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Your guide to mastering menopause symptoms with confidence

28.10.2024

Menopause is a significant transition in a woman’s life, marked by hormonal changes that can lead to various physical and emotional symptoms. For many, it’s a challenging experience, and while some women move through menopause with little discomfort, others face more severe symptoms that can impact their daily lives.

To help us better understand menopause and its effects, we spoke to Paula Escudero, a CBHS Wellness Consultant, qualified nutritionist, and diabetes educator with a Master’s degree in metabolic health. Paula has spent years studying the impact of menopause on women’s health and metabolism, and has her own lived experience of navigating this change.

Paula’s personal journey through menopause

Paula’s experience with menopause highlights how diverse the symptoms can be. “I didn’t get the more common symptoms like hot flushes or weight gain. Instead, I had to endure the lesser-known ones, like debilitating vertigo and severe migraines,” she shares. These symptoms left her feeling unheard and misunderstood, even by her doctor.

He thought I was having marriage issues. I felt gaslighted, and unsafe in my own body.

It wasn’t until she spoke to a colleague, an endocrinologist, that she found support. “She changed my life. What helped me most was changing my mindset. I wanted to be myself again—the happy person I’ve always been.”

For Paula, strategies like maintaining good sleep hygiene, exercising regularly, and engaging in stress-relief therapies like acupuncture played a crucial role in regaining balance. Additionally, hormone replacement therapy (HRT) proved to be a helpful tool for her, especially in managing sleep.

But let’s start at the beginning, what is menopause?

Menopause occurs 12 months after your last period, when a woman’s body stops producing oestrogen and progesterone, marking the end of her reproductive years. While some women go through this transition without significant symptoms, others experience a range of discomforts. About 20% of women will experience no symptoms, 60% will have mild to moderate symptoms, and 20% will face severe symptoms.

Understanding the changes

Many of the changes women experience during menopause are due to a radical decline in oestrogen and progesterone levels. This hormonal shift can cause noticeable changes, such as weight gain, altered fat distribution, and muscle mass loss, mood swings, sleep issues, hot flushes or night sweats.

Other lesser-known symptoms, for example auditory changes like tinnitus (usually a ringing or buzzing sound that other people can’t hear), and even voice alterations, can emerge during menopause.

We have oestrogen receptors in our ears, which is why some women experience hearing changes or vertigo.

Paula points out.

The emotional rollercoaster: mood swings and ‘zero patience’

One of the most challenging aspects of menopause can be the emotional toll. As a woman approaches menopause, hormone levels fluctuate, creating a rollercoaster-like effect that often leads to mood swings. Up to 23% of women experience mood swings before, during, and after menopause.

mood swings

Paula explains, “Progesterone is a calming hormone. When we lose it, many women notice they have zero patience, feel overwhelmed, and struggle with emotional regulation.” This hormonal imbalance can lead to irritability and strain on relationships.

In addition to progesterone loss, mood swings can also be linked to fluctuations in serotonin, a neurotransmitter often referred to as the “feel-good” hormone. The drop in oestrogen can reduce serotonin levels, which are vital for maintaining feelings of happiness and wellbeing. Low serotonin can contribute to distress, heightened emotions, anxiety, sleeplessness, anger, panic attacks, headaches, and even certain cravings.

Other menopausal symptoms, such as hot flushes and sleep deprivation, can further exacerbate mood swings. It goes without saying that when you’re fatigued from lack of sleep or dealing with constant hot flushes, your emotional resilience can be compromised.

HRT

Hot flushes and night sweats

Hot flushes and night sweats are one of the most well-known symptoms of menopause, affecting about 80% of women. Hot flushes can strike before, during, or even after menopause. When they occur at night, we call them night sweats.

But what causes them? Declining oestrogen levels affect the hypothalamus, the brain’s thermostat, causing it to misread body temperature. As a result, the body triggers a cooling response, which includes sweating and skin flushing.

Common triggers for hot flushes and night sweats include stress, caffeine, alcohol, spicy foods, and hot weather.

Night sweats can also severely disrupt sleep, affecting mood, concentration, and overall wellbeing. In some cases, they may even cause tension between partners who share a bed.

Addressing night sweats starts with identifying and reducing personal triggers. Treatments range from lifestyle changes—like maintaining a cool sleeping environment, exercising, and reducing caffeine and alcohol—to hormone replacement therapy (HRT). While herbal and soy-based treatments are often mentioned, evidence of their effectiveness is limited. Paula’s advice?

Listen to your body and find what works for you.

Seeking professional guidance is crucial. Along with HRT, non-hormonal treatments like cognitive behavioural therapy (CBT) can also help manage symptoms, providing more tailored relief and support. Your GP can discuss your personal circumstances with you and assess the benefits and risks of potential treatments for your unique situation.

Insomnia and sleep issues

Sleep disturbances are a common complaint during menopause, with more than 60% of women reporting issues. Hot flushes, night sweats, and hormone fluctuations can all disrupt your sleep patterns. Paula stresses the importance of good sleep hygiene:

I found that practising relaxation techniques and sticking to a consistent sleep routine was key to improving my rest.

In addition to hot flushes and night sweats caused by the decline in oestrogen, the reduction in progesterone during menopause may also contribute to sleep disturbances. Progesterone has a calming, sleep-inducing effect by acting on our brain pathways.

Another crucial hormone, melatonin, which regulates our sleep, naturally decreases with age. The production of melatonin is partially influenced by both oestrogen and progesterone, and as levels tend to drop during perimenopause, this further aggravates sleep issues.

To improve sleep and manage insomnia during menopause, it’s essential to start with healthy lifestyle changes:

Get moving with regular exercise
Eat in a way that supports hormonal balance and overall wellbeing
Manage stress and anxiety
Nurture healthy relationships and maintain a social life (go on walks with friends, grab a coffee with your coworkers, double dates with hubby, you choose!)
Keep your brain active and engaged.

Focusing on good sleep hygiene is also key, Paula advises. Use dim lighting in your bedroom, allow yourself time to wind down (like reading a book), avoid screens for at least an hour before bed, avoid overeating at dinner, and practise relaxation techniques like a warm shower, bath, meditation, or light stretching.

However, there are times when these strategies may not be enough, and you might need some additional help. In these cases, it’s important to consult your doctor. Specific treatments like hormone replacement therapy (HRT) can be particularly effective for sleep issues related to menopause, and only your doctor can advise if that’s right for you.

Weight gain and muscle loss

Weight gain during menopause is linked to the natural ageing process and changes in activity levels.

Women in midlife may notice fat is stored more around their waist than their hips and thighs. That’s due to the loss of oestrogen. While this may contribute to weight being stored around the abdomen, lifestyle factors like diet and exercise are crucial in managing weight gain.

explains Paula.

She also highlights the importance of maintaining muscle mass, as menopause can contribute to sarcopenia, the loss of muscle, which increases frailty in older women.

Menopausal symptoms like hot flushes, poor sleep, and low mood can make it harder to exercise and maintain a healthy diet, contributing to weight gain. Life pressures around this time, such as work stress or caregiving responsibilities, can also add up.

However, prioritising your health is crucial, as visceral fat (fat stored around the belly) is linked to increased risks of heart disease, type 2 diabetes, breast cancer, dementia, and it can make your menopausal symptoms worse.

So, what should you do?

Eat a healthy diet
A well-balanced diet can prevent weight gain and improve energy. Consider low-calorie or low-carb diets, especially if you have conditions like high blood pressure or type 2 diabetes. Avoid crash diets and consult a doctor or dietitian for advice.
Exercise regularly

Regular physical activity helps manage weight and reduce the risk of chronic diseases. Aim for 2.5 to 5 hours of moderate-intensity exercise (like brisk walking or swimming) or 1.25 to 2.5 hours of vigorous activity (like jogging or aerobics) weekly. Strength training two days a week is also recommended.

Remember to consult a doctor before starting a new fitness program, especially if you have pre-existing conditions or haven’t been active recently.

If menopausal symptoms are affecting your ability to exercise and eat well, or are impacting your daily activities, we recommend seeing your doctor. It’s also important to talk to your doctor if menopause symptoms are impacting your ability to manage your weight, sleep, emotions, or alcohol consumption.

As Paula reminds us:

You’re not alone.
Seeking professional help can make all the difference.

Every woman’s journey through menopause is unique, but as Paula’s story shows, there is hope and support available to all. By understanding the changes your body is going through and seeking professional advice, you can find strategies that work for you. Menopause doesn’t have to mean a loss of quality of life. With the right mindset and tools, you can continue to thrive and enjoy this beautiful new stage of your life.

All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.

Sources:

https://www.healthdirect.gov.au/hot-flushes-due-to-menopause

https://www.menopause.org.au/hp/information-sheets/what-is-menopause

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606909/

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tinnitus

https://www.menopausecentre.com.au/mood-swings/

https://www.healthdirect.gov.au/menopause

https://www.menopausecentre.com.au/night-sweats/

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy

https://www.verywellhealth.com/low-progesterone-8364911

https://www.healthdirect.gov.au/melatonin