I don’t know that any man can claim to be the complete expert on menopause. But I’ve probably seen well over a thousand of my female patients go through it, not to mention my wife, and one lesson I’ve learned is that a positive attitude, as well as some lifestyle healthy basics, can make a massive difference in how menopause is experienced – and the degree to which menopause symptoms interfere with everyday life, if they do at all. That’s not just my clinical experience talking either. Studies have shown that the more negative attitudes women bring to menopause, the more symptoms they’re likely to have. So, even if your mom had a rough time of it, it’s by no means a foregone conclusion that you will too. In fact, with the right tools, your transition is likely to be a good bit easier.  

First up, it’s essential to remember that menopause isn’t a ‘problem’ to be cured, or a feared life-stage to be stoically endured, it’s just human biology – your body knows what it’s doing. It’s a normal part of life, and in many respects it’s an achievement and a blessing to have made it to this phase. And, it’s interesting to note that in cultures that place a higher value on the wisdom that women acquire with age, women are more likely to navigate midlife hormonal changes more gracefully, with considerably fewer troublesome symptoms.

So how to approach this very natural, normal process in a proactive and positive way? Here are a few thoughts on how to ease body and mind through the transition as smoothly as possible:

Perimenopause is the prequel.

Menopause marks the end of menstruation and fertility. Technically, you enter it a year after your last menstrual period, which for most women occurs in their in their fifties, some early, some later. But by your forties, the production of sex hormones has slowed down --  perimenopause -- and fluctuating levels of the two primary female sex hormones, estrogen and progesterone, often produce uncomfortable symptoms like bloating, weight-gain and irregular and/or heavy periods.

Menopause symptoms are part of the process.  

By menopause, your ovaries and your adrenal glands are producing a fraction of the sex hormones they did in your twenties – and, somewhere, somehow, you’ll likely feel the difference. The potential symptoms are well-known: hot flashes/night sweats; sleep issues; fatigue; weight-gain; vaginal dryness, reduced libido; hair-thinning. Think of it as your body taking some time to sort itself out as it gets used to a new hormonal balance.

Unhealthy habits send hormones down a bad path.

My patients and my readers should by now be well aware of the essential role that the lifestyle basics – diet, movement, stress-relief techniques and good quality sleep  – play in enhancing health and well-being. Nowhere is that more true than in managing menopause. Why? Because cortisol, your primary stress and energy hormone, has a lot to do with it. Your body uses the same precursor hormone to make both cortisol and estrogen.

So, when you’re stressed out and your cortisol levels are high, that means more of the starter-kit hormone goes into making cortisol and less is available to make estrogen. All too often, that means more pronounced symptoms. And low estrogen levels can make uninterrupted, deep sleep challenging. Poor sleep further jacks up cortisol levels which in turn further tamps down estrogen, promoting fatigue and weight gain. It’s a vicious circle – but a breakable one, if you lean into stress reduction and upgrading your sleep habits.

Destress your menopause

If an uneventful menopause is your goal, it’s essential to a handle on excess stress, in the ways that are most effective for you. I’m a big fan of a formal meditation practice, for instance, ten or fifteen minutes or more a day where you tune out the world and tune into your body, typically, following the breath. Likewise, yoga or any kind of mindful stretching routine can quiet the mind and re-center the body.

There is no limit to the number of soothing techniques that you can skillfully use –the more the merrier. For some, it’s a hot bath or shower before bed, either are great ways to drain stress and invite deep sleep. For others, it’s taking lunch in a nearby park or a relaxing walk around the neighborhood after a meal. More vigorous movement has its place too. Few things set your body up for restorative deep sleep better than getting your heart pumping with a regular work-out – your choice of exercise – that tires the body out in a healthy way.

However, sometimes I do have to put the brakes on with some of my patients. They’re so eager to lose the weight they’ve gained in perimenopause and menopause, they exhaust themselves in the gym or on the jogging track which only drives up those cortisol levels, undoing all the good they’ve done. If this sounds familiar, I urge you as well to consider dialing down the strenuous workouts a bit and work with a trainer who guide you towards good results without overdoing it. The reality is, the needs and abilities of a 30 year old body are different from a menopausal one, so adjustment and adaptation to the transition at hand will do your body a world of good and help take the edge off both the number of symptoms and their severity.

Eat your way through menopause.  

For better or worse, there is no special ‘menopause diet’ that will turn back the hormonal clock, but you can eat to support the optimal function of the hormones you’ve got. To do that, remember that the same style of eating that benefits your health across the board – not too many carbs, lots of healthy fats, non-starchy, high-fiber veggies and lean, clean protein – is also what’s needed to get to the other side of menopause with a minimum of hassle. And, there are specific reasons why this approach to eating is your hormonally ally: Healthy fats provide the building blocks of hormones in the body, including the sex hormones, while omega 3 fatty acids in particular tamp down the inflammation that makes many menopause symptoms worse.

So, down with the sugar and starches, up with clean proteins and be liberal with small, oily fish, nuts, seeds, avocados and olive oil.  Fill up with high-nutrient, non-starchy veggies. which are not only indispensable for overall nutrition and satiety, but there’s even suggestive evidence that the fiber helps with balancing hormones so don’t hold back!

More foods to the hormonal rescue.  

Cruciferous veggies, for instance, broccoli and kale, boost the body’s ability to metabolize estrogen break-down products which are responsible for a lot of menopause mischief. They detoxify the body. Finally, the evidence suggests that foods high in plant estrogens can help mitigate some of the effects of naturally declining estrogen levels. Soy is the obvious choice but the industrially-produced GMO soy products that line shelves are a nightmare, so I recommend organic, fermented soy, like tempeh, eaten in moderation, say, not more than 2 or 3 servings a week.

Say no to sugar and processed foods.

This shouldn’t come as a surprise:  As we get older our capacity to metabolize carbs decreases, so keep sugar, starches, processed foods and junky low-fiber, refined carbs to an absolute minimum. They provide the most direct path to insulin resistance and weight gain, which can be challenging to counter during menopause.

The supplement solution  

I encourage anyone to look into some supplements that can take the edge off troublesome menopause symptoms. I have found Estrovera by Metagenics (Rhapontic Rhubarb) to be quite helpful for many menopausal symptoms, in particular hot flushes, night sweats and mood swings. Black cohosh (80 mg 2x daily) can help with issues like hot flashes and night sweats as can vitex or chasteberry.  Other supplements to add to your menopause tool box: Adaptogenic herbal remedies like ashwagandha, schisandra and rhodiola, which help support adrenal function and can help with menopause symptoms by turning the thermostat down on the body’s stress response.

Balance hormones…with hormones.  

And yes, I do have patients who do everything right and still may struggle with menopause symptoms. If you fall into that camp, I recommend working with an integrative health care provider to explore your hormone levels and supplementing the sex hormones if necessary. I’m not talking about the synthetic pharmaceutical variety, but “bio-identical” hormones prepared by a Compounding Pharmacist. If you go this route, you should definitely get a genetic test to see how your body processes these hormones, and take the relevant supplements to help metabolize them, so you don’t run afoul of possible side effects.

A final thought: Don’t forget that menopause is, for roughly half of the world’s population, a universal experience – so take a moment to honor and celebrate the start of your next life chapter.