What Really Helps During Menopause? Four Pillars for Greater Comfort

Pillar 1: Sleep and Recovery During Menopause

Why do you sometimes sleep worse during menopause?

Sleep problems are common during perimenopause and postmenopause. They may be directly related to hormonal changes, but can also be caused by night sweats, hot flashes, stress, mood swings, restless legs, or the need to urinate more frequently.

A bad night's sleep can lead to fatigue, irritability, and difficulty concentrating the next day. If this happens regularly, it can also reduce your mental and physical resilience.

What can you do on your own to sleep better?

A consistent sleep routine helps send clear signals to your body about when it's time to be awake and when it's time to rest.

These habits can help you sleep better:

• Get up at about the same time every day.
• Make sure to get plenty of natural daylight during the day.
• Keep your bedroom dark, quiet, and on the cooler side.
• Limit your alcohol intake right before bedtime.
• Avoid caffeine in the afternoon and evening if you're sensitive to it.
• Avoid intense exercise right before bedtime if you find that it keeps you awake.
• Create a relaxing evening routine, such as reading, listening to soft music, or taking a warm shower.

Also pay attention to your personal triggers. Some women find that alcohol, spicy foods, stress, or a warm bedroom can trigger nighttime hot flashes. This varies from person to person. Keeping a brief sleep and symptom diary can help you recognize patterns.

Do relaxation exercises help with hot flashes?

Relaxation can help lower your overall stress level and be part of a pleasant evening routine. However, according to current scientific evidence, breathing and general relaxation techniques have not been proven effective as a treatment for hot flashes themselves.

Cognitive behavioral therapy can help some women cope better with the effects of hot flashes and sleep problems. It does not necessarily reduce the number of hot flashes, but it can lessen the discomfort they cause.

When should you discuss sleep problems with your doctor?

Contact your family doctor or gynecologist if:

• You've been sleeping poorly for several weeks.
• Fatigue that affects your work, relationships, or daily activities.
• You snore loudly, gasp for air, or feel extremely sleepy during the day.
• Do night sweats or hot flashes regularly wake you up?
• You feel depressed, anxious, or exhausted for a long time.

Sleep problems are not always caused solely by menopause. Sleep apnea, thyroid problems, iron deficiency, symptoms of depression, or certain medications can also play a role.

Pillar 2: Nutrition and Hydration During Menopause

Is there a special diet for menopause?

There is no specific diet that eliminates all menopausal symptoms. However, a balanced diet does support your muscles, bones, heart, blood vessels, and overall health.

This becomes particularly relevant during and after menopause. As we age and experience hormonal changes, muscle mass can gradually decrease, while fat can accumulate more easily around the abdomen. After menopause, the risk of osteoporosis and cardiovascular disease also increases.

What's the best thing to eat during menopause?

Start by:

• A wide variety of fruits and vegetables
• Whole-grain products
• Legumes
• Nuts and Seeds
• A diet rich in protein
• Foods That Contain Calcium
• Unsaturated fats, such as those found in olive oil, nuts, and fatty fish
• As few highly processed foods as possible

Why is protein important during menopause?

Protein provides the building blocks for your muscles, among other things. Because muscle mass can gradually decrease with age, it’s a good idea to eat protein-rich foods throughout the day.

Good sources of protein include, for example:

• Fish, Poultry, and Eggs
• Yogurt, cottage cheese, and other dairy products
• Legumes such as lentils, chickpeas, and beans
• Tofu and other soy products
• Nuts and Seeds

Nutrition and exercise work together in this regard. Protein alone is not enough to maintain muscle mass. Muscle-strengthening exercises give your body the necessary stimulus to maintain muscle mass.

Why do calcium and vitamin D deserve special attention?

Estrogen helps protect bone tissue. When estrogen levels drop, bone loss can accelerate. Calcium, vitamin D, and weight-bearing exercise are therefore important components of good bone health.

Calcium is found in, among other things:

• Milk, yogurt, and cheese
• Calcium-fortified plant-based alternatives
• Certain green vegetables
• Legumes
• Nuts, seeds, and tahini
• Fish whose soft bones are eaten, such as sardines

Vitamin D is partially produced in the skin when exposed to sunlight and is found only in limited amounts in food. Whether you need a supplement depends, among other things, on your age, diet, exposure to sunlight, skin type, and medical condition. If necessary, discuss this with your doctor or pharmacist.

Should you drink more water during menopause?

Drinking enough fluids supports your body's normal functioning. Water is usually the best choice. Your fluid needs depend on factors such as the weather, your physical activity, your diet, and your health.

However, drinking more water is not a proven treatment for hot flashes or vaginal dryness. Vaginal dryness is primarily caused by changes in the vaginal and vulvar tissues. It is not simply caused by not drinking enough water.

Pillar 3: Regular exercise during menopause

Why is exercise important during menopause?

Regular exercise supports various aspects of your health:

• Your Heart and Blood Vessels
• Your muscle strength
• Your Bone Health
• Your balance
• Your energy level
• Your mood
• Your Sleep
• A healthy weight and a favorable body composition

Scientific research suggests that various forms of exercise, including cardiovascular exercise, strength training, yoga, and Pilates, can support sleep quality and psychological well-being during the menopausal transition. However, the magnitude of the effect varies among women and across studies.

What type of exercise is best during menopause?

The best form of exercise is one that you can and want to do regularly. Ideally, you should combine cardio, strength training, and exercises to improve your balance and flexibility.

1. Fitness Training

Brisk walking, biking, swimming, or dancing help improve your fitness and cardiovascular health.

2. Strength Training

Exercises using weights, resistance bands, or your own body weight help strengthen your muscles and bones. Examples include squats, lunges, and pushing and pulling exercises.

Try to work out your major muscle groups several times a week and build up gradually. If you're not familiar with strength training, guidance from a physical therapist or a qualified trainer can help.

3. Balance and Mobility

Yoga, tai chi, and specific balance exercises can help improve your stability, coordination, and flexibility. This becomes increasingly important as you get older.

Does exercise help with hot flashes?

Exercise has many proven health benefits and can help improve your sleep, mood, and overall quality of life. However, exercise alone is not a reliably proven treatment for reducing hot flashes.

So be sure to exercise for your overall health, muscle strength, bone health, and well-being. Do you suffer from frequent hot flashes? If so, discuss specific treatment options with your doctor.

How do you start exercising when you don't have much energy?

You don't have to start with intense exercise right away. Start small and make it as easy as possible:

• Take a ten-minute walk after lunch.
• Take the stairs more often.
• Do some simple strength exercises at home.
• Schedule your exercise for the time of day when you usually have the most energy.
• Gradually build up the duration, intensity, and resistance.

Ten minutes of exercise isn't a waste of time just because it's not a full hour. Consistency is more important than perfection.

Pillar 4: Intimate Comfort During Menopause

What changes occur in the vagina and vulva during menopause?

Due to the decline in estrogen, the tissues of the vulva, vagina, and urinary tract can become thinner, drier, and less elastic. Natural blood flow and moisture levels may decrease. The vaginal microbiome and pH level may also change.

This set of changes is called the genitourinary syndrome of menopause, or GSM.

Possible symptoms include:

• Vaginal or vulvar dryness
• A burning or irritated sensation
• Itching
• Pain or discomfort during sex
• Light bleeding after penetration
• Needing to urinate more often
• A burning sensation when urinating
• Recurrent Urinary Tract Infections

Unlike some other menopausal symptoms, these intimate symptoms usually do not go away on their own. Without appropriate care or treatment, they may persist or worsen. Yet they are still often not discussed, recognized, or treated.

How do you care for your intimate skin during menopause?

The vulva is made of skin and can become more sensitive and drier during menopause. Therefore, treat it gently.

• Wash the external genital area no more than once a day.
• Use lukewarm water and, if necessary, a very mild, fragrance-free product that is suitable for the vulva.
• For external use only: Do not clean the inside of the vagina.
• Avoid vaginal douches, perfumed sprays, deodorants, and harsh soaps.
• Gently pat the skin dry instead of rubbing it.
• Wear breathable underwear.
• Avoid wearing damp or very tight clothing for long periods of time if it causes irritation.
• If you have dry vulvar skin, use a product specifically designed to moisturize or protect the external intimate skin.

What is the difference between a vaginal moisturizer (vaginal hydration) and a lubricant?

A vaginal moisturizer and a lubricant do not serve the same purpose.

A vaginal moisturizer is used regularly, regardless of sexual activity. The goal is to help reduce recurringvaginal dryness and discomfort.

Lubricant is used just before or during sex. It reduces friction and can make penetration more comfortable.

Non-hormonal moisturizers and lubricants can provide relief for mild symptoms and are mentioned in medical guidelines as a possible first step. Medical treatment may be necessary for moderate, severe, or persistent symptoms.

If you have sensitive intimate skin, choose a fragrance-free product whenever possible. Stop using the product if it stings, burns, or causes irritation.

What can you do if sex hurts?

You don't have to put up with pain during sex. Stop if something hurts, and take enough time to get aroused. A suitable lubricant can reduce friction, but pain can have various causes.

In addition to dryness, an overactive pelvic floor, a vulvar skin condition, an infection, scar tissue, or another gynecological condition may also be a factor. Therefore, have persistent pain evaluated by a doctor. Sometimes, treatment from a pelvic floor physical therapist can help.

What medical treatments are available for vaginal dryness?

If mild skincare products, moisturizers, or lubricants aren't enough, your doctor can discuss other treatment options with you. Depending on your symptoms and medical history, this could include, for example, local hormone therapy.

Low-dose vaginal estrogen is an effective treatment for many symptoms of the genitourinary syndrome of menopause. There are also other hormonal and non-hormonal options. The most appropriate treatment must be determined on an individual basis.

Have you had breast cancer, or are you being treated for a hormone-sensitive cancer? If so, discuss any vaginal symptoms and any hormonal treatment with your oncologist and gynecologist.