• The menopause can have a multitude of mental, emotional and physical symptoms

  • Health coach Susan Saunders offers her 6 tips for optimum health post-menopause

  • We have therapists who specialise in supporting women through the menopause - find them here

If you believe everything you read in the media about menopause, you’ll think it’s nothing but agonising symptoms, hot flushes and brain fog. And I don’t deny for a moment that it comes with complex health challenges. But I urge you to look ahead. There are huge positives to be found post-menopause: it's time to create the adventures – large and small – that we want. 

My latest book, The Power Decade: How to thrive after Menopause, was inspired by the many women over 50 I could see around me who were powering up post-menopause and creating wonderful adventures for themselves. Midlife and beyond can – and should be – a time of exploration, freedom and expansion.

These adventures need to be built on a foundation of good health. The decade after the menopause transition, from our 50s to 60s, is the most important for women’s wellness. Here’s why: on average, women experience menopause at the age of 51 and, statistically, the chronic conditions of ageing, like osteoporosis, diabetes, cardiovascular disease, and dementia may take root by 65. That gives us a window of opportunity to nurture our bodies and brains.

Here are some tips to get you powering up post-menopause:

1. Understand the role of oestrogen in the body

Oestrogen is not just a hormone of reproduction: we have receptors for it throughout our bodies. It affects the urinary tract, heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles, and – critically – the brain. 

This is an extremely reductive way of looking at it, but during our reproductive years, oestrogen wraps us in a protective cloak, helping us keep healthy. Once it’s declined in menopause, (regardless of HRT status) we need to take care of ourselves.

2. Put yourself first

As a health coach working with women over 50 who want to age well and reduce their dementia risk, I hear a variation of, ‘My health comes last on the to-do list’ over and over again. 

Many women are juggling demanding jobs, caring for older parents, raising teenagers, or have some other combination of responsibilities which impact their ability to prioritise themselves. But, post-menopause, when hormonal shifts combine with natural ageing, we have to put ourselves first. 

It may involve a change of perspective, seeing a healthy lifestyle as an extension of the other priorities in our lives. It may also mean difficult decisions about how we use our time, because being ‘selfish’ now will help us give more to others over the years to come.

3. Learn about genitourinary syndrome

One of the biggest lessons I learned while writing The Power Decade was about the impact of menopause on our genitourinary health. This is a broad term that covers a variety of genital, sexual and urinary conditions, such as dryness, irritation, lack of lubrication, stress incontinence and recurrent urinary tract infections. It’s not the most comfortable topic to discuss, but vitally important. These symptoms may begin during perimenopause, or they may not appear until many years later, and there’s a tendency to suffer in silence.

Three things can help:

  • Pelvic floor training: squeeze the muscles around your back passage, vagina and urethra as if you’re trying to stop yourself peeing. Fully relax the muscles then do it again. Aim for 10 slow squeezes of 10 seconds each, then 10 fast one-second squeezes.
  • Topical vaginal oestrogen: I’m not a doctor so can’t recommend medication, but topical oestrogen isn’t the same as systemic HRT. It can be used safely by almost anyone and helps tackle many of the symptoms of genitourinary syndrome. Talk to your GP for more information.
  • Omega 7: an essential fatty acid. It’s part of the natural structure of our skin and mucous membranes. The best external sources are oily fish like salmon, macadamia nuts, avocados and a coastal shrub called sea buckthorn. Research has linked supplementation with 3g of sea buckthorn oil daily to a significant reduction in vaginal atrophy symptoms for postmenopausal women.

4. Boost bone health

Oestrogen regulates bone metabolism, the process of breaking down and rebuilding bone tissue so it can stay strong. Once reproductive hormones decline bone formation slows and bone resorption increases. This in turn can lead to cavities developing in the bone, making them ‘porous’, less able to support our weight and more likely to fracture.

Try these:

  • Create a combination of exercise: mix up weight-bearing exercise such as walking, jogging, running and stair climbing with strength training using weights or body weight, as well as balance exercises.
  • Calcium intake provides raw materials for bone turnover. Calcium-rich foods like dairy products, sardines (buy the cheap tinned ones with the bones!), soy products like tofu and green leafy vegetables are all good calcium sources.
  • Power up posture: sit or stand as tall as possible, shoulders back and down, stomach gently pulled in. Check yourself in a mirror and stick a post-it note somewhere you see regularly with the words ‘don’t slouch’ on it!

5. Build a better brain

Menopause fundamentally changes our brain chemistry. There are oestrogen receptors throughout the brain, and when levels of that hormone diminish, brain structure alters, energy metabolism falters and beta amyloid deposits (a sticky plaque linked to Alzheimer’s) increase. Without the neuroprotective benefits of oestrogen, the brain is more vulnerable to ageing and decline.

Try these:

  • Seek novelty: Staying curious about the world throughout our power decade is crucial to keeping our brains wiring and firing. Any new experience is good: that can be setting off on a world tour or taking a new route to work.
  • A strong social support system almost halves our dementia risk and has a profound effect on our longevity. Your life experiences may have changed you, or your goals  – ask yourself if your social support network has kept up?
  • Berries, greens, greens: this is the mantra that my clients tell me sticks more than any other! I use it as a simple reminder that each meal can help support our brain health. Add berries to breakfast, and greens to two other meals to create a way of eating that supports brain health.

6. Find the joy

It’s easy to get to midlife with a pervading sense that we’re so weighed down by responsibility that much of the joy has been sucked out of life. Add to that the hormonal changes of perimenopause and things may not be much fun. But now is time to rediscover the fun of life. Ask yourself who is the post-menopausal you? What would bring that person joy?

Susan Saunders is the author of The Power Decade: How to thrive after menopause

Further reading

The menopause and letting go of old identities

The impact of the menopause on relationships

Can hypnotherapy relieve menopause symptoms?