menopause

5 Strategies to Reducing Hot Flashes

Lifestyle /

Menopause, a natural transition in a woman’s life, is the point in time 12 months after a woman’s last menstrual period.1 The years leading up to this time, often referred to as the menopause transition or perimenopause, can be accompanied by symptoms including changes in monthly cycles, hot flashes, night sweats, and weight changes.1 During this time, the body’s production of two hormones made by the ovaries, estrogen and progesterone, drops. The hormonal shifts that occur during the menopause transition can have large effects on the body. Many of these symptoms, such as hot flashes, can significantly impact quality of life.2   What are hot flashes? Hot flashes are defined as sudden feelings of intense heat and are often accompanied by sweating and flushed skin.3 They occur due to hormonal fluctuations, primarily the decline in estrogen levels, that occur during the menopause transition. While this may be a “normal” part of menopause, managing hot flashes can help improve and enhance your quality of life. Incorporating certain lifestyle and dietary practices can help support your body and potentially reduce the frequency and intensity of hot flashes.   5 Strategies to Reducing Hot Flashes   1. Consider using a continuous glucose monitor (CGM) The decline in estrogen levels that occurs during the menopause transition can make women insulin resistant, or less sensitive to the hormone insulin, which helps regulate blood sugar.4 A CGM is a wearable device that tracks your blood sugar throughout the day. Wearing a CGM can give you data on how your body responds to various foods. Some evidence indicates that hot flashes can be exacerbated when blood glucose levels fall between meals.5 Thus, maintaining stability in blood glucose levels throughout the day may be helpful in reducing the symptoms of menopause, including hot flashes. The team at LCWNS includes Certified Diabetes Education and Care Specialists who have extensive experience in working with CGMs. Together, we can interpret your body’s response to food and develop a plan for optimal blood sugar regulation.   2. Eat Every 4 Hours Eating with regularity throughout the day can assist in keeping blood sugars stable. One study found that hot flash frequency increased as time between meals increased.5 Avoid going long stretches between meals and snacks to help minimize hot flash frequency. As a general rule of thumb, aim to avoid going longer than 4 hours without a meal or snack during the day.   3. Try yoga! Movement can be very helpful in regulating blood glucose levels.6 Movement also can assist in regulating body temperature and improving overall circulation, which may help with hot flashes.7  Practicing yoga has been shown to significantly reduce hot flashes and night sweats in perimenopausal women.8,9 Yoga has also been shown to lower blood glucose levels, hemoglobin A1c, and cholesterol levels in perimenopausal women.9,10 YOGA FOR MENOPAUSE Short Yoga Flow for Menopause 1. Easy Pose (Sukhasana): Sit comfortably with your legs crossed or extended. Close your eyes and place your hands on your knees. Focus on your breath, taking slow, deep inhales and exhales. 2. Cat-Cow Pose (Marjaryasana-Bitilasana): On all fours, alternate between arching your back (Cow Pose) and rounding it (Cat Pose) with your breath. 3. Downward-Facing Dog (Adho Mukha Svanasana): From all fours, lift your hips up and back, straightening your legs and forming an inverted V shape. Keep your hands shoulder-width apart and feet hip-width apart. 4. Warrior II (Virabhadrasana II): Step one foot forward, bend the front knee, and extend your arms out to the sides, gazing over the front hand. Keep the back leg straight and the back foot grounded. Repeat on both sides. 5. Triangle Pose (Trikonasana): From Warrior II, straighten the front leg and reach the front arm forward, lowering it to the shin, a block, or the floor, while extending the other arm upward. Repeat on both sides. 6. Seated Forward Bend (Paschimottanasana): Sit with legs extended forward, gently reach for your feet or shins, and fold forward while keeping your back straight. 7. Reclining Bound Angle Pose (Supta Baddha Konasana): Lie on your back, bring the soles of your feet together, and let your knees fall open. Support your knees with pillows or blocks if needed. 8. Legs-Up-the-Wall Pose (Viparita Karani): Sit next to a wall, lie back, and extend your legs up the wall. Adjust your distance from the wall for comfort. 9. Corpse Pose (Savasana): Lie flat on your back with arms at your sides, palms facing up. Close your eyes and focus on your breath. Tips: Modify as Needed: Use props like blankets, blocks, or straps to make poses more comfortable. Focus on Breath: Deep, mindful breathing can enhance relaxation and the benefits of each pose. Stay Hydrated: Drink water before and after your practice. This flow can be adapted based on your personal needs and comfort. Practicing regularly, even for a short time, can help manage menopause symptoms and improve overall well-being. Both Laura and Shannon are registered yoga teachers and can help tailor a yoga flow to your specific needs.  4. Choose anti-inflammatory veggies at each meal Diets full of fruits, vegetables, whole grains, and healthy fats are considered anti-inflammatory and have been shown to reduce the rate of hot flashes. One study demonstrated that a higher consumption of a Mediterranean-style diet, which emphasizes fruits, vegetables, whole grains, healthy fats, and leans proteins, was inversely associated with hot flashes and night sweats.11 Another study found that postmenopausal women who followed a plant based diet for 12 weeks had an 88% decrease in moderate-to-severe hot flashes.12 50% of the women who completed the intervention reported complete elimination of their moderate-to-severe hot flashes.12 While going completely plant based is not necessary, aim to build your plate with lots of colors at mealtime to get an abundance of plant-based nutrients. Consider adding in one of these anti-inflammatory veggies at each meal: Leafy Greens, like spinach, kale, Swiss chard, and collard greens Cruciferous vegetables, like broccoli, Brussels sprouts, cauliflower, cabbage Bell Peppers Tomatoes Beets Carrots Squash

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Exercise and Menopause

Lifestyle /

Menopause marks a significant transition in a woman’s life, often accompanied by physical, emotional, and hormonal changes. As the body undergoes these changes, maintaining an active lifestyle can be one of the most effective ways to manage symptoms and promote overall well-being. We’ll explore how exercise can positively impact women going through menopause and offer practical tips for incorporating physical activity into your routine. Understanding Menopause and Its Challenges Menopause typically occurs between the ages of 45 and 55, marking the end of a woman’s menstrual cycles and fertility. This natural biological process is driven by a decrease in estrogen and progesterone levels. Common symptoms include hot flashes, decreases lean body mass, weight gain, mood swings, sleep disturbances, and changes in bone density.   There are several treatment options to support menopausal symptoms, including hormone replacement therapy (HRT). Research also shows that regular exercise, as well as specific types of exercise, have been shown to alleviate many of them and help women feel their best during and after this transition period.1 Here’s how physical activity can make a difference: Mitigating Hot Flashes and Night Sweats Hot flashes and night sweats are among the most common menopausal symptoms. While exercise alone won’t eliminate them, it can help regulate body temperature and improve overall circulation. Engaging in moderate aerobic activities like brisk walking, swimming, or cycling can help manage these symptoms.  Maintaining Muscle Mass Hormonal changes during menopause can lead to increased fat mass and decreased lean body mass.  A focus on strength training can help regulate weight by boosting metabolism and maintaining muscle mass.  Strength training also helps improve functional strength, bone density, blood pressure, and heart rate.2 Incorporating activities like resistance training with free weights or bands, yoga, or pilates can also help enhance muscle tone and strength. Enhancing Mood and Reducing Stress Menopause can bring about mood swings and increased stress. Exercise triggers the release of endorphins, the body’s natural mood lifters. Activities such as walking, dancing, or group fitness classes can improve mood, reduce feelings of anxiety, and promote relaxation. Additionally, incorporating mindfulness practices like yoga or meditation can enhance emotional well-being. Not only does yoga help to reduce stress, but it also improves stability and balance to help prevent falls, increase flexibility, and strengthen muscles.3  Supporting Bone Health The decline in estrogen levels during menopause can lead to decreased bone density, increasing the risk of osteoporosis. Weight-bearing exercises, such as walking, jogging, and strength training, can help maintain bone density and strength. Research shows that incorporating high intensity interval training (HIIT) or other high-impact exercise such as jump rope, running, and tennis is effective at helping to maintain bone density in postmenopausal women.4 If you need cardio exercise that is easier on the joints, try swimming or working out on an elliptical machine or bike.  Improving Sleep Quality Sleep disturbances are another common challenge during menopause. Regular physical activity can promote better sleep by helping regulate sleep patterns and reducing insomnia. However, it’s best to avoid vigorous exercise too close to bedtime, as it might interfere with your ability to fall asleep. Improves Heart Health Estrogen helps protect the heart.  As estrogen declines during menopause, the risk of cardiovascular disease in women increases.  Regular exercise can help keep your heart healthy by increasing HDL cholesterol, lowering LDL cholesterol, and reducing blood pressure.5 Practical Tips for Getting Started Start Slowly: If you’re new to exercise or haven’t been active for a while, start with low-impact activities and gradually increase intensity. Listen to your body and give yourself time to adapt. Find Activities You Enjoy: Choose exercises that you find enjoyable to ensure consistency. Whether it’s dancing, hiking, or joining a fitness class, doing something you love will make it easier to stick with it. Set Realistic Goals: Set achievable and realistic goals based on your fitness level. Celebrate small victories and progress along the way. Incorporate Variety: A mix of aerobic, strength, mobility, and flexibility exercises can provide comprehensive benefits. Incorporate activities like swimming, resistance training, and stretching to address different aspects of fitness. Address Nutrition and Hydration: Proper hydration and nutrition support your exercise routine and overall health. Aim for a balanced diet rich in protein, calcium, vitamin D, and other nutrients to support bone health. Exercise is a powerful tool for managing menopausal symptoms and enhancing overall well-being. By incorporating regular physical activity into your routine, you can improve your mood, maintain muscle mass, and support bone health.  Remember, it’s never too late to start, and every step you take towards a more active lifestyle can lead to significant benefits. The dietitians at LCWNS are here to support you with nutrition and exercise recommendations specific to your lifestyle and goals in this unique stage of life.   Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019 Aug 11;55(8):466. doi: 10.3390/medicina55080466. PMID: 31405242; PMCID: PMC6722698. Capel-Alcaraz AM, García-López H, Castro-Sánchez AM, Fernández-Sánchez M, Lara-Palomo IC. The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review. J Clin Med. 2023 Jan 9;12(2):548. doi: 10.3390/jcm12020548. PMID: 36675477; PMCID: PMC9864448. Johnson A, Roberts L, Elkins G. Complementary and Alternative Medicine for Menopause. J Evid Based Integr Med. 2019 Jan-Dec;24:2515690X19829380. doi: 10.1177/2515690X19829380. PMID: 30868921; PMCID: PMC6419242. Manaye S, Cheran K, Murthy C, Bornemann EA, Kamma HK, Alabbas M, Elashahab M, Abid N, Arcia Franchini AP. The Role of High-intensity and High-impact Exercises in Improving Bone Health in Postmenopausal Women: A Systematic Review. Cureus. 2023 Feb 5;15(2):e34644. doi: 10.7759/cureus.34644. PMID: 36895528; PMCID: PMC9990535. El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick ML, Allison MA; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 22;142(25):e506-e532. doi: 10.1161/CIR.0000000000000912. Epub 2020 Nov 30. PMID: 33251828.

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Bone Density and Menopause Explained

Lifestyle /

During menopause, women are advised to take calcium and vitamin D supplements and lift weights, but why is that? It’s because women can experience weakened bones due to the changes in their hormone levels. The main hormone at play is called estrogen. When women go through menopause, estrogen decreases significantly. However, estrogen is critical to the formation of bone. In this blog, we will talk about what estrogen is, how it relates to bone density and menopause, and how you can maintain bone density, even if your estrogen levels have dropped.   What is Estrogen? Estrogen (also referred to as estrone, estradiol, and estriol) is one of the main sex hormones involved in female reproductive processes1. When girls start puberty, estrogen levels increase to give them female characteristics. Throughout their lives, estrogen and progesterone will naturally fluctuate over their menstrual cycles until menopause when their cycles end. At around age 52, women begin to experience symptoms of menopause. Most of the symptoms women experience, like hot flashes, dizziness, heart palpitations, mood changes, and new hair growth, can be explained by a large drop in estrogen2. These symptoms are very noticeable in women, however, an important consequence of low estrogen can go unnoticed. A drop in bone density may only be noticed because of pain or after an injury. While lower than women, men have estrogen as well. Estrogen plays an important role in regulating bone density for men. Bone Density Explained Bone density refers to the amount of calcium and other minerals in the bone3. Bones with more minerals are denser and therefore, stronger and break less. Bones build their density while individuals grow during childhood through early adulthood with peak bone density occurring between ages 25 and 45 in both men and women4. Things that influence bone development include physical activity, calcium and vitamin D deficiencies, and hormones5.   Bone Density and Menopause Naturally, both men and women lose bone density as they age. However, women will lose bone density at a significantly faster rate due to menopause when their estrogen levels decline4. Estrogen levels are tightly correlated to bone density. The main effect of estrogen is to prevent bone breakdown called “remodeling”, a naturally occurring process of the bone life cycle6. Remodeling refers to the process by which old or damaged bone is broken down and new tissue is formed7. However, bone can be abnormally broken down due to nutritional deficiencies in calcium or low estrogen levels. As estrogen levels drop in women, their body increases the rate of bone remodeling7. Without a steady supply of calcium and other minerals, the bones are worn away until they resemble the inside of a sponge. This condition is known as osteoporosis.   What is Osteoporosis? Osteoporosis is a progressive condition in which bones break down faster than they are built. It causes the bones to become weakened and more likely to fracture or break3. Women are more likely to experience osteoporosis because of menopause. Unfortunately, women are at a high risk of developing osteoporosis. Things you can do to decrease your chance of developing osteoporosis include5: Supplementation: Increasing daily calcium and vitamin D consumption is critical to bone formation. Calcium cannot be absorbed into the body without vitamin D, so it is best to take a vitamin with both. Weight-bearing exercises: Exercises that promote good posture and balance are great for increasing bone mass, like weight lifting, walking, running, jumping, and dancing5.   In Summary Women experiencing menopause are at a high risk of developing osteoporosis, a progressive condition that decreases bone density. This process is strongly correlated with the drop in estrogen levels that occur during menopause. While genetic factors play a considerable role in bone density loss, there are a few lifestyle factors that you can incorporate to prevent it from getting too severe, like exercise and supplementation.   Sources Delgado BJ, Lopez-Ojeda W. Estrogen. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Introduction to Menopause. Johns Hopkins Medicine. (2024, March 18). https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause#:~:text=During%20this%20transition%20time%20before,of%20the%20symptoms%20of%20menopause. Endocrine Society. (2022, January 24). Menopause and Bone Loss. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss#:~:text=Since%20estrogen%20helps%20prevent%20bones,seen%20in%20women%20experiencing%20menopause 6.6 Exercise, Nutrition, Hormones, and Bone Tissue”. Anatomy & Physiology. Openstax CNX. 2013. ISBN 978-1-938168-13-0. Archived from the original on 10 January 2017. Mayo Clinic Staff. (2024, February 24). Osteoporosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968 Khosla, S., Oursler, M. J., & Monroe, D. G. (2012). Estrogen and the Skeleton. Trends in Endocrinology & Metabolism, 23(11), 576–581. https://doi.org/10.1016/j.tem.2012.03.008 Rowe P, Koller A, Sharma S. Physiology, Bone Remodeling. [Updated 2023 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www-ncbi-nlm-nih-gov.proxy.library.cornell.edu/books/NBK499863/

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