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How to cope with disruptive symptoms of the menopause transition

Tips for tackling dry skin, hair loss, insomnia... and more of the challenges women can face

Going through the menopausal transition – something that can last several years – can be tough, physically and mentally. For some women, the severity of symptoms will have a serious impact on daily life. The good news is that help is available, in the form of medication such as hormone replacement therapy (HRT) and simple but sound advice on how to cope with many of the disruptive symptoms.

You are what you eat

It’s probably no surprise that ‘you are what you eat’ really comes into play during this time of hormonal upheaval. “I really encourage a good diet, especially the Mediterranean diet, to have the rainbow on their plate – most vitamins we need will be available in our food,” says GP and menopause specialist Dr Helen Casey of the Grange Clinic in Donaghmede, Dublin.

“The two vitamin supplements I do encourage are vitamin D – in combination with calcium to help reduce risk of osteoporosis – and also magnesium, which can be helpful for sleep and, again, bone and muscle strength.”

For those seeking specific dietary support, Meno Active is an expertly formulated vitamin-and-mineral supplement containing the herb ashwagandha as one of its 31 active ingredients. “It contains ingredients to support every system in a woman’s body that is impacted by menopause, from bones to hormonal activity,” explains Dr Fiona Barry, PhD, a member MenoActive formulation team.


Skin and hair

Skin and hair can take a hit during perimenopause and menopause as hormone depletion has an impact on both. During this time, many women complain of hair thinning, according to Casey. “This can be really upsetting for women and often they try over-the-counter supplements but really it’s because their hormones are dipping and HRT can often improve hair quality again,” she says.

Skin-health specialist Sherna Malone, who runs the Aesthetic Clinic in Clonakilty, Co Cork, says understanding what happens around the time of menopause and how that affects your skin health is key to understanding what changes need to be made to your skincare routine.

Neuroscientist and author Sabina Brennan advises avoiding multitasking and undertaking a declutter of ‘everything – your house, your desk, your laptop and your brain’

“Disruption to all hormones, particularly oestrogen during menopause and perimenopause can affect skin in many ways – increased dryness, itchy skin, increased oil/sebum, breakouts, sensitivity, loss of firmness, and texture differences, to name but a few,” says Malone. Now is the time to do a skincare audit, she advises. “To help combat dryness try products with glycerine, ceramides and niacinamide to actively moisturise for deep comfort. For loss of firmness and uneven tone and texture, look to skincare ingredients like vitamin C, peptides and retinoids,” she says. If you are in doubt, a skincare professional will be able to offer guidance.

Brain fog

Brain fog is a huge problem for women during the years of perimenopause – Casey says some even think they are developing dementia. “It affects their job, as completing tasks takes longer, and they question their judgment as they feel less on the ball.” Again she extols the benefits of good exercise and plenty of sleep and also the introduction of HRT, both oestrogen and progesterone. “Testosterone can also be helpful,” she adds. “It’s not just a man’s hormone and can be very helpful with brain function during menopause.”

Neuroscientist and author of Beating Brain Fog Sabina Brennan advises avoiding multitasking and undertaking a declutter of “everything – your house, your desk, your laptop and your brain”. “Take breaks from demanding tasks every 60 minutes and keep a list of easy-to-do tasks so that you can feel productive on days when the fog is bad,” she says. “Also, schedule an hour a day to do something just for you that is fun and enjoyable.”

Dreaming of sleep?

Plenty of sleep, you say? Unfortunately, insomnia can be a major symptom of menopause for many women. “This can be so debilitating for women as often they have busy homes and work,” says Casey. A number of factors may be to blame for this; hot sweats can be drenching and wake women, while the anxiety that often plagues women during menopause can be another recipe for restless nights.

“Again I return to the root cause, which is hormone imbalance – when you replace with HRT, many symptoms improve,” says Casey. Some women also find the pressure relief offered by weighted blankets works to improve their sleep, while keeping the bedroom cool aided by a fan may also help.

Pelvic-floor health

Pelvic-floor health issues often come to the fore during the perimenopause and menopause, says consultant obstetrician and gynaecologist Dr Hugh O’Connor, who is based at the Coombe Hospital and St James’s Hospital. “It’s one of those issues that people don’t openly talk about it but once we ask them about it, they admit it’s a huge issue for them and they have been wearing dark clothing to get by because of leakage,” O’Connor says. “The impact on your everyday life, personal and professional, as well as a person’s intimate life, is huge.”

Yet it’s never too late to address this and now a groundbreaking treatment for the condition is available in Ireland. Every 28 minutes in the BTL Emsella chair is equivalent to 11,000 pelvic-floor exercises, as it stimulates the muscle fibres directly, helping women to regain control. This is a major advance in women’s healthcare, says O’Connor.

“Most women probably don’t do their pelvic floor exercises – or not persistently. Then when they hit their mid to late 40s their levels of oestrogen, which had kind of glued everything back together, begin to fall and everything begins to drop, leading to issues like urinary incontinence.”

Danielle Barron

Danielle Barron is a contributor to The Irish Times