Q: What can I do about menopausal fatigue?
–Beth Cecala, Emmaus, PA
A: While some women sail through this time of life, many find themselves victims of the menopausal energy zappers: hot flashes, night sweats, and insomnia. Sleep disturbances are among the most common complaints.
Sleep issues often can be traced to hormone fluctuations that result in night sweats—basically, nocturnal hot flashes that wake you up, drenched. While there are natural ways to tame your hormones, you also have to calm your nervous system and reduce levels of the stress hormone cortisol. Here’s what I recommend.
Avoid hot-flash foods. Caffeine and alcohol affect everyone’s sleep, but we now know that excessive consumption can trigger hot flashes and night sweats. You don’t have to give up these drinks entirely. Just reduce your caffeine intake to under 4 ounces per day, and limit alcohol to two or three drinks a week. Sugar is also a hot-flash food, so cut refined sugars and simple carbohydrates.
Take the right supplements. So-called adaptogens—substances that help your body deal with stressors—decrease cortisol and stabilize estrogen fluctuations. The herbs rhodiola and ashwagandha, often found in combination, may help. Starting dose is 200 mg each. Studies have found that black cohosh can reduce hot flashes and improve sleep. Take 40 mg twice daily. Evening primrose oil, starting at 500 mg, may help manage night sweats.
Go Eastern. Trouble staying asleep? I treat this common problem with the Chinese remedy jujube (extract of red date). The starting dose is 250 mg. In Indian Ayurvedic medicine, Brahmi powder—a.k.a. Bacopa monnieri—mixed in warm milk (with a pinch of nutmeg and saffron) is a powerful sleep aid. Start with 100 mg. And learn to appreciate yourself and how far you’ve come. In Ayurveda, menopause is seen as a “vata” phase, an enriching time of transition, during which women are meant to be nurtured and respected. Nurture and respect yourself.