Lifestyle Bookazine 4741 (Sampler) by Future PLC

Menopause YOU &

NEW

EXPERT ADVICE · HEALTH TIPS · INSPIR ATION

BE KIND to your bones

RECLAIM Y

30 LOW-CALORIE RECIPES

LEARN TO COPE WITH HOT FLUSHES

FIRST EDITION

Digital Edition

OVERCOME sleepless nights

R WAIST OU

Take

control

and enjoy life’s most liberating stage

EMBR ACE THE MENOPAUSE

Celebrate your new freedom and enjoy life

UNDERSTAND HORMONES

Everything you need to know about HRT

From the makers of

MANAGE YOUR SYMPTOMS Help to reduce or prevent the effects

Contents

Coping with the big M -

15 things to remember -

5 things to love about the menopause -

Harness your hormones -

The surprising truth about testosterone -

The good news about HRT -

Ease symptoms with supplements -

Food for happy hormones -

Get your vitamin Bs right -

365 days of vitamin D

Natural ways to survive the menopause -

M E NO PAU SE

Magnesium: why midlife women need it -

YOU

The truth about CBD -

Why is it so hot in here?

Eat to beat hot flushes -

Take a moment for a mood booster -

Good mood foods -

Help your headache -

How to beat brain fog -

Elevate your energy

Don’t let hormones kill your confidence -

Guide to menopause at work -

Lessons in sleeping better -

Eat your leafy greens -

Omega oils explained -

Better bones at any age! -

The secret to healthier joints -

Eat well sleep better -

Love, sex & hormones in midlife

Pelvic floor bootcamp!

The power of an orgasm

Yoga vs Pilates

Reclaim your waist

Food for healthy joints

100

Foods to boost your libido

Skin & hair during menopause

102

Why exercise helps

The A-Z of gorgeous skin

78 -

How to stay fit over 40 -

106 -

114

Food for radiant skin -

124

Boost your Omega-3

Fight back against menopause weight gain

Have you got a menopause hangover?

The ultimate menopause workout

Are you winning at the menopause?

Food for healthy hair

126

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IT’S REALLY NOT ALL BAD

You might feel more creative, more balanced, more liberated. Without monthly periods and PMS, women often feel more capable and empowered – and do find joy in life.

YOU COULD STILL GET PREGNANT

Don’t throw away the contraceptives just yet! You need to wait until a year after your last period – or two years if you’re under 50.

HOT FLUSHES DON’T HAPPEN TO EVERYONE

MEMORY LOSS DOESN’T LAST FOREVER

A lucky 25% of women never get them, but if you’re in the unlucky 75%, avoid what makes them worse. Wear cotton sleepwear and have a fan by your bed. Regular exercise helps, too.

This is completely normal. Scientists believe the drop in oestrogen can make us feel a bit foggy, particularly during the perimenopause. Good news is it usually only lasts a year.

IT’S NORMAL TO BE A BIT LEAKY

It can happen when you laugh or sneeze, as falling oestrogen levels can make your pelvic floor muscles weaken – but don’t ever suffer in silence. Do pelvic-floor exercises religiously, and, if the problems persist, see your doctor.

CELEBRATE YOU

Low self-esteem can have a knock-on effect on your sex life. Just remember – you may not still have the pert bottom of a 20-something, but it’s important

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15 things to REMEMBER

15 THINGS TO REMEMBER

Is the menopause making you feel down? We’ve rounded up these helpful nuggets to encourage you through…

to celebrate your body and what you can do with it.

YOU WILL BE BETTER OFF!

The end of periods means no more tampons or towels – and, after around 40 years of buying them, that’s quite a relief. moneysavingexpert.com reckons a woman can spend up to £66 a year and £2,625 over the course of her lifetime on branded products. If you’re still having periods, check out the website’s guide to cutting the cost of sanitary protection.

MOVING AROUND CAN LIFT YOUR MOOD

PHOTO: GETTY

The menopause often coincides with other life stresses, such as work pressures, ageing parents and children leaving home, all of which can affect your mood. Regular exercise, yoga, meditation or simply making time for yourself can all help.

YOU SHOULD SWAP RED WINE FOR WHITE

While all types of alcohol can cause the release of the

hormone epinephrine, triggering a hot flush, red wine is especially potent. White wine is more likely to leave you flush-free – but, as alcohol raises your risk of breast cancer, drink moderately.

PILE YOUR PLATE HIGH WITH PLANTS

In a study of over 17,000 menopausal women, those who ate more unprocessed soy products, fruit, vegetables and fibre experienced a 19% reduction in hot flushes.

CUT BACK ON SUGAR

‘A dramatic increase in your blood-glucose level is often followed by a crash or dip in energy, leaving you feeling tired and weak,’ explains dietitian Helen Bond. ‘For a sweet hit, go for fruits and nuts that give you sufficient energy to get you through the day.’

CHECK YOUR IRON LEVELS

Both haemoglobin and ferritin are important for showing iron status, especially if you’ve had heavy periods in perimenopause.

Low iron can lead to a lack of energy, which in turn means you’re less likely to exercise.

YOU NEED TO FEED YOUR BRAIN

Most of the body’s serotonin – the happy hormone – is made in the gut and is produced more abundantly when we eat tryptophan. Chia seeds are a wonderful source, as are edamame beans, prunes, spirulina and natural yogurt.

HERBS CAN BE HELPFUL

Research has shown that black cohosh and St John’s wort are effective in relieving symptoms, particularly when taken together,’ says Dr Dick Middleton, former chair of the British Herbal Medicine Association. Choose sage to prevent hot flushes and use rosemary as a memory booster.

IT’S TIME TO DITCH THE CIGARETTES

According to a study from Pennsylvania, smoking speeds up oestrogen loss, bringing on menopause symptoms earlier.

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The good news about

HRT

Hormone replacement therapy is still the main treatment for menopausal symptoms – we explain how it works and bring you the latest advice, so you can decide what’s right for you

he menopause is no longer a taboo subject and women certainly don’t have to suffer in silence with hot flushes, painful joints, vaginal dryness, weight gain, mood changes, sleep problems and depression. While there are many natural solutions to help ease uncomfortable and sometimes debilitating physical and emotional changes during the transition, HRT frequently remains the go-to for women. ‘For many, it can transform their lives,’ says GP and menopause specialist Dr Louise Newson (menopausedoctor.co.uk). ‘Often, once a woman receives the right dose and type of HRT, menopausal symptoms disappear and energy levels improve.’ To help you decide if HRT is right for you, we asked our experts to share all the latest information.

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HOW HRT HELPS When oestrogen levels plummet during the menopause, HRT can be a lifeline for women during this huge shift. ‘We have oestrogen receptors in our brain, muscles, joints, ligaments, heart, vagina and bladder, so when levels drop we get symptoms in all these areas,’ explains Dr Rebecca Lewis, GP at Newson Health Menopause & Wellbeing Centre. HRT replaces lost oestrogen, and this not only alleviates reduced libido, brain fog, lack of concentration, increased anxiety and a weak pelvic floor, it can boost long-term health, too. One study* found it may halve heart disease risks, while US research says it

could lower chances of bowel cancer. Plus, menopausal women have a higher risk of osteoporosis and bone fractures due to a lack of oestrogen. So, NICE** recommends that any woman who goes through an early menopause (before 45) should take HRT. Progesterone also declines during the menopause, so is a key component of HRT. ‘Oestrogen on its own would cause the lining of the uterus to thicken, which can lead to problems, such as endometrial cancer,’ says Dr Lewis. Adding progesterone keeps the womb lining thin, and can be combined with your HRT or taken separately. If you’ve had a hysterectomy, these issues won’t affect you.

‘It can be a lifeline for women during this huge shift’

THE GOOD NEWS ABOUT HRT

WHICH WAY TO TAKE IT WORKS FOR YOU? HRT comes in many different forms including tablets, gels and patches. ‘A doctor will assess you and see what is most suited to you,’ explains Dr Lewis. If, for example, you Great skin and a sex-drive suffer with migraines boost are a couple of the or high blood unexpected benefits pressure, a patch where from taking HRT. oestrogen is absorbed through the skin might be best. ‘Your doctor should review your HRT prescription annually to ensure it’s still suitable,’ adds Dr Newson. Some women may experience side effects of headaches, nausea, indigestion, vaginal bleeding or breast tenderness when they start HRT, however these usually ease within a few months. Always speak to your doctor if you’re at all concerned.

SURPRISE BENEFITS

RISK FACTORS EXPLAINED

Despite its many benefits, HRT remains a hotly debated topic that has sparked a great deal of controversy due to a 2002 study by the Women’s Health Initiative (WHI) that linked the treatment to breast cancer, strokes and heart attacks. When these risks were widely reported in the media, it led to 50-70% of women coming off HRT within a year or two, however, many experts say these findings were misinterpreted. ‘After five years on HRT, there may be an increased risk of breast cancer, with five extra cases per 1,000 women,’ says Dr Lewis. ‘However, to help put this in perspective, your chances of developing breast cancer are actually greater if you are overweight (24 extra cases per 1,000 women).’ Dr Newson adds that taking HRT in tablet form may result in a small increased risk of a clot developing in your legs or lungs but this increased risk is still very small. ‘It is heightened by risk factors ,including obesity or a history of clots. However, if you take the oestrogen part of HRT as either a gel or patch, it gets >>

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NATURAL

ways to survive THE MENOPAUSE

Feel 10 years younger with these natural ways to ease symptoms

he huge hormonal shift during the menopause can make it seem like you’re ageing fast. And it doesn’t help that when discussing menopausal symptoms with a healthcare professional, only 28% of women receive any advice on how lifestyle tweaks could make them feel better.* ‘Hormone replacement therapy (HRT) remains the first-line treatment for most women, but it may not be an option for others,’ says GP and menopause expert Dr Louise Newson (menopausedoctor.co.uk). ‘There’s much more to managing menopause so it’s essential to take a holistic approach and optimise your lifestyle.’ Want to feel like you again? Here’s what to try.

LIGHTEN UP WITH LAVENDER According to Anxiety UK, 98% of women feel anxious during menopause due to a drop in oestrogen and progesterone. ‘Both hormones influence the production of serotonin, which is a mood-regulating transmitter,’ explains Kathy Abernethy from the British Menopause Society. ‘Alongside these emotional changes, physical symptoms, such as hot flushes and sleeplessness, can leave women

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feeling worn out and anxious.’ Pharmaceutical quality lavender oil has been shown to improve symptoms without the sedative side-effects of highly addictive anti-anxiety drugs.

MOVEMENT IS MEDICINE A study of women aged 40-59 found that those who led sedentary lifestyles were likely to experience more severe menopausal symptoms. Walking, jogging and aerobic exercise will help maintain bone health – we lose 10% of bone mass in the first five years of menopause – and the feel-good endorphins released can lift us out of a slump and reduce anxiety. Try yoga, Pilates or swimming.

FOOD FOR THOUGHT A balanced diet is key. Eat plenty of fresh fruit and vegetables, hearthealthy foods such as oily fish and complex carbohydrates. Cut back on alcohol, sugar, caffeine and refined carbs. Research suggests that foods containing

THE NATURAL APPROACH 95% of women said they’d be willing to try alternative therapies before HRT*

WORDS: Ali Horsfall. Photos (posed by models): Getty. If you have concerns about your health, see your GP. *Newson Health **Women's Health Concern

NATURAL WAYS TO SURVIVE THE MENOPAUSE

phytoestrogens may help with hot flushes and protect against heart disease. ‘Phytoestrogens are naturally occurring plant compounds that can mimic oestrogen within the body, meaning they may have hormonebalancing effects,’ explains nutritionist Lily Soutter. Rich sources include soy products, chickpeas, tofu, flaxseeds, lentils, oats and wholegrains.

HEMP HYPE

CBD is a cannabidiol compound offering the medicinal benefits of cannabis, but without the high. So what can it do for menopause? A study shows that CBD can have antidepressant-like results as it acts on the body’s endocannabinoid system, and so may help regulate your mood.

HYPNO BENEFITS

TALKING TREATMENT

HERBAL HELPERS

PHOTO: GETTY

Hypnosis could sort disrupted sleep, hot flushes and night sweats. ‘It can also be beneficial for treating anxiety or low mood,’ says

LUBE UP

Dr Caroline HoulihanEdwards. ‘Choose Burne, clinical one which carries hypnotherapist at the THR Low oestrogen levels can The Princess certification cause vaginal dryness that may Grace Hospital. mark, as this make sex and intimacy Once you guarantees uncomfortable or painful. ‘Try using a understand the quality, safety lubricant,’ suggests menopause practice, and has expert Dr Shahzadi Harper self-hypnosis is approved a helpful tool. dosage (theharperclinic.com). ‘Organic, ‘Close your eyes, information.’ plant-based products are breathe deeply and kinder to intimate count down from 10 to areas.’ one on each outward breat. Then repeat a positive suggestion, such as “I’ll remain calm”. Cognitive behavioural therapy When you’re ready to come out of self(CBT) is a form of talking therapy hypnosis, count from one to 10 and, that identifies negative thought on the count of 10, your eyes will open patterns to create positive and you’ll come out of the trance,’ says changes in feelings and behaviour. Dr Houlihan-Burne. It’s effective in menopause says clinical psychologist Professor Myra S Hunter. ‘CBT has been ‘Remedies containing black cohosh found to improve mood, sleep and St John’s Wort have been and quality of life, as well as clinically provento help common helping women to handle hot menopause symptoms, and if you flushes and night sweats,’ she says. find concentration and stressful If you're in the UK, it’s available situations difficult, Rhodiola rosea on the NHS or you can find a has been shown to relieve stress private therapist at without side-effects, says Dr David cbtregisteruk.com.

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Eat to beat

HOT FLUSHES These healthy – and delicious – recipes can help ease those annoying menopausal symptoms

For the freekeh: 4 spring onions, roughly chopped 300g beetroot, washed and cut into wedges 8 radishes, halved 4 tomatoes, halved 100g asparagus Handful thyme sprigs, leaves only 300g freekeh 1ltr vegetable stock 45g roasted almonds, finely chopped Parmesan shavings

Freekeh with kale pesto

Having a diet very high in veg is one of the most effective ways to limit hot flushes. Freekeh is made from green wheat that’s been roasted and crushed. Serves 6 • Ready in 45 mins

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For the pesto: 60g mixed nuts, toasted 100g kale 60g flat-leaf parsley, roughly chopped 1 garlic clove 60g Parmesan cheese Zest and juice of 1 lemon 100ml olive oil, plus 2tbsp for the freekeh

1 For the pesto, place the nuts in a food processor and blitz until fine. Pour boiling water over the kale, then drain immediately. Leave to drain and cool for 5 mins then roughly chop. 2 Add the chopped kale, parsley, garlic, Parmesan, and lemon zest and juice to the food processor. With it running, add half the oil. Check the consistency, then add more as required. Season to taste. 3 For the freekeh, heat the oven to 200C/Gas 6. Place the spring onions, beetroot, radishes, tomatoes and asparagus on a large baking tray. Drizzle with 2tbsp oil, season, add the thyme leaves, then roast for 30 mins. 4 Meanwhile, add the freekeh and vegetable stock to a pan, bring to the boil, then simmer for 20 mins until soft, with just a little bite. Remove from the heat, place a clean tea towel over the top of the pan, then put the lid on. Leave until ready to serve. 5 When the vegetables are cooked, fluff up the freekeh with a fork, and divide onto warmed plates. Share the pesto out onto each plate, then divide up the roasted vegetables on top. Scatter over the toasted almonds and Parmesan shavings. Per serving: 360 cals, 19g fat, 4g sat fat, 23g carbs

EAT TO BEAT HOT FLUSHES

Berry boost

Dietitians recommend that menopausal women add soy to their diet to help alleviate several symptoms, including hot flushes. Serves 1 • Ready in 5 mins 125ml soy milk 2tbsp soy yoghurt Handful blueberries Handful raspberries Handful strawberries, hulled Pinch of cinnamon ½tbsp oats 1 Put the soy milk in a blender with the yogurt, blueberries, raspberries, strawberries, cinnamon and oats. Blend until smooth. Per serving: 139 cals, 5g fat, 0.8g sat fat, 16g carbs

COOK’S TIP Keep packs of berries in the freezer so that you always have them handy to whip up a smoothie

Gluten free

Cranberry muesli bars

Flax seeds have been linked in some 1 Heat the oven to 180C/Gas 4. studies to reducing the frequency of 2 Put the butter, golden caster hot flushes. Mix them into muesli bars. sugar and agave syrup in a pan and heat until the butter has melted, Makes 20 • Ready in 35 mins stirring from time to time. Turn off the heat. 150g butter 3 Tip in gluten-free porridge oats, 50g golden caster sugar gluten-free self-raising flour, 200g agave syrup desiccated coconut, dried cranberries 275g gluten-free porridge oats and all the seeds, and combine. 100g gluten-free self-raising flour Spoon into the tin and press down 50g desiccated coconut well with the back of a spoon. 70g dried cranberries 4 Bake for 25 mins until just golden 150g mixed seeds brown around the edges. Leave to 3tbsp flax seeds cool in the tin, then cut into slices. You will also need: Per muesli bar: 231 cals, 13g fat, 18cm square tin, greased 6g sat fat, 26g carbs

COOK’S TIP Mix this up by adding different dried fruits or nuts ME N O PAUSE

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How to beat

BRAIN FOG Feeling tired, scatterbrained and anxious? Here’s how you can get your mind back in focus

ften find names suddenly elude you, lose your train of thought or you stride purposefully into a room, then can’t remember why? You may feel like you’re ‘losing it’, but that sensation of a mist descending could be down to brain fog. And it’s all normal. We asked the experts what causes brain fog, how to differentiate it from more serious brain conditions, like dementia, and how to help clear your head – fast.

WHAT IS BRAIN FOG?

‘It’s an umbrella term describing a collection of symptoms, generally coined as having a fuzzy head,’ explains dietitian Lola Biggs*. ‘You become less efficient at thinking and processing, and find tasks that require focus and thought difficult.’ What are the red flags? ‘Noticing increased forgetfulness, wandering thoughts and lack of clarity on decisions can all point to brain fog,’ explains Lola. Symptoms also include feeling tired and distracted, as well as mood swings.

THE REASONS?

Many women worry their forgetfulness is an early sign of dementia. But if it coincides with a change in hormone levels, it’s more likely to be the perimenopause. There’s also a

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number of other reasons you might not be firing on all cylinders…

AN UNDERACTIVE THYROID

Your thyroid controls your metabolism and, when it slows, virtually every body function does too – including thought processes. ‘You may want to say one thing, but find something else comes out instead,’ says nutritionist Judy Watson. Other signs could be weight gain and fatigue, so speak to your GP if you’re concerned.

STRESS

Anxious thoughts can intrude on thought processes, hampering concentration and clear thinking. Anxiety can make relatively easy

tasks trickier (more than challenging tasks), according to a study***. This is because straightforward jobs require less cognitive resources, leaving more space for anxiety to seep in.

PERIMENOPAUSE/ MENOPAUSE

‘Around menopause, hormonal changes make many women fear they’re going mad,’ says nutritional therapist Dr Marilyn Glenville. ‘This muzzy mind is thought to be due to the decline in oestrogen.’ Oestrogen, along with testosterone and progesterone, promotes blood flow to the brain, and when this drops, it can result in memory problems. Plus, having just one hormone out of balance can impact your ability to mentally function.

BRAIN FOG VS DEMENTIA The key difference is that dementia affects more than just your memory – it changes your ability to function in daily life. If you answer yes to any of the following questions, talk to your GP.** Have you stopped… ✢ Taking care of household finances? ✢ Doing household tasks you’ve always done? ✢ Doing social activities you used to do?

HOW TO BEAT BRAIN FOG

WAYS TO BEAT BRAIN FOG

Memory improves after the menopause, according to a study.**** However, there are things you can do now to help clear the haze.

BALANCE YOUR MICROBIOME ‘Gut flora that’s out of whack creates the perfect breeding ground for yeast candida albicans,’ says Judy. The yeast produces acetaldehyde, the same chemical that’s created when alcohol is broken down by your liver, which is why you might feel drunk or hungover. Reduce bread intake and try a probiotic to encourage friendly bacteria.

DRINK MORE WATER ‘Dehydration can lead to brain fog and reduced concentration,’ says Dr Glenville. It lowers blood flow and oxygen to the brain, which can lead to headaches, brain fog and confusion.

BE LESS SWEET A sugar overload is bad for your brain. ‘Sugary food causes a surge in blood sugar levels,’ says Dr Glenville. ‘It can trigger brain fog.’

EAT HORMONEFRIENDLY FOODS Menopause causing brain fog? Altering your diet could help. Eat flaxseeds, soy, chickpeas and lentils.

GET TO BED Sleep plays a huge role. ‘A good night’s sleep is essential for the brain to reset,’ says Lola. It boosts learning and creativity, and acts as the brain’s ‘selfcleaning’ cycle to prevent brain fog and get rid of Alzheimer’scausing plaques.

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PHOTOS (POSED BY MODELS): GETTY. *FROM TOGETHER HEALTH. **OREGON HEALTH & SCIENCE UNIVERSITY. ***STUDY BY THE NATIONAL INSTITUTE OF MENTAL HEALTH, MARYLAND. ****STUDY BY THE UNIVERSITY OF CALIFORNIA, WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE AND ALASKA NATIVE EPIDEMIOLOGY CENTER. IF YOU HAVE CONCERNS ABOUT YOUR HEALTH, SEE YOUR GP. CHECK WITH YOUR GP OR MEDICAL EXPERT BEFORE TAKING NEW SUPPLEMENTS

GOOD NEWS

FEED YOUR BRAIN Lola recommends eating oily fish once a week. They’re rich in omega-3 fatty acids, which improves mental fatigue and difficulties with attention and memory.

Guide to MENOPAUSE AT WORK Are your symptoms holding you back? Here’s what you can do

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GUIDE TO MENOPAUSE AT WORK

WORDS: EVA GIZOWSKA. PHOTO: ALAMY. *GOVERNMENT REPORT ON MENOPAUSE, 2019. **FOUNDER OF MENOPAUSESUPPORT.CO.UK

anaging menopausal symptoms, such as hot flushes, brain fog and anxiety, can be tricky enough at the best of times. But what about while trying to stay on top of things at work? Figures* show that menopausal women are the fastest-growing demographic in the workplace, with nearly five million aged 45 to 65 years earning a living. ‘Until fairly recently, menopause was still a taboo subject in the workplace, and many women are still too embarrassed to talk about their symptoms,’ says Diane Danzebrink**, who launched the Make Menopause Matter Campaign in Parliament. ‘They worry they might be unfairly judged or discriminated against.’ For some, it all gets too much. A recent survey by BUPA estimated that around 900,000 women have left their jobs due to menopause symptoms. And the impact menopause can have on working women was highlighted in a recent campaign by the Wellbeing of Women Charity, supported by Sophie, Countess of Wessex. But the good news is that the tide is changing. ‘We’re moving in the right direction,’ says Diane. ‘Increased awareness means that more employers are taking menopause seriously.’ As well as finding out what support your employer can offer (see box opposite), there are also self-help tactics to try.

ALWAYS CHOOSE NATURAL FIBRES

‘Experiencing hot flushes? The last thing you need is to be wearing tight clothes,’ says specialist menopause nurse Kathy Abernethy. ‘Instead, wear loose layers and choose natural fibres, such as cotton or linen, which allow your skin to breathe. If you wear a uniform, ask your employer to provide you with extra outfits. That way you have fresh clothes to change into should you feel hot and sweaty.’

STAY HYDRATED

‘Drink plenty of water and fluids,’ says Kathy. ‘Hot flushes and sweating can cause you to become dehydrated, which makes brain fog

worse. Over 70% of your body is made up of water, and studies show that even a 2% drop can affect concentration, focus and mood. Dehydration also makes you feel more tired and irritable, and it can affect your sleep.’

TRY AND MANAGE YOUR ANXIETY

‘Many women feel more anxious, irritable and prone to low moods as they approach menopause,’ says Kathy. ‘But if you’re working long hours or struggling with deadlines, this can make it worse.’ ✢ Always plan ahead. If you don’t feel prepared, this raises stress levels and exacerbates anxiety. ✢ Give yourself plenty of time to complete projects. ✢ Explore pathways of support. For example, join a menopause self-help group on the internet, or check if your workplace has one. Try the Peppy Health menopause support app, which offers access to healthcare practitioners and wellbeing programmes; peppy.health ✢ Meditate and practise mindfulness. Look on YouTube for videos to follow.

SLEEP BETTER

‘Night sweats can play havoc with sleep, and leave you feeling exhausted for work the next day,’ says Kathy. ✢ Aim to go to bed at the same time. ✢ Make sure your bedroom is dark and well ventilated. ✢ Don’t have caffeine after 2pm. ✢ Sleep in natural fabrics, such as cotton bed sheets and a lightweight silk duvet. ✢ Relax before bedtime – have a warm bath, do some yoga or try a few breathing exercises. ✢ Use calming essential oils, such as lavender, frankincense, ylang-ylang or camomile. ✢ Keep technology out of the bedroom.

EAT RIGHT

‘Make sure you have at least five portions of vegetables every day,’ says nutritional therapist Alison Cullen. ‘Vegetables help to balance blood sugar levels, reducing the stress hormone cortisol.’ Plus, eat healthy fats, such as wild mackerel, salmon, sardines, tuna, herring, chia seeds, walnuts, egg yolks, olive oil, yogurt, nuts and avocado.

HOW YOUR EMPLOYER CAN HELP

‘First, check if there is a menopause spokesperson you can talk to,’ says Diane. ‘If not, arrange a meeting with your line manager. Before the meeting, have a think about how symptoms are affecting your job and what adjustments might work for you.’ ✢ Do you have easy access to toilets and a washroom? ✢ Do you need a desk fan? ✢ Can the air conditioning or heating be adjusted? ✢ Is there somewhere you can rest or take a break? ✢ If sleeping is a problem, can you work more flexible hours, ie start and finish later? ✢ Can you work some days at home? ✢ Can you take time off for healthcare appointments? ‘Write everything down,’ says Diane. ‘If you have notes, this will help you to feel less anxious. Human resources or the occupational health department may have to get involved. But there is a legal onus on employers that they need to support the health and wellbeing of employees.’

OPTIMISE YOUR WORK ENVIRONMENT

✢ Try and sit by a window that opens if you get too hot. ✢ Keep a cooling spray and bottled water on your desk. ✢ Check if you can regulate the temperature, ie be first in meetings so you can turn it down. ✢ Set up your desk space properly, to avoid aches and pains.

CONSIDER YOUR TREATMENT OPTIONS

‘If your symptoms are particularly bothersome, talk to your GP,’ says Kathy. ‘They may suggest hormone replacement therapy (HRT).’

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LOVE, SEX & HORMONES

in midlife

Does the menopause mean saying goodbye to sexy sleepovers? ‘No,’ say the experts. Charlotte Haigh uncovers why you might well be having the most satisfying sex of your life

hen we think of the menopause, we often associate it with unfavourable side effects, such as weight gain, increased health risks including heart disease, a loss of our libido and in turn, our enjoyment of sex. But just because you’re creeping into your late 40s and 50s, it doesn’t mean accepting that feeling sexy, having

fun and a strong sex drive are gone for good! In fact, our experts claim that the menopausal age is when you’re most likely to be having the best sex of your life. Why? Confidence and knowing what you want! Not convinced? Our experts explain why in midlife, our sex lives flourish, and how to beat those menopausal symptoms that may be making things a little more difficult.

LET’S TALK ABOUT HORMONES ‘Women in their late-40s and 50s are in their prime,’ says Tania Adib, consultant gynaecologist at Twenty-Five Harley Street (25harleystreet.co.uk). ‘That said, because we’re living so much longer, you may end up spending a third to a half of your life in oestrogen deficiency once you’ve gone through menopause.’ The risk of heart disease and osteoporosis rises when you lose the protective effects of oestrogen, and some studies have linked dementia with lack of oestrogen, too. ‘Hormone Replacement Therapy (HRT) can ease menopausal symptoms and

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protect health in the longer term,’ says Tania. ‘It can also help with depression and anxiety linked with hormone changes, and is often a more appropriate treatment than antidepressants. I use the latest body-identical HRT, with hormones synthesised to mimic our natural hormones. I’d recommend seeking help as soon as you notice symptoms, and it’s not just the classic hot flushes – look out for low mood and aggression, and aching joints, along with changes t o your menstrual cycle.’ Don’t want to take the HRT route? ‘Natural options include soy isoflavones and black cohosh,’ says Tania.

SEX AND MENOPAUSE

In midlife you may be having the best sex of your life – whether it’s with a long-term partner or a new one. Research from Trinity College Dublin found 60% of over-50s are having regular sex – and that’s linked with feeling more positive about ageing. ‘For many middle-aged women, menopause is liberating because it means not having to think about conceiving, and women are often empowered to ask for what they want at this age,’ says Tania. Hormonal changes may get in the way, though. ‘Sex can become painful due to loss of oestrogen, which can cause the tissues of your vagina to become dry and thin,’ says Tania. ‘I often see women who say their sex life has declined just two years after menopause. HRT isn’t necessarily the whole answer, as it doesn’t always get to the vagina, but there are lots of incredible non-surgical treatments for

LOVE , SEX & HORMONES IN MIDLIFE

HOW TO FEEL SEXY

Need a little help to get you in the mood? Try these top tips from Tracey Cox’s book, Great Sex Starts at 50 (£12.99, Murdoch). ✢ EXERCISE Exercise will help reconnect you to your sexual self – it can increase sexual desire, even in women with a low libido, not least because it results in a better clitoral blood flow. If you hate the gym, get out for a walk or do a class at home. Your sex life will thank you. ✢ TAKE RESPONSIBILITY It’s not our partner’s job to arouse us, it’s our own. This might mean fantasising to get in the mood or during sex. It might mean putting on some music that takes you back to when you were young and up for it all the time. It might mean ‘warming up’ with your vibrator before you slip under the sheets (even better, still holding it). It might mean reading or watching erotica. If you like porn, explore it together. That way it feeds your erotic connection, rather than separates it.

✢ INITIATE SEX The person who initiates sex more often is seen as the ‘sexy person’. Being the ‘sexy person’ makes you feel sexy. Shifting power – changing from being the person who waits to be asked for sex to the person who is demanding sex – is an effective way to shake a sleeping libido.

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PHOTOS: ALAMY, GETTY

vaginal atrophy. Radiofrequency encourages the body to produce the same amounts of collagen as before menopause, rebuilding the tissues. The Mona Lisa Touch and ThermiVa are both technologies (available at 25harleystreet.co.uk) that can help.’ If you’re in a long-term relationship and it’s lack of excitement that’s the problem, why not explore tantra? It puts the emphasis back on intimacy and takes away performance pressure for both men and women. For a down-to-earth introduction to it, read Urban Tantra by Barbara Carrellas (£17.50, Ten Speed).

✢ BEING GREAT IN BED Improving sexual skills will do far more for your self-image than going on a diet. Women who know they are sexually competent rarely experience body consciousness while they’re having sex – even if they do out of the bedroom.

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Why exercise

HELPS Insomnia, hot flushes, low libido? Exercise really can make a difference to all these and more. Just match the activity to the symptoms you are experiencing and feel the benefits

Trouble sleeping? ‘A stretching routine, such as Pilates, can reduce tension and create a sense of relaxation in the body, which is more conducive to slumber,’ says health coach Mary Nash, who works with women struggling with menopausal symptoms. ‘Alternatively, gentle stretching in the evening can help de-stress from the day and get the body ready for sleep.’ Watch the beginner’s guide to Pilates at nhs.uk.

YOGA TO BENEFIT LOW LIBIDO

‘Certain yoga poses can increase circulation to the pelvic area, which improves arousal,’ says Mary.

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‘Stretches around the inner thighs can create a sense of openness, while deep tension release in and around the hips can ensure greater intimacy. There’s even the Kama Sutra Eagle pose, which drives blood flow to the cervix.’ For more information on how yoga can help with menopausal symptoms, contact the British Council For Yoga Therapy (bcyt.co.uk), which lists professional organisations whose members are yoga therapists.

WALK TO CALM HOT FLUSHES AND ANXIETY

‘If you’re feeling stressed, you’re more likely to get flushes,’ warns Mary. ‘Walking can help to calm the mind and body. Running can also make a difference but, for some

women, it can make them feel worse. Or try dancing, HIIT (high-intensity interval training), swimming (if you have a hot flush you won’t feel it in the cool water) or team sports, but make sure it’s something that you really enjoy and can fit in regularly.’

LIFT TO STOP MUSCLE LOSS

The biggest change in your body during menopause is the loss of lean muscle and increase in body fat, especially around your waist. This is due to falling levels of oestrogen. Resistance training will help to boost your metabolism, burn calories, zap tummy fat and reduce your risk of osteoporosis. You can use strength bands, dumb-bells or bodyweight

PHOTOS (POSED BY MODELS): GETTY

STRETCH TO HELP INSOMNIA

WHY EXERCISE HELPS

excellent cardiovascular workout. It is one of the most fun and sociable ways to stay active, especially at a time when you might be struggling with low mood or depression. Try vibrant styles such as salsa, tango and ceroc, or the more exotic flamenco, pole- or belly-dancing.

CYCLE FOR A WORKOUT

This is a great way to build strength in your legs and tone your behind, without the risk of injury or joint problems. It’ll give you your vitamin D fix and is a good workout for your heart and lungs. Riding through the countryside with the wind in your hair relieves anxiety and stress and can take you back to your childhood. Cycling is also fantastic to do with family and friends. Breeze rides are organised female-only rides aimed at getting women out on bikes. Check out letsride.co.uk/breeze.

exercises (such as press-ups or squats) at home in a 20-minute workout. Or get yourself a personal trainer for a tailor-made programme (go to nrpt.co.uk for a list of trainers).

SWIM TO BOOST YOUR MOOD

Research shows that swimming can help with hot flushes, as the water is cooling, soothing and calming, and it boosts your mood. It’s a perfect low-impact exercise, too, that can reduce the risk of heart disease, type 2 diabetes and stroke. It is also a fantastic way to keep active if you have joint or mobility problems. Start gradually (twice a week), slowly building up the distance you swim. Take a look at swimming.org/go/ get-started for more information.

T’AI CHI TO REDUCE STRESS

Calming, meditative t’ai chi integrates body, mind and spirit. It’s performed as a series of slow, graceful, controlled movements, stepping and shifting your weight, and rotating. It forces your breathing to become relaxed and deep, reducing stress and inducing a sense of calm. Visit taichiunion.com.

DANCE TO KEEP AWAY DEPRESSION

Dancing keeps you active, improves balance, posture and coordination, and, as a weightbearing activity, is great for bone health. And, depending on how vigorously you do it, dance can be an

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SKIN&HAIR

during menopause We explore what you can expect, why the menopause can impact your skin and hair, and what you can do to help

e often focus on the bigger changes associated with the menopause, but there are other things you might notice that are not as often talked about and yet are very common. For example, you may experience some changes to your skin and hair, which are due to your body entering a perimenopausal or menopausal state. Don’t worry, however, as there are things you can do to help maintain the condition of your skin and hair. In this feature, we look at the most likely changes you could experience, as well as a few tips and tricks to help you minimise the impact. First, though, why does the menopause effect your skin and hair? It’s thanks to those dropping hormones again, specifically declining levels of oestrogen. Normal levels of oestrogen contribute to the plumpness of your skin, its condition and moisture, as well as to hair growth and thickness. Not only that, your body will reduce the amount of collagen it makes, a protein that is essential for skin elasticity. You may experience a range of effects due to these hormonal changes, including sagging skin, less vibrant skin, more fine lines and wrinkles, and skin dryness. In terms of hair, you may notice that your hair thins, grows more

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slowly or falls out more quickly. Experts still don’t know what causes hot flushes, but the latest thinking is that it’s due to more than just falling oestrogen. ‘Flushes occur when the “thermoneutral zone”, the band of temperature at which you feel comfortable, shrinks. It’s thought that oestrogen primes the body to react to temperature change, and fluctuating levels at the menopause cause the body to become sensitive to the slightest rise,’ explains gynaecologist Mr David Sturdee. But oestrogen isn’t the only culprit. Overactivity of the stress hormone noradrenaline, and lower levels of the brain hormone serotonin, may also be involved.

COMMON MENOPAUSAL SKIN ISSUES

One of the most common skin problems you may experience is a lack of tightness and plumpness, which can make your skin appear less youthful. In some areas, such as on your hands, the skin can get quite thin, meaning you can see more of the veins and lines. Your priority is to try to encourage your body to create more collagen to help keep your skin glowing and plump. You can buy many collagen supplements, which can be >>

Exercise matters

Exercise boosts your circulation and increases blood flow to the skin, making it look brighter.

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