How lifestyle can influence health during menopause.

For a long time, menopause was treated solely from a hormonal perspective. But science has been showing that lifestyle plays a central role in how each woman navigates this phase. A recently published document by the International Menopause Society, in partnership with the World Health Organization (WHO), consolidates this concept by linking lifestyle medicine to women's health at this time.

“Any woman who is in this phase needs to make lifestyle adjustments. There’s no way to get through menopause well without doing so,” says gynecologist and nutritionist Alessandra Bedin, from Einstein Hospital Israelita. “This document has solidified something that has been discussed for some time.”

Menopause is a natural and inevitable process. With the increase in life expectancy, the topic gains even more importance. "If we consider an average life expectancy of 90 years, that's about 45 years of menopause. We need to think about quality of life, not just the length of it," notes Bedin.

The document emphasizes that, although hormonal and pharmacological therapies play an important role during this period of a woman's life, lifestyle care is the foundation of menopausal health. The publication is based on six main pillars, recognized by lifestyle medicine.

Learn more about how each of them applies during menopause:

Maintaining a balanced diet is the main way to avoid overweight, obesity, and cardiovascular disease during menopause. Estrogen is the main protective factor for women's health during their reproductive years, and the decline of this hormone from the age of 45 onwards favors the accumulation of visceral fat, which is more inflammatory and dangerous. Therefore, with menopause, the cardiovascular risk increases. "This is a critical turning point for women in terms of health and complications," notes Alessandra Bedin.

Diets rich in vegetables, fruits, and whole grains help reduce the risk of these diseases and osteoporosis. "The Mediterranean Diet food pyramid includes, in moderation, the consumption of animal protein. The base is vegetables and whole grains ; then come fish, poultry, and finally, lean red meat."

Adequate calcium and vitamin D intake is also essential for maintaining bone health. “During menopause, the recommendation is to consume 1,200 mg of calcium per day, or four servings of milk or dairy products. Each serving is equivalent to a glass of milk, a thick slice of cheese, or a cup of yogurt. Most women cannot reach this goal through diet alone,” says the doctor. Vitamin D, in turn, depends mainly on sun exposure, so supplementation is often necessary.

Regular exercise is one of the most important pillars of lifestyle medicine and the main recommendation for women who cannot undergo hormone replacement therapy due to health issues (such as breast cancer). "Exercise does indeed impact the reduction of vasomotor symptoms, improves sleep, helps prevent osteoporosis and sarcopenia, and has an important anti-inflammatory effect," emphasizes the gynecologist.

Ideally, aerobic and strength (resistance) exercises should be combined, but the document emphasizes that the essential thing is to overcome a sedentary lifestyle. A physically active life helps control weight, reduce visceral fat, release endorphins, and decrease anxiety. Furthermore, there is evidence that exercise reduces the hot flashes typical of menopause, possibly by acting on the brain's thermoregulation system.

Controlling stress and emotions is another essential aspect of lifestyle medicine. Studies show that chronic stress increases cardiovascular risk and worsens symptoms such as hot flashes. "When adrenaline and cortisol levels increase, vasomotor symptoms worsen. And with the drop in estrogen, women become more vulnerable to mood disorders and anxiety," explains the doctor from Einstein Hospital.

It's worth incorporating practices like therapy, mindfulness, and meditation, as well as seeking professional help when necessary. "We joke that menopause is like prolonged PMS. And it's important to take care of mental health with the same seriousness that we take care of our bodies," says Alessandra Bedin.

Smoking and alcohol consumption are potentially harmful to overall health. "Cigarettes increase the risk of cancer, cardiovascular disease, and osteoporosis. Alcohol, even in small amounts, is inflammatory and contributes to weight gain and fatty liver disease , which worsens during menopause," warns Bedin. It's worth remembering that, according to the WHO, there is no safe dose of alcohol.

Insomnia is one of the most common complaints during menopause. "Many women wake up around 3 a.m. and can't fall back asleep, which causes daytime sleepiness and impairs metabolism," explains the gynecologist. Weight gain during this phase also increases the risk of snoring and sleep apnea, worsening the quality of rest.

But getting a good night's sleep is one of the cornerstones of a healthy lifestyle. “Sleep hygiene is simple, yet extremely effective. Preparing for sleep is one of the most important strategies for health during menopause. This includes avoiding screen time for at least an hour before bed; not consuming caffeine at night; taking a relaxing warm bath; engaging in physical activity; and creating a bedtime ritual.”

The final pillar of lifestyle medicine is human relationships. Loneliness and social isolation, especially with aging, can affect adherence to healthy habits and increase the risk of disease. "Social and emotional connections are associated with longevity. Women who have a support network tend to take better care of their diet, exercise, and keep up with medical appointments," says the gynecologist.

Interpersonal relationships strengthen self-care and bring purpose, which are decisive factors for aging well. “There’s no way for a woman to avoid menopause, but it’s possible to go through it more easily. Those who take care of these pillars will have a better quality of life and will probably need less medication. The secret to longevity lies in daily choices,” concludes Bedin.

Source: Einstein Agency

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