In my years of caring for peri- and post-menopausal women, I've noticed a common thread: after learning about how their hormones—estrogen, progesterone, and testosterone—fluctuate and decline during these transitions, they want practical solutions to feel better. Whether or not hormone replacement therapy is right for you, there are several key habits that can help reduce negative symptoms and improve your quality of life during this transition.

*Note, nothing in this blog post should be taken as medical advice. Please consult your doctor before starting or stopping any treatment.

Sleep: A Top Priority

Let me emphasize this first: quality sleep is absolutely crucial, and you need a full eight hours per night. Gone are the days when we could power through on just four hours of sleep while juggling work and home responsibilities. If you're dealing with brain fog and irritability, you might be amazed at how much better you feel with proper rest. Developing a consistent bedtime routine is key—whether it's reading before bed or taking a relaxing hot bath, find what helps your brain and body unwind.

For those choosing bio-identical hormone replacement therapy (BHRT), progesterone can be particularly helpful with sleep issues. Taking it a few hours before bedtime can help you relax and drift off more easily. Some women might need sleep aids to prevent those frustrating 2 AM wake-ups. Remember, with all the mental and physical changes happening during menopause, your body simply cannot function efficiently without proper rest.

Nutrition: Time for a Revamp

Your nutrition needs are just as critical as good sleep habits. The reality is, we can't eat like we used to without facing consequences. Beyond weight gain, we're looking at increased risks for diabetes, high cholesterol, and heart disease if we don't adapt our eating habits. Plus, the wrong foods can drain what little energy we have left for our daily activities.

During menopause, declining estrogen affects how our bodies regulate and respond to insulin, making it essential for many to reduce carbohydrate and sugar intake. I often recommend following a Mediterranean diet as a practical framework. This means increasing your intake of lean proteins and fiber while cutting back on processed carbs and sugars. Whether you're using BHRT or not, these dietary changes are non-negotiable for feeling your best and protecting your long-term health.

Movement: Essential for Body and Mind

Here's something you might not realize: that new stiffness you're feeling? It's related to losing estrogen's natural anti-inflammatory properties—something we took for granted for years. While estrogen replacement through BHRT can help, regular exercise is crucial regardless of your hormone therapy choice.

But here's the twist: it's time to shift away from endless cardio and strict calorie counting. If you're still trying the same weight-loss approach you used at 20, you've probably noticed it's not working anymore. Instead, focus on strength training with weights, limiting cardio to about a quarter of your exercise time. This resistance training isn't just about looking good—it's essential for protecting and strengthening your bones by promoting bone production and supporting long-term weight management. See our prior post here for more on the specific benefits of resistance training for blood sugar and weight control. 

Another fact that everyone will be happy to hear: the old story of “you can’t add bone density after your 20’s” that wracked us with guilt when we were too busy- or nervous- to lift weights was recently disproven! The approach is to lift as heavy a weight as you can. Your bones respond to the actual mechanical stress by strengthening; it’s not the overall intensity that matters. In other words, an exhausting cardio session will have less of an impact than a well-designed weight training program.

Making It Work for You

While these lifestyle changes might seem challenging at first, they're fundamental for improving your quality of life during menopause and beyond. Everyone has the ability to implement these changes, and your healthcare provider can help modify these recommendations to fit your specific needs.

Stay tuned for my upcoming post about specific treatments and supplements that can help you manage other symptoms and navigate menopause effectively!

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