Lifestyle modification and home treatmentcan be summarised at follows:
Hot flushes: Keep your home and workplace cool; wear loose clothing in layers that are easily removed; drink plenty of water and juice. Avoid caffeine, alcohol and spicy foods if they bring on hot flushes; exercise regularly to help stabilise hormones and prevent insomnia and avoid confined spaces and hot, humid weather, if possible.
Vaginal dryness: Short-acting, water-based vaginal lubricants such as K-Y Jelly can be used immediately before sexual intercourse to supply moisture (avoid petroleum-based products such as Vaseline). It may also help to take a warm bath before intercourse. Regular sexual activity can help improve natural lubrication and keep the vagina moist and toned.
If sexual desire lessens during menopause, the cause may be physical: lower oestrogen levels sometimes cause physical changes in the sexual organs, making sex uncomfortable. Physical reasons for decreased sexual response should be identified and treated. Some women have a decreased sexual desire because of changes in self-perception and lifestyle stresses. Counselling and support groups can provide useful strategies for coping with this, as well as with physical and emotional symptoms.
Incontinence problemscan often be improved by doing regular Kegel exercises (pelvic muscle-strengthening exercises). Contract the pelvic muscles as if trying to close the vaginal opening. Hold the contraction for a count of three then relax. Wait a few seconds and repeat. Fast Kegels (squeezing and relaxing muscles as quickly as possible) can also help. Performing several Kegels per day (try for 50) can improve bladder control and may enhance sexual pleasure.
A healthy dietis extremely important to help reduce the risk of osteoporosis and heart disease. Adopt a low-fat, high-fibre diet rich in fruits, vegetables and whole grains, and get adequate vitamin D and calcium for strengthening the bones. Eat calcium-rich foods (such as dairy products) or take a calcium supplement, so your daily intake is 1 000 milligrams per day before menopause and 1 500 milligrams per day after menopause. Eating foods high in plant oestrogens (phytoestrogens) may alleviate menopausal symptoms and lower cholesterol levels. Good sources include lima beans, soybeans and soy products (such as soy milk, roasted soy nuts, soy burgers and tofu), nuts, seeds, fennel, celery, parsley and flaxseed oil.
Regular exercisehelps to keep weight down, improve sleep, strengthen bones and lift mood. Weight-bearing exercises such as walking may also help prevent osteoporosis.
In general, strive towards a healthy lifestyle, which includes stopping smoking, controlling weight and managing stress. Stress-reduction techniques such as massage and meditation may help reduce some symptoms.
Many women find relief from short-term menopause-related changes with nonprescription remedies. Products such as vitamin E and vitamin B complex and certain herbs such as black cohosh appear to help some women. However, studies are needed to fully determine possible benefits and risks of herbal medicines.
Mood changes:Discuss your symptoms with other women, or perhaps a therapist if symptoms are very problematic. Ask others for consideration and understanding during this period of transition.
Chart your progress
Being attuned to bodily changes helps make perimenopause less confusing. Monitoring your menstrual cycle for several months and keeping track of your symptoms will give you a greater sense of control, as well as useful information to discuss with your doctor.
Along with a good understanding of your body and the changes it is going through, a positive attitude about perimenopause and menopause is important for dealing with any difficulties it may bring.
Reviewed and updated by Dr Alan Alperstein, obestetrician and gynaecologists in Cape Town, in February 2011.
Previously partly reviewed by Dr Mike Davey, President of the South African Menopause Society & Dr Tobie de Villiers, gynaecologist and committee member of both the South African Menopause and International Menopause Societies.