Once upon a time, menopause was seen as the end of our vital years. But as I have pointed out, the end of our periods opens up a door (just as the start of them did), and these changes can be the beginning of a vibrant new life—an exciting transition. And what you do during this time can shape your physical and emotional life for years to come. If in reasonably good health, women who make smart choices in menopause are more likely to live longer, healthier lives. Remember, life is nowhere near over—in fact, it can be better than ever. It’s our choice to walk through this door and enthusiastically reclaim our lives.
As you have learned, the smartest choice of all is staying Keto-Green because of the way it affects the balance of insulin, cortisol, and oxytocin. Other smart choices that impact this balance are exercise and sleep.
Exercise is an excellent hormone fix. A number of studies demonstrate that many of the changes—both physical and mental—that we associate with aging and menopause are partly the result of inactivity. And many of the women I have worked with over the years—women who began exercising during menopause—tell me that it changed their lives.
Hormonally, oxytocin increases when you exercise. Excess cortisol is dissipated. With exercise helping the body to consume cortisol and other stress hormones such as epinephrine and norepinephrine, the result is a decrease in blood pressure, heart rate, and anxiety. Exercise makes your muscles more receptive to insulin, so you’re less likely to become insulin resistant. Endorphins—the feel-good hormones—are released during exercise and have been shown to have an effect in regulating blood pressure and body temperature. They may also have a role in controlling your appetite too.
More broadly speaking, there are other irrefutable benefits of exercise during menopause:
Your heart will be stronger.
Your bone density will be greater.
You will have more energy and stamina.
You will naturally detox your system.
Your mood will lift and you will get a positive feeling about your body and your life.
You will reduce the frequency and intensity of hot flashes.
You will fight creeping fat gain, especially around your middle.
You may prevent dementia.
Everyone always wants to know, what kind of exercise is best? My answer: Whatever you love and will stick to! Have you tried belly dancing, Zumba, or hooping? These are fabulous exercises that get you moving your hips, which will keep you flexible and more mobile throughout your life—and they are very oxytocin-boosting!
Exercise has powerful benefits for all ages, and particularly if you are over fifty. Any type of exercise is better than none at all, so no matter what your state of fitness right now, do what you can. You can start gradually, adding a fifteen-minute walk to your daily routine, taking the stairs instead of the elevator, or starting the day with some calisthenics. Tiny changes count. I’ve had many clients who began with a few extra steps and now run marathons. So it’s important to persevere and not give up.
Personally, I love to do yoga, walk, weight-train, swim, play tennis, and box—and I do one of these practically every day. Because I exercise regularly, I feel better and I have more energy. Sometimes during the week I get busy and can’t find the time. But when that happens, I miss it. I really do!
The research is clear—nothing turns back the clock and improves life and life expectancy like exercise.
I discussed yoga earlier as a way to relieve stress, but there is so much more to this ancient practice. The word “yoga” actually refers to a union of body, mind, and spirit, an alignment of the physical and nonphysical parts of yourself. It’s not an overstatement: If you practice yoga, you will not only find your health and well-being improve, but every area of your life will benefit.
The research bears this out. One study published in 2016 in Complementary Therapies in Medicine involved eighty-eight postmenopausal women who were randomly assigned to one of three groups: control (no intervention), exercise, and yoga. They all filled out questionnaires about their menopausal symptoms, and the researchers did lab work to check levels of cortisol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and estrogen.
After twelve weeks, the women who practiced yoga showed dramatically lower scores for menopausal symptoms, stress levels, and depression, as well as significantly higher scores in quality of life, when compared to the control and exercise groups. The control group presented a significant increase in cortisol levels. The yoga and exercise groups showed decreased levels of FSH and LH when compared to the control group. The researchers concluded that yoga would be a great complementary therapy for women undergoing hormonal changes with age. Yoga is a hormone fixer, for sure.
A 2016 study, published in Topics in Geriatric Rehabilitation, found that 80 percent of older participants, most of whom had osteoporosis or its precursor, osteopenia (low bone density), who practiced twelve yoga poses (often modified) a day showed improved bone density in their spine and femurs.* Each pose was held for thirty seconds. The daily regimen, once learned, took only twelve minutes to complete. These findings applied to younger women with healthy skeletons too.
I can see why. Yoga plays a vital role in preventing fractures by building stability, flexibility, and agility. This means you’re less likely to fall and break something—and if you do start to fall, your agility may help you catch yourself.
Not only can yoga help to fight disease, but in many cases it can halt chronic illnesses such as arthritis, asthma, and many other conditions. Yoga activates the parasympathetic nervous system, which initiates the more tranquil functions of the body.
Yoga is definitely a legitimate, natural treatment for menopause symptoms. Yoga classes are available at practically all gyms, fitness centers, and community centers, so you should be able to easily enroll in a class that meets your needs and level of experience. No matter how time-crunched you are, you can create time for yoga. In fact, yoga will create more time for you.
The idea of socking a punching bag after a stressful day at work sounded appealing to me—so I signed on with a trainer at my gym to put me through a thirty-minute boxing routine a couple of times a week. It’s a great workout, because you use your entire body—shoulders, arms, abs, butt, and legs—to throw a punch. I started in 2007, and it is my preferred exercise. Plus, if you love wearing off-the-shoulder blouses, nothing else gives you great shoulders the way boxing does!
It doesn’t take a long time to pick up the moves either. In my first session, I learned the proper position my body should be in before I even tried to box. Then, with my feet placed correctly and my fists (in boxing gloves) clenched and slightly tilted inward in front of my face, I learned about straight punches, undercuts, and hooks.
Next, my trainer put on a pair of pads and encouraged me to punch them with my left fist, then my right. There was a lot to think about. While throwing a punch with my right fist, and getting the correct position with it, I had to remember to keep my face protected with my left hand.
Moving on, I faced my first punching bag. What an arm and shoulder workout! I was sore for days.
Then I did crunches in which I had to alternately punch my trainer’s pads on the sit-up part of the move. We continued like that for thirty minutes in a circuit-type session. It was intense. Well, I was hardly Muhammad Ali, but with my trainer’s watchful eye and encouragement I was feeling a lot more confident. I love it.
The benefits are astonishing—especially if you want to burn belly fat. Australian researchers compared the outcome of a high-intensity boxing routine performed four times a week to walking on a treadmill. The boxers trimmed their waistlines, plus lowered their blood pressure and felt more energized. The treadmill exercisers did not improve in any of these areas. In fact, they ran low on energy! This study was published in 2015 in the journal BMC Sports Science, Medicine and Rehabilitation.
Plus, punching stuff is like therapy. I call it my meditation because I am focused on placing my punches and can’t really be distracted by anything else going on in my head. Also, though anger release isn’t the reason I box, I have to admit that when I kapow the bag, stress-reducing hormones are dissipated throughout my body, and as a result, I feel calm and relieved.
These days it is relatively easy to learn how to box your way to fitness. Boxing circuit-training gyms that cater to regular exercisers are popping up all over the place. Plus, most gyms and fitness centers have boxing equipment such as punching bags. As I did, have a trainer take you through the fundamentals to get comfortable with correct form so you won’t hurt yourself and will have fun.
Strength training is essential for skeletal health, weight control, and overall well-being of women after menopause. Findings from the Study of Women’s Health Across the Nation (SWAN), a study of ten thousand women as they go through menopause, showed that 20 to 30 percent of forty- to fifty-five-year-olds had difficulty performing simple physical tasks such as climbing a flight of stairs or carrying grocery bags around the block. Even putting clothes on over your head or clasping your bra strap can become difficult. If women are that weak then, what will happen to them at eighty?
Fortunately, various studies show that engaging in just two strength-training workouts a week increases strength in women over fifty quite significantly.
Lift weights, use strength-training machines, or do bodyweight functional exercises at least two days a week. Do one set each of ten to twelve moves that strengthen your major muscle groups—arms, shoulders, chest, back, abdominals, hips, and legs. If you’re beginning, choose a lighter weight you can lift at least 15 to 20 times. Once this gets comfortable, and you are over the soreness, increase the weights to where you can do a maximum of only 10 to 12 reps.
The bottom line: Get active, find something you love, and do it regularly!
An essential lifestyle fix I recommend is to get a good night’s sleep. I know this may seem easier said than done; I’ve had the toughest time with this lifestyle habit myself. Like most medical students, interns, residents, and doctors, I worked many hours and pulled many all-nighters. We are among the most sleep-deprived segment of the population, maybe even worse than new parents. The truth is that while I love to stay in bed, I was only getting three to five hours of sleep a night, and my PTSD aggravated my problems with sleep quality. But that is all behind me now. It is a working practice of mine now to get seven hours of sleep every night.
Good sleep influences the exquisite and vital balance of insulin, cortisol, and oxytocin. A mountain of evidence amassed by scientific researchers attests to the fact that too little sleep can raise insulin levels and lead to weight gain and insulin resistance. On the other hand, oxytocin released in the brain under stress-free conditions naturally promotes sleep, according to a 2003 study in the journal Regulatory Peptides. This makes sense because oxytocin has a calming effect. It leaves you feeling tranquil and loving, and certainly that helps your path to sleep.
Getting a good night’s sleep resets our circadian rhythm, or internal body clock. There’s a master circadian clock in the middle of the brain called the suprachiasmatic nuclei. It acts as a timekeeper for the rest of the body. Almost every hormone in your body is released according to this “clock.” For example, it helps the body pump out the hormone melatonin when darkness falls—this tells the body when it’s night, in turn helping us feel sleepy. Certain other hormones are more active long after the sun sets. Most of our growth hormone is released from the pituitary gland at the base of the brain during sleep—especially deep sleep, the most restorative stage of the sleep cycle. In adults, insufficient growth hormone is associated with fat formed around the tummy.
In women, follicle-stimulating hormone and luteinizing hormone—which regulate the function of the ovaries and control the reproductive system—are released at night too. FSH and LH decline during menopause, which is one reason why menopausal women notice more hot flashes and sweating at night.
How does your clock get properly “set”? It involves more than buying the right mattress or avoiding caffeine prior to bedtime (though both are important). More than anything, it has a lot to do with your eyes detecting light and dark. When your eyes detect light, this tells your brain (the hypothalamus, in particular) to wake up and release cortisol and other hormones you need to increase your metabolism and get through your day. When your eyes detect the colors of sunset and darkness, this tells your brain to release sleep hormones and wind down.
One of the best ways to keep your internal clock properly set is to catch sunrises and sunsets. The first thing I do in the morning is look out at the sunshine and let the light hit my eyes. In our house we also try to catch the sunsets. Sunsets naturally signal to our body that it is time to produce melatonin (our body’s sleep hormone), that it’s time to rest.
When you get proper sleep, your body gets an all-important time to rest and ready itself for a new day. Many wonderful things ensue: Your skin regenerates. Your blood pressure drops and vital functions, such as the beating of your heart, rate of your breathing, and urine output, reach their lowest points during sleep. Once you go to bed, your gut starts to slow at midnight, and then your liver begins to focus on housekeeping tasks, such as liberating calories to energize your vital organs.
Parts of the brain are more active during sleep. During the day, masses of information flood your brain, which temporarily stores it. But at night, during sleep, your brain converts these experiences into memory.
Research suggests the brain may also use sleep to cleanse toxins. A 2013 study published in the journal Science showed that brain cells temporarily shrink during sleep, opening gaps between the nerve cells that allow fluid to wash the brain clean. Interruptions to this process could contribute to diseases such as Parkinson’s and Alzheimer’s.
Here are ways to safeguard your needed beauty sleep:
Establish a healthy morning ritual. Think of it this way: A good evening starts with a good morning. A healthy morning routine will look different for every woman, but I enjoy gratitude journaling in the morning because it starts my day off by highlighting what I am grateful for and allowing me to set positive intentions for the rest of the day. I sip my Keto Coffee with breakfast, which is often a green smoothie. I might also take a short walk on the lawn or beach to ground with the Earth’s natural energy. As mentioned, this gives me a chance to catch the sunrise.
Commit to Keto-Green fasting. Go at least thirteen to fifteen hours overnight, while sleeping, without food. Eating late can interfere with digestion. If you have food during the night, the digestion process slows down. The passage of food through your gastrointestinal tract is slower, and activity of the enzymes that break down food is hindered. All of this can cause constipation, digestive issues, heartburn, and tummyaches. Also, you don’t want to go to bed on a full stomach. This can cause heartburn in some people. Leave at least three hours after your evening meal before sleeping.
Enjoy breakfast. It really is the most important meal. What we break our fast with sets the tone for the day, so be sure to have healthy protein and fats, but very low carbs, to keep insulin and ghrelin hormones low.
Get key lab work done. Low magnesium levels, which can be detected in bloodwork, can negatively impact your sleep. Make sure you are getting red blood cell (not serum) magnesium checked. Other markers to look for are low DHEA and IGF-1 levels. Also, if you have food allergies or food intolerances, these can impact your sleep. Talk with your doctor about testing and do an elimination diet to determine if you have food intolerance issues.
Try natural sleep aids. I routinely recommend a number of supplements to clients who suffer from insomnia, hormone imbalances, or mood issues. One of my favorites is bioidentical progesterone, applied as a cream or taken orally. Progesterone produces metabolites that work on sleep. You should see an immediate improvement in sleep, mood, and other symptoms. Oftentimes, improving sleep leads to changes in other body systems due to increased hormonal healing. You might also find that you are dreaming for the first time in a long time—a sign of restorative sleep.
I also recommend supplementing with 5-hydroxytryptophan (5-HTP). When we eat foods that contain the amino acid tryptophan, the body converts the tryptophan into 5-HTP, which is then converted into serotonin and then into melatonin. Higher melatonin levels dictate better depth and quality of sleep. 5-HTP is best taken on an empty stomach prior to bedtime. Typical dosages of 5-HTP can be from 50 to 200 milligrams. Take it with vitamin B6 for best results.
Additionally, you can take 1 to 3 milligrams of melatonin, preferably in the early to midevening, around sunset. Most people find that works better than at bedtime.
Turn off electronics by 9:00 P.M. (or, preferably, by sunset). Staring at computer and smartphone screens well into the night can disrupt your circadian rhythm, melatonin production, and thus your sleep. At times when I can’t avoid doing this, I use an app on my computer called f.lux, which at least reduces the blue light on my screen at a certain preprogrammed time. This is important because blue light tells our eyes that it isn’t nighttime, so then our body doesn’t produce melatonin. You can also purchase blue-light-blocking eyeglasses (see dranna.com/resources) as well as blue-light-blocking screens for iPhones (try products from Zen Tech), and keep your phones and digital clocks in the bathroom (to block out any LED lights and reduce EMF exposure).
Stop the stimulants. Caffeine, sugar, and alcohol taken in the evening will keep you awake. Although alcoholic beverages can make you feel sleepy initially, alcohol ultimately disrupts sleep cycles, especially REM (dreaming) sleep—the type that helps refresh our bodies.
Create an environment conducive to sleep. Your bedroom is your “sleep haven.” Keep the temperature at a comfortable level. Research shows that a cool (65°F), pitch-dark room improves sleep and reduces hot flashes. Use your bedroom for sleeping and lovemaking rather than for watching TV or using your computer in bed. Decorate it with colors you find soothing. Finally, keep your bedroom free of clutter so that it is a true place of rest and you can relax when you slip into bed. Clutter increases stress by provoking feelings of being overwhelmed and crowded. Decluttering creates a calm, serene setting and gives you a sense of peace and control.
Establish a healthy nighttime ritual. This might involve calming activities like a warm bath with lavender essential oils, sipping some chamomile or nighttime herbal tea, reading, or listening to music to make it easier to fall asleep. Light stretching will ease strain on your muscles and allow them to relax. Meditation and deep breathing help keep your hormones flowing naturally and support your natural rhythms.
My evening ritual often looks like this: I turn my bedroom temperature down to 65°F (or as close as I can get in summer without driving up my electric bill too much, typically 69°F), catch the sunset, go for a walk, and then stretch. I supplement with magnesium L-threonate (my Better Brain & Sleep formula), 3 milligrams of melatonin sublingual, and progesterone/pregnenolone cream (my Pura Balance PPr). I like a hot cup of tea, but I try not to drink after dinner, both to let my digestion work better and so that I won’t get up in the middle of the night to use the bathroom. Then it’s book and prayer time with my youngest daughter. I enjoy every minute of it.
* Doctors used to believe that women’s ability to build new bone basically ended at menopause when their levels of bone-protective estrogen and progesterone plummeted. But new research shows that yoga is surprisingly protective when it comes to staving off fractures and helping to prevent osteoporosis, which will cause approximately half of women age 50 and older to break a bone.