Latest news with #BritishMenopauseSociety
Yahoo
3 days ago
- General
- Yahoo
How common is perimenopause in your 30s? Tracy Beaker's Dani Harmer shares 'dark depression'
Dani Harmer has revealed she was diagnosed with perimenopause at the age of 36, raising questions about how common the condition is for women in their 30s. Harmer, best known for her role as Tracy Beaker, spoke candidly about her experience on This Morning today, sharing why she decided to go public with her diagnosis. "I just wanted to be open about it, because obviously I am on the younger side of it, and even though I think it's rare, I don't think it's that uncommon, especially looking through my comments," she said. "And so I just wanted to be quite open about it, because, actually, I had quite a good experience with my GP. So I just wanted to make people aware that going to the GP can really, really help, because I was just having such awful symptoms and I needed help with it." In a previous TikTok video posted on 23 May, Harmer shared that she experienced a "dark depression" before her diagnosis and spoke candidly about the toll perimenopause has taken on her health. "I have been diagnosed with perimenopause. More on that in a second. But what I need your help with is my hair. I am losing it, man, like it is thinning so badly, like you can see, like the bald patches coming in," Harmer said. She continued: "Brain fog, oh my gosh. I couldn't even, like, remember the word banana. That was odd, and then the night sweat started. My sleep was all over the place … I felt like I was being possessed by someone else, like it was horrible, and I was just getting deeper and deeper into a dark depression." To better understand how common perimenopause is in women in their 30s, Yahoo UK spoke to Dr Louise Newson, a general practitioner and menopause specialist. According to Dr Newson, perimenopause affects approximately four in 100 women under the age of 40, and at least one in 1,000 women under 30. Even teenagers can be perimenopausal or menopausal. "It's more common than people realise," she tells Yahoo UK. "I see a lot of women, and speak to a lot of women who are in their 20s and 30s, who have low hormones. "A lot of them have low testosterone, so they have low moods, they have poor concentration, they have fatigue and they have reduced stamina. They might have muscle and joint pains. They might have headaches and migraines, yet they've been misdiagnosed with depression and anxiety and given antidepressants. "The problem is, most people, including me, don't know that they're perimenopausal until they get their hormone [test results] back and think, 'Wow, I wish I'd done this years ago.'" Perimenopause refers to the period before menopause when a woman's body naturally transitions toward the end of her reproductive years. This average age this phase occurs is 47, according to the British Menopause Society, and it's marked by changes in menstrual cycles along with a range of physical and emotional symptoms. The menopause itself is traditionally defined as the point when a woman has not had a period for a year, which is caused by a reduction in hormone production. "Before the menopause is perimenopause, which can last for about 10 years before periods stop," says says Dr Newson. "So, hormone levels start to decline, but they often fluctuate. So they go up, they go down, they're all a bit crazy in our bodies. And these hormones – estradiol, progesterone, testosterone – affect every cell in our body and every tissue and every organ, especially our brains." According to Dr Newson, however, the broad term "perimenopause" doesn't accurately reflect the complexity of what's occurring hormonally and how it should be treated. For instance, many women in their late 20s and early 30s may experience a drop in testosterone well before noticeable changes in their periods. "Testosterone is more biologically active than oestrogen. We have more levels of testosterone than oestrogen in our bodies when we're younger, and then those levels decline quicker than the other hormones," she explains. "So a lot of women are testosterone deficient. And then people, as they get older, often their progesterone starts to drop first, and then their oestrogen starts dropping. So it really varies between different women. If we don't know what the hormone is that's changing, it's difficult to get the right treatment." During perimenopause, hormone levels are in flux, which means people may experience a wide range of symptoms, especially those affecting cognitive function and mood. "When the levels are changing and reducing, people get all sorts of symptoms, especially symptoms affecting our brains," Dr Newson says. According to the NHS, symptoms can include: hot flushes and night sweats vaginal dryness difficulty sleeping low mood or anxiety reduced sex drive problems with memory or concentration muscle and joint aches and pains joint stiffness and swelling reduced muscle strength pins and needles Dr Newson says it's incredibly important to work with someone who understands hormones. "What I would hate is for people to think, 'Oh, I just do a blood test and my testosterone is low, therefore my tiredness is due to low testosterone,' whereas they might have underactive thyroid, they might have anaemia, they might have some other cause," she explains. "So you do need to do this in conjunction with a doctor who understands hormones as well. Because also, if you do tests, our hormone levels are changing all the time." Dr Newson also recommends that people keep track of their symptoms. They can do this manually or use the free Balance app, which she created, that contains a symptom questionnaire; users can also create a health report. The Flo Health app also allows you to track perimenopausal symptoms. "What's changing more now than ever before is that women are learning for themselves, so they can be an advocate for themselves," she continues. "In the history of medicine, women have been gaslit the whole time, and we're always told, 'Oh, it's just stress, it's trauma, it's all in our heads,' and as a doctor, that really upsets me. "Just because the doctor they're saying doesn't know about hormones, it doesn't mean that there isn't a hormonal problem in that woman." Read more about perimenopause: I lived with extreme perimenopause symptoms for years without realising (Yahoo Life UK, 8-min read) Perimenopausal women '40% more likely to suffer depression' (PA Media, 3-min read) Perimenopause has brought chaos to my life – but also peace (The Guardian, 5-min read)
The Australian
30-04-2025
- Lifestyle
- The Australian
Best back exercises for a toned back
Every year, it seems that no sooner have we started thinking about our summer holidays, than we are assailed with advice for achieving the perfect beach body. Invariably, this ripped physique is all about achieving washboard abs, chiselled biceps and athletic legs. And all too often, something really important gets overlooked: our backs. Not only is a strong and poised back is essential to reduce the risk of injury and joint pain in our everyday life, it can be an aesthetic asset in our midlife arsenal against ageing. Just ask Jennifer Lopez, 55, who, attending a pre-Grammy gala earlier this year, showcased an expanse of sculpted flesh in her backless dress. Dedicated exercisers such as myself will appreciate the graft that went into its execution, the fact that, as personal trainer Cornel Chin puts it, 'a well-defined back is a rare commodity''. Backs can fall off our fitness radar because they are hard to see in the mirror. Picture: iStock Why? Well, to state the obvious, we seldom see our backs, so they can easily fall off our fitness radar, and by our forties poor posture and weak muscles can turn an already neglected area into a veritable problem. Sedentary lifestyles sabotage our posture and midlife weight gain fuelled by hormonal changes often obscures any muscle we do have. According to the British Menopause Society women put on an average of 10kg during menopause and 'most of this weight accumulates around the abdomen and upper body''. Plus, the back is composed of several complex muscle groups, 'so getting a defined back isn't as easy as, say, getting strong legs where there are more exercises that work all the major muscle groups simultaneously,' Chin says. But, he stresses, 'with persistence and carefully targeted exercises, it's absolutely doable''. The largest muscle groups in the back include the latissimus dorsi — 'the lats' — triangular-shaped muscles that span from the upper arm to the pelvis and across the ribs; the rhomboids in the upper back that stretch from the spine to the edge of the shoulder blade, and pull the shoulder blades together; the trapezius, which runs across the shoulder blades under the neck and is used to turn the head and arms, and the erector spinae, which runs the length of the spine and helps us stand up straight. Back muscles are complicated, the biggest being the latissimus dorsi. Image: iStock Good posture, meanwhile, is dependent on smaller muscles called multifidus between the vertebrae in our spine. 'When these get short and tight they limit how the bigger muscles function,' says the American chiropractor Dr Steven Weiniger, author of Stand Taller Live Longer: Posture & Anti-Aging Strategy. This is what happens, he says, when we constantly look down at devices, causing our head and shoulders to round forward and our torso to lean back to compensate, compressing the vertebrae and 'creating a round back''. Pilates and strength instructor Jo Tuffrey adds that 'people want to work aesthetically with what I call the front line — the muscles you see in the mirror — but a strong back and flexible spine is paramount. When people have a beautiful posture they're almost ethereal. They float.' While I can't lay claim JLo's elegantly protruding erector spinae, after I started exercising my back with weights at home in my forties my niggling upper back pain disappeared. My core is stronger, I'm pretty good at hauling heavy suitcases into overhead compartments on planes and feel a body confidence that eluded me in my thirties. After interviewing Weiniger, who says ten minutes a day of posture exercises are all we need for a more youthful back, for this paper last year I incorporated his advice into my life, helping me stand taller. Exercise to strengthen the back can range from deadlifts in the gym to more walking. Picture: iStock I stretch my back in front of the TV in the evenings whenever I remember and stick to a diet high in protein, vegetables and wholegrain carbohydrates where possible. I think a better back is achievable for anyone who, like me, has no gym membership, a busy job, a penchant for chocolate and family demands to juggle. Warm up before exercising — the lower back in particular is prone to injury because it bears most of our body weight. Chin suggests arm circles, hip rotations, side bends, and a few minutes of light jogging on the spot. Here are my back exercises, and my experts' other recommended moves. Back exercises Bent-over row Keeping your left arm straight, place your left palm and left knee on a chair or coffee table. Holding a weight in your right hand, keep your right arm straight, perpendicular to the floor, right leg straight, right foot on the floor. Bend forward. Keeping your back straight and your elbow close to your body, pull the weight towards your torso, squeezing your shoulder blade. Lower. Repeat on the opposite side. I do 25 repetitions on each side with 10kg weights. 'This is fantastic for lats and rhomboids,' says Chin, who recommends beginners use 5kg dumbbells and do three sets of ten repetitions for each weight movement. Bent-over lateral raise With feet hip-width apart, arms by your side, a weight in each hand, lean forward, keeping your core tight, back straight, knees slightly bent. 'Raise your arms to the side until level with your body,' says Chin, who suggests 3kg weights for beginners because 'you're working the backs of your shoulders, a smaller muscle group, as well as rhomboids. You can tell when a celebrity wearing a strappy dress does these — they have great upper back definition.' Deadlift Standing feet hip-width apart, push your hips back and bend your knees slightly to grasp a barbell or dumbbells at your feet, palms over the bar. Don't let your knees extend over your toes. Return to standing, weight in front of you, keeping your back straight, core engaged, head in line with your body. As well as your lats, erector spinae and trapezius, the deadlift works your entire posterior chain — the muscles in the back of the body, including the legs and glutes. 'These are essential for a strong back because if one muscle group is deficient it throws the equilibrium out,' says Chin, who adds: 'Technique is important. Don't go too heavy.' I do three sets of 12, with two 15kg dumbbells. The plank Place your palms shoulder-width apart on the floor, in line with your shoulders, arms and back straight, feet hip-width apart and toes curled under. Bend your elbows and rest your weight on your forearms and toes, keeping your body in a straight line. I hold for one minute then do a one-minute side plank on each side: Rest on your right forearm and the outside of your right foot on the floor and lift your hips so your body is diagonal to the ground. 'The plank strengthens the transverse abdominis [TVA], the deep muscles which wrap around the spine like a corset, reducing the risk of back injury and improving posture,' Tuffrey says. Upright row Standing with feet hip-width apart, hands by your sides, weight in each hand, palms facing inwards, lead with your elbows to raise your arms until your hands are under your chin, your forearms forming a V-shape. Lower slowly. 'This works upper back muscles including the trapezius and shoulders,' says Chin, who points out that 'defined shoulders give the illusion of a smaller waist''. Seated row Sit on the floor, legs slightly bent, back straight, a resistance band around the balls of your feet, holding it in both hands, shoulder-width apart. 'Pull the band towards you so your upper arms brush your rib cage and your elbows are slightly behind it,' Tuffrey says. 'You're engaging the muscles in between the shoulder blades and the lats. I'd repeat ten times, three times a week maximum.' Lower back raise Lie on your stomach, hands by your sides, chin resting gently on the floor. Slowly raise your chest and shoulders three to four inches and gently lower. 'Squeeze your glutes as you raise to accentuate engagement of the erector spinae,' says Chin, who suggests two sets of 10-15 repetitions. The erector spinae can strain easily, 'so don't overtax them''. Superman On all fours, back straight, extend your right arm until it is straight out in front of you, parallel to the floor, at the same time raising your left leg straight behind you, parallel to the floor. Hold for five seconds, lower your right arm and left leg and repeat on the opposite side. This works the erector spinae, trapezius and shoulders, 'and because it's a unilateral exercise — using one arm at a time — it's also good for balance,' Chin says. 'Start with a set of 10 to 20.' Row, swim or use a cross trainer for cardio Unsurprisingly, perhaps, the rowing machine is your back's best cardio friend, the pulling motion strengthening your lats, trapezius and rhomboids (as well as shoulders, legs, arms and abdominals.) 'If you have access to a machine, do at least 15 minutes three times a week,' says Chin, who adds that elliptical cross trainers in the gym are also effective at working back muscles and swimming is 'another good cardiovascular option. Front crawl and backstroke are best for the upper back.' Or go for a walk If (like me) you're not a rower, don't despair. Regular walking has been linked to better posture because it activates muscles such as the erector spinae, multifidus and TVA. Keep your head up and shoulders down to avoid putting stress on your upper back. Move every hour Sitting, 'our bodies slowly collapse', says Weiniger, who compares a sedentary spine to 'a rusty hinge. The muscles get weaker, there's less circulation, more mechanical stress. Motion is lotion. If you've been sitting for more than 60 minutes, get up and move around a bit, intentionally.' In other words, not with your nose in your phone. He divides the body into four 'posture zones' — the head, torso, pelvis and lower extremity (legs and feet) — all of which, when standing upright, should be symmetrical and roughly stacked on top of each other, and says: 'I like to take the stairs two at a time with an awareness that I'm standing tall to retrain the muscle memory how to stack my body.' I follow his advice — any excuse to make a cup of tea. Shoulder shrug Hunching our shoulders — which most of us do unthinking when typing or looking at our phones — puts constant strain on our trapezius, leading to a stiff upper back and an unsightly hunch. To get out of the habit, Weiniger suggests this exercise while sitting at your desk: 'Breathe in. Shrug your shoulders as high as you can, arms by your side, palms facing forwards. Keeping your shoulders up, pull your shoulder blades back, slowly push your shoulders down and breathe out. Do this once an hour.' My posture has improved in the nine months I've been doing this. Door-frame hang To stretch the chest muscles, which get weaker and tighter as the shoulders slump, stand in an open doorway, feet hip-width apart, hands on either side of the frame, and lean forward until you feel a stretch. 'Your elbows should be in line with your shoulders, shoulders down, and keep your head back. Hold for five slow breaths,' Weiniger says. The Swiss ball stretch To mobilise the spine, sit on a Swiss ball and roll forward slowly until your shoulders touch the ball, then your head, 'and then relax and lean back', Weiniger says. You should roll back over the ball until you feel a comfortable stretch, spine supported by the ball. 'Hold for five slow breaths. To get up, focus on aligning your pelvis under your torso. Bend your knees to drop your pelvis down, tuck your chin to your chest and walk your feet back to push your pelvis into the ball and roll up, sitting tall.' Thread the needle 'On all fours, bring your right arm under your left, palm facing up, passing through the space between your left knee and body, gently resting your right cheek on the floor or a pillow while keeping your right arm extended,' Tuffrey says. 'Hold for a few seconds and repeat on the other side.' This improves the rotation of the thoracic spine in the upper and middle back, which we can lose as we get lazy in our daily movements and turn our whole body to, say, reach for an object or look at something behind us instead. I do this while watching TV in the evening. Cat-cow This yoga pose, which stretches the back and front of the body, 'is great for spinal mobility,' Tuffrey says. 'On all fours, round your spine, gently tucking your chin towards your chest while drawing your navel to your spine. Simultaneously lengthen the crown of your head and tailbone away from each other, drawing the chest slightly forward and extending the spine.' The Times
Telegraph
20-03-2025
- Health
- Telegraph
The 10 most common questions I'm asked about the menopause
Do you have a question about menopause? Dr Naomi Potter will be on hand to answer questions in the comments from 2pm 'What I love as a menopause doctor is having the opportunity to transform someone's life completely for the better,' says Dr Naomi Potter, a 48-year-old menopause specialist. 'You take a person who feels utterly broken, and you put them back together.'After 16 years working for the NHS, Naomi is now one of the UK's leading menopause experts. She is the founder of the Menopause Care clinic (the UK's largest team of British Menopause Society accredited doctors and specialists) and co-authored the frank and taboo-busting book Menopausing with Davina McCall. She is also a mother of five with three boys and twin girls. Here are the 10 questions she's usually asked – and what she advises 1. Why is my hair getting thinner? Oestrogen affects every system in the body, including hair quality and the way it grows. In the same way that when you're pregnant, you have really noticeable hair changes e.g. its thickness, a massive hair shed. It's all driven by hormones and with menopause, that's the decrease in oestrogen. Yet women are notoriously bad at judging the true extent of hair loss and it's common to feel that it's more dramatic than it actually is. However, with everything related to the menopause, the main rule is that there are no rules. Every woman's experience is different. Some women find that their hair gets better – becoming thicker, glossier and faster growing – at menopause, and others notice a big change during perimenopause, but post menopause things settle, and then they can improve, and then they settle. Hair can also change going from being straight to curly and vice versa during this time. Dr Potter's solutions If hair's gone very dry and brittle, then moisturising shampoos might help, but anything you put on won't really influence the speed of hair growth. And while it's tempting, if you're unhappy with your hair, overtreatment can make it worse so don't just keep going to get it coloured. Make sure there's no other underlying cause – such as vitamin deficiencies, a thyroid imbalance or anaemia. Any significant changes including a receding frontal pattern or totally bald spots need to be investigated. Very slim women, or those restricting calories, may notice more hair loss because as far as your body is concerned hair isn't a priority and it will preserve nutrients for the body instead. So make sure you're eating well and cut back on alcohol. Liver conditions associated with alcoholism can cause endocrine disruption and hair loss. 2. Why am I getting brain fog? Brain fog is a common complaint, and it's a description that encompasses many different symptoms – being forgetful, struggling to find words and not remembering which way you're going, even on familiar routes. It can come and go. Not feeling as sharp or switched on can shatter confidence. Lorraine Candy, the former editor of Elle magazine, described on Dr Potter's podcast Is It Hot In Here, having to put post-it notes all over her wall to remember the most simple facts. She feared she had a brain tumour until her friend Trish Halpin admitted the same thing – and they thought it was unlikely they both had tumours at the same time. Dr Potter's solutions For Lorraine, within days of her trying hormone replacement therapy (HRT), brain fog disappeared. But it's one of those symptoms that is hard to tease out from other life things, is it actually hormones, or the pressures of work, relationships, child rearing or elderly parents? Ask yourself how you felt coping with challenges five years ago – when perhaps you were still sleep-deprived from toddlers? If you felt able to cope better with stress back then, it could well be menopause-related hormones. Think about what in your life is causing sleepless nights. For many women, quite naturally, it has to do with your children and how they're doing. We can feel the need to be in control all the time – but that's just not possible. Sometimes we have to step back and say 'OK this isn't brilliant, but I have to let them get on with it'. It's the same for elderly parents, sometimes we need to let go a bit instead of fretting. It's important to make time every day for yourself – eating properly, getting some exercise (outside, ideally) even a walk around the block counts. Breaking the alcohol/coffee cycle can help too if you're not coping. It's common when people are stressed to drink half a bottle of wine, then not sleep properly and wake feeling anxious and tired and then drink coffee and get caught in a vicious cycle. Stopping both can help. 3. Is menopause weight gain inevitable – and will HRT stop it? Our hormones influence not just metabolism but also how fat is deposited. In fertile years, females classically have a curvy physique, laying down fat on hips, bottoms, breasts and face. With the loss of oestrogen, you change shape, with fat depositing more centrally around the organs. Ageing generally causes fat gain and muscle loss as metabolisms slow down. So while HRT can offer some protection about where you're storing fat, it won't affect general metabolism alas. Dr Potter's solutions You may believe that by restricting what you eat, the weight will come off like it did in your 20s and 30s, but it doesn't always work during menopause. It is important to make sure that you eat well, with plenty of protein, fibre, fruit and veg. The right kind of exercise is also very important, especially strength training that will help grow muscles and boost metabolism. But finding an exercise that makes you sweaty but you actually enjoy is arguably more important to ensure you do it regularly. Be realistic about what you can fit into your life and try and get outdoors. Humans were meant to be outside and it shouldn't be surprising if we're inside all day, we don't feel good! Personally I like running four times a week to clear my head as much as for my body, and no I've never worked out with Davina McCall despite co-writing our book together. She's fiercely fit! Ultimately, it can be helpful to be more self-accepting. Is it that bad if you gain a few pounds? It's inevitable that happens as we age. 4. Why am I so tired? Hormonal changes and oestrogen loss can cause fatigue. But not everybody is affected, and it can get better on its own. Are you tired because you are having menopause symptoms at night, which are disrupting your sleep? Surges in anxiety, night sweats or getting up at night needing a wee (more common in the menopause)will all disrupt sleep making you more tired. Dr Potter's solutions If broken sleep is down to menopause symptoms, HRT would help. But if you're managing nine hours and still exhausted I'd suggest looking for other causes. The reason why multiple loo trips happen is because there are oestrogen receptors all over your urinary tract, so when you lose oestrogen the function and integrity of that system is affected. Bladder irritability (feeling like you need to empty it more frequently) is common, as are UTIs, and your bladder can shrink, so there is just less capacity to hold wee. During the day, avoid having what I call 'just in case' wees, because if you're always emptying your bladder before it's reached its full capacity, you're unwittingly training it to be smaller and get triggered at a lower volume. Ask yourself if you really need to go – chances are if you've had a wee and then a cup of tea in the morning you don't actually need to go an hour later because your bladder volume is much bigger than a cup of tea! 5. Why have I gone off sex? This is a classic complaint and worth remembering that a lot of libido is multifactorial (involving several causes). Hormones – your declining oestrogen and declining testosterone – can definitely play a role. You'll feel less interested in sex, but that's not the only part of the picture. Vaginal symptoms common in the menopause can include soreness, dryness, poor lubrication during sex, and difficulty with arousal. If you've suffered pain while attempting to have sex your body will object to doing something it associates with a previous negative experience. Testosterone declines from your 20s, and some women notice that affects libido more than others. Throw into the mix the stresses of general midlife and the fact you may have been with the same partner for a long time (which naturally becomes unexciting) it's easy to see why libido can crash. However, while less common, some women can suffer from a very high libido, which can cause women serious distress. One of my patients believes her high libido led to her affair, another one had to take herself out of the marital bedroom to pleasure herself, and one lady would have to do so when she was out shopping in Sainsbury's and had to pop to the loo. So it can seriously affect daily life, despite people's inclination to say 'lucky you'. Dr Potter's solutions Lots can be done! Local symptoms (dryness etc) can be very easily treated with lubricants, moisturisers, and topical oestrogen (in gel form used on the skin or inside the vagina) works really well. There's an argument for every menopausal woman being on topical oestrogen because unlike oral oestrogen (HRT which is absorbed into the bloodstream) topical oestrogen is absorbed mainly into the surrounding tissues where it is applied, allowing for targeted treatment of dry, itchy or uncomfortable vaginas. Now, in terms of desire, it's not as straightforward. Replacing oestrogen can help, as can replacing testosterone for some women. We don't have enough data to categorically say how many women should be on testosterone for the therapeutic benefits in the menopause, but there is data suggesting it can help low libidos. There's anecdotal evidence that it helps with more than libido, but equally, there's data suggesting there is a strong placebo effect. The absolute truth is, we just don't know. I personally don't believe women should be held back from trying it, if they want it. If these things don't help, I point my patients to a book called Mind The Gap by Dr Karen Gurney, who brilliantly explains all this. 6. Why are my joints so achey? Knee aches, frozen shoulders, plantar fasciitis and tennis elbow are all more likely to happen during the menopause, once again it's the decline in hormones to blame, affecting your muscles, ligaments and joints. For our joints to function optimally (remain pain-free and supple) there needs to be lubrication, and when your reduced hormones lessen this, you can feel more discomfort as bones endure more friction. Dr Potter's solutions HRT can – but not always – improve things. Finding the right exercise can help, cycling is surprisingly good for sore knee joints as strengthening the quad muscles can help stabilise the knee joints. For frozen shoulders, a steroid injection can do the trick, even just as a one-off. Bear in mind that just because you have that symptom now, it doesn't mean it's going to stay throughout the entire menopause and after. These issues fluctuate. 7. What exactly are hot flushes? Also known as ' hot flashes' (a US term that's been adopted here), this is when you experience a sudden rise in heat, often from your chest up into your neck and face. But it can also affect your whole body. This is caused by your blood vessels dilating and – as they get bigger and open up – the blood rushes to the surface of your skin in an attempt to cool you down. You may start sweating more, too. Essentially this happens because fluctuating oestrogen affects a part of the brain that regulates temperature, and a body lacking oestrogen is tricked into thinking you're already hot. As your body attempts to cool itself down, you experience this flush. In my podcast, the presenter Lisa Snowdon describes her confusion as she suffered hit flushes in her early 40s when she was still thinking she might have children and not realising what they were. You can get them several times a day or just now and then, or never at all for some women. Women can also actually suffer the reverse of this, a 'cold flush,' in which your body cools you down even though you're not hot. Fewer people complain of this because it's less well recognised as a symptom, but is also less debilitating – if you're suddenly freezing cold you can put on a jumper. If you suddenly become red-faced during a work presentation, say. Dr Potter's solutions HRT can be very good for this, but if you don't want to take it, and this is the only symptom bothering you, there are other medications available to address flushes. It's also useful to learn what your personal triggers are so you can avoid them. Stress, spicy food (or food that's hot temperature-wise) alcohol and smoking are all common triggers. 8. Why do I feel so anxious? Anxiety is often the first symptom women notice in perimenopause and this is because your hormones impact brain chemistry. Its impact is different for every woman but, for some progesterone causes a really nice calming effect. So when that drops in menopause, you feel more anxiety. We don't really understand how oestrogen or progesterone impacts serotonin and dopamine, the neurotransmitters that affect mood, learning, and behaviour, or why some women are affected more than others. It's all connected, and while not every menopausal woman will suffer anxiety, there are many who have never suffered it before and then it creeps in towards the late 30s and early 40s and they're not used to it and it's overwhelming. Dr Potter's solutions Lots can be done and mostly it's about looking at your lifestyle. Drinking coffee and alcohol increases anxiety, both are stimulants causing adrenaline surges (which feel similar to anxiety) – cut back or stop and see if it helps. Reducing stress, whether through mindfulness or meditation will also help, and exercise is wonderful for combatting anxiety. Some people find alternative therapies helpful – there are many herbal remedies for anxiety and some swear by things like acupuncture, massage, or Reiki. I'm not against anyone trying anything they feel works for them, so as long as it's ripping women off. It makes me annoyed when I see hugely expensive supplements marketed for menopause which contain the same ingredients you'd find cheaper at the supermarket. There are no supplements I'd particularly recommend, some women say magnesium before bed can help calm restless legs, and I think there's a little bit of evidence that it works and won't do any harm. 9. I think I smell differently – and why is my skin breaking out? Because oestrogen changes the environment of your skin, and the way you smell partly depends on the bacteria that live on the surface of your skin, women can sometimes notice a slight change in their smell – in their sweat or vaginal discharge. It's likely temporary, but any offensive discharge odour needs to be investigated by a doctor as it's more likely to be an infection. It's not uncommon to have hormonally driven skin breakouts, whether it's rosacea (little spots over your nose or across your cheeks) or cystic acne that can form around the chin. This is often down to the change in the balance of testosterone, so even if your testosterone level has remained relatively unchanged, dropping oestrogen will create an androgenic shift in the balance (making male hormones more dominant than before), which can lead to breakouts. Dr Potter's solutions In addition to the common sense lifestyle changes – eating well, exercising, and getting enough sleep, there are also topical antibacterial medications available, such a benzoyl peroxide for acne and topical metronidazole for rosacea. 10. Why can't I sleep through the night? Those 4am awakenings can be caused by a sudden surge of adrenaline that wakes you up and then you feel anxious and unable to get back to sleep. It's complex why this happens, and it's about the activity or hormones in our brains, but we don't really know why it happens, or why with depression falling asleep isn't as much the problem as staying asleep. Dr Potter's solutions Good sleep hygiene is crucial, and part of that is only going to bed when you're sleepy. If you don't fall asleep straight away, get back up and only return to your bedroom when you feel ready to sleep. Spending two hours in your bed wide awake only sets you up for failure for the subsequent nights. However little sleep you've had, set your alarm at the usual waking time and get up the next morning and keep doing this routine as it should help retrain your habits.
