Archive for Menopause Symptoms

Feb
09

Safety of Fibroid Surgery Questioned

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Every year, many women undergo treatment of their uterine fibroids. Many of them are menopausal, as this is the time fibroids can cause problems.

Up to 20% of women have fibroids at some time of their lives. These usually benign growths often occur in pregnancy and shrink after the uterus returns to its normal size. For some women however, they can continue to grow and become quite large. If there is rapid growth, concerns that a sarcoma are raised. A sarcoma is a rare cancer of the muscle cells within the uterine wall.

If you have one or more fibroids, you may experience heavier than normal menses as you approach menopause. This can be a nuisance, but it can also cause anemia. This anemia can impact your health with lack of energy as well as place a strain on your heart if the anemia is significant enough.

There is a wide range of treatments for fibroids, with the final treatment being a hysterectomy. This is usually the coarse of treatment if the anemia is persistent enough, and other treatments have not been successful at lessening the heaviness of the menses.

Many women are happy to have a hysterectomy after months or years of heavy menses and anemia. In the past, a hysterectomy was done exactly has you may be picturing it. An incision in the abdomen, removal and then stitches. A 6 week recovery follows at which you may not be able to work.

A new procedure has been utilized over the past several years that significantly reduces recovery time as it is not as invasive. It is called morcellation. This surgery allows the surgeon to remove the uterus and fibroids through a small incision near the belly button! This has been a tremendous advancement in hysterectomy for women, and the decreased recovery time has helped make the difficult decision of hysterectomy easier.

Your are probably wondering how this enlarge uteruse, sometimes the size of a football; can fit through a tiny opening.

The morcellation procedure involves cutting the removed parts into small peices and removing them as such. A spinning blade is sometimes used, and this is the potential cause of a serious problem.

If your fibroid has a small focus of cancer cells-a sarcoma, within it; this spinning blade can spread this cancer onto other organs within your abdomen. It is very rare that this happens, but it has.

A less lethal but equally serious complication can arise when benign fibroid tissue latches on the other organs, microscopically, and causes problems months and years post operatively.

How can you use this information? If you have fibroids and are considering a hysterectomy, talk to your gynecologist about your concerns regarding this procedure. Ask your surgeon if there have been any patients to experience this adverse outcome and what he or she can do the minimize the chance of post surgical problems. Make sure your surgeon is experienced and qualified to do a morcellation if this is the route you choose.

As with any surgery, there are risks and benefits and it is up to you and your surgeon the discuss and weigh these. This procedure has benefitted many women without any adverse outcomes, and it is still a good procedure in experienced hands.

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Nov
03

What You Can Do About Menopausal Hair Loss

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Losing your hair is a pretty scary thought, and when we begin to experience this, we worry that we may actually go bald. While I am sure most men experiencing hair loss are not thrilled, somehow it is different for women.

Rest assured, most menopausal women do not actually go bald, but some hair loss is to be expected. There are a few things that are important to do if you notice significant thinning of your hair.

First, it is important to determine the cause of your hair loss. This can be addressed by your medical provider, and sometimes a dermatologist is needed to help make a diagnosis and treatment plan.

When you go to see your medical provider, make sure they understand how important this issue is for you. Do not list it along with several other issues, as it may get overlooked or glossed over.

The causes of hair loss can include a condition called Androgenic Alopecia. This is a genetically determined condition where the hair follicles are more sensitive to the level of androgen in the body. As we enter menopause, our androgen (and other hormones) start to fall. The hair follicle cannot sustain the hair, resulting in the hair falling out.  This is the most common cause of hair loss in women, and varies in severity according to your genes. This is some treatment available though, and the sooner your start the better the response is. Topical minoxidil, or Rogaine, causes the follicle to be better supportive of the hair.

Telogen effluvium is another cause of hair loss, often experienced after an illness or major stress; sometimes even pregnancy. All hair follicles have 3 different stages, growth, maintenance and resting (anagen, catagen, telogen). It is considered normal to lose up to 100 hairs a day; hairs in the telogen phase. After a major stressful event to the body such as an illness or surgery, or even emotional stress; the hair follicles enter the telogen phase prematurely. This can cause unusual hair loss, sometimes as much as 6 months following the event. Other causes of this sort of hair loss include some medications, rapid and major weight loss, malnutrition, and some endocrine abnormalities.

Treating telogen effluvium often requires treating the underlying cause. Talk to your provider about changing or discontinuing medication if you think this is the cause. Improving your diet to include plenty of nutrients, and getting plenty of rest and stress reduction are also helpful. A supplement of Biotin can be helpful in restoring the health of the follicle.

There is also traction alopecia, where increased stress on the hair follicle occurs with tight pony tails and hair buns, as well as use of hair extensions. Consider stopping these hair styles, adding a biotin supplement to your diet. Overuse of chemicals on your hair as well as frequent use of heat can also contribute to hair loss through increased breakage of hair. Discontinuing these treatments and adding biotin also helps promote healthy hair growth.

There are a variety of skin related inflammatory conditions that can cause hair loss, and these are best diagnosed and treated by a dermatologist. However, if you notice that more hair loss that you feel is abnormal; it is most likely from one of the causes above.

Some simple steps to arrest your hair loss is good nutrition, stress reduction, a biotin supplement; as well as eliminating any harsh chemical or heat treatments you use. Adopting a hair style less stressful to your hair and scalp should help maintain a relatively full head of hair!

 

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Menopause can be confusing, and it can make you feel as if you are falling apart or losing your mind!

For most of us, we have the irregularity of our menstrual cycle to clue us into a possible cause for the slew of new symptoms we are experiencing! This can become a very confusing time for women who do not have a menstrual cycle any more because of having had a hysterectomy.

When a woman has a hysterectomy, usually the ovaries are left in. This means that a women will still be getting estrogen that the ovaries produce. That is until the ovaries sputter out and stop functioning. When this sputtering is occurring, the symptoms of menopause occur and can be continuous or come and go.

Women with a uterus with have irregular periods during this peri menopausal time. This menstrual irregularity is sometimes, but not always, accompanied by some or all of the symptoms of menopause: hot flashes, sleep disturbance, fatigue, joint and muscle pain to name a few. If you do not have a uterus, you can still experience these symptoms but you may not get clued into menopause as a cause!

It can be mystifying and sometimes scary if you are experiencing these symptoms and do not realize it is menopause.

You may think you are sick from an infection if you are tired and achy, feeling hot and cold. You may wonder if you have diabetes with some of these symptoms. The heart palpitations that come with menopause can cause concern over your heart health. The brain fog of menopause can make you wonder if you are developing dementia.

Before you become frightened about what your health is doing, see your medical provider. A few easy tests can tell you the answer. Your provider can do a test looking at the hormones that control ovarian function to see if you are in menopause. This is called the FSH and LH hormone test. An estrogen level can also be tested but this hormone fluctuates so much, it is not always diagnostic. At the same time, a thyroid test can be done to check for this as a cause. A check for anemia is a good idea, as this can help determine if anemia is contributing to your fatigue.

If you have not had a physical in over a year, the onset of menopause is an excellent time to get a health check. You may think you do not need a female exam following a hysterectomy, but you do! A breast exam and an ovarian exam are two important exams to participate in. Additionally,  blood work to check for diabetes and elevated cholesterol, as well as blood pressure measurement are all important yearly measurements.

Whether or not you have had a hysterectomy, discussing your concerns with your medical provider can allay your fears and concerns regarding your health. Having had a hysterectomy can confuse the picture for you, but your provider has tools at his or her disposal that can be used to clear up any confusion!

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Apr
29

THAT BURNING MAY NOT BE A UTI!

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If you are a woman reading this post, chances are you have experienced a urinary tract infection at some point in your life.  Burning with urination, frequency, and discomfort in the pelvic and genital region are all familiar symptoms to many of us by the time we reach menopause.

Having these symptoms and seeing a medical provider for antibiotics may seem like an automatic “no brainer” therapy. It would certainly be a surprise to be told there is no infection present. Your next questions would most likely involve what could be causing your symptoms.

All that burns is not a UTI! There is a condition that many women suffer from called Vestibulitis. The vestibula is the region inside the vulvar tissues and the entrance to the vagina. This area is loaded with nerves, and can easily become irritated by vaginal or urinary infections. For some women however, this irritation becomes cyclic and persistent, never seeming to completely go away with the standard UTI or vaginitis treatment.

Vestibulitis can be uncomfortable or downright painful. It can affect sexual relations, and it can affect the ability to exercise or even sit for long periods of time.  This pain is often felt as burning, stinging, raw or an irritated sensation. Surprisingly it affects white women between ages 20-60 almost exclusively; researchers are unsure why this demographic is most affected.

The two main types of vestibulitis are cyclic and vulvar. Cyclic vestibulitis occurs mainly with triggers such as intercourse, bike riding for extended periods; and tends to be more intermittent. It is felt to be a reaction to a prolonged mild or undetected yeast infection. It is treated with an extended course of antifungal medications such as Diflucan.

Vulvar vestibulitis is more constant and unremitting. It too can be from an undetected yeast infection but can also be from atrophic tissues  experienced in menopausal or peri-menopausal years. This type of vestibulitis is most likely to occur with menopause when it does occur. It can be treated with topical estrogen cream, sometimes with steroid creams for short periods of time.

Vestibulitis can become chronic primarily due to irritated nerves that release chemicals which further inflame the vestibular tissues, creating a vicious cycle. Because of the potential chronicity of this problems, treatment is usually carried out for many weeks. Along with medication to relieve the symptoms, dietary changes are often helpful. Taking calcium and consuming a low oxalate diet is felt to neutralize the urine and reduce irritation to vulvar tissues.

This problem can have a major impact on a woman’s life and it is important to get to a professional that specializes in vestibulitis if your symptoms are ongoing for months or years. Many medical centers and university hospitals have specialist within their gynecology divisions that specialize in vestibulitis. A specialist is often required for treatment as many gynecologist and family practice providers are not trained to treat this condition; as well as that surgery is sometimes required.

If you are experiencing vaginal or vulvar burning, first see your regular provider to get an exam. Your provider can examine you for a urinary tract infection, vaginal infection, atrophic changes, or other skin conditions that can cause your symptoms. A simple short therapy may take care of your symptoms. If it does not however, I suggest asking your provider for a referral to a specialist.

You may feel your symptoms are too embarrassing to discuss with a specialist, but pain that affects your life should be  evaluated and treated. This will give you quality of life.

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Feb
25

OH MY BEATING HEART!

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Have you ever heard that song by Sting, Still My Beating Heart? Going through menopause has brought that song up from my memory recesses. Many a night I have been left to wonder what the heck was going on in there!

I make light of it, but the truth is that a pounding and flip flopping heart is a very scary thing to feel. Add to this a poor diet and lack of exercise, and many a women might think they are having a heart attack.

While heart disease is the number one killer of women, chances are what you are experiencing is from menopause. Yes, you heard me-MENOPAUSE.

Having said that, it is still important to see your medical provider if you experience these symptoms. You need to have an EKG which can determine an abnormal heart rhythm. You also need to have your cholesterol checked as this can alert you to a possible danger of heart disease if it is very high. Blood pressure, glucose, electrolytes and thyroid can also be contributing factors to an irregular heart beat.

Heart disease causes 1 in 3 deaths for women yearly as compared to breast cancer claiming 1 in 31 lives yearly! Not all women are susceptible, and knowing your risk factors can help guide you.

Family history of heart disease, smoking, diabetes, age are some of the major risk factors. Relative inactivity and being overweight, having high blood pressure and cholesterol factor in also.

Most likely your symptoms on palpitations do not represent any serious medical condition; but it is important to have your heart health evaluated as you enter menopause.

The American Heart Association campaign: goredforwomen is designed to educate women regarding heart disease and has a wealth of information.

This is one issue of aging that is important to be knowledgeable of!

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Dec
14

When Is It Time to Get A Hysterectomy?

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Would you be surprised to know that a hysterectomy is the second most common surgery for a woman in the US to have, second to having a C-section. Up to 1 in 3 women in the US will have a hysterectomy by the age of 60 according to government statistics!

There are many important reasons for having a hysterectomy and these can include cancer of the uterus, ovaries or cervix; large fibroid causing pain or heavy bleeding, endometriosis, or prolapse of the uterus.  If you are experiencing peri-menopausal heavy menses (menorrhagia), you may find yourself thinking how nice it would be to “have it all taken out”. Having a hysterectomy because of heavy bleeding resulting in anemia, can sometimes a reasonable option for you.

For many women entering the premenopausal years, a heavy and prolonged menses can result in anemia. Occasionally this anemia persist as there is not enough time in between the menses  to build the iron stores back up. If this is what you are experiencing, your provider may have advised you to consider a hysterectomy. Or, you may wish he or she would!

Most gynecologists will not do a hysterectomy unless a patient’s life is at stake, or their quality of life is extremely impacted by the symptoms of dysfunctional uterine bleeding. The following are some of the considerations you should discuss with your provider if a hysterectomy is suggested:

  • What are the reasons for my having this surgery?
  • Are there any medications or procedures that can be tried first?
  • What type of hysterectomy will I have and will my ovaries and cervix remain intact?
  • What will my recovery time be and how soon can I return to normal activities and work?
  • Will my condition be cured with a hysterectomy?
  • Are there any long term consequences of having a hysterectomy such as bladder prolapse, consequences of estrogen deficiency if ovaries are removed?

The need for a hysterectomy if cancer is involved is fairly obvious and often does not require further explanation. Surgery for endometriosis is sometimes needed if excessive pain occurs. It is important to understand your ability to have children will end with a hysterectomy. If you have endometriosis, you will want to be sure there are not any other viable options. The same can be said for fibroids, sometimes they are large enough to cause pain or press on the bladder and the bowel causing an interruption in normal daily functions.

There are a few different approaches to hysterectomy. Abdominal hysterectomy involves an incision into your belly and removal of uterus, sometimes cervix and ovaries. This can cause longer healing time as many layers have been cut through and must heal. A vaginal hysterectomy is simpler and usually involves removal of uterus and cervix. This type of surgery is done for non cancerous reasons as an inspection of abdominal cavity is not required. More recently, laparoscopic hysterectomies have been perfected. This allows for abdominal inspection, and removal of necessary organs without a large abdominal incision. There is a shorter recovery time, and this would also be done for non cancer reasons.

If you have a hysterectomy with removal of ovaries, you will want to discuss estrogen therapy if you are still relatively young and there has been no cancer. Surgical menopause can be abrupt and very difficult to tolerate for some women.

If you are having menorrhagia, there are a few other procedures that can be performed prior to consideration of a hysterectomy. There is uterine ablation where the lining to the uterus is cauterized to prevent any further periods. Large fibroids can sometimes be removed or reduced in size by injections to disrupt to blood supply thus causing shrinkage.

There are numerous considerations regarding hysterectomy and whether it is a necessary option or merely a consideration. If you feel you are being pressured into a surgery you do not want to have, I suggest getting a second opinion from a specialist.

Hysterectomies have become very safe and not as much of a life interruption as in the past. Your hysterectomy could be the best thing that happens for your health, but it requires serious thought and decision making as it is major surgery.

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Oct
14

MY MENOPAUSE JOURNEY PART 2

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I consider myself lucky to not have had a multitude of menopausal symptoms. I entered menopause slender and very active with a regular exercise routine and a fairly healthy diet. I do like sugar, and I love good bread and butter. As many of you know, these are some of the enemies of the menopausal woman.

I noticed hair loss early on. My hairdresser snorted when I pointed this out, stating that my thick mane of coarse curly hair could use some thinning. As it turns out, I guess I had nothing to worry about as I still have a decent amount of hair .

Memory became a bit of a worry. One day, I needed to send a money order and went to a market to do this. I actually had never sent a money order, and drew a total blank on what I wanted when asked by the very young woman behind the counter. I made a promise to myself to do crossword puzzles and soduku when I saw her look of derision as I attempted to describe a money order. To date, I have several books on how to preserve your memory as well as bookmarked websites on the subject. I will post on this later!

Fatigue of course is present to this day, and I have accepted that I can never do all that I want to do in a day. To be truthful, I don’t think I did as much in my single 20′s in a day; so I feel ok about this.

Weight gain, ugh! I have fought this tooth and nail, and still have gained a total of 16 lbs in 15 yrs. I have recently lost a few pounds, and I realize this weight gain is modest compared to many women. It takes constant tweaking of my diet and plowing forward with regular physical activity even when I am tired.

Low libido, dare I bring this up? The jokes between the guys when socializing with friends began many years ago. I believe this is a universal problem for women and couples that have been together for a while. Occasionally I meet a woman who states this is not a problem, and usually she is in a new relationship. That can account for a lot. Take heart, it does get better.

So what did I do wrong?

  • Assumed that a life time of healthy habits would carry me through temporarily giving those habits up.
  • Gave into cravings and fatigue; should have pushed forward and stuck to my rules of healthy living
  • Thought I was ‘above it all’ being a health care professional. HA, I am much more humble now.
  • Let stress get to me and did not see the importance of meditative activities such as yoga, meditation or tai chi.
  • Many more minor things that are not important in the large scheme of things

What did I do right?

  • Sought help from my provider as soon as I realized I was losing the fight. In this case it came in the form of short term HRT.
  • Began forcing myself to exercise, albeit at a much reduced intensity
  • Slowly, and I mean slowly, accepted I could not eat the same way unless I accepted massive weight gain
  • Accepted I would not remain the same my 30′s and early 40′s, but vowed not to give up the fight to stay on top of things.

My journey through the last 10 years has given me more patience and personal peace than I ever thought I would have. I am not saying I have all the answers, but I have been able to achieve and maintain more of a balance than I have in the past. I have learned much, both through experience as well as commiserating with friends/ family/patients.

You may feel that you cannot do this, you cannot make it through menopause without losing yourself.

That is just not true. Women have been transitioning through menopause for decades and centuries. We baby boomers think we need to do it better! It is all within our power to let menopause make us healthier or less healthy, depending on the myriad of choices we make along the road.

 

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There are many injustices suffered by a woman in her lifetime. But none can quite match the fear and sometimes horror of hair loss during menopause. I suppose if we knew when it would stop, we could know whether to start searching for the wig stores! But like much in menopause, we feel and are to some degree, out of control of our bodies.

Our hair is one thing that defines us. It is the representation of the kind of care we take of ourselves. It can indicate our style, like the clothes we wear.  Compared to most men, we have spent a small fortune at  the hair dresser getting the perfect cut, coloring,  and perming.

When we see our hair falling out in clumps, we feel we are watching our womanhood fall down the drain also.

Why does this happen and what can we do to stop it?

First and foremost, understand that some hair loss is expected. If female baldness does not run in your family, you are most likely not going lose a significantly noticeable amount of hair.

Secondly, get yourself to your medical provider and make sure you are not anemic, have a healthy thyroid and iron levels, don’t have a connective tissue disease. These can be the major medical causes for hair loss.

Next, look at what sort of styling you are routinely doing to your hair. Persistent tugging and twisting of hair can strain follicles and cause them to shed their hair a little sooner. Believe it or not, most hair lasts 2-6 years, then falls out. That follicle then stays dormant for  short time, then grows another hair. Harsh chemicals and dyes can dry the hair, causing early breaking off at any point on the length of the shaft.

Lastly, look at your diet and lifestyle. Do you get enough vital nutrients to feel the scalp and hair? Do you practice stress relieving activities to lower stress hormones. High levels of stress can cause the hair follicle to loosen the hair within the shaft and shed it; sometimes months after the stressful event.

Menopausal hair loss can last for up to 2 years, but usually your hair does  recover most of its thickness within that time frame following the loss. You can accelerate this process by:

  • Using gentle shampoos and eliminate any harsh chemicals and tight hair styling to lessen the stress on the follicle
  • Consider taking hormones if you have other compelling reasons. The main reason you are losing this hair is a hormonal imbalance which makes the hair follicle less likely to grow new health thick shaft of hair. This is only a temporary solution, but it could give you time to work on healthy lifestyle changes including diet and stress reduction.
  • Increase healthy nutrients in your diet by including foods high in iron, Vitamin E, vitamin D, calcium, as well as Omega-3 fish oil.
  • Learn to meditate if you are stressed, or exercise to help reduce stress hormones.
  • Drink plenty of water, eliminate cigarette smoking and drink alcohol only in moderation (7 drinks a week).

Hair loss occurs because of lower hormone levels, and as your hormones settle at a post menopausal level, the hair loss will stop. There are few medications for women other than topical rogaine, or the use of estrogen replacement.

The important thing is to take good care of yourself and your hair. Get plenty of rest and relaxation to keep stress low, consume a diet high in healthy nutrients. You may need to rethink your hairstyle or the chemicals you use. Don’t despair, your hair will most likely grow back.

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Oct
01

MY MENOPAUSE JOURNEY

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I don’t talk much about myself or my own journey through the menopausal years, after all I am a fairly private person. We are taught in PA school that a patient encounter is about the patient and not us, and we are encouraged to be teachers and not share much personally. This may make some readers wonder how well I can actually relate to their situation. I decided it was time to share my own experiences with menopause with my readers.

Menopause began early for me, much to my surprise. My mother had gone through menopause in her mid-50′s and I expected thus it would be for me. So when I started to develop extreme irritability that occurred pre-menstrually; I assumed I was stressed working a full time job and helping to raise 2 active preteen and teenage boys.

Next came fatigue and the inability to exercise to my normal capacity. While I was accustomed to running 3 miles almost daily on a route that included some hills; I suddenly found myself too tired to run or at best, I was walking up all the hills. It was spring, so I finally assumed I was suffering from allergies and the Zyrtec I was taking must be causing my fatigue. Mind you, my menses were still regular and I was not experiencing any hot flashes or difficulty sleeping.

My weight had been slowly creeping up, but I assumed this was from not exercising as much. Being the astute clinician I like to think I am, I finally made an appointment with my medical provider who screened me for anemia, thyroid disease and connective tissue disease. Luckily for me, all was normal. Still no clues!

It never for once occurred to me that I was peri-menopausal. Even when a patient kindly reminded me that I needed to become an expert on menopause, as this would be my specialty with an aging baby boomer population and me squarely in that category. This was early on and I was busy keeping up with the changes in treatment if hypertension, diabetes, heart disease. I figured I had a little time for learning about menopause!

Finally, the light bulb went on when discussing the signs of puberty with another patient. This also coincided with the first missed menstrual period, and it all became clear to me. And so started the ride that has lasted 10 years for me.

I am mostly at the end of experiencing menopause symptoms, and have been for several years. I still occasionally experience hot flashes at night, but they are mild.

The 10 year journey has given me much insight into the impact of  physical well being on happiness and productivity. I have read countless articles and websites to gain an understanding of what I have experienced, as well as what my patients have and are experiencing.

I have swung between believing medication is the only help there is, to believing that lifestyle and emotional health can cure all. I have now settled in the middle to that pendulum and endorse the benefits of both treatment processes.

In one of my future posts I will share my personal does and don’t.  I have done much reading in order to educate you, and in the process have come to appreciate the mistakes I have made and what I may have done right! The menopause journey is as variable as we women are, and it can be empowering to realize you are not alone in what you are experiencing, and that there are solutions!

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Sep
22

IMPROVING YOUR SLEEP DURING MENOPAUSE AND BEYOND

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Sleep can be one of the most important and frustrating aspects of our lives to be disrupted during the menopausal years.

Many women enter menopause with poor sleep habits, only to find their sleep really becomes a miserable nightly event. Even though not all women have problems sleeping as they go through menopause, most are affected to some degree. Having healthy sleep hygiene (habits) helps to prevent insomnia, and it is not too late to establish this.

Sleep hygiene is a term used by sleep specialist to describe the habits that will best help foster sleep initiation. In other words, there is a list of do’s and don’ts that contribute to the ability to fall asleep and stay asleep.

Our bad habits at the beginning of menopause can set us up for problems during menopause, as we additionally go through physical changes that can disrupt sleep. Changes such as hot flashes, joint pain, stress and anxiety to name a few.

Bad habits that can prevent your from falling asleep can include:

  • Computer use until bedtime, or worse, late into the night. The light from the computer screen is felt to stimulate the awake center of the brain.
  • Drinking caffeine into the evening. Caffeine is a stimulant this can interfere with relaxation and production of melatonin. Melatonin is the substance our brain produces to help make us sleepy.
  • Drinking alcohol. This surprises many people as alcohol is a depressant and can make many people tired. In some, it interferes with melatonin production and can cause a rebound wakefulness after the alcohol is metabolized.
  • Eating late at night.

There are several lifestyle changes you can make to improve your sleep.

  • Exercise! While you may not feel like it, exercise will tire your body and help with sleep.
  • Avoid stimulation prior to bed. In other words, keep noise, music, lights, activities low in the hour before bedtime. Avoid meals, sugar and caffeine for several hours before bedtime.
  • Establish a regular bedtime. This will allow your body to produce melatonin which is the sleep hormone.

What can you do if none of this works?

First, see your medical provider to ensure there are no medical conditions inferring with sleep.

Next, you can try herbal supplements and over the counter sleep aids. These can be helpful, however check with your provider if you are on any medications before starting a new supplement.

I recently began using Estroven Nighttime, and have found it to be very effective for me. It contains Melatonin, which works by itself for some people; and Valerian root which has slight sedative properties. There a other herbs to help with hot flashes, such as soy and black cohosh.

Tylenol pm is one tried by many people. This is basically tylenol and benadryl mixed together, both of which are safe. It is important to not use too much Tylenol mixed in other products, as a total high dose can cause damage to liver and kidneys over time.

It is also important to keep your bedroom cool, use fans at night. Many houses in the south, where I live, have ceiling fans which are helpful. A small fan on the night stand can also work.

Establishing a consistent sleep routine takes some work, but it is worth the effort to gain the much needed rest and restorative healing that occurs during sleep. Try some of these tips and let me know how they work. Write in with any tips of your own to share with our readers!

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