CHAPTER 5
Lifestyle Changes
MENOPAUSE, EVEN THE SURGICAL kind, is not a disease. A woman’s body was created to go through this transition naturally, without interference. Things that can help lessen or alleviate symptoms include exercise—aerobic, weight-bearing, and flexibility—proper nutrition, rest, and consistent effort to reduce stress.
I was willing to shift my lifestyle and change some of my habits to help reduce and alleviate my different surgical menopause symptoms. Overall, these changes allowed me to feel more balanced in wellness.
Exercise Your Body
Exercise can have powerful benefits before, during, and after menopause, regardless of whether it is natural or surgically induced. My doctor cleared me to walk just days after surgery, but it was six weeks before I could do cardiovascular, strength, or flexibility training.
Fitness experts recommend exercising aerobically three to five times per week for twenty to sixty minutes. Add in weight-bearing exercise two times a week, focusing on strengthening all major body parts. Flexibility can be accomplished through active stretching or yoga. This may be the goal in wellness, but as we recover from surgery, we’ll want to ease into it gradually.
Exercise has always helped me to relieve stress and release excess energy. Cycling was and continues to be a tool that helps me through the stress and hormonal fluctuations of menopause. Strength training allows me to maintain and build lean muscle, which helps to speed up my metabolism, which helps with weight management. I have found that when it comes to exercise, it is most important to find what you love and then to do it with consistency. You may need to explore a few things to discover what that is for you.
As I eased back into fitness, the first step was to start building healthy habits. There were days when all I had the energy for was a five-minute walk. So, I did that. And I did it every day, multiple times. I made it habitual. Every day or so, I added another minute in duration.
I know a woman who, when she was recovering from her hysterectomy, joined a fitness class for older adults. She was the youngest in the group, but she made some great friends, some of whom previously had experiences like hers: surgical menopause. She found the class to be just the right place to ease back into fitness. The instructor was even able to provide modifications to movements in consideration of her sensitive abdomen area.
When I was cleared to begin strength training, I had mixed emotions. I was both excited and scared. I had this image that my insides were going to fall out. Then I remembered I didn’t have anything left to fall out. So, I went to the gym. I started small and used very light or even no weight. The first few weeks the most important thing was to show up for my workout and reestablish the habit in my schedule. I was patient with myself and gradually my strength and endurance came back, stronger than ever.
It is natural to feel intimidated when starting an exercise program even without the symptoms of menopause. I find working with a personal trainer to be extremely helpful. Many trainers will offer introductory specials to help you get started. Fortunate for me, I’m married to one.
Jim likes to joke that in all areas of life, I’m the boss. His only demand … er … request … is that he’s the boss in the gym. And I gladly let him. In the gym, I trust his guidance.
Trust is the key factor in any relationship, but especially with your doctor and other healthcare providers and personal trainer. A good personal trainer can help you before surgery, and then again once your doctor gives you the green light to exercise. Your trainer can create a customized program that balances cardiovascular, strength training, and flexibility exercise. All three are important at this time in your life to build muscle and strength, burn body fat, and rev your metabolism.
Exercise also gave me a boost in confidence. Pole fitness helped me feel sexy again. Likewise, hula hoop, belly dance, and aerial silks workouts can do the same. There is something graceful, captivating, and attractive about these forms of exercise. There are times in life when we just don’t feel sexy. But there’s no reason we can’t feel good in our bodies and about our sexuality after surgery and throughout the various stages of menopause. This is especially true if we struggle with weight gain.
Finally, flexibility training can help prevent injury, alleviate back pain, and assist with balance and range of motion. And it certainly helped to ease some of the stiffness I had post-surgical rest and recovery.
Nutrition
Every day our bodies require vital nutrients to function. Before and after surgery we can eat foods that are easy to digest and whose anti-inflammatory properties help our bodies heal. We can use nutrition to maintain or lose weight. Certain foods can minimize our menopausal symptoms, while others, such as caffeine, can exacerbate them.
Nutrition to Support Healing
An anti-inflammatory diet is well balanced and something anyone can benefit from, but especially someone preparing for or recovering from surgery. Inflammation is the body’s way to heal after trauma. It brings increased blood supply and nutrients to the affected body part and helps to fight off infection. Its sole purpose is to repair. So, in the short-term, inflammation is good. Long-term inflammation is what we want to avoid, as it starts to damage healthy tissue.
There are two aspects to an anti-inflammatory diet.
Some top healing foods that will reduce inflammation and speed post-surgical healing include green leafy vegetables, bok choy, celery, beets, broccoli, blueberries, pineapple, salmon, bone broth, walnuts, coconut oil, chia seeds, flax seeds, turmeric, and ginger.4
Foods that cause inflammation as they elevate insulin and glucose levels include flours, sugars, corn oil or peanut oil, pastries, cakes, and margarine.
You don’t have to sacrifice flavor by eating more anti-inflammatory foods. To avoid excess sugar and salt, I experiment with flavor enhancers such as garlic, onion, ginger, turmeric, rosemary, cloves, nutmeg, and cayenne.
Nutrition to Maintain or Lose Weight
Weight gain is a common complaint from women in menopause. As a wellness coach, I know what to do to lose or maintain weight. Even so, I still gained weight with surgical menopause. Losing weight is not always easy, but it is possible, and it starts with nutrition.
Here are a few tips to assist you with managing your weight.
Drink more water. Drink half your body weight in water daily. Add eight ounces for every twenty minutes of cardiovascular exercise or thirty minutes of strength training. Add additional water if you drink coffee or alcohol, if it is hot out, or if you sweat excessively.
Eat smaller meals more often. Three hours after a meal, blood sugar levels begin to fall. At four hours, your body has digested what you previously ate. Hit the five-hour mark and your blood sugar plummets and you will likely grab whatever you can to refuel. To avoid this, plan to eat at least five meals a day, eating one meal every two to three hours. Finish your last meal three hours before bedtime.
Eat more protein. There was a time when a typical breakfast for me was a bagel and coffee. I have since learned that every single moment, even when at rest, the body is breaking down and building up protein. And protein is the building block of muscle. At any point in time, our bodies are either building muscle or building toward fat.
Eat more vegetables. Vegetables provide an assortment of nutrients. The more variety of colors, the wider variety of nutrients we get. I add spinach or broccoli to eggs, build a salad, or stir fry with the goal of having a rainbow of colors—topped with a lean protein.
Flavor with herbs and spices. We train our taste buds to enjoy high-sodium, high-sugar, gluten-filled, and processed foods. We can just as easily train them to like healthy foods. Consider a “fast” from sauces, salt, and sugar. Instead, choose flavor from pepper, garlic, onion, and cumin. Add cilantro and dill to your salads. There is a whole world of herbs and spices that will tantalize your taste buds. You may even try foods plain—and realize you love their natural taste—especially as you reduce your sugar and salt intake.
Have a plan. When I have a plan, I avoid emotional eating. At night, I plan and prepare my meals and snacks for the next day. A healthy afternoon snack helps me avoid the vending machine and other office goodies. If friends gather for happy hour, I plan to be the designated driver or opt out of drinking alcoholic beverages. If a friend asks to meet over a meal, I suggest an alternative that does not involve food: a walk or hike, or a new yoga class. Other options to suggest are hitting the batting cages or playing mini-golf.
Be prepared. I cannot always predict where I will be at the time of my next meal, or if healthy options will even be a choice. I stay prepared by carrying the necessities: water, healthy snacks and even a meal on the go such as a high-quality protein shake or meal replacement bar.
Nutrition to Minimize Menopausal Symptoms
According to the weight-loss blog Eat This, Not That, there are several things we can eat and drink to help us age gracefully and minimize menopausal symptoms.5
Water. Staying hydrated helps women to avoid dryness, itch, and bloat.
Flaxseeds. Flaxseeds are beneficial during hormonal changes due to their estrogen-like compounds. Store them in the refrigerator and grind just before eating.
Almonds. Almonds are a healthy fat and can counter the drying effect of low estrogen.
Eggs. Eggs are a good source of vitamin D, iron, and B vitamins for energy as well as strong bones.
Green leafy vegetables and blueberries. Both green leafy vegetables and blueberries are foods that fuel the brain. Think kale, swiss chard, collard greens, and lettuces.
Naturopath, chiropractor, and certified nutrition specialist Josh Axe also suggests foods such as broccoli, cabbage, kale, nuts, seeds, legumes/beans, avocado, wild-caught salmon, halibut, sardines, coconut milk, kombucha, and sauerkraut to help manage menopausal symptoms.6
In addition to the list above, nutritional cleansing and replenishment helped my body recover from all it had been through related to surgery: the tests, the X-rays, and the stress, both physical and mental. A side benefit was weight loss. While I wanted to cleanse the bad out, I also want to make sure I was bringing superior nutrients into my body: vitamins, minerals, essential amino acids (the nine that cannot be made by the body, but must come from food), and phytonutrients (chemical compounds from colored vegetables and fruits).
Foods that Exacerbate Menopausal Symptoms
According to the women’s wellness blog 34MenopauseSymptoms, there are five main foods and drinks to avoid when struggling with menopause symptoms.7
Salty processed foods. Extra salt will cause fluid retention, which leads to bloat. It can also increase blood pressure, leading to diseases that can complicate menopause symptoms.
Alcohol. Alcohol can trigger headaches, anxiety, hot flashes, and night sweats, all common complaints during menopause.
Spicy foods. Hot peppers and other spicy foods can trigger hot flashes and night sweats.
High saturated fat and sugar. Foods like white bread, pie, cookies, muffins, and cake can cause blood sugar to spike as well as weight gain. My friend Lucy, who is a Catholic, gave up sugary sweets for the six weeks of Lent one year. After Easter, she snuck a treat from her child’s Easter basket. She started getting headaches about the same time, and it took three times doing this before she connected the headaches to adding sweets back into her diet. What a great life lesson from the Easter basket, especially if one of your symptoms of menopause is migraine headaches.
Caffeine. Coffee and soda can interrupt our natural energy and sleep patterns.
Fatigue is a common complaint of menopausal woman and caffeine is a common response. Therefore, what I’m about to tell you may cause alarm, fear, disbelief, and absolute rebellion, but if you are willing to try this simple solution, you may find yourself sleeping better, experiencing less anxiety, and getting over the roller coaster of energy highs and lows you live with. For good. I know I did.
The year after my surgery, I found myself having trouble sleeping, another common symptom of menopause. It may have been my wired mind, menopause, adrenals, stress, or any combination of things. Anyone who has trouble sleeping will tell you: It sucks. Yes, I’m the all-natural girl, but as I mentioned earlier, I did fill my prescription for Ambien back then, and alas, I did use it. Every last little pill.
What made the biggest, long-term difference was giving up my morning cup of “joe.” This is a controversial subject. I wish I had a $1 for everyone who has said to me “I’ve already given up every other vice. I’m not giving up my coffee.” Yes, they use the term my. They own it. It is their possession. Which borders on obsession.
I get it. I truly have exhibited all the behaviors of an addict when it comes to coffee. I was willing to give it up for my health and well-being, especially when fatigue was one of the predominant menopausal symptoms. Relief did not happen overnight. It got worse before it got better as my body slowly released this chemical from my cells. But I’m happy to say, it is no longer part of my daily routine, and I’m now falling asleep easier and staying asleep longer.
As I transitioned away from coffee, I found two natural drinks that brewed and tasted very much like my beloved coffee: Teeccino® and Dandy Blend. I also found I love herbal tea.
It took close to three weeks for me to feel the full effect of life without caffeine. But it had a drastic effect on my energy levels. Ironic, isn’t it?
I believed that caffeine gave me an energy boost, but the reality was that it was contributing to my fatigue. With each cup of coffee, I was borrowing energy from the future. The problem was, I was never replenishing it with rest and sleep, which left me frazzled, overtaxed, overwhelmed, and anxious. Caffeine is a chemical stimulant, not a source of true energy. This “energy” is on loan from the adrenals and liver.
Check out some more of the negative effects caffeine has been associated with: irritability, mood swings, panic, and anxiety, anger, sleep disturbances (quality and duration), PMS, fatigue, depression, hormonal imbalance, headaches, gastrointestinal distress, increased stress, and reductions in iron and calcium absorption. It also increases the appetite for sweets and fatty foods, resulting in weight gain. It can even decrease levels of estradiol (the primary form of estrogen in our bodies) and testosterone, thereby throwing off the delicate balance of our hormones and affecting our libido, strength, power, and zest for life.
I struggled with many of these symptoms before giving up coffee. However, I found that as I removed caffeine and sugar from my diet, my cravings for them decreased. My energy improved, I experienced better digestion and sleep, fewer headaches and bloat, and weight loss. I noticed a difference in my ability to concentrate as well as my emotional response to include anger, irritability, mood swings, and depression. Not to mention, I saved a few bucks every week from not buying coffee, which always helps to reduce stress.
Rest
Surgery did one thing for sure: It took me down. I was forced to rest, which was a good thing. Good, but not always easy for a type A personality like me. I work hard, and I play hard. I’ve now learned to rest as well. In athletics, there is an intensity-to-recovery ratio. The more intense your workout, the more recovery is required. Think of surgery as an extreme workout for your body, mind, and emotions.
If I’m honest with myself, life before my hysterectomy was lived at 180 miles per hour. I have since learned that a balanced life requires—even demands—rest and recovery on a daily basis. I cannot wait for an annual vacation to take a break. I require timeouts on a quarterly, monthly, weekly, and daily basis. This is where I take time to tune out the world and relax, play, and release the stress of everyday life. It is a time to rest, recover, reflect, and bring my life back into balance. I had to learn to make this a regular aspect of my healthy lifestyle, not a quick fix. When my body is tired and my spirit weary, the best thing I can do is rest.
Signs that would indicate you may not be recovering from surgery or that surgical menopause is taking a toll on you include:
~ Difficulty waking up in the morning.
~ Requiring more stimulants (caffeine, sugar) to keep going.
~ Utilizing alcohol, sleeping pills, or other substances to wind down or fall asleep.
~ Exhibiting a shorter fuse than normal, especially with loved ones.
~ Lack of focus, creativity, or productivity.
To become more aware of what areas of life might need some extra attention, you can ask yourself the following questions.
“Am I fueling my body with the proper nutrients?”
“Am I sleeping enough? Do I require a nap?”
“When was the last time I had a date night? Family day? Time with a friend?”
“When was the last time I got lost in a good book or a movie?”
“Can I give myself a creative outlet through writing, music, dance or art?”
“Do I need to unplug from the computer, phone, or social media?”
“Have I taken a day, weekend, or week off lately?”
“Are my vacations becoming staycations, where I work so hard around the house that I have to go back to work to rest?”
“Have I rejuvenated at the beach, by the lake or an ocean, in the mountains, or elsewhere in nature?”
“When was the last time I laughed?”
“Is my schedule too full? Where can I build in rest and recovery?”
If you find yourself less focused, creative, friendly, or productive, as I did, it may benefit you to slow down or take a break. As our intensity-to-recovery ratio improves, we are better able to come back stronger, more creative, productive, and refreshed, and with renewed energy and excitement. We have more passion for our career, relationships, and life in general. We’ll find we are balanced through the transition of menopause.
Sleep
Sleep is a major part of rest and recovery, especially after surgery. It is also one of the most underrated yet critical aspects of our health and hormones.
After surgery and despite my case of insomnia, my body required more rest and sleep to heal and recover, and it took longer than I thought it should. However, I learned to listen and allow myself more grace for what was required: mornings without pressure, a chance to snuggle into the covers, burrow my head like an animal in its den, and allow healing and recovery to take place for a little longer.
Now, I’m not naturally a napper. In the past, when I hit afternoon fatigue or feel an energy crash, I would deny it. I’d stuff it back in. Carry on, warrior! But often this made situations worse. I noticed that the more caffeine I consumed, the harder I pushed, and the more wound up, anxious, and irritable I got.
I no longer ignore my body’s signals to rest. I take a nap. I don’t feel guilty. It usually only takes twenty minutes and I awaken feeling remarkably better and ready to conquer the world, or at least my small part of it. Ah, the restorative benefits of sleep. It is where the body does its best repair work.
In addition to napping, evening rituals benefit the quality and quantity of my sleep. I keep the final hour or two before bedtime sacred. I turn off all electronics, including television, computer, and phone. As the sun goes down outside, I begin to dim the lights inside. I take a bath, read, or meditate. Lavender essential oil helps me to relax, as does chamomile tea. I also use a melatonin sleep spray. Melatonin is a hormone we naturally produce that helps us sleep, providing feelings of relaxation. When the levels are correct, it allows us to naturally rest at night for twelve hours and wake up with ease.
Magnesium is a supplement that is critical for regulating melatonin and calcium is beneficial for undisturbed sleep. I take both. I have also been known to drink tart cherry juice to help me fall asleep. Why? Because tart cherries assist with serotonin production, which is necessary for the body’s natural production of melatonin. Other foods that do this include bananas, oats, tomatoes, and pineapple.
An interesting fact I learned from John Gray, author of Men Are from Mars, Women Are from Venus, is that men relax in front of the television while women relax reading. It’s how our brains are wired. Jim and I enjoy being next to each other, or at least in the same room. But I am grateful for the headphones he bought so he can continue to relax and unwind watching television. They mean I can be in the same room as him, reading in silence before bed.
One additional all-natural tool I use for relaxation and sleep is an acupressure mat. I’ve heard this referred to as a “bed of nails” and when I first laid my naked back down on this foam mat with hundreds of sharp, short, plastic needles, that’s what it felt like. It seems counterproductive, but after the initial shock of the “needles” my body and mind relax, and I drift off.
Stress Reduction
Chronic stress that goes untreated can affect body, mind, and emotions. Mine also made my menopausal symptoms worse. To find balance and avoid burnout, I had to find ways to reduce stress.
A somewhat newly recognized complication of surgical menopause is adrenal fatigue. The adrenals are two endocrine glands that sit above the kidneys and produce hormones like adrenaline and cortisol. These hormones are so critical to our well-being that being depleted of them, as we become during long periods of continuous stress, can multiply our symptoms on top of surgical menopause.
Adrenal fatigue occurs when the accumulative effect of stress starts to manifest with illness, anger, frustration, and overwhelm. Suddenly, we find ourselves burned out and fatigued. We scream at our kids, partners, loved ones, coworkers, employees, and bosses. We damage relationships. I found myself experiencing all these symptoms in the months after surgery. The longer I experienced symptoms of surgical menopause without relief, the worse they seemed to get.
Our health is affected by the decisions we make daily. Stress is often not a result of one factor, but the cumulative effect of many factors. It helps me to look at what I can control now. In this moment, I may not be able to leave a stressful job, but I can decide not to eat the cookie someone has offered me or reach for caffeine to get me through my day.
I’ve also learned to say no more often, especially to things that don’t align with my healthy goals, purpose, passion, and priorities. Some weeks I still cross off the morning and evening hours on my calendar and schedule those as sacred “me” time. I do my best to create good habits with food and exercise, and I now build in time to rest and recover, practice yoga, and meditate.
These are all part of my system of self-care that helps to reduce stress, alleviate symptoms, and bring me back into balance. As a woman I tend to put others first, to my own detriment. This leaves me compromising on my needs, especially when it comes to relaxation and self-care. After surgery and during surgical menopause it was important to make myself a priority. I learned what I required to relax, and I asked my family to adjust.
Yoga
Yoga is a major support in stress reduction for me. It helps me to calm my body, which in turn, quiets my mind. In the past few years, I have explored many different forms of yoga and I’m still learning. When I take care of myself and practice yoga even once or twice a week, I’m more connected to my body and spirit with a sense of calmness.
My friend Theresa, who is a yoga instructor and owner of Anahata Yoga and Healing Arts in Kingston, New York, says: “Yoga may not be able to fully replace hormones that are no longer being produced by a woman’s body if due to surgery or menopause, but it can have a powerful effect on her state of mind as she learns to embrace her new body. Yoga’s unique effect on the mind-body connection is one of the reasons it is routinely used to help overcome stress, depression, and other unpleasant emotional states. Even the simple act of stepping into our practice, and of committing to ourselves, sends self-love messages to the brain—and self-love is sometimes the most powerful medicine we can give ourselves.”
Self-Love
Self-love was a powerful component of my healing. Most religions and spiritual traditions teach a version of the principles “Love they neighbor as thyself.” It’s the premise of showing the same kindness to others that we want to be shown to us. The problem is, we don’t love ourselves enough, which adds to our stress levels.
During surgical menopause, we hate our symptoms and our bodies. But the last thing any of us needs is hate, especially when it comes to ourselves. Think of a child who falls and skins her knee. Her caregiver jumps in with gentle kindness and kisses the boo-boo to make it better. What if our symptoms are our bodies’ ways of saying, “Hey? Love me. Hug me. Nurture me. Think good things about me. Get more rest. Stop feeding me that.” Are we listening?
Self-love is the act of taking care of ourselves, which includes taking care of our bodies and health. Self-love is showing respect for ourselves and our well-being. Self-love is taking responsibility for our happiness. Self-love is accepting and embracing all the past, present, and future.
I love my body and all it’s been through, even when it doesn’t look or feel its best. I love the miracle that it can heal from the trauma of major surgery. I recognize that I woke up, I left the hospital, and I am making positive progress toward true health and balanced wellness every day. There are some aspects of my body, emotions, and life that I don’t always like. I love myself anyway. I love my future self, the person I am becoming, and the woman right now who is lovable just because she exists. She is more than enough.
Forgiveness
There were times before and after surgery when I felt guilt and shame. I beat myself up with what I should have, could have, or shouldn’t have done to prevent this thing called surgical menopause from happening. This only added to my stress. I chose to forgive myself. As I did this, I relaxed and allowed peace and harmony to be restored to my mind and heart. I tried not to feel bad for being emotional or for snapping at a loved one. At the same time, I learned to apologize often.
Meditation
Meditation was a tool that helped me create balance and reduce stress. The more my symptoms spun out of control, the more I required the silence that meditation brings. Meditation is a form of quiet listening and turning within.
The abruptness of losing our ovaries and uterus in surgery can destabilize our hormones and rob us of our sense of familiarity with our bodies. This can make us go through mood swings and affects our judgment. We may also grieve the loss of who we were. Healing our mind can work simultaneously and collaboratively with traditional medicine to help us put our lives and sense of selves back in order.
When my life gets hectic or symptoms spin out of control, I have discovered that I have a real choice: I can listen to the noise, focus on the symptoms, and pay attention to the minutia, or I can tune into the still small voice within me and listen for its guidance. I can learn to calm the chaos in my body and mind, which results in more peace and harmony in my life.
My meditation practice began with a daily fifteen-minute “sit.” At first, the only goal was to keep my body still for the entire time. I’d often start out all bundled up, snuggled under a blanket. Halfway through, a hot flash would hit. I had two options.
Meditation can also be practiced through making art or music, writing, coloring, and even gardening. Gardening is one of the few places where I lose all track of time. It’s also the one place I’m not thinking of my next meal. Isn’t it funny how something as simple as weeding the garden could bring peace, harmony, and weight loss?
When you think about how you plan to meditate, permit yourself to add any activity you do on your own where you go into the “zone” to the list. Meditation can be done seated, walking, or dancing. Look for places where you flow naturally and effortlessly in life.