Hot flashes. Night sweats. Weight gain. A waning sex drive. Tell us something we don’t already know about “the change.” Well, it turns out there are plenty of side effects—and even some upsides—of menopause that few people talk about. “Many women just think of a handful of symptoms when they hear the word ‘menopause,’ ” says Nieca Goldberg, MD, medical director of the New York University Langone Joan H. Tisch Center for Women’s Health. “The good news is that this transition really can be a time of empowerment.” Here are the tidbits you may not know about, plus advice to make this time of life a little bit easier.
And not necessarily in that fun, excited-about-a-new-love-interest kind of way. In the time leading up to menopause (called perimenopause), many women can experience heart palpitations, says Goldberg. “In some women, these palpitations could indicate a heart problem, but in others it’s due to hormonal fluxes,” she says. The way to differentiate: if your heart palpitations last more than a few minutes, make you feel short of breath or cause you to faint (or nearly faint), it could be a sign of something serious. “My advice is that if you’re ever concerned about this symptom, get it checked out by a doctor,” says Goldberg.
Turns out estrogen does a lot more than help regulate our periods: It keeps LDL cholesterol (the bad kind) low and HDL cholesterol (the good kind) high. So, as estrogen decreases during menopause, LDL tends to rise and HDL stays the same. The good news, says Goldberg, is that if you lead a healthy lifestyle as you approach menopause you can prevent these fluctuations. What’s more, making sure you get plenty of exercise and that you’re eating a heart-healthy diet are two lifestyle changes that can go a long way toward countering these cholesterol changes during menopause, she says.
If you’ve always been an extrovert, you may be surprised when you suddenly feel like spending more time alone. “Menopause is an introspective period, which means you might experience an emotional shift that could affect your social life,” says Holly Lucille, ND, a naturopathic doctor in Los Angeles. “Don’t just jump to the assumption that you’re depressed. This newfound introspection should be honored.” At long last, this is often a time in a woman’s life when she starts to put herself first. “Prior to menopause, women are more likely to make sure that their kids, partner, parents, co-workers—you name it—get what they need, and only then does she take care of herself,” says Barb Dehn, RN, a nurse practitioner in Mountain View, Calif., and author of The Hot Guide to Cool Sexy Menopause. “During menopause, many women start prioritizing themselves and start thinking about what they want to do.”
Recent research shows that certain chemicals in the pesticides on the food we eat and in the household products so many of us use contain hormone-disrupting compounds—not exactly what you want during a time in your life when your hormones are already transitioning to a new normal, says Lucille. “I tell my patients to detox as much as possible when they’re in menopause,” she says. “It’s already a disruptive time for your hormones. Why risk making things worse?” Steer clear of products that contain parabens, phthalates, and BPAs.
As estrogen levels drop, so does oil production in your skin, causing excess dryness that can lead to a flaky complexion. The solution: Use a heavier-duty moisturizer or even a facial oil, says David Bank, MD, a dermatologist in Mt. Kisco, New York, and author of Beautiful Skin: Every Woman’s Guide to Looking Her Best at Any Age. “If there’s some good news, it’s that if you were prone to acne, decreased oil may stop your breakouts,” he says. “So don’t shy away from oil-containing products.” In addition to using a richer, more hydrating facial cream or oil, Bank says it’s crucial to keep yourself hydrated from the inside out. “Drinking lots of water really does add moisture to parched skin,” he says.
In fact, they tend to gang up at night, says Alyssa Dweck, MD, an OB/GYN in Mt. Kisco, New York, making it tough to get a good night’s sleep. Lowering the thermostat and using sheets made of breathable, cooling materials can help. So can deep, yogic breathing, adds Dehn. “Simply breathing more slowly—aim for a total of six breaths per minute—can actually decrease the severity and frequency of hot flashes,” she says.
In terms of the type of weight gain you hear women mention when they talk about menopause, it’s true, says Dweck. “Without sufficient estrogen, the body tries to maintain some body fat—especially around the belly and hips,” she says. “Even women who exercise regularly and eat well can experience weight gain.” Lucille agrees, but adds that sticking to your workouts or even starting a new regimen can go a long way toward keeping the pounds from really piling on—and also toward improving your mood and helping you sleep well. “You don’t have to go to a gym,” says Lucille. “Even power walking and doing some strength training moves that use your own body weight is great. The key is exercising consistently.”
As if the hot flashes weren’t vanity-wrecking enough, thinning hair (or even hair loss) is one symptom of menopause, says Bank. “Hair can also become dry and brittle due to those fluctuating hormones causing overall dryness in the body.” So use mild shampoos and conditioners formulated to treat dry hair, says Bank, and avoid chemical treatments that can further weaken strands.
Remember a time when you weren’t on hormonal birth control, and your fluctuating hormones made you frisky at certain times of the month? Well, you’re on a similar hormonal roller coaster now, which means your sex drive won’t just dive deep into the depths of despair—it’s likely to go up, too. “Before menopause, hormonal shifts can lead to dramatic surges in estrogen, which means you may feel a lot more in the mood,” says Dehn.
If you’re not feeling turned on, it may be due to vaginal dryness, which, unlike those hot flashes and night sweats, doesn’t tend to improve with time. “Our vaginas have many estrogen receptors, and as estrogen levels decline, not only does the vagina get drier but it also gets less able to expand,” says Dehn. The fix? Lube, and lots of it. “Just because you’re going through menopause doesn’t mean you should stop having sex,” says Dweck. “Using a quality silicone lubricant can really alleviate painfulsex caused by vaginal dryness.”
Even if you used to sleep like a champ, menopause can do a number on your shut-eye—which can take a toll on your body, impacting energy levels, your emotions, your weight, and even your libido. “I tell my patients to try to squeeze in a 20-minute power nap every day,” says Dweck. “The more rested you are, the easier it can be to manage your symptoms.”