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Managing the menopause without HRT

Whilst HRT can be life changing for some women, it is not an option for everyone.

If you have had a breast cancer diagnosis, you may find that as a result of your treatment you are now going through the menopause. You might vaguely recall a doctor mentioning menopause as a consequence of your treatment but your focus at the time was not unsurprisingly on survival.   

You just want to get on with your life, but as some women have found, having a multitude of different menopausal symptoms can prevent you from thriving. To add to this, if you have been diagnosed with a hormone positive cancer it is unlikely that you will be offered HRT to relieve any of your symptoms.

BUT the good news is that even if HRT is not available to you or you choose not to take it, you do not need to suffer in silence.

Every menopausal woman has decreasing oestrogen levels, but not every woman will have symptoms affecting their quality of life. One of the main reasons for this is diet and lifestyle.

In fact, making a few simple diet and lifestyle changes can often make a significant difference and can help you to tackle your most troublesome symptoms.

Common menopausal symptoms are:

Hot flushes, mood changes, brain fog, anxiety, sleep problems, aches and pains, night sweats,  vaginal dryness,  urinary tract symptoms (leaking, UTI’s), low libido, skin problems and hair loss.

Here are some diet and lifestyle considerations to support you through the menopause

  • Watch your weight – Hormone fluctuations, aging, and exercising less can all contribute to weight gain. If you need to lose a few pounds, there is no time like the present to think about how you can do this. Losing weight can be harder at this life stage, often the weight loss tips and tricks we used in our 20’s and 30’s just do not work anymore, but you can still lose weight.
  • Overnight fasting (eating your dinner early and your breakfast late – for example, dinner at 6 and breakfast/brunch/lunch at 11).
  • Are you eating too many carbohydrates? Is breakfast a bowel of porridge and lunch a sandwich and dinner a bowel of pasta? If you are not burning off the excess energy, it will be stored as fat. Make some healthy swops, salad for lunch instead of a sandwich, poached egg and spinach instead of the oats, fish and veg for dinner instead of pasta.
  • Watch the amount of alcohol you are drinking, it can pack on the pounds.
  • Exercising regularly will help with weight loss, particularly HIIT (high intensity interval training) type exercises.
  • Eat a Mediterranean diet – Plenty of vegetables, nuts, seeds and oily fish. The Mediterranean diet is one of the most researched diets in terms of optimising health and has shown to support weight loss, protect the heart, reduce the risk of strokes and cancer, support your blood sugar and much more.
  • Reduce/remove alcohol – Alcohol is linked to an increased risk of a number of different cancers. In addition, it can also play havoc with your hormones, sleep, blood sugar and more – all the areas we want to be supporting to reduce your menopausal symptoms.
  • Stop smoking – Bone health is an important factor in menopause and smoking increases your risks of osteoporosis. Smoking also significantly increases your risks of heart disease and many other diseases. I don’t think I need to say much more about smoking as most people are aware of the negative health consequences.
  • Manage stress – This is a bigger subject than I can cover in this post, but here are the basics. Research shows clear links between an increased severity of menopause symptoms and high levels of stress. The reason for this is the adrenal glands (which make your stress hormones) also make small amounts of oestrogen after the menopause. Our bodies are remarkably smart which is why the adrenal glands always favour the production of stress hormones over oestrogen (survival over fertility). If the stress is persistent and excessive then the adrenal glands may be unable to make enough oestrogen. So what little oestrogen your body might have been able to make is now compromised further. So in a nutshell, stress can have a direct impact on hormone levels, further exacerbating menopausal symptoms.
  • Avoid stimulants – Caffeine increases cortisol and adrenaline, which can impact on oestrogen levels. There are a number of studies which have shown a connection between caffeine and hot flushes and night sweats.
  • Move your body – Women who are sedentary are more likely have severe menopausal symptoms. Exercise can improve your mood, support your bone health (low oestrogen can increase the risk of osteoporosis), and reduce aches and pains. In fact, having aches and pains (injuries aside) shouldn’t stop you from exercising. Exercise protects your heart health, which is very important at this life stage as cardiovascular disease is the number one killer of post-menopausal women. Remember the best form of exercise is the one that you do.
  • Fix your gut – Flatulence, bloating, constipation, diarrhoea and gut pain might be common, but they are not normal. If your gut is not functioning properly then you may not be able to absorb all of the nutrients from your food. This can have far reaching implications, ranging from compromised immune health to impacting your mood and heart health. To optimise health, your gut needs to be functioning well. The good bacteria in your gut thrive on a diet which includes a wide variety of plant foods. Aim to include at least 30 different types of plant foods in the diet each week. Try some fermented foods such as kimchi, sauerkraut or kefir. Look out for foods that aggravate your gut and eliminate them for a few weeks to see if this helps your digestive symptoms.
  • Sleep – Ensure that where you are sleeping is dark enough and cool enough. You need to be cool to sleep well, so change your duvet to a lighter tog if necessary and open the bedroom windows. Don’t drink too much liquid for a couple of hours before bed to ensure you are not woken by your bladder. Other things that can help are meditating or reading before bed. Restrict devices for at least an hour before you want to go to sleep. Magnesium supplementation can be helpful, but you should discuss any supplementation with your health care provider and if you are still struggling, you can make an appointment with your GP to discuss if Melatonin supplementation would be helpful for you.

There are many ways that the menopause can be managed without the use of HRT. My advice is to start with the basics which I have mentioned above, and if you still find that you are struggling,  make an appointment to discuss how I can help you to thrive.