As a young girl entering puberty in the 80’s, I read Judy Blume’s books. Her most famous one, “Are You There God? It’s Me, Margaret,” helped me navigate the awkwardness of my first period and not feel so alone. It’s hard to believe that Judy Blume is over eighty. I turned 54 this year, and I haven’t found too many relatable novels to help me with menopause, but I hope this blog will be comforting to women my age. My ob-gyn, also in her 50s, asked me a few years ago how I felt. I laughed out loud. There weren’t enough adjectives in the English language to cover my range of feelings and body changes: dry, irritable, cranky, anxious, cankles, melting, sleep-deprived, exhausted, brain fog, sweaty, bloated, gassy, puffy, swollen. I’ll stop now. Her droll reply was that aging is not for the faint of heart. I am a scientist, so I looked at my symptoms as a puzzle to be solved, if possible. I have been evaluating several life changes, medications, and supplements to find my menopause Minerva, and I have some successes to share. Because every woman is so incredibly unique, I suspect that each person who enters menopause will have to conduct their own trial-and-error experiments to find optimum relief for their symptoms.

Let’s start with one of the big menopause disruptors, Vasomotor Symptoms or VMS. Symptoms can include hot flashes, night sweats, heart palpitations, and even changes in blood pressure. Researcher Keiko Uohashi recently published in the Journal of Mid-Life Health that the cause of VMS is resonance phenomena in the vascular bed in the uterus or intestines. This is technical, so stay with me. The sex hormone estrogen thickens the endometrium (the tissues that line the womb), and progesterone aids the growth of capillaries in the uterus and intestines. As estrogen levels decline in menopause, the uterus loses elasticity, which slows the blood flow in the uterine capillary veins. Most people feel hot flashes, sweating, and pain in tendons and muscle ends. Patients feel hot flashes when the outflow of blood takes a longer time than the inflow. A simple way of saying this is when your blood flow entering and leaving your organs is out of balance; you may experience a hot flash.
For me, my estrogen levels dropping meant I could no longer sleep through the night because I would experience a hot flash around 4 a.m. and wake up. Helpful if you work as a morning show anchor or at Dunkin Donuts, but for most women, not so much. My ob-gyn prescribed Estradiol Vaginal Cream, 0.01%, that I use twice a week. She also wrote me a prescription for an antidepressant, Citalopram. Antidepressants balance norepinephrine and serotonin, which also help stabilize the body’s temperature. Anxiety and depression can be other symptoms caused by dropping estrogen, so an antidepressant is helpful for this side effect, too. Unfortunately, these medications don’t give you relief immediately, so plan for a few weeks to months to see improvement in your symptoms. I used a low dose of Ambien to help with sleep at first, and thankfully, I was eventually able to stop taking it. I also added the over-the-counter supplement Amberen, which has a blend of bioactive antioxidants (succinates), amino acids, and minerals. The succinate salts in Amberen may stimulate the hypothalamus, allowing the body to regulate estrogen better. I also tried Estroven and Provitalize, but Amberen gave me the most relief from hot flashes.

In addition to hot flashes and mood instability, another menopause symptom most women struggle with is weight gain, especially around the waist. Sleep disruption is one factor because if you wake in the middle of the night, your insulin will remain higher with your overnight fast disrupted. Taking a magnesium supplement at bedtime helps me stay asleep most nights. Declining estrogen can also cause low Vitamin D levels. I had mine checked during my annual physical. You can add a Vitamin D supplement if you need it. I have also continued to build muscle through regular exercise, including walking, yoga, and biking. More muscle fiber means a higher metabolism when resting, so staying active is critical. Strenuous exercise may work against weight loss for menopausal women because it can raise the levels of the stress hormone cortisol, which helps your body respond to stress or danger by increasing glucose levels in the blood. In addition, if you have a stressful life, as many of us do, cortisol levels may remain high throughout the day, promoting fat storage. Taking time for daily relaxation and meditation will help reduce your cortisol levels and keep your body in a more favorable fat-burning state. I have also increased my lean protein intake to help stoke my body’s metabolic fire throughout the day. My Metabolic Meals offers a no-commitment meal subscription program that you can use to supplement your regular diet. I am also using the Metabolic Renewal program that offers delicious high-protein shake mixes, exercise videos, and higher protein recipes customized to your stage of life and hormone type.

My last piece of advice for menopause is to laugh more. Many of us are entering a life stage where children are leaving home for college, and parents are passing away. It’s a time of incredible emotional upheaval. Judy Blume has a quote, “Life goes on if you’re one of the lucky ones…” I couldn’t agree more. I feel blessed to be here as a woman in her fifties, living a wonderful life and sometimes writing about it. Life is good.