Hot flashes. Wrinkles. Leaky bladder. Weight gain. Menopause symptoms can feel like they’re taking over and ruining your life.
But you don’t just have to suffer. JoAnn Pinkerton, MD, offers 7 things you can do to take charge and get through menopause stronger than ever. Pinkerton is one of the world's top menopause and estrogen replacement therapy experts.
#1: Do Daily Kegels
Keep your pelvic muscles in shape to help avoid later incontinence and pelvic organ prolapse, two of the pelvic floor disorders that affect 1 in 3 women.
But how many Kegels do you have to do a day to really make a difference?
Pinkerton recommends a daily routine of 10 sets of 10, and that you hold each Kegel for a count of 10, or 100 10-second Kegels a day.
Pinkerton advises women to make sure to pull upwards toward your belly button when you contract your pelvic muscles. This squeeze activates all the abdominal muscles.
“If you’re not able to do it, or if you don’t know if it’s tight enough, there’s pelvic floor physical therapists who can work with you to get a better Kegel. They can monitor how strong it is and work with you to make sure you’re tightening enough,” she says.
What’s a Kegel? Find out how to do one.
#2: Combat Sarcopenia
With the onset of menopause, you lose estrogen and testosterone, Pinkerton explains. And the result is a loss of muscle mass, called sarcopenia. Aging without muscles puts you at risk of becoming frail and not being able to stay active in your older years.
What you need to do: Stay fit and active and keep a healthy weight, Pinkerton says.
- Cardio exercise for 30 minutes 5 times a week
- Strength training 3 times a week
“You want to do both,” Pinkerton says. “Strength training helps your bones and immune system as well as your muscle mass.” It also can help you avoid the massive weight gain that can accompany other menopause symptoms.
#3: Stop With the Wrinkle Cream
“Thinning of skin is why you start to see wrinkles,” Pinkerton points out. “As your hormones decline, you lose the thickness of your skin and connective tissue.”
Anti-wrinkle creams overrun store shelves – and many women’s, too. An attempt to defeat one’s wrinkles dominates many a middle-aged skin care regimen. But this may be a fight you just can’t win.
Those expensive creams may have superficial benefits, but ultimately, they cannot remove your wrinkles. “Estrogen can help, though,” Pinkerton adds, because maintaining hormone levels can prevent the loss of skin tissue.
A better investment of your cash? Buy yourself a massage. Get enough sleep. Taking care of stress and getting enough rest can help you both feel and look younger.
#4: Try Alternatives to Treat Hot Flashes
When it comes to licorice, black cohosh, and other home remedies, clinical trials have not resulted in conclusive evidence as to their benefits.
But in her experience, a few treatment alternatives Pinkerton believes to be “better than waiting” and doing nothing include:
- Cognitive behavioral therapy
“Research has shown that mental exercises to think about coolness can actually work with hot flashes,” Pinkerton notes. As for acupuncture, “both acupuncture and sham acupuncture seem to work, but we’re not sure why.”
Long story short: If you find something that works for your menopause symptoms, it works!
You can find acupuncture treatment and other integrative therapies at the UVA Primary and Specialty Care clinic on Pantops.
#5: Keep the Faith: Your Sex Drive
One possible side effect of menopause is the decline in your sex drive. This isn’t surprising, given all the hormonal changes you’re experiencing. But it may feel problematic, and you may wonder: Will my sex drive ever come back? Or do I have to do something extra?
Pinkerton offers her perspective, saying that “once through menopause, women may find they cope better. Their energy and libido goes up, mainly because they just aren’t feeling menopausal symptoms all the time (sleeplessness, hot flashes).”
She does point out that libido in women is more complicated than for men. “For men, it’s an on/off switch. For women, it’s a whole panel of switches, like in an airplane. There’s so many factors.”
Bottom line: Don’t give up. If you’re having a drop in your sex drive, don’t ignore the problem. Even if you’re still having menopausal symptoms, your provider can help you figure out a possible solution. It just might take a few rounds of trial and error.
#6: Consider Hormones: They're Safer Than You Think
“They’re safer than you think,” Pinkerton says. “Recent studies have shown that the fears of cancer and heart attacks and strokes with hormones just aren’t true.”
What studies do show are benefits, like:
- Relief from hot flashes
- Prevention of bone loss and fewer fractures
- Reduction of painful intercourse
Pinkerton explains that non-oral sprays and gels, among a number of new low-dose estrogen products, give women an increased range of options. Applying low-dose estrogen directly in your vagina to help with dryness, for example, does not raise hormones in blood levels.
The bottom line: “New products keep coming all the time,” Pinkerton says. So even if you've seen a provider in a year or two ago, it could be worth it to return and learn about the new options on the market.
Looking for Answers?
Our midlife health experts can help you find relief from your menopause symptoms.
#7: Get Individualized Care
Pinkerton encourages women approaching menopause to seek out a doctor’s help and get individual attention.
“I offer patients control over how they want to manage menopause,” she says. “There are lots and lots of options. We look at the risks and benefits. We look at what we know about you, why something would help you, how you can minimize risks, and we individualize the dose.”
If your provider doesn’t offer the expertise to work with you to develop this kind of detailed, tailored plan of action, find another one.
“There’s no reason to just suffer through it,” Pinkerton says.
This post was originally published in 2017 and updated in October 2021.