Living Well Through Menopause: Prioritizing Sleep, Health, and Balance

Menopause is a normal part of women’s aging process.  It occurs when the balance in hormone levels shift, resulting in low estrogen and progesterone levels.  These hormonal changes, particularly of the low estrogen levels, are linked to disruptions in sleep and mood.  With estrogen decline, the protective health benefits it imparts for bone, brain and heart, and sexual health may be reduced. Furthermore, unmanaged menopause symptoms carry a significant economic burden from a combination of reduced: productivity, career progression, income and retirement savings.

Optimizing womens health is a cornerstone of high quality comprehensive primary care services.  Engage your provider in a discussion about evidence based menopause treatment options.  To aid in that discussion, we offer a brief summary  about menopause, highlight effective National and International guideline supported treatment options, as well as non pharmacological strategies you may use as a compass to navigate to a healthy menopause path.

What is Menopause?

Menopause is the natural phase in a woman’s life when her menstrual periods permanently stop,  marking the end of her reproductive years. Outside of treatment induced menopause most women in Canada start their menopause transition in their mid forties as their estrogen and other hormone levels start to shift.  This transition period can last for a decade or more,  As hormone levels shift,  menstrual cycles irregularities occur.  Other effects, such as changes to sleep and mood are often experienced.  Both anxiety and depressive symptoms may be more pronounced, irritability is common, as well as functional cognitive symptoms like reduced concentration and difficulties with memory recall may occur. Additionally, joint pain, weight gain, vaginal dryness, reduced libido,  hot flushes and night sweats are all commonly experienced, primarily due to the fluctuating low estrogen levels.  Once a woman has 12 consecutive months without a period or any spotting, menopause has officially arrived.

The Importance of Sleep During Menopause

One of the most common complaints associated with the menopause transition is the disruption of sleep. Vasomotor symptoms (VMS), which refers to hot flushes and night sweats, are a product of the effects on fluctuating hormone levels on the hypothalamus (the part of your brain that regulates temperature). When VMS occur at night, particularly if they occur several times during the night, sleep impairment often occurs. As a foundation of our health, disturbances in sleep quality are not only associated with worsening mood, functioning and overall quality of life, but is an independent risk factor for the progression of chronic diseases including adiposity,  heart disease, hypertension, kidney disease, diabetes, and even cancer. 

For the majority of women, hormone replacement therapy (HRT)  is a safe, effective first line treatment option for managing VMS.  This needs to be emphasized.  Sleep is critical for health and wellness.  VMS may impair sleep and contribute to reduced productivity, loss of income and retirement savings, and impart a higher risk of development of chronic diseases.  Most women with menopausal symptoms benefit from HRT.  A discussion with your provider about effective management of menopausal symptoms is  part of optimal womens healthcare. 

What can you do to help improve your sleep – 

• Keep your bedroom cool: A room temperature of around 18°C is ideal. Cooling the room can help reduce the severity of night sweats and make falling asleep easier.
• Select light breathable clothing and sheets – flannels are a non starter..
• Sleep Hygeine: Maintain a regular bedtime and wake-up routine, even on weekends. Avoid screen time at least 90 min prior to your bedtime.  Avoid eating large meals within 4 hours of your set bedtime.  Try some pre-bedtime stretching exercises, yoga, breathing exercises or meditation. Journal the day’s events and / or set out your agenda for tomorrow’s activities.  Read or listen to music or an audiobook.. If you can’t sleep within 30 min, get up and go to another room for a while until you are ready to try again.  
• Avoid stimulants: Stay away from caffeine, alcohol, and large meals before bed. While alcohol may help you fall asleep, it disrupts deeper REM sleep, which is crucial for emotional regulation and cognitive function.

Managing Low Mood, Anxiety, and Stress

The hormonal changes occurring during menopause can result in mood swings, anxiety, depression and unmask underlying ADHD symptoms. It’s common to feel more irritable or stressed, but it’s important to recognize that these emotional shifts are often temporary and can be managed with the right tools.

Here are some ways to keep stress and anxiety in check:

• Practice mindfulness and meditation: Just 5-10 minutes of meditation, deep breathing and mindfulness may help reduce cortisol levels and improve mood.
• Stay connected: Socializing, even when you don’t feel like it, can release mood-boosting hormones and help combat feelings of isolation.
• Seek professional help: If your mood swings or anxiety are severely impacting your life, talk to a healthcare professional. Hormone Replacement Therapy (HRT) and hormone testing by a trained professional is a great place to start when creating a management plan for this phase of life. 

Exercise for Physical and Mental Balance

Regular exercise is so valuable for staying healthy during menopause. It improves mood by releasing endorphins, strengthens bones and muscles, reduces heart disease risk, and helps manage weight.

• Strength training: Women become more prone to losing bone density and muscle mass as estrogen levels drop. Incorporate weight-bearing exercises like walking, resistance training, or yoga to maintain bone strength.
• Cardio workouts: Activities that raise your heart rate, like swimming, biking, or dancing, improve overall cardiovascular health and can reduce heart disease risk.
• Enjoy leisure activities: Find activities you love, whether it’s hiking, swimming, or a simple walk in the park. The key is to stay active in a way that makes you feel good both physically and mentally.

Nutrition: Eating Well for a Healthy Menopause

A healthy diet greatly contributes to managing menopause symptoms. The Mediterranean diet, rich in vegetables, whole grains, lean proteins, and healthy fats, is particularly beneficial during this stage of life. It provides essential nutrients that reduce inflammation, supporting heart, brain, gut and bone health. 

• Calcium and vitamin D: These two nutrients are critical for bone health. Leafy greens, select dairy products, and fortified foods are excellent sources.
• Choose low glycemic index foods: Whole grains, vegetables that grow above the ground instead of below it, berries, and leafy greens help to stabilize blood sugar levels which can otherwise contribute to adiposity, diabetes, sleep disturbances and worsen mood disorders.  
• Boost gut health:Foods with anti-inflammatory properties like garlic, ginger, unsweetened yogurt, as well as fermented foods like sauerkraut and kefir support healthy digestion. Avoiding processed foods and “white foods” like sugar, flour, rice and salt reduce inflammation in your body, and help you stay healthy during menopause.

Comprehensive Primary Care for the whole you, not just your symptoms.

Compass Health Services is Alberta’s leader in private primary care delivery. Offering affordable high quality comprehensive care for individuals and families.   Flexible clinic bookings virtual and in person visits, weekend, evening and holiday clinic visit availability, in – clinic blood work, and secure patient to provider messaging provide you the level of access to your provider when you need them.  With over 30 years of clinical expertise, our nurse practitioners deliver exceptional care at each clinical encounter.   Contact our clinic for more information or to book a free consultation with one of our providers.