With the current average life expectancy of a woman in the UK being 81, and the average age of menopause being 51, women are now enjoying many years of periodfree living after this life-changing event. This part of your life is extremely important in terms of looking after your health, but the transition from being a pre-menopausal woman to post-menopausal (known as the perimenopause) can be a tough road to travel for some. This is a key time to make long-lasting changes to your exercise and health routines to promote a happier and healthier life – and to ensure you keep running. I found myself on this rocky road unexpectedly, beginning the perimenopause aged 43. At times throughout this year I’ve had weeks when I’ve not run thanks to feeling completely exhausted. A week later and I feel I can train again. I’ve had to constantly hold back my effort levels, as I felt panicked when I ran and my heart was racing like a train in my chest. Like every other woman on the planet, I’ve always known my fertility would wane as my body left behind the era of child-bearing, but my youngest daughter is only eight and still very reliant on me. I wasn’t expecting the menopause so young, which is why I didn’t realise I was in it for nearly a year. I’m just not ready for it!
Taken by surprise
Just like you, I had that stereotypical film playing in my mind of a woman with greying hair suffering hot flushes in public which everyone ‘ooohs’ and ‘aaahs’ at but few people really empathise with. After all, everyone can cope with a hot flush, right? Yet I don’t have any grey hair (yet) and didn’t feel hot; rather I couldn’t sleep, had terrible aches in my shoulders and hips (which contributed to more sleeplessness), felt chills rather than hot sweats, my hair came out in clumps, but much worse, I started suffering constant, alarming heart palpitations. About every 15-20 seconds, and constantly – for weeks. I booked a GP appointment, fearing a heart condition. It still hadn’t dawned on me that, together with no periods all year, I was already heading down the road to menopause. A quick blood test and this was confirmed and my big worries melted away. Surges of adrenalin were responsible for my palpitations, and surprisingly, in time, you get used to them – even when you run. Read around the subject and you quickly get an idea of what’s in store, with the most important definite being that every one of us may experience some of the symptoms, or none of them, and they may last years, or months. Just like menstruation, pregnancy and childbirth before it, menopause follows no common rule and can vary wildly from woman to woman. My symptoms have at times dramatically affected my running as I’ve become increasingly cautious about doing too much. It’s certainly been a rollercoaster experience so far!
What’s going on?
“During your perimenopause you move from ovulating every month and having normal periods to a time when this stops,” says consultant obstetrician and gynaecologist Dr Nitu Bajekal, who specialises in the menopause. “The number of ovarian follicles becomes less and this results in low oestrogen levels and high FSH (Follicular Stimulating Hormone) levels. This is what causes the symptoms of menopause.” The perimenopause usually lasts around four years. “However it can range from two to eight years,” says Dr Bajekal, “and it usually commences around age 47, though it can occur from 39 to 51 years.” A woman is called post menopausal when she hasn’t had any periods or bleeding for one year. If you are experiencing any of the menopausal symptoms should you consider reducing, or even stopping running? “The changes that occur due to oestrogen deficiency, (particularly weight change and change in heart and bone health) makes this is a really important time in your life to keep doing exercise, or even start!” advises Dr Heather Currie, chairman of the British Menopause Society. “There are no strict rules as to whether you should change your exercise routines, however, the most important factor is to go with how you feel.” Some women take up exercise at this stage in their life as they find it helps them control their symptoms. “Keep doing what you can and what you enjoy,” says Dr Currie. “Any exercise is good even if it is less than you could manage previously.”
HRT – Should I or shouldn’t I?
One of the biggest choices you now face is whether to take HRT. Hormone replacement therapy is a medicinal minefield at the moment. For some women HRT has been linked to higher risks of cancers; others, like me, who hit the menopause early, have increased risk of heart disease if they don’t take it. Even though there are benefits to HRT, there are also side-effects. “If you are considering HRT you should discuss your concerns with your GP or specialist,” advises Dr Bajekal. “You also need to talk about the benefits and side-effects, how long you should take it for and what the alternatives are.” Then, you need to make your own decision when you’ve weighed up the risks and the benefits. As each of us arrives at the menopause at different ages and with a different set of symptoms, reaching a decision is highly personal. “Current thinking is that while no medicine is completely risk-free, for most women under the age of 60, and for many beyond that age with persistent symptoms, HRT provides more benefits than risks,” advises Dr Currie. “Your treatment is an individual decision depending on your symptoms, what the impact of them is on your health and running, past history, family history, personal views; the most important point is that all women have access to accurate information to help them make their decision,” she says.
If you are unsure about HRT, changing your diet may also help relieve some of your symptoms and keep you up and running. Your hormonal changes will have resulted in a drop in testosterone as well as oestrogen. “Testosterone is essential for muscle tone and strength, so women may find running is more difficult and that their stamina changes,” says Helen Ford, a nutritionist from Glenville Nutrition. “A drop in testosterone is a natural process but to support this, it is important to maintain a good diet with plenty of omega 3 oils from oily fish, walnuts and flaxseed and good amounts of quality protein including fish, eggs, quinoa, tofu and pulses,” she says. Eating protein with each meal and snack maintains healthy blood sugar control which in turn supports our adrenals, glands that produce small amounts of testosterone. “Good fats from fish, nuts and seeds are really important as they help with hormone production and also keep our joints lubricated to help with efficient running,” adds Helen. “Bone health is also a consideration around this time because the drop in oestrogen is a risk factor for osteoporosis.”
If you know you have weak bones or a family history of osteoporosis, running is a good form of weight-bearing exercise, but it’s important to keep your bones healthy through your diet. “Eat a calcium- and magnesium-rich diet which includes plenty of dark green leafy vegetables, nuts and seeds and oily fish,” suggests Helen. Incorporate phytoestrogen-rich foods like soya, flaxseed, lentils and chickpeas. “Phytoestrogens are plant foods that can have an oestrogen-like activity and a hormone-balancing effect on your body,” she says. Always make sure you take a vitamin D supplement, too, as this helps your body absorb calcium. A healthy diet and lifestyle is important for everyone as they grow older. “A good diet with a range of foods will provide most of what we need to combat menopause symptoms,” says Dr Currie. “There’s also some evidence that isoflavones and black cohosh taken as supplements may help.”
The Right Remedy
There’s a huge range of alternative remedies that claim to combat your unwelcome symptoms, although few of the herbal remedies have been properly studied. Some promising evidence has emerged for black cohosh and red clover, but they haven’t been shown to be as strongly beneficial as HRT.
I’ve found that Menopace helps alleviate my flushes and sweats, but if you choose not to take HRT you may have an increased risk of osteoporosis; a bone density scan will show your osteoporosis risk. Also, when choosing a supplement, compare ingredients to find the one with the strongest dose of the active ingredients. One thing’s for sure: late autumn has never felt so warm!