would sail through the menopause with only the occasional heavy period and hot sweat. Why I thought this I have no idea but it meant that I wasn’t prepared for the full impact of the Menopause Miseries.
Before the menopause years crept up on me, I had no idea that there was such a wide range of symptoms. Everyone is affected in different ways but the list of issues associated with the menopause is flabbergasting. Off the top of my head these are a few: Migraines, itchy skin, sore joints, cramping muscles, exhaustion, hair loss, incontinence, urinary infections, low libido, sleeplessness, depression and anxiety. And not forgetting heavy and irregular periods and hot sweats.
Perhaps I am also so in tune with my body – for many years I have been very aware of good days and bad days of fitness – that I feel the effects of the menopause symptoms more acutely. I am not sure, but I do know that I have suffered a full spectrum.
However, there are some positives here in this blog post. I have worked out a few ways to cope through the menopause years. This time of hormonal change and imbalances is different for all women but there are some general tips to help.
Coping with the hot sweats
Hormones adversely affect the body’s natural air-conditioning system. Normally, your blood vessels expand as you warm up, sending blood closer to the skin for cooling but reduced oestrogen levels blunt this response and this means that we trap more heat in our bodies. The brain’s thermostat, the hypothalamus also appears to be hit.
All this causes hot sweats – also called hot flushes/flashes – which are believed to affect three-quarters of menopausal women.
I find the hot sweats are worst at night, which is annoying because it affects my sleep. I also suffer hot sweats when exercising and, I am coming to believe, when stressed. (A friend made the point that our emotions can have physical results and increasingly I see a pattern between stress and hot sweats.)
I have tried all kinds of remedies for coping with hot sweats but really the only thing that works is to take off layers when I get over-hot – and replace them when I cool down.
I wear lots of thin layers and although it is annoying to have to keep stopping when, for example, I am hiking in the mountains, running or cycling, it does make me feel better. Wearing a baselayer of merino wool will help with the horrible damp and cold sweaty feeling or take a spare baselayer with you to change into mid-walk or run.
I also find that I am generally a bit warmer in the core of my body than I used to be and still chilly at the extremities, such as hands and feet. So I start off my exercise session or walking day with fewer layers than I used to. But I always wear gloves and good quality socks, as well as a hat or buff.
At night, I have learned to relax as much as I can. If the hot sweats wake me up I try not to get too flustered. I get up, have a pee, swap a top to a dry one and get back into bed and then hope that this has not woken me up too much. It doesn’t always run smoothly but I am learning to cope.
I have also found that HRT helps to reduce the number of hot sweats. It’s not a cure for the sweats but it does take the edge off the severity of them.
Friends who can’t take HRT have been prescribed various anti-depressants; the side effects of which are claimed to help to reduce hot sweats.
Also read Hot and bothered by the menopause.
Sleepless nights
According to the National Sleep Foundation, almost two-thirds of menopausal women report some symptoms of insomnia. Lower levels of oestrogen and progesterone decrease the production of the hormone melatonin, which helps you drift off to sleep, partly by lowering your core temperature.
This means that the changes to your temperature-regulating system make you less likely to go to sleep easily and then a cycle of hot sweats at night cause you to wake up.
It’s important that you are tired when you go to bed. Physical activity is ideal for making you physically tired and I’m pretty sure that this has helped my sleep through the menopause.
I avoid caffeine (this is thought to be a trigger for hot sweats actually) after mid-day and I try to have at least an hour of chilling out before I switch off the bedroom light.
As I have written above, if I am woken by a hot sweat I try to stay calm because this usually helps me to get off to sleep.
I tend to suffer with short periods of poor sleep, perhaps a few days at a time, so I try to remind myself that it will improve soon. This is easier said than done when you are really tired from lack of sleep but a good mental attitude is helpful.
Reduced muscle mass
Declines in oestrogen and testosterone can decrease your ability to build and maintain muscle. The percentage of fast-twitch fibres, which help you run faster, also decline. However, your muscle strength and power through the menopause does depend on what you had to start with.
The chances are you will not be beating Personal Best times for running when you were in your teens or 20s (although some extraordinary people do!) but there is good news as well. You can still maintain good muscle mass by doing strength-building classes such as weights and circuits.
As well as maintaining muscles, strength building will reduce your risk of osteoporosis (another menopause issue) because the pull of strong muscles on your skeleton increases bone density.
Other great strength-building exercises include doing hill reps, sprint sessions at the track and faster intervals while running longer distances.
I have been following some of this advice and have attended a weights-based circuits class for about a year and I have just joined my Glasgow Triathlon Club track night sessions.
I have not measured my strength before and after but I feel stronger. I also feel that my muscles have maintained a stronger look.
I am saddened by the layer of cellulite that has grown around my leg muscles and the loosening skin generally but I am trying to focus on what is underneath rather than the layer on top.
Muscle cramps
At their worst, I had cramps in my feet, calves, thighs, hands and shoulders that were so bad they would stop me still in my tracks in pain and sometimes tear muscles.
They could come on at night when I involuntarily stretched my feet, during exercise, while stretching after exercise and even when squeezing a toothpaste tube.
I was flummoxed. I had never suffered cramps so badly. I even had a cramp in my abdominal muscles when gently stretching at a yoga class.
The cramps became so bad that I couldn’t, or didn’t want to, exercise. This made me feel low.
So I started doing a bit of research on-line and came across menopause forums and chats that suggested many menopausal women had cramps in their feet at night and first thing in the morning. I started to wonder if mine was simply a bad case of this.
I asked the doctor, who wasn’t sure, but we agreed that I should try HRT. Within a couple of months the cramps had almost disappeared. I do still find that at different times of my hormonal cycle – my irregular and unpredictable cycle – that I feel the twinges of cramps again but I have found the HRT to be really good for reducing the number of cramps and the severity of cramps.
A great side effect is that while I was also suffering horrible migraines, the HRT has reduced these as well. If I get too tired I can be susceptible to the symptoms of a migraine but mostly they have disappeared.
Bladder issues
Okay, I am going to say this out loud: “I suffer with bladder leaks.” It I sneeze, laugh too strongly and even when walking and especially while running I suffer a bit of incontinence. It’s common for women who have given birth and it can worsen through the menopause years.
Just like the skin on the outside loosens, so the internal membranes stretch and become less taut. Added to this is a reduction in muscle power, which overall means a reduced amount of control over the bladder.
There are ways to help with this including pelvic floor exercises (who ever does enough of these?) , devices that claim to help to improve the pelvic floor muscles (anyone found any that work?) and Pilates.
I have started doing Pilates and I am hopeful this will help to strengthen the internal muscles but in the meantime I used light pads (I buy the cheapest sanitary pads; the really thin ones) to catch any drips.
I also wear both pants and a running skort, which I find covers any potential embarrassment from a small leak during a run or a circuits class. Oh, and I always make sure I empty my bladder before exercise and I usually have to go again mid-exercise. It adds extra time to everything but it’s worth it – and often necessary.
Dicky tummy
For about a year, I suffered with an upset stomach when I ran any further than six miles.If I ran for 90 minutes or more, or I ran hard for a short while, I would have terrible nausea. At its worst, the nausea could last for two days.
As you might expect, this put me off running too far. But, sometimes, I like to run far. It doesn’t have to be fast but the idea of being able to run for a couple of hours at a time really appealed to me.
However, the stomach issues (usually requiring a number of toilet stops mid run) and the nausea afterwards put me off.
I tired the FODMAP diet. This aims to work out what food groups make your stomach upset, bloated or generally irritated. As it turns out, the chances are I have IBS and that was being irritated by foods such as onion, garlic, beans and pulses. Mass produced bread doesn’t go down well either.
Soon after I started the HRT, too.
I don’t know whether it was the food avoidance, the HRT or a combination of both but I rarely suffer major stomach issues anymore. I am pretty sure it had a lot to do with hormonal changes.
Low mood
Many women experience bouts of sadness during menopause. Again, this is due to the hormonal changes. I am very aware of depressive feelings and I suffered several years of depression around a decade ago.
As soon as I feel the signs I try to get outdoors for some exercise, or I make sure I meet with other people and friends. I find it’s important to do something sooner rather than later.
Anxiety is another problem for many menopausal women.
Running, walking, cycling – it doesn’t matter what it is and how fit you are – are all great for lifting the mood. They increase the production of serotonin, a contributor to feelings of well-being, and simply being outdoors, especially surrounded by nature, has been shown to vastly improve mood.
If your runner’s high doesn’t lift the blue, it’s important to talk to your doctor. There are various medical solutions including anti-depressants and cognitive behavioural therapy.
Just don’t give up
Sometimes it can seem like the easiest thing is to give up on much of what you loved before. Running, swimming, exercise at the gym, healthy eating, friendships, sex etc. But you need to remember there will be good days and bad days – and eventually there will be more good days than bad days.
If you are really struggling speak to a friend or go to your doctor. Seek help. There is help. Many issues connected with the menopause can be eased if you know what to ask for.
Please do tell me your tips for staying fitter and stronger through the menopause.
Also read other blog posts on this topic at Fit Over 50.