(© Bonnie Schiedel. Originally published in Canadian Health, November/December 2007). 

“Many women think menopause is a doorway: you go through it and it’s over,” notes Dr. Marla Shapiro, a Toronto family physician and North American Menopause Society menopause practitioner. “But menopause is the period of a woman’s life that begins with the total cessation of menstruation.” It is not a single moment in time and can represent 30 years and more.

Perimenopause versus menopause
That transitional phase leading up to menopause is known as perimenopause. On average, it begins in Canadian women around age 45, although the range is between age 39 and 51, and it tends to last around 5 years. The aging ovaries are producing fluctuating, and ultimately declining, amounts of the female hormones estrogen and progesterone. As the hormone levels rise and fall, your periods may change—heavier or lighter, closer together or further apart.

Early hot flashes, night sweats, mood swings and sleep disturbances may also be part of the countdown to the “change of life,” as our grandmothers discreetly called it. A woman is considered to be in full menopause when she has had no menstrual periods for 12 months.
If you’re struggling with perimenopausal symptoms, your doctor may prescribe medication such as birth control pills, antidepressants or hormone replacement therapy. But there are also lots of lifestyle choices you can make to ease your passage through perimenopause and into menopause, as well as reduce the risk of conditions such as osteoporosis and heart disease, which you become more vulnerable to as you age. Try the following doctor-recommended tips. 

1. Eat well Now’s the time to take charge of your diet. Choose whole-grain foods, deep-coloured fruits and vegetables, and lower-fat dairy products. Go easy on red meat and foods that are high in fat or salt. Limit caffeine, alcohol and spicy foods, which may contribute to hot flashes and sleep disruption. Maintain a healthy weight too: several studies, such as one from the University of Michigan, found that obese women were two times as likely as women of normal weight to have earlier, more frequent and severe hot flashes. 

2. Consider supplements One in four Canadian women over the age of 50 has osteoporosis, which means decreased bone mass and deteriorating bone tissue. Calcium and Vitamin D help prevent this bone loss during perimenopause and menopause. Ask your doctor about taking a daily high-quality calcium and Vitamin D supplement, as well as a multivitamin. 

3. Deal with stress Chronic stress and anxiety can make hot flashes worse. Take time every day to work on a favourite hobby, laugh or talk with loved ones, breathe deeply and relax with music, yoga or meditation. “Anything that buys you me-time helps to deal with stress,” says Dr. Shapiro.

4. Get moving Thirty to 60 minutes of daily exercise helps to combat stress, prevent weight gain and ward off heart disease, diabetes, cancer and osteoporosis. Mix cardio and resistance-training activities for heart and bone health, strength, flexibility and endurance. “Exercise has to be a priority because it affects countless aspects of our health,” notes Dr. Shapiro.

5. Set up for sleep Cool down your bedroom, wear light nightclothes and use layers of bedding that can be removed as needed. A decompressing routine, like reading in bed, can help you get to (or back to) sleep, too.

6. Quit smoking and avoid secondhand smoke Smoking makes hot flashes worse and also limits your medication choices. “Smokers tend to go through menopause earlier,” adds Dr. Shaprio.

After attending a workshop held by the Calgary Health Region, Brenda Henley, 47, made many of these healthy choices part of her routine. “Knowing what to expect from perimenopause and how to handle it made such a difference to me,” she says. “Making these changes has helped me the best I can be at this stage in my life.”