The clocks are set to spring forward by one hour on 30 March, paving the way for brighter mornings and lighter evenings.

But the time change that signals the start of British Summer Time also means an hour less in bed, which can make a difference if you are struggling with poor sleep during the perimenopause and menopause.

Sleep issues can be common during the menopause due to hormone changes. The hormones estrogen and testosterone both have important effects on your brain, including helping the quality and duration of sleep. Low estrogen levels can also lead to fatigue, difficulty concentrating, headaches, weight gain, and mood changes, all symptoms which can be exacerbated by a lack of sleep.

Another hormone, progesterone, is beneficial for sleep too, as it increases the production of GABA (gamma aminobutyric acid), a chemical in your brain that works to help sleep. Progesterone can also improve relaxation and mood and a drop in progesterone levels can lead to symptoms such as anxiety, restlessness and trouble sleeping, including a tendency to wake up frequently.

RELATED: Daylight and vitamin D: why you need them during the menopause

Here, balance looks at some tips on how to minimise the impact of the lost hour.

Try going to bed a little earlier

A consistent routine is like an anchor to your sleeping patterns. Going to bed at the same time every night and waking up and getting up at the same time every morning (yes, even at weekends) helps maintain a regular routine.

But in the run up to the clock change, make some small adjustments to your routine: start preparing three days before by going to bed and getting up 20 minutes earlier each day. By Sunday, your body will be in tune with British Summer Time.

And did you know that you can log your sleep quality and duration via the balance menopause support app?

RELATED: Sleep and hormones factsheet

Embrace the lighter mornings

Starting your day with a walk outside is a great way to let your body know you need to be awake and active and reset a healthy circadian rhythm.

There are light receiving cells in your retinas that tell your brain to stop making the sleep hormone melatonin and the light stimulates production of the hormone cortisol, to help get your brain fired up for the day. A light early morning walk will usually help you fall asleep more quickly at night too.

So on the morning of March 30, why not throw those curtains open wide bright and early and embrace the day?

Don’t forget about good sleep hygiene

Sleep hygiene refers to the routines and practices that promote good sleep. It’s about getting your mind and body into a favourable state for sleep, and making your bedroom the best possible environment to fall asleep in.

This includes:

• keeping it cool: It’s much easier to get to sleep and stay asleep if you are on the cool side of comfortable rather than warm, especially if you have hot flushes and night sweats
• avoid (or limit) alcohol and caffeine close to bedtime. Both are stimulants that can disrupt your sleep cycle, so if you are suffering with menopause-related sleep issues this could exacerbate them
• try and curb time spent on mobiles and tablets at the end of the day. Blue light in the evening disrupts your brain’s natural sleep­wake cycles. There are several ways to block blue light in the evening, including dimming or turning off the lights in your home and amber tinted reading glasses
• keep your room as dark as possible as it helps your body’s natural sleep rhythms. Blackout blinds or curtains are great for this.

RELATED: Alcohol and the menopause

Have young children? Prepare them too

Children’s sleep routines can be disrupted when the clocks change, which will also likely mean broken sleep for you. Look to adjust your child’s bedtimes by having afternoon naps, meals and bath time slightly earlier in the days leading up to 30 March.

RELATED: How to talk to your children about the menopause

The post Coping with the clock change appeared first on Balance Menopause & Hormones.

Ramadan is one of the holiest months in the Islamic calendar and marks four weeks of fasting, prayer, reflection and community.

From the evening of Friday 28 February to the evening of Sunday 30 March 2025, many Muslims will observe the month by not eating or drinking in daylight hours.

Here Dr Hina Shahid, a GP and chair of the Muslim Doctors Association, offers advice on managing the menopause during this special month.

What about my hormone replacement therapy (HRT) medication?

Some medication can be affected by the Ramadan fast, so here is what you may need to change if you take HRT.

If you replace hormone levels using skin patches, skin gels, an intrauterine device such as a Mirena coil, or a vaginal pessary or cream, then you don’t need to make any changes during Ramadan.

‘Continue as normal with these forms of HRT,’ says Dr Shahid. ‘These are absorbed through the skin, they are not ingested and have no nutritional value, so they don’t break your fast.’

However, oral HRT does break your fast, so move them to before or after daylight hours.

‘Most women take their HRT tablets first thing in the morning, so just move it back earlier to your suhur, the predawn meal. If you normally have them in the evening, just wait until the sun goes down.’

These small tweaks shouldn’t disrupt their effectiveness, Dr Shahid says. ‘If you just move it by a short amount of time it won’t have an impact on your hormone levels, and as they tend to be taken once a day they are not hard to move.’

RELATED: HRT doses explained

I’m perimenopausal. What if I’m on my period during Ramadan?

Women on their period do not fast during Ramadan, so if you’re in perimenopause and still having periods, Dr Shahid says the exemption to not fast applies, and you can make it up at a later date.

‘If you’re having irregular bleeding, and you have already seen a doctor about this, then you may still be able to fast and it would be advisable to speak to an Islamic scholar who can give specific advice around this,’ she says.

RELATED: Heavy periods during the perimenopause: what you need to know

Don’t be tempted to skip suhur

Your menopause is unique to you, but many women can find their sleep is poor and they are tired as hormone levels decline.

Dr Shahid says it can be easy, especially when you’re tired, not to get up early and leave time for suhur before dawn.

‘But I would always recommend women, especially those experiencing menopause, to get up and have a good healthy meal,’ she adds.

‘Aim for lean protein, like meat, fish or vegetarian options, wholegrains and fruit and vegetables. These will help give a continuous, steady supply of energy that stabilise your sugar levels. Oatmeal is a good option. Make conscious choices about what will work best for your body and provide the nutrients you need.’

Drink plenty of water at night

Keeping hydrated is important for energy and wellbeing and can be tricky for those observing Ramadan as the fast includes not drinking any liquid.

Ensure you drink two litres of water during non-fasting hours, so you are topped up for the day and eat plenty of hydrating foods, such as fruit and salad vegetables, before dawn and after sunset, Dr Shahid says.

Choose evening foods that won’t aggravate perimenopausal or menopausal symptoms

When breaking the fast after sunset, it can be easy to be drawn to a large, rich options for iftar, which can be geared towards unhealthy food.

‘You might really want a samosa, but try and avoid fried and fatty foods,’ Dr Shahid says. ‘They can disrupt your energy levels, give you heartburn, make it harder to sleep and worsen night sweats. It’s really important to pay attention to your nutrition, especially if you are going through menopause. Again, focus on lean protein, wholegrains and a balanced diet.’

Try to stick to a routine

Find a new routine during Ramadan, keeping your meals at similar times every day and following the steps that usually help you manage your symptoms, like not getting too hot in bed.

Many women will go to the night prayers at a mosque, which are often busy and warm. Wear layers of cool natural fabrics to these sessions to minimise hot flushes, Dr Shahid says.

‘You are not going to be perfect every day of the month, but try and have some structure,’ she says. ‘Ramadan is meant to challenge you but within limits. If you can get a daytime nap, and some people take time off during Ramadan to really concentrate on it, then this can help.’

Focus on the positives and joy that Ramadan brings

A month of fasting can bring emotional up and downs, and when mixed with menopause, when declining levels of hormones can affect your mood, this can be a difficult combination.

While some days will be harder than others, there are many positives to take from Ramadan, says Dr Shadid.

‘For women experiencing fluctuating moods due to perimenopause and menopause, it may become more noticeable during Ramadan when you are hungry and tired,’ she says.

‘This is when lifestyle measures are really important, and Ramadan is a really supportive month with a focus on community and family. A lot of people do extra prayers, it is a spiritual time with an emphasis on gratitude. This can lead to an amazing positive synergy between Ramadan and mood.’

Reaching out into the community and talking to other women who are going through the menopause during this time can be a great source of support, says Dr Shahdid.

And if you are really struggling on some days and break your fast, don’t feel you have failed.

‘There are all sorts of reasons that people need to break their fast, and people are encouraged to stop if they need to,’ says Dr Shahid.

‘You can make it up at another time. It is important for women not to feel bad and beat themselves up, it is absolutely fine.’

The post Managing your menopause during Ramadan appeared first on Balance Menopause & Hormones.

• Menopause can bring relationship issues to the fore and prompt the desire to divorce
• Divorce litigation can be costly, stressful and emotionally damaging
• Alternative dispute resolution methods are well worth considering 

It’s becoming increasingly clear that divorce and menopause often go hand in hand. In a poll of almost 1,000 women, 7 out of 10 (73%) respondents blamed the menopause for the breakdown of their marriage [1].

RELATED: Menopause puts final nail in marriage coffin

However, many women find divorce and accompanying litigation paperwork extremely burdensome. Menopause symptoms such as brain fog, anxiety, insomnia, mood changes and depression (to name but a few) can make it difficult for women to remember facts of their case or meet court deadlines and deal with complex legal arguments when it comes to splitting the money or sorting arrangements for their children.

RELATED: Assessing the impact of menopause and divorce on women

Why is divorce litigation so tough?

Divorce litigation is replete with risks – there can be extensive legal costs, it can be emotionally damaging for family and loved ones, and outcomes are hard to predict since you are largely putting your trust in the hands of a single judge at trial.

There are better ways to deal with divorce and its aftermath than court litigation, especially for perimenopausal or menopausal women who want to achieve outcomes with less hostility and better efficacy. The thought of giving evidence in the witness box can be daunting, especially if you are experiencing brain fog, cognitive impairment, and anxiety.

But throwing in the towel is not an option either if that means giving up on splitting the assets fairly or accepting arrangements for yourself or your children that are far from ideal.

RELATED: Podcast: divorce, perimenopause and menopause with Farhana Shahzady

What are the alternatives to divorce litigation?

Alternative dispute resolution (ADR) can help you navigate a difficult divorce. Several ADR options are available and worth considering alongside your family lawyer. These include:

Mediation

Mediation is a voluntary process where an independent, professionally trained mediator can help you find solutions to issues you are experiencing when going through a divorce, separation or dissolution of a civil partnership and all the related issues involving finances and children.

Mediation is a safe and constructive place for open and honest conversations to take place and decent mediators can skilfully guide you in discussions to help find a way forward after divorce or separation.

The job of the mediator is to seek to bring everyone together to reach a fair resolution.

One of the key benefits of mediation is its flexibility and lower cost. Mediation can be conducted at a pace that suits both the parties involved, unlike the court process, which can be slow and inconvenient.

It also allows both parties involved to set the agenda and discuss what is important to them in an environment and pace that suits them. Where appropriate, it may also be possible to involve children in the process, enabling their voices to be heard.

Costs of mediation are a fraction of those involved in court proceedings so it’s worth considering mediation in most cases.

RELATED: read more relationship articles in the balance menopause library

Collaborative process

This process involves all parties, including collaboratively trained family lawyers, sitting around a table to discuss and work through the issues surrounding divorce or separation, instead of having decisions imposed upon them by the court.

The collaborative process is completely confidential, and it allows both parties to stay in control of their personal situation. This often establishes a more flexible, creative approach to financial and childcare arrangements than may have been possible with the traditional court process.

RELATED: Podcast: families, relationships and the power of connection with Julia Samuel

Solicitor-led negotiations

Solicitor-led negotiations can take place at any point during a divorce or separation and can often reduce conflict in the relationship, ultimately making the experience less stressful for everyone involved. It can also be used during court proceedings, to help negotiations and to reach settlement before final trial if possible.

Usually taking the form of round table meetings or telephone and letter correspondence, solicitor-led negotiation can be particularly useful for families where children are involved. It offers parents more control, and a chance for them to work together to decide the best care arrangements for their child.

As with mediation and the collaborative process, a family therapist can be used to help with any emotional issues that are causing difficulty in reaching an agreement.

Arbitration

So long as both parties agree on using the arbitration process, an arbitrator can adjudicate on all the issues and can take the time to understand what is involved, whether it’s to do with finances or child arrangements. This will give the parties involved a fair, impartial and binding decision on the specific concerns they have.

Arbitration is an effective alternative to the court deciding the way forward and, like the other dispute resolution processes, offers greater control and the ability to tailor what is needed.

The family courts are currently extremely stretched, and the arbitration process is instead designed around the parties’ needs and timescales.

RELATED: Menopause and relationships – a guide for partners booklet

Emotional support and family coaches

Family consultants, therapists and coaches are regularly used to reduce the emotional stress and impact for clients throughout divorce or separation and often work side by side with the family lawyer in a complementary way. They can help shock absorb some of the added stress that comes from menopause and divorce.

Thankfully there is growing awareness amongst some family lawyers that litigation should be a last resort and it is vital that women find a sympathetic family lawyer skilled in the latest dispute resolution techniques. These techniques are appropriate for many cases that otherwise find themselves in court.

Farhana Shahzady is senior family lawyer, collaborative practitioner and mediator at Beck Fitzgerald as well as being a menopause campaigner and founder of The Family Law Menopause Project.

References

1. Family Law Menopause Project and Newson Health Research and Education, 2022

The post Menopausal and getting divorced? How to make your split as smooth as possible appeared first on Balance Menopause & Hormones.

• Perimenopause and menopause can be a lonely time of life
• Loneliness can be detrimental to your physical and mental health
• Discover ways of building up layers of connection

In today’s busy world, most of us are surrounded by people – be it at work, home, through social clubs or friendships, or caregiving or volunteering. And yet according to the Office for National Statistics, women (24%) are more likely than men (20%) to feel lonely at least some of the time [1].

When we think of loneliness, we often associate it as something that happens later in life, maybe an old person alone in a care home, or we’ll recall times as a child or a teen when feeling that no-one “got you” was part of the norm. It can be perfectly possible to feel lonely, and it’s something that even social butterflies or successful businesswomen experience. Being surrounded by people is no barrier to feeling lonely.

Is loneliness bad for you?

Make no mistake, spending time alone and enjoying your own company is perfectly healthy – sometimes there’s nothing nicer than shutting the doors on the outside world. But if you feel lonely, that’s been shown to have detrimental effects on your physical and mental health.

Social isolation has been found to rival smoking, obesity and physical activity in terms of increasing risk of premature death [2]. It’s also associated with a 50% increased risk of dementia, plus higher rates of depression, anxiety, and suicide [3].

RELATED: Am I depressed or menopausal?

Even if you are not socially isolated – you have people in your life but still feel lonely – this can have a negative effect on your health, especially during the menopause.

Why can menopause make you lonely?

Midlife can be a liberating, freeing period of life full of possibility and change. If you have children, they may be older and require less of your time; you might be flourishing in your job and feel secure in your relationships. On the other hand, it can also be a time of loss – an empty nest if your children move away, you may have elderly relatives who need care or struggle with their health, and if you’re entering the menopause, you may feel a sense of loss over your fertility or overwhelmed by what the next chapter of life might bring.

RELATED: How do I cope with grief during menopause?

Perimenopausal and menopausal symptoms can be challenging. Some women find their mood dips or they have increased feelings of anxiety or irritability. Symptoms can have a knock-on effect on your relationships – with your partner, friends and family, and at work. This can lead to a loss of confidence and you may feel others don’t understand what you’re experiencing. Conversely, it’s been found that as women’s levels of loneliness increase, so too do their menopausal symptoms [4].

How can I tackle my loneliness?

Acknowledging you feel lonely can help – understand that it’s not a reflection on you as a person but is about your circumstances. Consider what’s at the heart of your loneliness.

For some women, it’s menopause itself. In the Department for Health and Social Care’s ‘Women’s Health – Let’s Talk About It’ survey of nearly 100,000 people in England, less than 1 in 10 participants said they have enough information on menopause (9%) [5].

The free balance app is full of resources to help you track and learn about your symptoms. There are also community pages – just knowing other women are experiencing similar things can help you realise you’re not alone.

The same government survey also found that 70% are comfortable talking to friends about the menopause, and 64% are comfortable talking about it with healthcare professionals (compared to 61% with family members). These conversations can help you build up a circle of support.

If your relationship with your partner is a contributing factor to your loneliness, consider if you’ve grown apart or any reasons you might not be connecting. Some couples bond over shared caring commitments of children but then when the children leave home, discover they don’t have as much in common. Your partner also may not understand how your menopausal symptoms can affect you – and they can’t be expected to know unless you tell them!

RELATED: Emotionally supporting each other through the menopause

Similarly, friendships can take work, and that can feel hard when you’re not feeling your best. If you’re feeling lonely, consider your closest relationships. Robin Dunbar is a biological anthropologist and founder of Dunbar’s number, a theory about the number of social relationships a person can maintain. His research suggests most people have an inner circle of five people, usually made up of family members and up to two or three close friends. These relationships need investment to help them to thrive. If you’ve lost contact with a friend and their friendship is valuable to you, pick up the phone or send them a message. It can be tricky to socialise if you’re not feeling your best but you don’t have to be the life and soul of a night out – a walk with a friend can be beneficial for both of you.

RELATED: Friendships and menopause: how conversations can be transformational

According to Dunbar’s theory, we have successive layers of friends, contacts, acquaintances, and people you recognise. These require less work but they can still be of value in combatting loneliness. Saying hello to a neighbour as you walk your dog in the morning, for example, is a connection.

Consider joining a group to help to help find a sense of purpose and of belonging. It might be an exercise group or starting a new hobby or joining a committee at work. Think of your midlife as a time to discover yourself – it’s OK to question who are. What might you like to do or try now?

RELATED: Why menopause can be your second spring

References

1. NHS Health survey for England 2021

2. National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.

3. National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.

4. Bayri Bingol, F. , Demirgoz Bal, M. , Yilmaz Esencan, T. , Ertugrul Abbasoglu, D. & Aslan, B. (2019), ‘The Effects of Loneliness on Menopausal Symptoms’, Clinical and Experimental Health Sciences, 9(3) 265-270. doi:10.33808/clinexphealthsci.533511

5. Gov.uk: Results of the Women’s Health – Let’s Talk About it Survey

The post Loneliness and menopause appeared first on Balance Menopause & Hormones.

• The Mediterranean diet has been proven to improve health and life expectancy
• It also has specific benefits to women experiencing perimenopausal and menopausal symptoms
• Discover the foods and meals to fill up on

By the time of perimenopause, most women will have been on a diet of one sort or the other. We’ve heard all the claims before and have been there, counted the calories. But rather than a diet per se, the Mediterranean diet is a way of eating – it’s inspired by the way people traditionally eat in coastal Mediterranean countries, including Italy, Greece, Turkey, Spain and France.

Unlike many other diets, with their short-term focus on weight loss, the Mediterranean diet is simply about eating healthily and making this a long-term way of life.

RELATED: Creating long lasting food habits for better health

What is the Mediterranean diet?

The Mediterranean diet principally contains plenty of fruits, vegetables, beans, nuts, seeds, whole grains and unsaturated fats such as olive oil. It also includes moderate amounts of dairy foods, eggs, fish, and poultry. There is then a limited amount of red meat and saturated fat, such as butter.

As it’s a more “natural” way of eating, this diet limits sugar, highly processed foods, refined carbohydrates, and processed meats. This means you’re eating more food in its natural form and don’t need to track down any special ingredients – they’re all readily available.

What are the benefits of the Mediterranean diet?

For many years now, the health of people living in southern European countries has been studied and it’s been found that those who eat a Mediterranean diet have a better life expectancy, lower rate of chronic disease, lower cancer rates and better heart health.

Research has shown that a traditional Mediterranean diet can reduce the risk of developing conditions such as type 2 diabetes, high blood pressure and high cholesterol. There is data to suggest that it has a protective role against Parkinson’s disease onset and progression [1]. According to Alzheimer’s Society there is some evidence that eating a Mediterranean-style diet can reduce the risk of developing problems with memory and thinking, and getting some forms of dementia.

RELATED: How to beat menopausal brain fog

Can the Mediterranean diet help in menopause?

A review of observational studies and randomised trials on the effects of the Mediterranean diet on menopausal health found that if adhered to long-term, it can reduce cardiovascular disease risk factors, improve bone mineral density (even in women with osteoporosis), prevent against cognitive decline, reduce the risk of breast cancer, help prevent cognitive decline and reduce all-cause mortality [2].

With regards to hot flushes during menopause, researchers found that of about 6,000 women who were followed for over nine years, those who ate a lot of strawberries, pineapple and melon and most closely followed a Mediterranean-style diet were about 20 per cent less likely to report symptoms [3].

There is also evidence that the severity of menopausal symptoms can be reduced by eating a Mediterranean diet. A study found that the intake of legumes and extra-virgin olive oil was associated with lower severity of total menopausal symptoms and psychological symptoms, respectively [4].

RELATED: Nutrition, mindset and maintaining a healthy weight in menopause

What foods should I eat in a Mediterranean diet?

These are the foods that should make up the bulk of your diet.

• Vegetables
• Fruits
• Legumes, nuts and grains
• Healthy fats and vinegars: the likes of extra virgin olive oil, apple cider vinegar, balsamic vinegar, red wine vinegar
• Herbs and spices
• Extras: olives, sesame seeds, tahini

These can be eaten in more moderate amounts

• Dairy and cheese
• Seafood (especially oily fish) and poultry (with limited red meat)

RELATED: 7 foods to eat more of during the menopause

What can I drink in a Mediterranean diet?

Water and unsweetened drinks such as tea and coffee and fresh juice. Wine can be drunk in low to moderate amounts, as part of your meal.

What is a typical Mediterranean diet?

Breakfast options can include the likes of:  

• Yoghurt, nuts, seeds and fruit
• Frittata – try spinach and feta or one packed with your favourite veggies
• Tomato and avocado on toasted sourdough, or roast tomatoes, peppers add garlic and spices, and serve with kale and a poached egg
• Oats, chopped apple and walnuts, add cinnamon and ginger
• Wholegrain toast with peanut butter and a banana

Lunch options could be:

• Nicoise salad
• Vegetable soup such as minestrone
• Greek salad
• Grain bowl – add in your favourite salads/veggies, protein such as chicken or egg
• Pasta salad or pasta puttanesca

Dinner options include:

• Lemon and garlic chicken with feta and olives
• Baked salmon parcels with veggies and grains
• Fish stew
• Roasted vegetable and halloumi traybake
• Stuffed peppers

RELATED: How menopause friendly is a vegan diet?

Can I have snacks and desserts in a Mediterranean diet?

You don’t need to forgo snacks but if you eat plenty at your main meals you may not feel the need to snack as much. Mediterranean-style snacks include homemade dips such as houmous and tzatziki, with crudites, wholewheat crackers or pitta; a handful of nuts; fuits; oatcakes with cottage cheese or peanut butter. For dessert, think Mediterranean and fruit based – so the likes of fruit salad, fruit crumble, baked pears, Greek yoghurt and berries, etc.

RELATED: Do I need supplements during menopause?

References

1. Bisaglia M. (2022), ‘Mediterranean Diet and Parkinson’s Disease’, Int J Mol Sci. 24(1):42. doi: 10.3390/ijms24010042
2. Cano A, Marshall S, Zolfaroli I, Bitzer J, Ceausu I, Chedraui P, Durmusoglu F, Erkkola R, Goulis DG, Hirschberg AL, Kiesel L, Lopes P, Pines A, van Trotsenburg M, Lambrinoudaki I, Rees M. (2020), ‘The Mediterranean diet and menopausal health: An EMAS position statement’. Maturitas. 139:90-97. doi: 10.1016/j.maturitas.2020.07.001
3. Gerrie-Cor M Herber-Gast, Gita D Mishra. (2013), ‘Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study’, The American Journal of Clinical Nutrition, 97(5), pp 1092-1099, doi.org/10.3945/ajcn.112.049965
4. Vetrani C, Barrea L, Rispoli R, Verde L, De Alteriis G, Docimo A, Auriemma RS, Colao A, Savastano S, Muscogiuri G. (2022), ‘Mediterranean Diet: What Are the Consequences for Menopause?’, Front Endocrinol (Lausanne). 25;13:886824. doi: 10.3389/fendo.2022.886824

The post Can the Mediterranean diet help menopausal symptoms? appeared first on Balance Menopause & Hormones.

Anna, 48, has been slender all her life. A Pilates teacher, she walks her dog every day, is fit and active and yet: ‘Over the last couple of years, since I started getting perimenopausal symptoms, I’ve developed what can only be described as a pouch of fat around my belly. I eat a healthy diet and think I’m doing everything ‘right’ but I just can’t shift it.’

The balance app’s community pages – where women can share their experiences of perimenopause and menopause and offer support – are full of similar stories. Faye, 36, had a hysterectomy two years ago and has been taking HRT for 18 months. She asks: ‘I can’t seem to lose weight and it’s getting me down. I’ve recently completed Couch to 5K and try to eat well but I’m so hungry all the time! It used to be so much easier to lose weight, has anyone found a diet or exercise routine that helped?’

In a Newson Health study of 5,744 women, two thirds (68 per cent) said they had gained weight since the start of perimenopause or menopause [1]. This can influence self-esteem and body confidence. Plus, it can be hard enough to lead a healthy lifestyle when you are struggling with symptoms of menopause but if you’re trying to do so and still gaining weight, it’s not only disheartening but can be demotivating.

RELATED: Help – I’m heading for the menopause and I can’t control my weight!

Often, women will find that while their eating habits haven’t changed, the weight has crept up on them, particularly around the waist. For many, the average weight gain – approximately 1½lb each year during midlife [2] – might not seem significant, rather it’s the appearance of the “spare tyre” that causes concern.

Why am I getting a belly in middle age?

While there is no single reason for the midlife tummy, hormones, age, changing body composition, and lifestyle factors can all contribute.

Does oestrogen affect belly fat?

When oestradiol (oestrogen) levels fall, such as during perimenopause and menopause, it can lead to several changes in your body:

Insulin resistance

Oestradiol, progesterone and testosterone all help regulate how your body uses insulin, a hormone produced by the pancreas that controls blood sugar levels. When you eat, your blood sugar levels rise. In response, your pancreas releases insulin. Insulin acts like a key, unlocking cells so glucose can enter and be used for energy. In insulin resistance, the cells in your muscles, fat, and liver don’t respond well to insulin. It’s like the key (insulin) isn’t working properly, so glucose can’t enter the cells as easily.

To overcome this, your pancreas produces more insulin. Initially, this extra insulin can keep blood sugar levels normal. Over time if the cells become more resistant, even the extra insulin isn’t enough to keep blood sugar levels in check. This can lead to higher blood sugar levels, a condition known as hyperglycaemia. Persistent insulin resistance can lead to prediabetes and eventually type 2 diabetes. It also contributes to weight gain, especially around the abdomen, because high insulin levels promote fat storage.

Think of it like this: imagine trying to open a door with a key that doesn’t fit well. You might be able to jiggle it and get the door open at first, but over time, it becomes harder and harder until you can’t open the door at all. Lower hormone levels can make your body less sensitive to insulin, causing insulin resistance.

Metabolic changes

Oestradiol also plays a role in maintaining a healthy metabolism (the rate that your body uses calories). Lower levels can slow down your metabolism. Also, during menopause, your lean muscle mass reduces, which in turn affects your metabolism. A slower metabolism is one reason that your weight can still increase even if you are eating the same as you always have, and continue the same amount of exercise.

Change in fat distribution

During the perimenopause and menopause, your body tries to combat decreasing levels of oestradiol by trying to obtain it elsewhere – chiefly from a different form of the hormone, called oestrone. This is produced in your fat cells (as well as your adrenal glands) and is less effective than oestradiol and is more inflammatory in your body.

Oestradiol regulates your body’s fat distribution.  Before menopause it distributes fat mostly to your breasts, bottom and thighs but as levels of oestradiol fluctuate and reduce during perimenopause, fat distribution shifts to your abdomen. The fat is also different – rather than subcutaneous fat (the type that sits just below your skin), it’s visceral fat, a deeper, internal fat that surrounds your vital organs. Visceral fat is hormonally active, which means it can release hormones that affect your metabolism. One study has found that during perimenopause the rate of fat gained doubled [3].

Can stress affect my weight?

Your sympathetic nervous system (the part that increases heart rate, blood pressure and breathing rate) is supported by oestradiol. Low levels of oestradiol can trigger a fight/flight/freeze reaction, which is your body’s way of facing a perceived threat. This stress reaction also releases the stress hormones adrenaline and cortisol, which causes your liver to release glucose to give you energy (to run or fight). However, when this glucose isn’t used – because you are, for instance, stressed at your desk at work – insulin is released, which then stores the glucose away as fat. Too much stress, and resulting cortisol, can therefore increase your risk of visceral fat.

RELATED: Why is the menopause so stressful?

What else can give me a belly?

Some women find their menopausal symptoms – such as joint pains and vaginal dryness – mean they don’t exercise as much as they did previously. Others experience poor sleep and/or anxiety, both of which can contribute to food cravings, often those high in sugar or unhealthy fats, which the body lays down as oestrone-producing abdominal fat. Dr Louise Newson, GP, menopause specialist and balance founder confirms: ‘A study I was involved in, led by epidemiologist Professor Tim Spector, demonstrated that menopausal women are more likely to weigh more, eat more sugary foods, have higher levels of glucose and insulin and to report sleep difficulties. Menopausal women are also more likely to have raised glucose levels after eating.’ [4]

Is belly fat dangerous?

Even if your weight stays stable or within a healthy range, carrying extra fat around your middle can increase your risk of health issues. Metabolic changes and accumulating visceral fat can lead to a greater risk of insulin resistance (increasing glucose levels and increased risk of type 2 diabetes) and a rise in cholesterol [5,6].

RELATED: Navigating your diabetes and the menopause

What can I do about belly fat?

Consider your diet

Considering your diet is not the same as dieting. While it’s sometimes touted that women in their 50s might need about 200 fewer calories a day than they did in their 30s and 40s to maintain their weight, the situation is complicated and individual. And it’s worth remembering that according to the BMS, no high-quality studies evaluating the effectiveness of popular diets such as ketogenic, time-restricted eating and fasting have been conducted amongst perimenopausal and menopausal women [7]. What works for men won’t necessarily work for women, and what works for younger women won’t necessarily work for midlife women.

RELATED: Nutrition, mindset and maintaining a healthy weight in menopause

What you can do is optimise your diet.

Protein helps to keep you fuller for longer between meals by reducing levels of the hunger hormone ghrelin, while boosting levels of the appetite-regulating hormone peptide YY. Although we need protein throughout our lives, during menopause it can help energy levels, which can be at a low ebb.

Carbohydrates are another important energy source. They are not all created equal – try to obtain your carbohydrates from low-GI sources. These are foods that are broken down slowly so will cause smaller increases in your blood-sugar levels, keeping you satisfied for longer, and encourage your body to burn fat. Vegetables such as lettuce, broccoli, cabbage, cauliflower and peppers are great sources as they also contain fibre and other nutrients.

In contrast, high-GI foods, such as white bread, white rice, potatoes and sugary soft drinks, can cause blood-sugar levels to rise rapidly (causing your pancreas to release more insulin) and then quickly fall. This can lead to you craving food and/or overeating.

Maximise your exercise

Many women (and men!) become less active as they age. It might be that your menopausal symptoms are preventing you from exercise or the habit has dwindled. Being active doesn’t have to mean punishing gym workouts – if you enjoy the exercise, you’ll more likely stick at it. Think about your everyday activity levels – have you got in the habit of driving to the shops instead of walking, for instance?

Strength or resistance exercise is paramount at this stage of life – not only will the likes of squats, ankle taps, bicep curls and press up (start by doing them against the wall), help tackle the decline in muscle mass, it can increase your metabolic rate.

RELATED: Get stronger during the menopause

Remember to think long-term when setting yourself goals. The BMS says calorie reducing diets with increased exercise, including strength exercise, is the route to achieving long-term (over four years) weight management, and leads to both reductions in waist circumference and body fat [8].

Learn about HRT

If you are experiencing perimenopausal or menopausal symptoms, HRT is the first-line treatment. A study found that women taking HRT had less visceral fat, lower glucose and insulin levels [10]. More research is needed to determine if HRT directly influences visceral fat or if because it helps women manage their menopause symptoms, they are more likely to feel better and look after themselves through healthy diet and exercise.

Many women find that when they take testosterone in addition to their HRT, they have more energy and stamina so exercising is easier. 

RELATED: Will HRT make me gain weight?

Be kind to yourself

Sometimes you can do everything “right” but still gain fat around your belly. Hopefully, by understanding the physiological changes behind this, you can turn off your inner critic, be kinder to yourself and learn to appreciate your body throughout all its changes.

References

1. Glynne, Sarah et al. ‘Overcoming barriers to health: diet and exercise habits in perimenopausal and menopausal women’. Maturitas, Volume 173, 37
2. Sternfeld B, et al. (2004), ‘Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women’s Health Across the Nation’, Am J Epidemiol, 2004. 160(9): p. 912–22. https://doi.org/10.1093/aje/kwh299
3. Greendale G.A., Sternfeld B, Huang M, Weijuan Han , Carrie Karvonen-Gutierrez , Kristine Ruppert , Jane A. Cauley , Joel S. Finkelstein , Sheng-Fang Jiang , Arun S. Karlamangla,(2019) Changes in body composition and weight during the menopause transition}, JCI Insight,3 (4) https://insight.jci.org/articles/view/124865},
4. Bermingham, K. M., Linenberg, I., Hall, W. L., Kadé, K., Franks, P. W., Davies, R., Wolf, J., Hadjigeorgiou, G., Asnicar, F., Segata, N., Manson, J.E., Newson, L. R., Delahanty, L. M., Ordovas, J. M., Chan, A. T., Spector, T. D., Valdes, A. M., Berry, S. E. (2022), ‘Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study’, EBioMedicine, 85:104303. doi:10.1016/j.ebiom.2022.104303
5.  Zhu, D., Chung, H. F., Dobson, A.J., Pandeya, N., Brunner, E. J., Kuh, D., Greenwood, D. C., Hardy, R., Cade, J. E., Giles, G. G., Bruinsma, F., Demakakos, P., Simonsen, M. K., Sandin, S., Weiderpass, E., Mishra, G. D. (2020), ‘Type of menopause, age of menopause and variations in the risk of incident cardiovascular disease: pooled analysis of individual data from 10 international studies’, Human Reproduction, 35(8), pp. 1933–43. doi:10.1093/humrep/deaa124
6. Christakis, M. K., Hasan, H., de Souza, L. R., Shirreff, L. (2020), ‘The effect of menopause on metabolic syndrome: cross – sectional results from the Canadian Longitudinal Study on Aging’, Menopause, 27 (9) pp. 999–1009. doi: 10.1097/GME.0000000000001575
7. BMS: Nutrition and Weight Gain
8. BMS: Nutrition and Weight Gain
9. Bermingham, K. M., Linenberg, I., Hall, W. L., Kadé, K., Franks, P. W., Davies, R., Wolf, J., Hadjigeorgiou, G., Asnicar, F., Segata, N., Manson, J.E., Newson, L. R., Delahanty, L. M., Ordovas, J. M., Chan, A. T., Spector, T. D., Valdes, A. M., Berry, S. E. (2022), ‘Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study’, EBioMedicine, 85:104303. doi:10.1016/j.ebiom.2022.104303

The post Why can’t I shift my menopause belly? appeared first on Balance Menopause & Hormones.

• More women are asking their doctor for HRT for treating their perimenopausal and menopausal symptoms
• Tracking your symptoms and researching the perimenopause and menopause can help
• Understand your rights and why shared decision making is important

Only 15% of menopausal women in the UK take HRT [1], and in some areas it’s as low as 7% [2]. This is despite HRT being the first-line treatment for perimenopause and menopause, as recommended by NICE (National Institute for Health and Care Excellence) [3].

We often hear from women who have had trouble getting a correct diagnosis for their perimenopausal or menopausal symptoms, or who are denied the treatment that they would like. If you are experiencing symptoms and would like to discuss HRT with a healthcare professional, this can feel daunting. And even if you’ve already been given HRT, you might need to adjust it, need to talk about any ongoing symptoms or want to talk to your doctor or healthcare professional about testosterone.

It’s worth remembering that doctors and healthcare professionals want the best for their patients. However, they might disagree with you or, if your situation is complicated, want to find out more, or worst-case scenario, not be up-to-date with the evidence and guidelines.

Dr Louise Newson, balance founder and menopause specialist says: ‘I feel very strongly that it’s about having a choice and knowing that there are options available. Women can empower themselves, they can get information, and they can advocate for themselves.’

Here’s our six-step plan to do just that:

1. Do your research

Dr Louise advises: ‘Before that first appointment, download the balance app where you can track your symptoms, and your periods, if you still have them. Read as much information as possible, again there are lots of resources on balance.’

Become an expert in what’s going on in your body – what the changes are, how long they’ve been going on. Complete the menopause symptom sheet and, for a really deep dive, you might like to sign up to Newson Health’s Confidence in Menopause Course.

Then brush up on the guidelines healthcare professional use to advise their patients. The General Medical Council (GMC) guidelines, Decision Making and Consent (read them in full here), states that doctors need to: keep their professional knowledge and skills up to date; work in partnership with patients; listen to, and respond to, patients’ concerns and preferences; and respect patients’ right to reach decisions about their treatment and care.

Similarly NICE’s Shared Decision Making guidelines (NG197) state that clinicians should: encourage the patient to take an active role in making decisions about their treatment; take into account what is most important to the patient, their expressed needs and priorities, and explain treatment options in light of these; have an open discussion about the risks, benefits, and consequences of each treatment option; allow time to answer questions and time to make decisions, making it clear that the patient can change their mind down the line; come to a joint decision that is satisfactory to the patient.

Finally, the NICE menopause guidelines are a useful set of guidelines for doctors in diagnosing and managing the menopause.

Doctors are not always aware of these recommendations, so you may want to print off particularly relevant sections for you and take them to your appointment.

2. Go prepared

‘Once you have tracked your symptoms, and any periods, on balance, you can print out a health report, which pulls them all together,’ says Dr Louise. This will be really useful for your doctor. Also make a note of any questions you might have.

If you feel the usual 10-minute appointment time isn’t going to be long enough to discuss things adequately, then ask for a double appointment before you book. And if you feel nervous or just want some moral support, it’s perfectly acceptable to ask a friend to come with you – they can act as a note-taker too.

RELATED: empowering women unheard during menopause

3. Know what to say

As Dr Louise advises, appointments are usually only 10 minutes so every second counts. Try to be as succinct as you can when explaining things to your doctor. ‘Show them your health report, tell them you’ve read up on your symptoms and say, “I’ve made the diagnosis myself, I’m 99% sure I am perimenopausal or menopausal, I’ve read about HRT and this is what I want,’ says Dr Louise.

4. Aim to make a joint decision

Your healthcare professional may ask you to explain your reasons for your decision, your understanding of what is involved, and your expectations of how HRT would improve things for you. You have the right to choose what treatment you would like as long as you show you fully understand all the implications of the decision, including any risks. This includes any treatment option that your healthcare professional does not think is the best option. Regarding your decision as ‘unwise’ is not enough of a reason to refuse, if you can show you are informed and have considered the consequences of your choice.

Your doctor should answer your questions accurately, and as fully as they can in the time allowed. They should be clear about the limits of their knowledge and, if they can’t answer a question, they should explain whether it’s something they just don’t know themselves or something that no one knows yet because the research hasn’t been done.

If, after discussion, the professional does not consider your treatment choice an appropriate course of action, they do not have to provide it. They should explain their reasons for refusing it to you and explore what other options might be available, including your right to seek a second opinion.

If your doctor wants to provide a treatment for you that you disagree with, say so. Professionals need to show that you consent (agree) to any decided course of action.

5. Face obstacles

‘If your doctor says no, you are allowed to challenge that decision. Say “is there is a reason why you are refusing?”,’ says Dr Louise. Some reasons women have been incorrectly told they can’t have HRT include: ‘You’re too young to be menopausal’, ‘But you don’t get hot flushes’, ‘HRT is too risky’, ‘The drug is not licensed to be used in this way’, ‘You’re still getting periods’. This is where your research comes in – your doctor may need to see your evidence.

A Newson Health study of 5,744 women showed that over a third of respondents (39%) were offered antidepressants instead of HRT as the first course of treatment [4].

In this case, Dr Louise advises you to point out: ‘Menopause guidelines are very clear that antidepressants should not be given first line for low mood associated with the menopause because there is no evidence that they will help. Research has shown that if women are given HRT when they are perimenopausal then this can reduce the incidence of clinical depression developing.’ 

Other women have found their access to HRT is delayed as the doctor wants to conduct a blood test. This may be necessary in some cases, but if you’re over 45 and experiencing symptoms, there’s mostly no need as blood tests are unreliable. ‘It’s more important to listen to the woman regarding her symptoms. If your periods have changed or stopped and you are having symptoms, that’s enough,’ says Dr Louise.

Alternatively, your doctor may say they need to refer you on to a menopause specialist, which can cause long delays. ‘This shouldn’t be necessary unless you have a complicated situation and even women with family history of breast cancer can still safely take HRT,’ says Dr Louise.

Don’t be afraid to advocate for yourself and disagree with the doctor. Listen and consider their explanation. If you still don’t agree, Dr Louise advises saying: ‘I know there are benefits for me taking HRT and I’m prepared to take any risks, they are very small. If you won’t give it to me now, when can I come back and when can I get it and who can I see?’

6. If at first you don’t succeed…

Be persistent! If you don’t get the desired outcome at the first appointment, try again another time, and in the meantime research the evidence base for the reasons why your preference was denied.

You can ask to see another doctor (or nurse) within your practice – ask who has an interest in menopause or women’s health. If there is no one, consider changing practices or consider having an appointment with a private menopause specialist.

Don’t give up. You may need to talk to several doctors or nurses, explaining your reasons for wanting HRT, the information that’s led you to this decision, and that you know what the associated risks might be but that it is still what you choose to do. Persistence often pays off when you can give a clear and rational argument that shows careful consideration of the evidence of the risks and benefits to your health.

References

1. GOV.UK
2. NHS BSA Healthcare inequalities: NHS Prescribing of Hormone Replacement Therapy to Treat Symptoms of the Menopause 
3. NICE Menopause Guideline [NG23]
4. Experiences of Perimenopause and Menopause, December 2022

Resources
NICE Shared Decision Making guidelines: https://www.nice.org.uk/guidance/ng197
GMC guidelines on decision making: https://www.gmc-uk.org/-/media/documents/updated-decision-making-and-consent-guidance_pdf-84160128.pdf

The post How to talk to your doctor about HRT – and get results appeared first on Balance Menopause & Hormones.

On this week’s podcast Dr Louise Newson is joined by her friend Liz Earle MBE, writer, TV presenter, award-winning entrepreneur and best-selling author of A Better Second Half: Dial Back Your Age to Live a Longer, Healthier, Happier Life.

Liz is synonymous with wellbeing, and as we head into 2025, she talks about why most New Year’s resolutions fail because they are unachievable. Instead, Dr Louise and Liz together offer practical tips on making some small but meaningful changes to improve health and wellbeing in midlife and beyond, including nutrition, exercise, mental health and hormones.

They also talk about the importance of prioritising yourself – and why self-care is anything but selfish.

For more about Liz, visit www.lizearlewellbeing.com

You can follow Liz on Instagram @lizearleme

Click here for more about Newson Health.

Transcript

Dr Louise Newson: [00:00:11] Hello. I’m Dr louise Newson. I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause, symptoms and treatments and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on the podcast I am very excited because I have someone who is a friend and mentor. She’s very inspirational and I’ve learned a lot from her in various ways over the years, and she’s been on my podcast before. So welcome back Liz Earle. [00:01:17][67.0]

Liz Earle: [00:01:18] Hello. [00:01:18][0.0]

Dr Louise Newson: [00:01:19] Thank you so much for joining me today. [00:01:19][0.4]

Liz Earle: [00:01:22] Well, honestly, it works two ways, you know? You’ve taught me so much. So I’m really delighted to be here, thank you. [00:01:27][5.6]

Dr Louise Newson: [00:01:27] Ah, well, you’re inspirational in many ways. And one of the things that I’ve really enjoyed over the years, knowing you, is that you’re very evidence based. There’s lots of people I talk to who take things at face value, and you don’t. And I can see as soon as I say something, you’re constantly thinking right, why has she said that? What does it mean? Let me look at some papers. Let me get back to you. You’re very calm in your approach. And one of the things, I’ve been reading a book recently about how to slow down to achieve more, which I think is actually really interesting because then you do, you’re very considered and I think this is so important when you’re talking about areas that not everyone’s in line with. So I’m sort of thinking many years ago, you talking about olive oil, actually. And people were all into Flora and, you know, low fat spreads and you knew that it was the right thing. But we were all thinking about low fat at the same time. [00:02:28][60.8]

Liz Earle: [00:02:30] We were. Yeah, it felt really quite perilous back then. I mean, this is going back more than 30 years, when I dared to question the narrative that saturated fat was bad and that actually we should all be eating low fat. And of course, well I mean you know, from a hormonal perspective that if you go low fat, your hormones fall apart. But actually, you know, we need fat in our brain. We need it for our skin. We need it for overall good health. And, you know, thankfully now I think people are beginning to realise that it’s carbs and sugars that cause the issue. It’s not cholesterol and it’s not saturated fat. [00:03:01][30.6]

Dr Louise Newson: [00:03:01] Yeah, but you were very ahead of your time then, weren’t you? I mean, there’s lots of people who obviously agree and it makes so much sense, but at the time it must have been quite. Was it difficult to continue messaging when other people are saying no? [00:03:14][12.9]

Liz Earle: [00:03:15] It was. Well, I don’t know. I mean, I hopefully I am a truth seeker. And so I think, you know, that when fundamentally it is the right thing, that definitely emboldens you. But yes, it it is hard to kind of stick your head above the parapet. I mean, nobody knows that more so than you. And it can be quite isolating and particularly when you are up against big organisations who have a lot of funding, there’s a lot of vested interest, there is the ability to throw rocks at you and to skew information and you know, these days it’s, you know, it’s about being cancelled, isn’t it? I mean back then we didn’t even have social media, so that wasn’t a risk. But yes, I think we have to be very careful. And also on social media, I think as a lone woman, that is also potentially quite a perilous place to be. So, but then hopefully there is strength in numbers and I think you do kind of find your tribe and you do realise who the good guys are out there and the ones who are really trying and who are evidence based and who have the best interests of women at heart. I mean, hopefully all of humanity. But you know, particularly my tribe is midlife women. That’s who I’ve, yeah, I’m punching for. [00:04:20][64.9]

Dr Louise Newson: [00:04:21] Absolutely. And it is so important because, you know, when you came to my show and I was talking about Semmelweis, you know, that amazing obstetrician who quickly realised that washing hands saved lives, but they didn’t know about germs then. And he was completely ostracised by the medical community. And actually ended up in an asylum, beaten to death. And many times I’ve thought about. Am I mad? Am I absolutely mad? Am I just looking at one part of the evidence? Have I not looked at the bigger picture? And if I didn’t have such a supportive tribe as you like, I think I would have driven myself mad just by this one part, thinking about hormones. But that’s the same with a lot in, when you’re sort of a thought leader, a pioneer, just thinking ahead of time, you know? And I think what’s amazing with your work is that you are always looking in a very considered way, and often it is the most obvious thing. So one of the things I really want to talk to you is about the obvious things about how to keep healthy because, you know, you talk about midlife, but you’ve just had your amazing book out thinking about you and your 60th birthday and your second half of your life. So it’s, it’s so much that we forget because we have this fast paced life we’re, well I say we I don’t eat it, but fast foods, processed foods, you go into any, I was in the supermarket the other day and the colours, the brightness, the packaging like I tend to shop online so I’m not experienced with this overload often because it would trigger a migraine. But just think, God there’s all this awful stuff that’s going on, but it helps us because we’re so busy. But it doesn’t really because it’s making us far more unhealthy. Slowing us down in the way that we’re putting on weight. We can’t think the same way. We’re not sleeping the same way. So there’s things that are working against us. So I’m really keen to just learn more about what we can do that’s very simple. It’s not very expensive to keep healthy because as we age, it’s not so easy to keep healthy you know, and we have to invest in ourselves and be true to ourselves. It’s, you know, the beginning of a new year. We always think it’s going to be a better year this year and various things we can’t control, as you know. But the things we can are the things that can make quite a big difference to us and the people around us. Because if we’re healthier, we can help others. [00:06:54][153.2]

Liz Earle: [00:06:55] That is such a good point. Thank you for mentioning my book. And actually, you know, when I was writing that, I did start, the starting point is how do you start? And it’s about deciding to prioritise yourself. And I think the thing that I’ve learned over the years as somebody who’s now, you know, going to be 62 this year, so I’m kind of of that slightly older generation where being selfish in terms of looking after yourself was seen as really a bit self-indulgent and you should actually put everybody else first. And of course we do need to look after others. And a lot of midlife women spend their lives doing that. You know, they tend to be the primary caregivers, having children, looking after elderly parents, being active in their own communities, their workplace, whatever. And so deciding that actually we’re going to push ourselves up the to do list is quite a big thing for a lot of women. And actually self-care is not selfish. It’s really important. And if we are not fully capable ourselves and how on earth can we help others? So let’s prioritise ourselves. Let’s switch that mindset right now. You know, to quote another beauty giant ‘because we’re worth it’. We really need to be doing that because this is our time and we’ve probably put the time in for lots of other people over the years, and this is our time to thrive. And, you know, when I hit 60, I realised that I was actually healthier, happier, stronger, fitter, more purposeful, more sorted than I’ve ever been in my life. Definitely during my 40s and 50s when I kind of lost myself a bit, as so many women do. And I thought, you know, if that’s the trajectory I’m going on this upward, why can’t I be better at 70? That’s my goal. You know, a better second half is literally, I’m aiming to hit 120. Actually, I was speaking at a longevity conference in Oxford recently and listening to what’s going on, I’m think I’m going to push it to 130. But it’s not so much just about adding on those years. It’s about having the healthy years and having full brain health, cognitive function, muscle strength, motivation, mobility, all of those things. Otherwise you kind of think, well, what’s the point? So let’s age but age well. [00:09:09][134.7]

Dr Louise Newson: [00:09:10] Well, you’re absolutely right. And, you know, I often say to people, you have to look after yourself first. And it was one of my take home messages from the tour is, you know, because it feels really self-indulgent and it’s not self-indulgent, actually, because I know that if we do look after ourselves physically and mentally, we’re going to have more energy to look after others. We’re going to be in a better place as well. And I’ve always tried that even for my patients, because the last thing you want to do is visit a doctor who’s really unhealthy because. [00:09:43][33.1]

Liz Earle: [00:09:44] That’s not a good look, is it, really? [00:09:45][1.0]

Dr Louise Newson: [00:09:45] It’s not a good look. But it also it’s so easy to say you need to exercise more, but if you’re not doing it yourself, then how can you really understand how to fit it into a timetable? Because we’re always busy. It’s always like, I never have time. [00:10:00][14.3]

Liz Earle: [00:10:00] There’s always a reason why we can’t. [00:10:01][0.6]

Dr Louise Newson: [00:10:01] Of course there is, course there is. And it’s… [00:10:04][2.2]

Liz Earle: [00:10:04] It’s tiny changes. You know, it’s little things. It’s not, certainly why do most New Year’s resolutions fall down? It’s because they’re too big and they’re too fast. And actually, you know, just pick one tiny thing that you’re going to do this week. Is it having an extra glass of water? I mean, it could be something as simple and as easy and accessible and as free as that. Yeah. You know, is it the fact that you’re going to turn the water down to cold at the end of your shower for 10 seconds to give you that little micro cortisol spike first thing in the morning that will set you up for the day and that will help boost your blood circulation and help your lymphatics and all of that. And then you build up. Is it about swerving that muffin or bowl of granola or whatever first thing, and thinking, do you know what my first mouthful of the day is going to be protein. I’m going to have a boiled egg, I’m going to have some yoghurt, I’m going to have a bit of avocado. You know, I’m just going to make sure that I don’t spike that insulin during the morning, which is going to make me crave more carbs. So tiny changes and, you know, I think of these things as individual beads in that in and of themselves they are small and insignificant and can get lost. But when you add them up and you string them together, whether you can make a bracelet or a necklace or whatever, it becomes something quite substantial and something really valuable. So let’s add in these little tiny hacks and be kind to ourselves and reward ourselves, you know, put a picture on the fridge like we used to do with our kids and go, Yeah, you know, I did that. I’ve had those five glasses of water today. I’m winning. [00:11:32][87.4]

Dr Louise Newson: [00:11:32] Yeah. And I think you’re right. It is. And I’ve said this before, it’s adding rather than taking away because it’s so easy to say, I’m not going to eat X, Y, Z. But actually, if you do add in A, B, C, you’re less likely to be hungry, less likely to have those sugar cravings, less likely to want those things that aren’t so healthy. So it is a different mindset actually is adding something, even if it’s really small, adding, I love the idea of building a new bracelet or necklace rather than changing the one that you like that you’ve won for years, you know, because it will over a while, yeah so over a while, it can take, because it takes quite a few months doesn’t it, to change eating habits. yeah. You know, foods are very addictive and they’re more addictive than ever now. You know, I was watching something. I mean, I love Chris Van Tulleken, and he was talking about the processing and, you know, just even I mean, I make cakes for the children. We don’t buy cakes. And as you know, they’re really easy to put together. But, you look at the ingredients of cakes, even just very simple cakes that you buy from supermarkets and you just think, actually, this is really not good. And it doesn’t taste as nice, but of course it lasts longer. But actually a lot of people don’t realise that. They’re like, really? Gosh I didn’t, you know, whenever I make a cake, people are like, How have you got time? Well, literally it doesn’t take very long. The cakes I make are not very complicated. [00:13:00][87.8]

Liz Earle: [00:13:01] It’s five minutes throwing it together. [00:13:01][0.9]

Dr Louise Newson: [00:13:02] Yeah. But if you’d never learned it. [00:13:03][0.9]

Liz Earle: [00:13:03] Flour, sugar, butter, eggs. Yeah. And it’s very satisfying. I love actually cooking. You know, I don’t have a huge amount of time. And, you know, one of the things, you know, people say is that, you know, cook from scratch is going to take so much time, is literally scrambling an egg and chucking a bit of grated cheese. You know, serve it with a bit of, I don’t know, veg on the side or you know, chop up an avocado or something. It is super easy. It takes less time actually than unwrapping a packet that you’ve had to go out and buy in a supermarket, shoving it in a microwave and waiting for it. And it’s I think it’s the whole thing, isn’t it? It’s the plastic packaging, it’s the ultra processed nature of it. It’s the fortified with synthetic vitamins which actually aren’t bio absorbed. So it’s a whole complex thing. And just getting back to real food. Somebody said to me recently about food, their mantra was don’t eat anything with a label on it because it has to have a label on it, it’s not real food, is it? I mean, why do you need a label to tell you what it is? It should be fairly obvious that what you’re eating is whole food. [00:14:03][59.8]

Dr Louise Newson: [00:14:04] Yeah. [00:14:04][0.0]

Liz Earle: [00:14:05] But you know, things like lentils. You know, lentils are our best friend. They’re really cheap. I shove them into everything. Sauces, make lentil soup. You know, my bolognaise, don’t tell the kids I hope they’re not watching this, but it’s, you know, it’s half lentils and it’s half meat. They just have no idea. [00:14:21][15.7]

Dr Louise Newson: [00:14:22] No, I mean I grate all sorts, finely chopped, I’ve got one of those whizzers. So I’m chopping all sorts of vegetables and, and it makes it cheaper as well because meat’s expensive if you have good quantity meat. So then you can, you know, make it better. [00:14:33][12.0]

Liz Earle: [00:14:34] But that’s the thing. By less but better quality. [00:14:36][1.6]

Dr Louise Newson: [00:14:36] Yeah, I think so. You know, I cook a lot for the freezer as well, which is definitely a godsend because suddenly when the children are all there and you’re busy working, you’ve got to have things ready. So food, I think. Well, of course, it’s the most important thing. You know, we can choose whether we drink alcohol or not. We can choose if we smoke or not. We can’t choose whether we eat or not. We all have to eat. And a lot of people I speak to either actually aren’t eating enough, but they’re trying really hard. So I’ve got patients that say to me well I only have, you know, fat free yoghurt in the morning and then I have a low calorie something bar at lunchtime, and then I’ll have a ready made sauce with some pasta and maybe a glass of wine. So actually they’re not eating much, but they’re not getting much nutrition. So I think the first thing, if you agree, is looking at this new year and what we can do is adding fresh veg, fruit, protein, obviously we’ve got to think more about protein because so many people don’t have enough. But in really simple like 1970s type food, don’t you think? [00:15:39][62.3]

Liz Earle: [00:15:39] Yeah, I do. Just really stripping it back. And you know, eggs are one of my favourite food. You know, they’re very sustainable. They’re just they’re a complete form of protein they have those are choline, which is great for the brain. There’s this whole question about, you know, cholesterol. But of course it’s that they have the good type of fats. And, you know, we need to get away from this narrative. And I think it’s about not having the processed stuff. I mean, the only bit of processed food that I probably do use quite a bit of actually is protein powder. But I tend to have it unflavoured. It’s literally like pure casein powder or bone broth powder, and I just shove that into loads of things. I put it into my coffee, I put it into soups and sauces and, you know, yoghurt. I mean, everything basically has a bit of extra protein powder put in it because a midlife woman worried about sarcopenia and losing my muscles and wanting to have higher protein and I’m busy. And you know, it’s easy when we’re out and about. You know, most of those snacks that we might reach for don’t have very much protein in them. So, you know, that is one of the things that I do use in the house that is a bit more processed. [00:16:41][61.7]

Dr Louise Newson: [00:16:42] Yeah, I shove it on my yoghurt in the morning, but also thinking about adding things, like obviously not if you’ve got an allergy, but nuts are really good. Seeds are very good. You know, herbs, even just having some fresh herbs on your windowsill can make a big difference, can’t they? [00:16:57][15.7]

Liz Earle: [00:16:59] Yeah. And spices and all this talk about diversity, you know, and having 30 plants a week or whatever. I mean, you can have 30 plants a day if, you know, without really thinking about it because, you know, you could put ten different herbs and spices in a sauce. You know, you can put ten different herbs and spices and nuts and seeds and berries and all the rest of it in a bowl of yoghurt. So it’s not actually that hard to get lots of little things and doesn’t have to be a great big portion, you know, a little teaspoon of kimchi, which is one of my favourite kind of fermented foods. So good for the gut. And we know that the gut oestrogen link is obviously really important as well. So we’re looking after our hormones as well. But one little teaspoon of kimchi can have a billion beneficial bacteria in it. So it’s little teeny things that we added that will build us, make us stronger and fitter. [00:17:46][47.0]

Dr Louise Newson: [00:17:46] Yeah. And then thinking about being fitter, I know your exercise regime has changed quite a lot over the last ten years or so, hasn’t it? [00:17:54][7.5]

Dr Louise Newson: [00:17:54] Other than that, yeah, it has so much. I used to leap around like Jane Fonda wearing leg warmers and Lycra and I kind of look back now, I think what was the point? You know? I mean, yes, it got my blood circulation going and it used up a few calories. But, you know, I wish somebody had said to me earlier, Liz, you need to lift weights. You need to lift weights to keep your bone density, to keep your bones strong, to create stem cells and just be more resilient overall. And so now I was lifting weights this morning and, you know, I lift I mean, not crazy heavy weights, but I have I do weighted squats with 20 kilos in each hand, which is more than half my body weight. And that’s kind of the guide that you should aim for when you are building up to lift weights is you should really be able to hold half your body weight for at least a minute. So that’s, you know, if you’re say, 60 kilos, then you should maybe be holding two lots of 15 kilo weights. And I love that challenge of, you know, every six months or so I’ll go up the stage. So when I started lifting weights for doing squats, I was maybe having ten kilos in each hand. And then I went up to 12 and then 16 and then 18. And then recently I bought myself a pair of 20s. And, you know, that was a great moment. And, you know, maybe during this year ahead, I’ll be up to 22s in each hand. I don’t know. [00:19:14][79.7]

Dr Louise Newson: [00:19:14] So it’s really important. As you know, one of the things I as a menopausal woman are scared about is osteoporosis, it’s such a common condition. 1 in 2 women over the age of 50 who don’t take hormones will have it. I’ve seen so many women with osteoporosis of their spine. The pain, the deformity is really difficult to describe, and many people don’t know they have it until they have fractures and fractures in the spine can be very painful as well. So anything to keep our bones but also, like you say, the sarcopenia, loss of muscle mass really important. So definitely more and more people are talking about using weights, in the right way. And it’s really important that it is done in the right way. But, you know, I’ve got weights at home. I do it, you know, a lot of yoga. But I also will add in some weights as well. But my husband’s got weights from university days and they’re so heavy I literally move them just because he leaves them lying around and when I’m trying to tidy up I’m like how does he carry these? But we are all different and it doesn’t matter. And sometimes even using lighter weights, but more repetition can be as beneficial as just trying to lug a big weight and think you’ve done it. So you have to be really careful how you do it. [00:20:28][73.3]

Liz Earle: [00:20:28] There are lots of different ways I agree. And actually you don’t even need to buy weights. So using your own body weight, just doing squats up and down with no weights at all, just doing push-ups, you know, start doing them against the wall, standing up and gets a little bit of strength and then, you know, go down and you can do them on your knees and then you can do, you know full plank push-ups. You’re using your own body weight. And then if you want to, you can think about, you know, maybe doing some weights or not. [00:20:53][25.3]

Dr Louise Newson: [00:20:54] Yeah, absolutely. And there’s a lot we can do with our own body weight. And obviously I’m biased with yoga, but it still is really important. And well, you know as well as I’m quite a huggy person, I often have hug people when I see them rather than just shake hands. But actually, as we get older, you can feel whether someone exercises or not. And I was in Norway recently and these women are really strong and you hug them and you’re like, Wow, they’re solid. Whereas sometimes you hug people people our age and you can just feel, that they don’t have muscle tone. And that is so important when, you know, we look at older people sitting in nursing homes and, you know, they can’t get up by themselves, they find it very difficult to be independent. And, you know, I think one thing is people think we exercise because we want to look really good in a bikini or whatever, which is actually not true. What we want to do is to be really independent and get out of that chair, go for a walk in the garden, be independent when we’re older and because we’re living so much longer. You know, you talked about the longevity conference. People are not waking up to the fact that women especially are not ageing well, and in the last ten years of a women’s health is often in poor health because of inflammatory diseases. And some of it is related to not having hormones, and some of it is related to not having the right lifestyle as well. And I worry it’s going to get even worse because we’re eating inflammatory diets we’re more sedentary than ever before, and the majority of women are not taking hormones. So there’s things stacked against us, but we’re still living longer. So it’s it’s really important isn’t it? [00:22:36][102.1]

Liz Earle: [00:22:37] It is a terrifying thought, isn’t it? It is. And I think it’s terrifying these you know, how do we live our later years well, pain free and with joy and purpose and all of those things, you know, that we want to live live, we probably earnt it? You know, and we take retirement and unfortunately, you know, that’s when, you know, your hormones conspire against you and all of that. So, you know, I’m very grateful that I kind of, and I wish I’d started my hormone replacement earlier. You know, I didn’t start it until I was kind of early 50s. And I look back on my perimenopausal years, I just thought I was stressed, you know, that’s why I didn’t sleep. And I had headaches and I had tinnitus and all of that. So many UTIs, you know, all of that. Thankfully, now that is all resolved. So I can move on to then think about, well, now I’ve got some more energy and I’m sleeping. So now I can go and lift my weights and I can actually be motivated to want to eat better. And I do it because it is a form of future proofing. And, you know, when you think about your body, it’s the only place you have to live. I mean, it is that is it. You know, we have one body, we have one brain. You know, we have one central nervous system. This is it, guys. So how do we prioritise it? And, you know, I take a lot of supplements, for example, and people say, you know, you know, how do you afford to do all of this and say, I can’t afford not to. I cannot afford to be ill. I’d rather spend my money on that than other things. And I think we just need to perhaps take a little bit more ownership about how we age and just realise a few of these basic fundamentals, you know, food, fitness, human health, lifestyle, purpose, community, you know, you talk about hugging, but you know, what is it that we need to have? Is it seven hugs a day or five hugs a day? I forget what the exact number is, but, you know, the act of just boosting your oxytocin in your brain. And if if you haven’t got anyone, you know, romantically, you could hug a friend, you could hug a pet, you know, hug a colleague if that’s, you know, allowed, you can hug yourself. Even this very action of just hugging is creating happy hormones within the body. [00:24:48][131.3]

Dr Louise Newson: [00:24:49] Yeah. And that is so important. I think so often neglected. And, you know, mental health has got to come into this conversation as well. You know, how we can look after ourselves and others. And, you know, I think it’s so easy to compare ourselves to others and think we’re no good. We’re not right. Because you look at all this rubbish on social media and everyone having their perfect lives and everything else. But one of the books I’m also reading is about kindness actually, and it’s so interesting. Just being kind to people makes you feel happier yourself rather than this self-critical, and critical about other people because it’s so easy to judge people in the wrong way. And then that brings you down internally and then you start to critique yourself and then that downward spiral. So and one of the things I think you are always so good at is focusing on positive things because everybody has got negative things going on in their life. But actually, for most of us, what’s the point of sharing them? Because who wants to see a negative person? You know, you work out who you can share some things with and who you can’t, and that’s fine. So but it’s also not being shaped by negative experiences. I think having anything negative, acknowledging it, but turning into a positive way. So some of the things that have been very negative to me have taught me resilience. Taught me independence, has taught me not to depend on other people, you know. Taught me just different things about myself. Rather than wallowing in self-pity. And for anybody listening, there are going to be things that have happened or are going to happen that are going to really challenge you. But dealing with it is very important. Talking about it to the right people is crucial. But moving forwards, I think, is even more important, would you say? [00:26:42][113.8]

Liz Earle: [00:26:43] I would. And it’s you know, it’s like they say, you know, bullies at school are ones who are likely to have been bullies. And I think, you know, when people are unkind and, you know, I think a lot of us have experienced that. And certainly, you know, if you have any kind of profile in the media or in social media or whatever, you know, there is a risk of that. You kind of almost have to take a step back and think, you know, what’s going on in that person’s mind. You know, are they mentally unwell? You know, is there some kind of awful situation that they’re facing that is making them so angry and agitated and, you know, get the wrong end of the stick or whatever? Or is there a vested interest, you know, something that’s, you know, kind of hidden, that hidden agenda behind that. So I think it’s really important just to sort of start try and protect yourself and stay distanced from it and realise that there actually is you know, there are an awful lot of good people out there. And, you know, you can probably well, I’m sure you do, get tens of thousands of amazing comments and support, but of course it’s the 1 or 2, you know, that may be deliberately there to chuck rocks that are the ones that stick and that you remember. And actually, we just need a bit of balance, don’t we? Remember that most people want the best for everybody. [00:27:54][70.8]

Dr Louise Newson: [00:27:55] Yeah, I think balance is so important and prioritising. We only have one life. It’s never going to be perfect, but optimising it for our future health is so important and there is so much information in your book. You’re updating it as well, aren’t you, for a paperback, are you? [00:28:13][18.6]

Liz Earle: [00:28:14] Yeah, I am. Well, no, they’re going to keep it in hardback. Okay. A big revised section. You’ll be pleased to hear there’s quite a bit of revision on hormones as well. Not changing, but actually just beefing up, you know, things that we’ve become more aware of, I guess, in recent years. There’s quite a big section now on testosterone, right. Which I think is really important for women. You know, it’s something that I benefit from. You know, I’m very lucky. I have a very enlightened, forward thinking NHS GP. It was interesting actually, because I, you know, I was first prescribed it really very much for my memory and for brain, and it was at a time when I was single, so I wasn’t being prescribed it for libido. And it has made such a difference and also with muscle tone and just overall vitality. So I think the more research that we see coming out hopefully this year, yeah, about testosterone and its use for midlife female health is going to be really valuable for us. [00:29:11][56.8]

Dr Louise Newson: [00:29:11] Yeah, we’ve well, we’ve published one paper showing about mood and cognition improving with testosterone, women who take HRT and we’ve just submitted another paper actually it’s quite interesting. It’s written with some pre-clinical researchers in America who do a lot of research in mice, and so they look at the effects of low testosterone in mice and rodents and show that actually those that have low testosterone have this anhedonia, I can’t be bothered to do anything. So even if you give them sugared water, they won’t be interested. Give them testosterone, they go straight for the sugared water. They’re more motivated, they exercise more, and they’ve done lots of experiments looking at the role of testosterone, especially in the brain. So we’ve written a paper showing, looking at their preclinical research with, you know, the effects of testosterone in the human body and our clinical research as well. So it’s a very meaty paper. It’s quite hard, some of it it’s quite technical to understand, but hopefully that will be published later this year. So that’s going to be really interesting too, because it’s just showing basic, basic, you know, science. So this is what this is all about. And so, you know, we’ve talked a lot about keeping things basic, and I think that’s really important. We almost need to being go back in time. I often think about how my parents lived in the 70s. So simple food, simple exercise, simple hormones and looking after each other and keeping happy. So really key messages that we need to remember actually, and try and move forward this year to be healthier and happier. So very grateful, obviously, for your time, again, Liz. Before we end, I always ask for three take home tips. So some people might have been listening to this and think, it’s all very well she’s saying that, but how am I going to do? What am I going to do? How am I going to start? So what are the three main things that you think people could prioritise to feel better and be healthier? [00:31:01][109.9]

Liz Earle: [00:31:02] Well, one of the things that I’ve learned over the years is that sleep is a superpower and we really do need to prioritise. I used to think it was just flopping into bed and switching off, but actually it’s a really active process and it helps regulate our mood, our hormones, our emotion, our weight, everything. So prioritising sleep, prioritising getting to bed a little bit earlier and think about setting up a good sleep routine. And there are lots of resources you can find online to help you with that. I think also the morning routine is actually really important. How you set up your day is how you set up almost the rest of your life. So people say, I have no time in the morning. Well, okay, why don’t you set your alarm clock for just ten minutes earlier so that you can do something simple, like drink a glass of electrolytes. That’s your first mouthful to rehydrate and give you a bit of cellular energy in the brain. Open a window. Look at the day. I talk a lot on my Instagram about this. The importance of real daylight, especially the low level ultraviolet and near-infrared that we get first thing in the morning, get that light into the retinal cells in your eyes. Again, it’s a free health hack is there for everybody, but don’t do it wearing contact lenses or glasses or through a glass. You have to actually open your window. Ideally step outside and if you can take your shoes and socks off, do a bit of grounding. You know, it sounds a bit woo woo, but the studies are there that it can lower inflammation in the body and just help you feel more connected. And then I think ultimately don’t beat yourself up when things don’t go right. I have a very simple rule of thumb. It’s the 80:20 rule 80% of the time, you know, it’s pretty good. 80% of the time I’m mindful of what’s on the end of my fork and what I put into my body. 20% of the time it’s tequila and cake. So it’s just keeping that right ratio of 80:20 and not letting it slip the other way around and just being consistent just every day. Little tiny things, consistently small changes adds up to a big difference. [00:33:00][118.4]

Dr Louise Newson: [00:33:01] Perfect. Really great advice. So thank you ever so much. So let’s hope we can all do it. [00:33:06][5.0]

Liz Earle: [00:33:06] Well, honestly, more more grit to your wheel or whatever it is that you need grit with. Because what you’re just carrying us through this year ahead and look forward to connecting much more in the months to come. [00:33:18][12.2]

Dr Louise Newson: [00:33:19] Thanks, Liz. You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk and you can download the free balance app on the App Store or Google Play. [00:33:19][0.0]

ENDS

The post Liz Earle: why self-care isn’t selfish appeared first on Balance Menopause & Hormones.

• New year is traditionally a time for resolutions, while menopause can be an opportunity to form healthy habits
• Felling overwhelmed? Setting small, realistic goals can be more achievable
• Advice on setting meaningful goals when you’re experiencing hormone changes

With the end of 2024 fast approaching, now is traditionally the time to make resolutions for the year ahead.

Maybe it has been a few years since you’ve tried to make – and stick to – some New Year’s resolutions. Or perhaps you’ve tried to do so in the past, but when the ‘new you’ fails to materialise, it’s easy to lose confidence in your ability to make healthy changes and incorporate them into your everyday habits.

Perimenopause and menopause present a perfect opportunity to take stock of your health and wellbeing and consider how you could improve certain aspects to help your menopause journey and invest in a healthier future.

Looking at your diet, levels of physical activity, alcohol intake, sleeping habits and levels of stress are a good place to start when thinking about making healthy changes for the year ahead.  Whatever your aims, it’s worth knowing a little about the science of making healthy behaviour changes so you don’t set yourself up to fail from the start.

RELATED: Sleep and hormones

Plan to ‘do’, rather than trying to avoid

Research shows [1] that ‘approach’ goals are more effective than ‘avoidance’ goals as they are associated with more positive emotions and greater psychological wellbeing. This means setting goals on what you are going to do differently rather than what you want to stop doing. Instead of ‘I’m not going to reach for a bag of crisps with my 11am coffee’, frame it more positively such as ‘I’ll have a piece of fruit or a yoghurt with my coffee’.

How to define your goals the SMART way

A well-defined goal is key. If you’re struggling to form your goal, use a SMART approach to help make it more concrete. SMART stands for:

• Specific
• Measurable
• Achievable
• Realistic (or relevant)
• Time-based.

Using the SMART approach will turn ‘I need to do more exercise’ into ‘I will go for a one-mile walk, three times a week, consistently for the next month’, so you’ll know on a week-by-week basis how well you did and whether you achieved the goal or not.

RELATED: How walking can ease your mind

Learn and problem solve

Don’t fall into the trap of only setting performance-based goals; weight loss goals is a good example of this. If you set a goal to lose ten pounds, and then don’t achieve this goal you will feel you have failed – this thinking may make you less likely to try again. But the 10lb goal depended only on judgment from the scales to evaluate how well you did and it didn’t take into account any other positive changes you might have made.

RELATED: changing body shape during the menopause

Incorporating goals that focus on learning and mastering a new skill promotes healthier self-evaluation, so if weight loss is an aim, add to this by setting goals around learning a new sport or exercise activity and mastering cooking healthier meals. With learning-based goals, challenges are viewed as part of the natural process and you’ll be more likely to stay engaged and problem solve your way around any issues.

Choose goals to motivate you during menopause

Challenging goals produce better results than easy ones, but only if you are highly committed to making changes and have confidence in your own abilities. How committed you are will depend on whether you have intrinsic motivation – do you gain personal satisfaction and enjoyment from the activity or change itself or is the only motivation the consequence or reward at the end?

Choose goals that are intrinsically motivating and you will be more driven to achieve them despite their level of difficulty. Setting and achieving challenging goals will improve your confidence and chances of future success.

RELATED: Looking after your mental health and emotions

Choosing the right goals and defining them well is key, but that alone doesn’t automatically translate into behaviour change. The ‘intention-behaviour gap’ has been well demonstrated in studies [1] and it’s turning good intention into action that is the crucial step towards progress.

Action plans and coping plans

Take time to plan and describe the ‘where, when and how’ you will tackle your goal and behaviour changes. It works best if you have created the plan yourself, and then share it with others. Keep the timeframes short, for example weekly. Judge your confidence on achieving your plan out of ten, and if you gave yourself less than a seven, change the plan to one you have more confidence in.

Anticipate any barriers that may get in the way of your action plan to make sure you don’t get distracted or let the plan derail due to other influences. If you plan to workout with a friend, what is your plan if she can’t make it? If tiredness is likely to stop you from cooking a nutritious evening meal, what can you do in advance to plan for this?

RELATED: How friends can ease your menopause

Part of keeping a plan realistic and achievable is to not try and work on everything at once. Pick one or two areas that you feel really committed to and focus on those.

If perimenopausal or menopausal symptoms are affecting your energy, stamina, motivation and mood, see your healthcare professional about replacing your hormones via hormone replacement therapy (HRT) or tweaking your dose if you already take HRT.

Establishing a balanced level of hormones will often enable you to have the energy and motivation to continue making other helpful changes in your life.

It’s also important to take a holistic approach to managing your perimenopause and menopause, such as a balanced diet, exercise and relaxation – and setting meaningful goals can help towards this.

RELATED: How the Mediterranean diet can help menopausal symptoms

References

1. Bailey R.R. (2017), ‘Goal setting and action planning for health behavior change’, American Journal of Lifestyle Medicine, 13 (6), pp.615-18. doi: 10.1177/1559827617729634

The post Menopause wellbeing: how to set goals to boost your health and happiness appeared first on Balance Menopause & Hormones.

With all the organisation that goes into creating the ‘perfect’ Christmas day, the pressure to keep family and friends happy, and the financial burden of paying for the festivities, it’s unsurprising that December can be a stressful time of year.

Add in the hormone changes and symptoms such as low mood, anxiety, fatigue and hot flushes that can occur during perimenopause and menopause, and things can soon feel overwhelming.

So, how can you protect your wellbeing this Christmas? Here, we offer some tips on thriving during the festive season.

RELATED: Menopause and mental health: wellbeing at Christmas

Consider your relationships

Christmas is a time for family to gather but this in itself can be stressful. A survey by counselling charity Relate found that 70% of UK adults said they were worried that Christmas put extra pressure on their relationships [1].

Your perimenopause and menopause may also bring additional stressors to your relationship. Menopause has a clear and negative impact on divorce, separation and relationships – a survey of 1,000 women found that more than seven in 10 women (73%) who responded blamed menopause for the breakdown of their marriage [2].

RELATED: Read more about our menopause and divorce survey here

Relate advises you to have conversations with your family and friends about everyone’s expectations of Christmas well in advance. That way you can deal with any difficult demands and make compromises that suit everyone.

How to diffuse or avoid family arguments

If you have a house full of guests and tempers are starting to fray, suggest leaving the house for a walk to break things up a little. This gives everyone the chance to chat to someone different, or even to stay at home if tension is building.

Rebecca Lewis, GP and menopause specialist at Newson Health, says talking about your menopause with your loved ones can help. ‘During perimenopause, you may feel detached and isolated even among your friends and family,’ says Dr Rebecca. ‘Talk to them about what you are experiencing, and explain that it is caused by your hormones changing. This can really help people to understand and respond with empathy.’

RELATED: HRT: Is a repeat prescription on your Christmas to-do list?

Take the pressure off

The notion that Christmas must be ‘perfect’ means you can heap extra pressure upon yourself.

‘We can often feel overloaded by this pursuit of Christmas having to be incredible,’ adds Dr Rebecca.

‘But if your brain is feeling a bit foggy due to perimenopause, and you’re also working, and thinking about all the presents that you need to get, and stocking up on all the food needed, and ensuring the house is ready for guests, you may not be feeling very joyful. It is no wonder we can feel overloaded – it is such a barrage.’

Simple steps can help make your Christmas overload and menopausal symptoms more manageable.

Set realistic goals, try to get some exercise outdoors every day, delegate jobs to others and do one thing at a time, Dr Rebecca says. ‘Take time to do the things that help you. That might be some yoga, practicing mindfulness, a few minutes to meditate or go for a dog walk.’

Also suggest to friends and relatives this Christmas could take a simpler approach. ‘After all, it is your Christmas as well and you should be able to enjoy it,’ says Dr Rebecca.

Alcohol and hot flushes

It may be the season to eat, drink and be merry, but Dr Rebecca advises being sensible when it comes to alcohol. ‘While reaching for a drink feels the right thing when stressed, it often increases tiredness by disrupting sleep, can make hot flushes worse, increases anxiety and lowers mood,’ Dr Rebecca says.

About 80% of women will experience hot flushes [3]. The exact cause of hot flushes isn’t known, but it is thought to be related to changing oestrogen levels impacting on the areas of the brain involved in maintaining temperature [4].

In addition to alcohol, there is some evidence that spicy foods and caffeine can also exacerbate hot flushes, which is worth bearing in mind during the festive period.

Manage anxiety

Falling levels of oestrogen and testosterone in your brain can increase your anxiety. This can make socialising and planning Christmas events harder, especially as your confidence may have dipped, says Dr Rebecca.

If you’re finding this Christmas hard, you might not realise your anxiety could be linked to menopause. ‘Perimenopause and menopause can really affect your self-esteem and confidence, and bring feelings of paranoia,’ says Dr Rebecca.

Pause to think if the way you are feeling could be menopause related. If you’re unsure, use the symptom tracker on the balance app to record how you are feeling, and take this information with you to a healthcare appointment.

Being aware of the issue and informing your friends and family can help. ‘Involving others can help, so be open if you are struggling,’ says Dr Rebecca.

RELATED: Why is the menopause so stressful?

Prioritise your sleep

Get enough good quality sleep is important over the busy Christmas period. Sleep boosts brain power, immunity, heart health and curbs hunger hormones.

But during perimenopause and menopause, declining levels of hormone can have a significant impact on sleep. Some women find it difficult to fall asleep when they go to bed, others struggle to stay asleep for long periods and wake frequently during the night, never feeling they have gone into a deep sleep, while some women find they wake up way too early every morning and can’t drift back off.

Having a regular evening routine, going to bed at the same time, even during Christmas, can help, as can keeping your bedroom cool. HRT will improve perimenopause and menopause symptoms such as night sweats and urinary symptoms like frequent urination, which can in turn improve your sleep.

RELATED: Sleep and hormones factsheet

Resources

Relate

References

1. Relate, ‘Sex at Christmas’

2. Menopause puts final nail in marriage coffin

3-4. Deecher, D.C., Dorries, K. (2007), ‘Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and postmenopause life stages’, Archives of Women’s Mental Health, 10 (6) pp.247–57. doi.org/10.1007/s00737-007-0209-5

The post How to cope with Christmas and menopause appeared first on Balance Menopause & Hormones.