Four Tips for Navigating a Healthy Menopause

Brain fog. Mood changes. Night Sweats. Insomnia. Hot flashes. The reality is menopause is the biggest change women go through since adolescence, and you’ll likely experience some, if not all, of the symptoms.

But are there things you can do along the way to help you navigate it? In most cases, the answer is yes. Every woman’s menopause journey is different, but here are some tips that may help along the way.

Don’t Try to Predict When the Change Will Happen

I see a lot of women who are looking for ways to predict when menopause may start. Since stress is one of those triggers that makes menopause worse, it’s important to just let Mother Nature run her course.

There isn’t a correlation between how early or late you started your menstrual period and when menopause will start. And, you MAY follow in your mother’s footsteps on timing, but then again you might not. Checking your hormone levels doesn’t work either.

At the end of the day, your period is your best gauge. I tell my patients to check in with me once three periods are missed, although women are not considered to be officially in menopause until 12 consecutive months of missed periods. Your symptoms will become more pronounced the longer you’ve missed periods. Also, if your periods are persistently less than two weeks apart, touch base with your doctor.

Avoid the Things that May Make Hot Flashes Worse

  • Stress
  • Alcohol (especially wine)
  • Caffeine
  • Hot Drinks
  • Spicy Foods
  • Sugar

Remember, not all of these things may affect you. Pay attention to what you’re eating around the same time as you have episodes to see if there’s a pattern.  For you, it may be something on this list or it might be some other food.

Know What Helps Lessen Hot Flashes or Their Inconvenience

  • Moderate to Vigorous Exercise (Four times a week)
  • Losing Weight
  • Dressing in Layers
  • Ice Water/Cool Drinks
  • Meditation/Deep Breaths
  • Fans

Know There Are Treatments Beyond Hormone Replacement Therapy

It’s hard to know when to seek out additional treatment and every woman is different, so my rule of thumb is if your symptoms are persistent enough to continually disrupt your life you should talk with your doctor. Three common treatments are:

  1. Over-the-Counter Naturals (such as Estroven and IsoRel)—These mimic estrogen. You should give them at least three months to see effectiveness, and they generally have a 30 to 50 percent success rate.
  2. Antidepressants (such as Effexor and Brisdelle)—These are non-hormonal options for women who have blood clots or have had or are at higher risk for breast cancer. Brisdelle was specifically created to treat menopausal symptoms. It’s a lower dose than what would be used for anxiety or depression. You should give them at least three months to see effectiveness, and they generally have a 30 to 50 percent success rate.
  3. Hormone Replacement Therapy (HRT)—I recommend transdermal estrogen or oral natural progestin in the lowest amount that provides relief. HRT is individualized, and I recommend you talk to your doctor because it is not prescribed for everyone like it used to be.

No matter which method you try, look at things in six-month blocks. Are your symptoms better? Are you able to handle it better? If you’re still having moderate to severe symptoms that interfere with your life, check back in with your doctor.

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ByKaren Hardart, MD, Anne Arundel Medical Center Karen Hardart, MD, an OB-GYN at Anne Arundel Medical Center. She can be reached at 410-573-9530.


  • Karen says:

    Thank you for your suggestions. I’ve just started Hrt, and I’m amazed how well it works for me. My symptoms have for the most part come to a halt. I also stopped eating carbs , and am physically active more. All in all, I feel better now than when I was younger and still getting regular periods.

  • nancy says:

    Was glad to see information regarding menopause. I haven’t had any of the posted symptoms but what I have been experiencing and doesn’t seem to be addressed is vaginal atrophy, dryness, and UTI’s. I haven’t had any problems with UTI’s but the atrophy is a big problem. No one seems to be able to help me with an answer. The atrophy affects many things including sexual. Sex becomes extremely painful. The medication that is on the market doesn’t seem to be a good option. Is there anything new on the market that will help?

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