At around age 49, Nuria Flores became very familiar with 3:00AM. During the transition to menopause, night sweats would wake her up, and falling back to sleep proved difficult. Her workday began to suffer. “I had trouble concentrating. I would read the same page over and over, and the littlest things would make me fly off the handle. I was worried because being able to focus at work and keeping my cool was important,” says the New York City corporate lawyer.
Sleep disruptions, mood changes, and depression are common symptoms women begin experiencing during perimenopause, or the time when your body transitions to menopause. For Flores, relief came from a personalized treatment regimen prescribed by Samantha M. Dunham, MD, co-director at the Center for Midlife Health and Menopause, part of the obstetrics and gynecology services at NYU Langone.
First came hormone therapy, which helped relieve the night sweats that were waking up Flores and causing fatigue during the day. Next came guidance on sticking to a fitness regimen to reduce stress and help maintain a healthy weight. Having excess weight can contribute to heart disease and diabetes.
“When we meet with our patients, we get a holistic view of their overall health, including their diet and exercise patterns, and address the most bothersome menopause symptoms first,” says Laurie S. Jeffers, DNP, co-director of the Center for Midlife Health and Menopause. “After you’re prescribed hormone therapy and feeling better, we discuss any lifestyle changes you might benefit from, such as cutting back on caffeine or alcohol. It’s very individual.”
Within a short time after starting hormone therapy, Flores’s hot flashes stopped, she began sleeping through the night, and her ability to concentrate on the job was restored. “It was amazing,” she says. “My expectations for hormone therapy were very low, but then when I tried it, I thought, wow, this is actually working.”
That helped Flores put a renewed focus on her physical health. She cycles indoors for an hour three times a week. “On the weekends when it’s nice out, I’ll go on five-hour bike rides. I’ll go across the George Washington Bridge and all the way up to Nyack,” she says. “Exercise has helped me not gain weight.”
To make an appointment with a certified menopause practitioner, please visit the Center for Midlife Health and Menopause.
Overall, menopause is a good time to evaluate your lifestyle and make changes to improve your health long term. “In and of themselves, each of these lifestyle changes won’t make or break menopause. But when you layer them together, they can have a powerful impact on your health and longevity,” Jeffers says.
Here are some healthy habits and fitness tips that can help you feel your best during and after menopause.
Watch Your Weight
During menopause, weight gain can be common. But it’s where those pounds tend to accumulate in menopause that makes it a greater health threat.
“People who are pear-shaped can become apple-shaped,” Dr. Dunham says. Fat is more likely to be stored in the midsection during menopause, and abdominal fat is more likely to increase your risk of heart disease than fat carried in the hips or thighs, even if you’re at a healthy body weight.
Weight gain can be a normal part of getting older, so don’t beat yourself up if the scale starts inching up despite your best efforts. But do think about ways you can counter those extra pounds, such as tweaking your diet and participating in physical activity that’s targeted to help your body stay healthy as you age.
Focus on Weight Training
Muscle mass, which helps keep your metabolism revved, decreases by roughly 3 to 8 percent each decade after age 30. Lower metabolism affects how your body uses energy, which is another reason you may find yourself gaining weight more easily during menopause, even though you’re eating the same amount.
Women also experience accelerated bone loss at menopause with the end of bone-protecting estrogen. This begins 1 to 3 years before menopause and lasts for 5 to 10 years, increasing the risk of bone-weakening osteoporosis. “Bone mass can take a hit in the years before and after menopause due to falling estrogen levels,” Dr. Dunham says. “It’s important to do what you can to maintain the bone mass you have.”
How can you counter the loss of bone and muscle? Wander over to the weight room at the gym. Menopausal women benefit from two weekly sessions of strength training, which helps increase your metabolic rate and maintain strong bones.
Even exercises that use your own body weight as resistance rather than weights or weight equipment, such as jogging, jumping, and brisk walking can benefit bone health and increase muscle mass and strength.
Adopt a Mediterranean-Style Diet
The risk of heart disease increases after menopause. Estrogen protects the heart and keeps it nimble and strong, so when estrogen declines, you have to work harder to help your heart stay healthy. Jeffers and Dr. Dunham both advocate adopting a Mediterranean-style diet, which features lots of fruits and vegetables, fish, grains, olive oil, seeds, and nuts while limiting saturated fat and red meat. “It’s an excellent go-to diet for overall health,” Dr. Dunham says, and can also reduce your risk of osteoporosis and diabetes.
Every patient at the Center for Midlife Health and Menopause receives a nutrition evaluation, which includes a 24-hour diet inventory and discussion about what they typically have for breakfast, lunch, and dinner. “Many of my patients can benefit from tweaking their diet by not skipping breakfast and adding more protein to meals, which helps stabilize blood sugar to help maintain satiety,” Jeffers says. And here is her favorite breakfast for herself and her patients: plain, nonfat Greek yogurt, which packs a powerful protein punch and 300 to 400 milligrams of calcium for bone health. “Top it with blueberries for added fiber and disease-fighting antioxidants, and walnuts to boost heart-healthy omega-3 fatty acids,” Jeffers says.
Dr. Dunham often encourages her patients to cook at home more instead of eating out or ordering in because it provides more control over ingredients and portion sizes for nutrition and weight management. Dr. Dunham recommends tracking what you’re eating on a diet app or keeping a food diary to see where there might be room for improvement.
Be a Quitter
Smoking can make menopause symptoms worse and further compound the risk of bone-weakening osteoporosis. Taking part in a tobacco cessation program, which incorporates medications, coping strategies, and individual and group counseling, can help you quit smoking.
“Alcohol can trigger hot flashes in some women,” Dr. Dunham says. The research isn’t clear on exactly why this happens, but alcohol can also have other negative effects during menopause, such as interfering with sleep and worsening mental health challenges. “The menopause transition can make some women more susceptible to anxiety and depression, which alcohol can exacerbate,” Jeffers says.
Moreover, drinking any amount of alcohol can increase the risk of breast cancer, which increases with age. The empty calories in alcohol can also make it more challenging to maintain a healthy weight during menopause.
The recommendation is to have only one drink a day, and not every day. One drink is equal to 1.5 ounces of liquor, 12 ounces of beer, or 5 ounces of wine. Awareness is key. “I talk with my patients about how much one drink is because they may be drinking more than they think. If you’re drinking wine in a big goblet, for example, you’re likely consuming more than 5 ounces of alcohol,” Jeffers says.