Counteracting the effects of perimenopause and menopause

By Danielle Pasquale, PT, DPT

Women face many issues as they age in the perimenopausal and menopausal stages of life, such as increased risk of osteoporosis, metabolic diseases, cardiovascular issues, and more. These obstacles create a challenge for women trying to develop a healthy lifestyle or maintain it as they age. Aging can create a whole mix of emotions, from mentally and emotionally, from experiencing feelings of anxiousness and uncertainty to physically feeling due to the hormonal changes. The best way to optimize your health as you age is to work with a collaborative team of professionals that can help guide you through the process. As a Pelvic Health Physical Therapist, it’s my job not only to address acute issues, but to provide tools to help my clients stay healthy in all aspects of their life.

While awareness of these issues is the first step, it is important to learn how you can combat them and prevent them from hindering your quality of life.

The most common symptoms of menopause include:
1. Hot flashes/chills
2. Sleep problems
3. Mood changes
4. Vaginal dryness and decreased libido
5. Urinary incontinence
6. Weight gain/changes in metabolism

While seeing these symptoms can be scary and overwhelming, there are professionals that can help you overcome the challenges that menopause presents. The most efficient way to manage symptoms is through three different categories: exercise, nutrition and stress management. All three should be incorporated into a weekly regime in order to optimize your overall health.

Exercise and Fitness
A recent study in Obstetrics and Gynecology Clinics of North America looked at the effects of physical activity in menopausal females and found that moderate intensity aerobic exercise led to positive changes in sleep quality, insomnia, and overall improvements in mood, especially for women experiencing symptoms of depression. Research published in Medicine & Science in Sports & Exercise has also shown that exercise decreases the risk of cardiovascular and metabolic diseases, as well as some cancers specifically breast and colon cancer, and provides longer periods of energy and improved musculoskeletal health.

Menopause also causes decreased ovarian hormone production, therefore decreasing estrogen levels in the body. Regular physical exercise can counteract these changes, such as protecting against bone loss.

Exercise is highly recommended to reduce osteoporosis, falls, and related injuries to falls. Working with a trainer who is knowledgeable about safe and effective exercise programs for someone with decreased bone density can help maintain strength and prevent future injuries.

Pelvic health issues are also more common than people may think. 67.5% of women experience at least one type of pelvic floor dysfunction, including endometriosis, post-natal issues, pelvic pain, and more. “Unfortunately, many of these pelvic health issues go untreated and undiagnosed because of one simple fact: It’s a little weird to talk about, but it shouldn’t be! Pelvic physical therapy can actually help people manage or treat these issues, and shouldn’t be ignored as an option to prevent pain or discomfort,” Pelvic Health Specialist at Performance Optimal Health Jessica Klecki, DPT, explained.

Proper Nutrition
“As women traverse menopause, estrogen levels — an important regulator of insulin, which helps us to control blood sugar — naturally decline, followed by insulin levels, causing insulin resistance, or the inability to control blood sugar. This can result in issues such as weight gain (especially around the abdomen), loss of muscle mass, elevated cholesterol, type 2 diabetes, and even cardiovascular issues,” explained Koren Bradshaw, MS, CDN, CLC, a nutritionist at Performance Optimal Health.

It is important to avoid an unhealthy diet and instead focus on good quality proteins, a wide variety of vegetables, and avoiding processed foods, which will help you avoid unhealthy cravings and keep you fuller for longer periods of time.

“Working with a certified nutritionist or registered dietician can help you create a plan on how to nourish yourself for maximum health benefits, without depriving yourself of the foods you love,” Bradshaw finished.

Managing Stress
For many women, the transition into menopause can be stressful in itself. During menopause, hormone fluctuations can cause significant changes in your mood, which some women report as almost feeling “out of control.” When the body is under stress and feeling like it’s under attack, it releases more cortisol from the adrenal glands, putting more stress in the body. Finding ways to manage your stress and stay aware of stressful situations can help combat its negative effects on the body.

Poor sleep also makes it more difficult for the body to recover from the day prior. Here are a few tips to facilitate good sleep hygiene:
. No screens 2 hours before bed
. Decreased temperature in bedroom
. Limit meals and snacks 2 hours before bed

Focusing on stress management techniques and enjoyable exercise will also help. Some ideas for relaxation and exercise-based techniques include:
. Deep breathing exercises to help calm your nervous system. There are meditation apps and online videos to help guide you through this if you’re unsure where to begin.
. Frequent massages
. Pilates and/or yoga: coordinating breathing with the strengthening movements causes decreased levels of cortisol.

With a team approach, a woman can get the guidance she needs to help navigate the changes she will face during the transition into menopausal years. Each woman is different and needs a personalized plan based on their specific health and wellness goals. If you’re interested in working with a team to assist you, contact the professionals at Performance Optimal Health in Naples. Call to schedule a consultation at 239.342.1342.

Danielle Pasquale, PT, DPT, is a physical therapist and North Naples site lead who is certified in women’s pelvic health, dry needling and pre/post-natal fitness.