Engage in an informed conversation with your doctor about hormone therapy (HRT) as it is the ‘absolute gold standard’ for managing menopause symptoms and offers significant protective benefits for long-term health. Every woman deserves to understand her options and make her own choice regarding HRT.
If considering hormone therapy, aim to start it between ages 50-59 or within 10 years of menopause onset, as this ’timing hypothesis is key’ for maximizing cardiovascular protection and cognitive benefits. Estrogen is more effective at prevention than cure, and earlier initiation leads to better outcomes for heart health and brain function.
Engage in resistance training three to four days a week to combat the accelerated loss of muscle and bone strength that occurs with aging and menopause. This is crucial for maintaining strength, controlling basal metabolic rate, and supporting overall longevity.
Increase your daily protein intake to 80-120 grams, depending on body composition, and distribute it throughout the day, rather than stacking it at night. Adequate protein is essential for building and maintaining muscle mass, which is vital for metabolic health and insulin sensitivity.
Consider using vaginal estrogen, as it is safe and effective for treating genital urinary syndrome of menopause (GSM), preventing recurrent UTIs, and helping with urge incontinence. It improves tissue health in the genitourinary system without systemic absorption.
Incorporate a weighted vest, starting at 10% of your body weight, into daily activities like walking or chores to stimulate the musculoskeletal system. This practice can significantly improve bone density and help prevent osteoporosis.
Embrace an anti-inflammatory diet (Mediterranean-esque), regular exercise, and good sleep habits long before perimenopause begins. The healthier you are entering this transition, the better your overall course will be.
Aim for 25-32 grams of fiber per day by focusing on fiber-rich foods, as most women consume only 10-12 grams. Fiber supports a healthy gut microbiome, slows glucose absorption, and helps lower inflammation, which is crucial as estrogen’s anti-inflammatory protection declines.
Discuss testosterone therapy with your doctor for issues like hypoactive sexual desire disorder (HSDD), osteoporosis, osteopenia, or sarcopenia. While off-label for women, it can improve libido, bone density, muscle strength, and cognitive clarity.
If experiencing middle-of-the-night awakenings or racing thoughts, take oral progesterone at night before bed. Progesterone, likely through its effects on GABA, can help settle the brain and promote better sleep.
Reduce or eliminate alcohol consumption, especially if you are in perimenopause or menopause, as women often cannot tolerate it as they used to. Alcohol significantly disrupts sleep, leading to awakenings and other sleep disturbances.
Inquire about the age your mother and aunts went through menopause, as genetics is the biggest factor determining your own menopause age. This information can provide valuable insight into your likely timeline.
Measure your waist-to-hip ratio monthly (waist at smallest part, hips at widest part, relaxed) as a better indicator of metabolic health risk than weight or BMI. A ratio less than 0.7 for women indicates lower visceral fat, while greater than 1 suggests higher levels.
If considering estrogen therapy, opt for non-oral formulations like patches, gels, or sprays, especially if you have a family or personal history of blood clots. Non-oral delivery bypasses liver metabolism, reducing the slight increase in clotting factors associated with oral estrogen.
If you started hormone replacement therapy early in menopause, remain healthy, and have no contraindications, you can continue it indefinitely. HRT provides ongoing protection for bones, the genitourinary system, and skin.
If you experience dysfunctional uterine bleeding (heavy, frequent, or unusual bleeding), consult a gynecologist for evaluation before starting hormone therapy. This is crucial to rule out cancer or other underlying conditions.
Do not start hormone replacement therapy if you have known hormone-sensitive cancer, are actively being treated for a blood clot, or have severe liver disease. These conditions are contraindications due to potential risks or impaired hormone metabolism.
Educate yourself about perimenopause and menopause to understand the profound physical and mental changes your loved one may be experiencing. Offer support, attend appointments, and be a partner through this transition to maintain a healthy relationship.
Consider supplementing with 5 grams of creatine monohydrate daily, as studies in women have shown benefits for muscle and bone health. This supports the musculoskeletal system, which is critical for longevity.
Explore specific bioactive collagen supplements (e.g., Verisol, Fortabone) that have shown promise in improving bone density and reducing the appearance of wrinkles and cellulite in menopausal women. While not a complete protein, it may offer targeted benefits.
Address potential Vitamin D deficiency, as 80% of patients are often deficient and struggle with absorption. Supplementation is important for overall health.
Use a topical estriol cream on your face to help slow the rapid loss of collagen and improve elastin concentrations in the skin, which commonly occurs in the first five years of menopause. This can help maintain skin health and appearance.
Consider prescription vaginal DHEA preparations like Enterosa, which locally convert to testosterone and estrogen. This can improve vulvar health and sexual function, particularly for patients who may have limited HRT options, such as those with breast cancer.
If experiencing hypoactive sexual desire disorder (HSDD), where libido has significantly decreased, testosterone therapy can be a beneficial option. It works at the brain level to help restore sexual drive.
If experiencing pain, tearing, or fragility during sexual activity due to loss of elasticity and moisture, vaginal estrogen therapy can help. It improves tissue health and reduces discomfort.
For arousal disorders where blood flow to the genital area is diminished, topical sildenafil (Viagra) can be a helpful treatment. It can improve blood flow and enhance arousal symptoms.
Recognize that relationship dynamics can significantly impact libido and sexual function. Ensuring you feel loved and supported by your partner is fundamental for sexual desire.
If prescribed GLP-1 medications like Ozempic or Mounjaro, prioritize adequate protein intake and resistance training. This strategy helps mitigate potential muscle loss associated with these medications, supporting long-term health.
If you are a female patient taking GLP-1 medications and do not wish to become pregnant, discuss contraception with your prescriber. These medications can restore ovulation in women who previously had difficulty conceiving, leading to unexpected pregnancies.
Refrain from smoking, as it is known to accelerate the onset of menopause. Smoking can cause you to go through menopause sooner than you otherwise would, impacting long-term cardiometabolic health.
Be aware that any inflammatory process in the abdomen, such as irritable bowel disease or endometriosis, can accelerate the loss of ovarian life. Managing these conditions can help preserve ovarian function.
Be informed that certain surgeries, like a hysterectomy (even if ovaries are left) or tubal ligation, can shorten the lifespan of your ovaries. A hysterectomy can reduce ovarian life by four years, and a tubal ligation by 1.5 years.
Using birth control methods that suppress ovulation for an extended period may slightly delay the onset of menopause. This is because fewer eggs are lost each month when ovulation is inhibited, potentially extending ovarian life by up to nine months.
If you experience a skin rash or hives from an estradiol patch, it may be due to the adhesive, not the hormone. Try an alternative non-oral form of estrogen or apply an over-the-counter cortico nasal spray to the skin and let it dry before applying the patch to reduce reaction.
Incorporate a wide variety of colorful fruits and vegetables into your diet, such as greens, reds, purples, and yellows. Each color represents different beneficial phytochemicals that support various aspects of your body’s health.
Exercise caution with most over-the-counter menopause supplements, as many lack robust scientific data to support their efficacy in treating symptoms. While generally not harmful, they may not address the root cause of hormonal changes.
Utilize a smart mattress cover like 8Sleep to control your sleeping environment’s temperature. Programming the temperature to drop by 1-3 degrees for sleep and rise for waking can significantly improve sleep quality and duration.
Consider engaging in professional therapy with a licensed therapist to develop healthier thought patterns and actions. Quality therapy can be immensely valuable for personal and professional life, helping to direct focus toward what truly matters.
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