Happy Labor Day!
My sister Christell and I were chatting on Facetime the other day, and the subject of menopause came up.
She is 45, and she had breast cancer eight years ago. Her cancer was “estrogen fed,” so part of her treatment besides chemo was stopping the hormones. As a result, she went through full-blown menopause at 37. At 48, I am perimenopausal — changes are happening but gradually. Perimenopause can start around 40, and you are considered to be in “real” menopause when you have not had a period for 12 months. She said it is nice to see her friends (and sister) finally dealing with the same symptoms she has been dealing with for almost eight years.
So, when does it start? In the mid-30s, hormone production in the ovaries starts to slow down. Symptoms typically start in the mid-40s, but moreso in the 50s (in the U.S., the average age for menopause is 51). Symptoms of these changes can be:

• Hot flashes
• Depression, stress and anxiety
• Sleep disorders
• Irritability
• Osteoporosis
• Cardiovascular disease

Before you are in total menopause, you could skip one or two months, even more, and start again. And yes, in these times, you are still fertile. I hear about unplanned pregnancies too often.
Going through menopause has some other side effects, such as possible weight gain, particularly around the belly and the waist line.
What some research shows is that when the hormones drop, food intake increases and physical activity decreases. So with the hormone drop, you are doing less and eating more — a big reason for weight gain. With age, muscle mass already quickly disappears if you don’t use it. When your metabolism plummets even more, it becomes a snowball effect.
Check with your gynecologist for what treatments are available. See what you can do to minimize the effects and what steps you need to take to maintain a healthy weight.
Research shows that exercise is one of the best preventions of the negative side effects of menopause such as osteoporosis, muscle loss and cardiovascular disease.
Strength training can lower the risk for osteoporosis. Exercise also can prevent cardiovascular disease ­— it keeps the joints and muscles strong, relieves depression and anxiety and improves overall health.
Strength training during and after menopause is highly recommended to increase muscle tone and improve metabolism. Low impact aerobic exercise can help your cardiovascular health. Water exercise or swimming is great to improve your overall health. (The benefits of that were in a column about one month ago.)
As always, check with your primary doctor or gynecologist first before you start a new exercise program.
Alternative therapies such as reflexology and acupuncture have shown great results in managing menopausal symptoms. Of course, a healthy diet is crucial. Stay away from processed foods and start logging your food intake. You will be surprised how many calories you actually eat. Try to avoid eating late — typically the choices aren’t the best ones late in the evening. Check with your gynecologist, create a plan and see what your options are. And most of all, embrace getting older. My sister had to deal with menopause way too young, but she survived breast cancer. She has embraced menopause, but foremost, life. Embrace that getting older is not a bad thing.
Ester H. Marsh