Menopause and its effects on women's health

Menopause comes with symptoms that can be uncomfortable for a woman. Every woman's experience is unique, but there will be physical changes and emotional effects that you will have to manage. Menopause starts gradually, usually when a woman is between the ages of 45 and 55. For some women, however, it can happen as early as in their 30s, and for others, only when they're in their 60s. It's helpful to know what to expect and how you can look after yourself while you transition through menopause.

What symptoms to expect

Menopause symptoms can start around four years before a woman's last period, and can last the same number of years after her last period. Months to years before menopause, there is a change in the production of the hormones that regulate the menstrual cycle. Not all women experience menopause in the same way, and symptom duration often varies. Lifestyle habits such as smoking can make menopause symptoms last longer and more severe.

Women commonly experience some or a combination of the following symptoms, and more:

• Hot flushes
• Changes in their mood
• Feeling tired
• Vaginal dryness and other vaginal changes
• Difficulty sleeping
• Concentration and memory problems, with brain fog
• Frequent need to urinate
• Tenderness of the breasts
• Urinary tract infections

Managing emotional effects

When menopause symptoms include emotional difficulty or depression, it doesn't mean you're unable to cope. It is a change that happens in the brain during menopause, which needs more research to be properly understood, but there are ways to take control and manage the symptoms.

• Take note of worrying symptoms
  Knowing that depression can occur during this time of your life, it is important to be aware of symptoms that could point to depression so that action can be taken sooner.
• Hormone therapy may or may not help
  Hormone therapy may help to counter depression, but it is important to discuss the potential benefits and risks with your doctor. Considerations should include how long the therapy will last and whether this strategy will include taking antidepressants for a while.
• Think about making some lifestyle changes
  An approach that does not include hormones or other medication can also be highly effective in lowering your chances of depression. Such an approach would be more holistic, looking at interventions such as carefully managing stress, becoming more physically active and eating a healthy diet.

Looking after your health in menopause

When menopause starts, you might find that you're not getting the same results from the lifestyle that worked for you when you were younger. At this stage, you will have to change a few things to manage the effects of hormonal changes, which affect your cardiovascular system and your muscles.

Your goals now should focus on maintaining a healthy weight, eating a diet that protects your heart and staying strong.

Here are some steps you can take to achieve your new goals:

• Make sure you get enough vitamin B12
  As we age, we have a greater risk of developing a deficiency of vitamin B12, which is essential for healthy nerve and blood cells and for making DNA. If you don't get enough from you diet – it occurs mainly in meat and fish – then consider taking it as a supplement.
• Say goodbye to salt
  It is well known that too much salt causes high blood pressure. Processed foods are the main culprit when it comes to salt content. Eating a bag of chips with salt, for example, can lead to dehydration, which could result in hot flushes, heart palpitations, anxiety, dry skin, and joint pains.
• Your iron levels are probably fine
  When a woman stops having her menstrual periods, her body's need for iron decreases. Don't assume you still need to supplement with iron if you had to when you were younger. Have your blood iron levels checked, and only supplement if you doctor says you need it.
• What you need now is calcium and vitamin D
  At around age 40, hormonal and gastric changes decrease your body's ability to absorb calcium and vitamin D. Also, research shows that there is an increased risk of osteoporosis in postmenopausal women due to lack of estrogen. On top of this, your body breaks down more bone than it builds after the age of 50. To lower your risk of osteoporosis and bone fractures after age 50, make sure you get sufficient amounts of calcium through foods such as sardines, spinach, broccoli, kale and low-fat or fat-free milk and yoghurt. Have your vitamin D levels tested and supplement as needed.
• The perfect time for the Mediterranean
  According to a study in the British Journal of Nutrition, people who eat lots of fruit, vegetables, whole grains and olive oil, and drink moderate amounts of wine (widely known as the Mediterranean diet) have a lower risk of cancer and heart disease, and live longer.