Wednesday 26 July 2017

How to work out the menopause

Many women are familiar with symptoms of the menopause - hot flushes, mood swings, low libido, and most of all, weight gain. But recent research that links the brain to our lack of motivation for working out during these turbulent years, could help women to keep their bodies in shape during and after 'the change'.

Aisling Grimley, 52, upped her exercise regime when she began to get sympyoms of menopause in her late 40s. Photo: Steve Humphreys
Aisling Grimley, 52, upped her exercise regime when she began to get sympyoms of menopause in her late 40s. Photo: Steve Humphreys
Aisling Grimley upped her exercise. Photo: Steve Humphreys
Aisling Grimley exercising. Photo: Steve Humphreys
Aisling Grimley exercising at her home at the South Circular Road in Dublin. Photo: Steve Humphreys.
Aisling Grimley performing some of the exercises when you are at home. Photo: Steve Humphreys
Aisling Grimley performs chair dips at home. Photo: Steve Humphreys

Arlene Harris

Menopause: the word strikes terror into the heart of women everywhere. It is not simply the liberating phase in a woman's life where her ovaries stop releasing eggs and her periods stop - meaning she is no longer fertile. It is a time of plague, when hot flushes, mood swings, exhaustion and weight gain are rained down upon us.

But if new research from the US is to be believed, not all of these symptoms are unavoidable when menopause strikes. The study shows that exhaustion and attendant weight gain can result during menopause due to changes in a woman's brain activity, which causes a lack of motivation to keep active.

The team of researchers from the University of Missouri has identified a link between ovarian hormones and dopamine levels in the brain, which make us feel good after exercising.

By pinpointing the reason why menopausal women lose interest in exercise, researchers may lead the way to new methods of treating lethargy and increasing motivation during menopause.

"Postmenopausal women are more susceptible to weight gain and health issues," one of the study's authors, Dr Victoria Vieira-Potter, has said. "This is especially frustrating for women who already are dealing with significant changes to their bodies. We found that the decrease in physical activity that leads to weight gain may be caused by changes in brain activity.

"Understanding what is causing the decrease in activity and subsequent weight gain may allow us to intervene, possibly by activating dopamine receptors, to preserve the motivation to be physically active."

Diet and nutrition expert Fiona Montague says menopausal women can reduce the propensity towards weight gain by taking extra care with their diet to combat the potential reduction in exercise.

"Reduced energy, changes to our moods and increased cravings are just a few of the symptoms we have to look forward to with the menopause, so it's no wonder women turn to food and find it difficult to feel motivated to exercise," she says.

Montague says changing what you eat during menopause can have a huge impact on your health and well-being.

"The importance of balancing your blood sugars is often only considered a necessity for those suffering with diabetes. However, something as simple as balancing your blood sugars and [so, your] hormones during the menopause is one simple, yet effective way, to help reduce these symptoms."

The Dublin-based nutritionist offers five dietary tips to help with menopause:

1. Eat every three hours, combining complex carbs such as wholegrain bread, pasta, brown rice, quinoa or oats, with a small amount of protein with every meal.

2. Ensure you are getting enough good fats found in oily fish, nuts and seeds.

3. Avoid sugar and watch for hidden sugars found in processed foods.

4. Eat phytoestrogens such as chickpeas, lentils, seeds, soya products and lentils.

5. Drink plenty of water or herbal teas while reducing your tea, coffee and alcohol intake as these dehydrate you.

Aisling Grimley, who lives in Dublin with her four daughters, started experiencing menopausal symptoms in her mid- to late-40s, and five years later, they are still ongoing. Having been pre-warned of the possibility of putting on weight, she started exercising more when the symptoms began. While it was difficult, the hardship has been worth it.

"One of the big fears many of us have at menopause is the dread of putting on weight and getting fat around the middle," says the 52-year-old. "A friend warned me that even though she hadn't changed her routine, she was gaining weight. So I became motivated to get exercising and saw it as an investment in my future.

"One of my great pleasures in life is food, both cooking and eating - so it's vital for me to take some form of exercise every day. Getting moving also improves my mood and sense of wellbeing so it's a double positive.

"I try to cycle or walk places rather than drive, and I make sure to move every day as I would rather do this than be medicalised.

"It can be tough, but menopause is one of the few guarantees we have in life, so it's essential to do weight-bearing exercise, like walking, and also to stretch and do strengthening exercises in order to protect our bone health as well as heart health," says Aisling.

Aisling's regular forms of exercise include walking (and talking) with a friend, planking, and swimming in the sea. "There is something to suit us all and finding your mojo during menopause is empowering," she says.

Aisling felt that there was little or no support available to her - so decided to take matters into her own hands.

"When I first started developing bizarre hormonal surges, I thought I could be pregnant," she says. "So it was with great relief I discovered that I wasn't, but then realised that I was probably starting the menopause.

"I went online for advice but was amazed at how little information there was out there - this spurred me on to set up a website mysecondspring.ie, as a hub for women to learn and share information.

"I now get over 14,000 hits a month from all over the English-speaking world, which shows that women are looking for information and inspiration on a topic that is often hushed up, feared, or brushed aside out of embarrassment."

Dr Caitriona Henchion, medical director of the Irish Family Planning Association (IFPA), says every woman's experience of menopause is different, and it isn't always doom and gloom.

"Many women will experience some negative symptoms leading up to menopause. A minority will suffer significant interference with their quality of life during this time but, for many, menopause is seen as a new beginning," she says.

"We at IFPA would advise women to become informed in the years before it actually happens (perimenopause), so they are better prepared when they do reach menopause.

"Information on a healthy lifestyle is really important, including what steps to take to live a happy, healthy and long life.

"Women should also obtain information on hormone replacement therapy (HRT). Not every woman needs HRT nor is it necessarily suitable for every woman, but for some it will be very beneficial," Dr Henchion says.

"I haven't seen the study from the University of Missouri so can't comment on it, but simple lifestyle improvements such as regular exercise, a healthy diet, quitting smoking and eradicating stress, can also protect from serious health problems later in life," she says.

"I would encourage women to visit their GP or local family planning clinic to ensure they get the right information about the tools available to successfully manage menopause."

About menopause

• Menopause is the phase in a  woman's life when she no longer  menstruates. Her ovaries stop  releasing eggs and her periods stop, meaning she is no longer fertile.

• The average age of menopause in Ireland is 51 years.

• Common menopause symptoms can include fatigue, hot and cold flushes, night sweats, irregular periods, mood swings, disturbed sleep, headaches, hair loss, memory or concentration difficulties, vaginal dryness or soreness and a low sex drive.

• Other symptoms can include skin dryness and hair thinning, weight gain, poor bladder control or prolapse of the uterus due to decreased support for the pelvic organs, osteoporosis due to reduced bone density and cardiovascular (heart) disease.

• Symptoms can start long before a woman's last period and their duration and severity varies considerably from woman to woman.

• Women can still become pregnant while they have menopause symptoms - so it is advisable to continue using contraception for two years after the last period, after which it is safe to assume that they are no longer fertile.

* For more information see healthandnutrition.ie; ifpa.ie

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