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The Menopause

I didn’t actually know I was in perimenopause for at least seven years, maybe longer, writes Ann Marie McQueen, founder of Hotflash inc.

By the time I realised at the age of 47, I had amassed an arsenal of tools to manage my mental health. And since launching Hotflash inc, a global platform to inform and inspire women through perimenopause, midlife and intentional aging, I’ve had access to some of the top experts around the world.

I’ve taken the best of what they’ve offered, combined with my own processes, bolstered by research, and made it as simple as I can. I know these work because when I do them I feel good, and when I start skipping steps, I can feel dreadful.

  • Have a solid morning routine

Mornings can be hard in perimenopause. For a few years I had what I call “morning dread”: open my eyes, feel fine for a few seconds, then dum-dum-dum, a terrible feeling descended. As much as I can I head out for a walk as soon as I can after waking up, even if it’s just around the block, even if it’s the height of summer. Everything is better after a walk, even a short one, and we have evidence that it’s a particular tonic for perimenopausal and menopausal women. A review published in the August 2020 issue of Menopause, the journal of The Menopause Society in North America, charted 96 studies looking at 77 different walking programs and found a whopping 91 percent showed improvements in at least one menopause-related condition. Walking will build muscle, increase your body’s demand for energy, helps to address or ward off insulin resistance, and gets you out of your head. The earlier the better, because that red light helps to set my circadian rhythm, and I usually try to do it barefoot around the park near my house. This makes me happy because a) I get in some “grounding” – connecting to the earth and balancing my body’s positive charge with its negative,  like we did in the days before shoes and b) I’m triple-tasking.

  • No screens before bed

Nothing, and I repeat nothing, messes up my sleep like looking at my phone anywhere near bedtime. Even if I glance at it sideways – and I try, I really do try this weekly – the impact is palpable. Although not everyone is impacted in the same way, a population-based, cross- sectional study of more than 20,000 people in China, published in the Frontiers in Psychiatry journal in June 2022, revealed it’s harder for older people than young. Whether it’s the light or the EMFs, or the upsetting content that’s unavoidable these day, whenever I break this rule I end up paying the price.

  • Stretch, do yin yoga or foam rolling before bed

This is one of my favourite tricks to a restful night’s sleep. Yin or restorative yoga takes minimal energy and helps soothe the nervous system and release physical and mental tension for a better, longer and deeper sleep. A 2020 systematic review and meta- analysis published in the BMC Psychiatry journal found yoga to be effective in managing sleep problems in women. If yoga doesn’t do it for you, try foam rolling or even simple stretching. According to a 2014 study from Japan published in the Bulletin of the Physical Fitness Research Institute, stretching before bed yielded better REM sleep and a diminished stress response in participants. When I’m really lazy and trying to talk myself out of it, I have an app called StretchIt. Some of the routines are just eight minutes. There are loads on YouTube as well.

  • Lift weights

If you don’t lift weights, now is the time to start. Bone density is a major concern, as is osteoporosis. Studies of Super Agers have shown that it’s the activity they did in their 40s, 50s and 60s that had the most impact on their vitality – and superior quality of life – decades later. I also think there is a really good argument to be made for lifting weights leading to more mindfulness. Throughout my 30s and 40s, exercise was mostly dashing to a range of classes and getting it done. I was rarely present for those workouts. Now, I’m amazed that I actually enjoy pulling, pushing and lifting weights, and seeing how those movements actually connect to and contract various muscles. It helps me build my body, but also be in my body, too.

  • Take magnesium and taurine for hot flashes and sleep

This is part of New Zealand- based naturopathic doctor Lara Briden’s Rescue Prescription for Perimenopause and Menopause, included in her book hormone repair manual. Studies have shown most of the population is deficient in magnesium, which is essential for hundreds of the body’s biochemical reactions, including energy production and muscle and nerve function. Taurine is an amino acid with effects on the liver, brain and immune system, and in women, estrogen can slow how it works.This combination is relaxing but it also cuts down on night hot flashes, which can jolt you awake before the heat sets in and make it hard to get back to sleep.

  • Whole foods most of the time

Even when delivery is “healthy”, it’s usually made with cheap, highly processed oils that are not good for us – and wreak havoc on the gut. This can lead to inflammation, in combination with alcohol, sugary foods and refined carbohydrates. Our guts and metabolism are in flux during this time. And while you might start to see weight shift to your middle, know that this can be from inflammation and it can also spark more inflammation – a potentially dangerous loop that can be caused by or lead to insulin resistance, which is the precursor to prediabetes, and many other diseases. Most experts advise tackling the root cause by eating optimally for perimenopause, adding in lots of nourishing, nutrient-dense foods, including vegetables, good fats and lean protein, starting from breakfast right through the day. This will reduce sugar cravings and set you up for success.

  • Let myself cry for as long as I need to, when I need to

Here’s the thing: It’s never that long. Yes, there are those epic sessions when something is really wrong, amid grief or loss. But what’s happening during perimenopause is different: we are often processing hurts, traumas and Adverse Childhood Experiences (ACEs) from our past. I don’t think random sad thoughts from long-ago times are random thoughts; I think they are our body’s way of telling us that we didn’t properly process these things at the time, and that we really need to. A large, cross- sectional study published in Maturitas in 2021 showed a significant association between childhood adversity and self-reported menopausal symptoms. I always say you didn’t have to be chained to a radiator to have experienced ACEs. Most of us had them in one form or another, and the pain they can cause can linger and lurk for years, reaching a fever pitch in midlife – think of the pressure like a lid on a pot about to spill over. Undealt with, they can truly exacerbate the physical and emotional impact of our menopause transition. A good cry though. That moves them on through – and out.