How to Get Through the Phases of Menopause With Ease

For many women, menopause is one of the most challenging times in their lives. You may feel like you’ve become irrelevant to society, simply because you’ve reached the end of your reproductive years. You may even mourn a loss of “femininity.”

These feelings often stem simply from the unknown. There are so many unanswered questions, like “How can I prepare myself so that I don’t have to suffer like other women I’ve seen?” or “What can I do to support my mental health when I don’t feel like myself?”

The good news is that menopause isn’t an end. It’s the beginning of a whole new phase of your life. A time of transformation and growth.

Keep reading to learn my top recommendations on how to adjust your lifestyle to get through the phases of menopause with ease.

What are the Phases of Menopause?

Menopause is a process that tends to last between 7 and 14 years, though the duration can depend on factors like smoking, race, ethnicity, and the age it begins.¹

Menopausal transition can be divided into three main stages: perimenopause, menopause, and postmenopause. Let’s briefly go through each of them.

Perimenopause

Perimenopause is the time when your estradiol and progesterone level changes rapidly. How quickly they decline depends on your race/ethnicity and your body mass index at the beginning of the transition. Research indicates that African American and White women experience the most pronounced differences.²

During perimenopause, you may experience symptoms like irregular periods, anxiety, difficulty sleeping, weight gain, hair changes, loss of sex drive, and difficulty concentrating.

Menopause

Menopause is identified after it happens. This means there are no distinct points at which perimenopause ends and menopause begins. Instead, you’ll know when you’ve reached menopause when you haven’t had a menstrual period for 12 consecutive months. It can begin in your 40s or 50s, but the average age in the United States is 51.³

Postmenopause

Once you’ve gone 12 months without a period, you’ve entered postmenopause. At this stage, your ovaries are making very little amounts of your female sex hormones, estrogen and progesterone. Some women may experience fewer or less intense menopausal symptoms, while others may experience no changes.⁴

My Top 6 Tips to Help You Get Through Menopause With Ease

Our society depicts women in the menopausal transition as moody, emotionally unstable, and old. It’s no wonder that so many women’s spiritual, physical, and mental needs aren’t being met during this critical period.

There’s no sugar-coating it. Menopause isn’t a breeze, for anyone. But there are things you can do to support your body and reduce your menopausal symptoms. Here are my top 6 tips.

1.   Maintain Muscle Mass

If you’ve avoided weight-bearing exercise until now, there’s no better time to get started.

Humans naturally lose muscle mass with age. But the incidence of sarcopenia, an age-related loss of muscle mass and strength, is increased among women as we age and transition through menopause. The onset of sarcopenia results not only from changes in your estradiol levels, but also from increased abdominal fat, decreased bone density, increased inflammation, and lower protein intake.^5,6

Research also links sarcopenia to more severe menopausal symptoms.⁷ For postmenopausal women, the situation is even more dire as their high levels of oxidative stress greatly increase their risk for metabolic syndrome.⁸

A brisk walk outside will certainly boost all the “feel good” hormones.⁹ But to minimize your risk of sarcopenic obesity and harmful metabolic conditions, I recommend weight-bearing exercises for all women. A study published in 2020 found that maintaining lean muscle mass during menopause transition may protect against the development of vasomotor symptoms, also known as hot flashes and night sweats.¹⁰

Another study compared the impact of a 1-year resistance training program on the body composition and muscle strength in postmenopausal women. The results indicated that resistance and weight-bearing exercises significantly increased lean soft tissue in the exercise group.¹¹

High-load, low-rep routines of compound exercises have also been shown to stimulate muscle development around vulnerable areas of a woman’s body, such as the hips, spine, and arms.¹²

And don’t forget about protein! A study of 387 healthy postmenopausal women found that higher protein intake (at least 0.8 grams of protein per kilogram) was linked to lower body mass (fat and lean mass) and fat-to-lean ratio.¹³

As always, remember to consult your healthcare provider before beginning any exercise program or changing your diet.

2.   Prioritize Hormone Balance Early

Your hormones help your cells communicate with one another. And just like how one member of a band playing out of tune can derail the entire performance, your hormones depend on one another to do their jobs seamlessly.

This means even minor imbalances can affect your entire body.

The dramatic fluctuations in your hormones during menopause take the blame for many menopausal symptoms, including brain fog and slower metabolism.

Hormone replacement therapy may help you regain hormone balance. If you and your doctor determine that hormone replacement therapy is right for you, I recommend starting it early rather than waiting until you’re already in postmenopause. That’s because the benefit-risk ratio of hormone replacement therapy is less favorable for women who are either over the age of 60 or initiate therapy more than 10 years after the onset of menopause.

Hormone replacement therapy can take some time to get right. By starting early, in perimenopause or even sooner, you’ll save time finding a practitioner, getting comfortable with him or her, and keeping a watchful eye on your hormone levels so any imbalance can be addressed quickly and efficiently.

For more information on hormone replacement therapy, read How Hormone Replacement Therapy Can Help You Through Menopause.

Some women take phytoestrogen supplements during menopause. Phytoestrogens, or plant estrogens, are natural substances that have a similar chemical structure to estradiol, a form of estrogen found in your body. This means that phytoestrogens are able to bind to the same receptors on your cells, leading to estrogenic effects.¹⁴  Phytoestrogens are found in many whole foods including fruits (plum, pear, apple, grape, berries), vegetables (beans, sprouts, cabbage, spinach, garlic, onion), and seeds.

The interest in phytoestrogens is in part due to the fact that fewer women in Asian countries experience vasomotor symptoms. Researchers believe phytoestrogens in Asian diets may be a contributing factor.

But so far the evidence has been inconclusive. An analysis of 15 clinical trials found that while phytoestrogens may not provide effective relief from all menopausal symptoms, they may help reduce hot flashes.¹⁵

It’s important to note that there is a lack of standardization in dosages used in these studies, and a majority of them used only one type of phytoestrogens called isoflavones. Further study of phytoestrogens will be needed to confirm whether they may be of benefit for menopausal women.

In addition to your sex hormones, it’s important to prioritize your adrenal hormones. Your adrenal glands excrete hormones like cortisol, epinephrine (adrenaline), and norepinephrine (noradrenaline) to help you cope with stress.

As you progress into menopause, an adrenal hormone called androstenedione becomes the primary hormone secreted by your ovaries. Along with dehydroepiandrosterone (DHEA), androstenedione gives rise to both male and female sex hormones.

Since the parent hormones of your sex hormones are produced by your adrenal glands, it’s important to keep them in optimal health during your menopausal transition.

Unfortunately, it’s becoming difficult to do so. Chronic stress places a high burden on your adrenal glands, which may lead to imbalances in adrenal hormone production.

The good news is that there are many changes you can make to your lifestyle to support your adrenal glands. Here are a few ideas:

• Monitor your cortisol levels so you know when there’s a problem
• Get adequate sleep to recharge your adrenal glands
• Identify stressors and implement stress management strategies, such as meditation and exercise
• Eat a healthier diet. A poor diet can negatively affect your adrenal health. Try to minimize caffeine, refined carbohydrates, alcohol, and fried foods.
• Exercise regularly. Physical movement isn’t just about losing weight; it can help improve your mood and stress levels as well.

3.   Take Time for Self-Care

You spent your whole life taking care of other people — now you need to care for yourself. And no, self-care isn’t selfish.

But change is hard, especially when you already have so many things on your plate. I get it. The key is to start small, with something you know you can do once a day on most days.

Here are some ideas:

• Stay hydrated: We all know water is essential for life. In our youth, our bodies are made up of 60% to 70% water. But this changes once a woman transitions into menopause. Just about 55% of a healthy postmenopausal woman’s body is composed of water, a substantial drop. Furthermore, aging lowers your thirst sensitivity and slows down the rate at which your body replenishes fluids, putting you at a greater risk of dehydration.¹⁶ A 2012 study reported that just 2% dehydration can negatively impact your focus and memory.¹⁷

So how much water should you drink per day? That’s hard to say. It depends on many factors, such as your activity level. An average person should aim to drink 1.5 to 2 liters of water a day. If you’re otherwise healthy but continue to have symptoms of dehydration, such as dark-colored urine, frequent headaches, or dry skin, try drinking more water.

• Get a massage: A massage is great at any age, but could it help with menopausal symptoms? A clinical study randomly assigned 90 women to an aromatherapy massage group, a placebo (plain oil) massage group, or a control (no massage) group. After 8 sessions, women in both massage groups rated their menopausal symptom severity much lower than those in the control group. Between the two massage groups, aromatherapy was found to be more effective.¹⁸
• Keep a journal: It’s easy to focus only on the physical symptoms of menopause. But ask any woman who has gone through menopause, and she’ll likely tell you emotions were a huge part of it. If you’re going through menopause, you may feel like you’ve lost a sense of who you are. To regain control of your emotions, try journaling. It may help you organize your thoughts, release tension, and put things into perspective during a time when you feel like you have little control.
• Talk to yourself with kindness: Whether you believe it right now or not, you are powerful. And it’s important to love yourself just as you are. But I know how negative thoughts and emotions may be intruding into your view of yourself. To challenge these, try practicing self-affirmations.

You can start with statements like “I am enough,” “I am beautiful,” or “I am loved.” These affirmations will teach your brain to redirect negative thoughts to positive ones. It really does work!

• Practice gratitude: Gratitude is something everyone should practice at any age because it brings so many benefits to our emotional and mental health. And when times get tough, like during menopause, it’s even more important to be grateful. Remember, life isn’t over when you hit menopause. It has only just begun! Don’t try to make it super complicated. Being grateful for things you may have taken for granted in the past, like having a cup of coffee every morning, can fill your mind with positivity.

4.   Don’t Short Yourself on Sleep

Our modern society has led many of us to believe we need to give up sleep to be successful. That we’re fine as long as we can maintain a basic level of function.

Nothing could be further from the truth.

Unfortunately, the percentage of sleep-deprived men and women has increased significantly in recent years. According to one national survey, 30.7% of women and 31.1% of men between the ages of 45 and 64 years reported sleeping less than 7 hours a night.¹⁹

Menopausal symptoms like hot flashes and night sweats also make it difficult to fall asleep. Forty to 60% of perimenopausal and postmenopausal women report problems sleeping.²⁰

Long-term sleep disturbances in menopausal women have been linked to cardiovascular and metabolic disorders, cognitive impairments, and a suppressed immune system. Some studies even suggest lack of sleep can increase your risk of developing malignant tumors.²¹

It shouldn’t come as a surprise, then, that getting enough sleep is absolutely imperative for menopausal women.

If you’re having trouble falling asleep, there are many things you can consider, such as aromatherapy. A small study of 57 women found that lavender-scented steam inhalation increased sleep quality and quality of life during menopause.²²

You can also consider hormone therapy. An analysis of 15 studies found that a combination therapy of estrogen and progesterone reduced sleep disturbances.²³ Check out How Hormone Replacement Therapy Can Help You Through Menopause to learn more.

Here are some other tips on how to improve your sleep quality:

• Follow a regular sleep schedule.
• Develop a bedtime routine, like reading a book.
• Avoid watching TV or using your phone right before bed. The blue light emitted from these screens can throw off your internal body clock (circadian rhythm), making it harder for you to fall asleep. Your body is already experiencing significant drops in melatonin during the menopause transition, so it’s important to not add to the burden.²⁴
• Avoid eating large meals before bed.
• Keep your bedroom at a comfortable temperature.

If these tips don’t help you, talk to your doctor about your sleep issues. Be sure that any therapy they recommend has been shown to help women during menopausal transition.

5.   Practice Daily Meditations

Yoga is not simply an exercise or a spiritual practice. Rather, it is a way of living that aims to improve your mind, body, and spirit to achieve balance and harmony in your day to day life.

A core element of yoga is meditation, or the practice of quieting the mind and focusing on the present. Research studies suggest meditation can have numerous health benefits, including improving your sleep quality.²⁵

Yoga can also be used to overcome low self-esteem and self-image. It serves as a distraction from daily life, which may help you (at least temporarily) forget about other obligations. A consistent practice of yoga may lead to lower depression and anxiety.²⁶

If you’re on the fence about yoga, it might help to know that its benefits are backed by science.

In February 2022, the journal Nursing & Health Sciences published the results of a clinical trial, which studied the effects of yoga on menopausal symptoms and sleep quality. A total of 208 participants were divided equally into either the yoga group or the control (no treatment) group. The women in the yoga group were asked to practice for 20 weeks. At the end of the study, researchers saw that yoga significantly improved sleep quality in both postmenopausal and perimenopausal women.²⁷

A 2016 clinical trial reported similar findings. In this trial involving 88 postmenopausal women, researchers found that yoga reduced menopausal symptoms, stress levels, and depression symptoms. The women who practiced yoga also rated their quality of life higher than those in other groups.²⁸

6.   Get Smart With Your Diet

With so many fad diets these days, it can be hard to determine which one is right for your body. Keto? Paleo? How about vegan?

First and foremost, I’m not a fan of fad diets. Instead, I recommend mindful eating to foster a deeper connection to your food intuition and eating habits.

For example, reducing or eliminating processed foods and added sugars can help stabilize your hormones and metabolism. Since both take a nosedive during menopause and postmenopause, I believe this step is particularly relevant to women. You may also notice that you have more energy and feel more positive without all the junk food weighing down your body and mind.

You can find more steps to mindful eating in How to Move From Diets and Fads to Mindful Eating.

Intermittent fasting has become a popular eating practice. Fans of intermittent fasting claim it can promote a variety of health benefits, such as improved gut health and weight loss.

While there are different approaches to intermittent fasting, they all involve eating for a short period of time during the day and fasting for others. During a fasting window, only fluids and other low- or no-calorie fluids are allowed.

So what’s the verdict on intermittent fasting for women during menopausal transition?

The truth is that research looking into how intermittent fasting affects women’s hormones is still early. The evidence we have so far suggests intermittent fasting can help with weight loss and lower blood pressure, insulin resistance, and fat mass.²⁹

From my clinical experience, I can say that intermittent fasting is safe for most women. But it’s important to start slow. Fasting for 16 hours a day when you’re starting out could be too stressful for your body. Skipping a meal or fasting one day a month might be a better option.

If you have questions about intermittent fasting, you may find my blog post Intermittent Fasting for Women: What You Should Consider Before You Fast helpful.

Master the Menopausal Transition With Ease

If you’re a woman going through the menopause transition, you might have been told your symptoms are “part of the process.” That may be true. All women go through menopause and most of us will experience some symptoms.

But your symptoms are communications from your body, and it’s important that you don’t ignore them or suppress them. Covering them up will only leave the issues smoldering and could lead to a more serious issue.

If you’re struggling through your menopause transition, or just want to be prepared for what’s to come, I’m here to help.