WHAT TO DO: Lift weights! Hike! Swim! Zumba! Regular
exercise boosts your metabolism by burning calories and
building muscle. Small diet tweaks can also have a big
impact: Findings from a Duke University School of Medi-
cine trial published in July found that healthy, lean, or
slightly overweight adults who cut only about 300 calories
of any food daily—say, ordering a fried egg on wheat
toast instead of a bacon, egg, and cheese sandwich; or
eating a cup and a half less pasta at dinner—lost 10 percent
of their body weight, and had lower blood pressure and
less inflammation, as well as better cholesterol and blood-
sugar control. A simple blood test can detect hypo-
thyroidism, says Angela Leung, MD, an endocrinologist
and associate professor of medicine at the UCLA David
Geffen School of Medicine. If it’s to blame, a thyroid-
replacement pill, like levothyroxine, should kick-start
your levels, and potentially your metabolism.(^2) MY MIND IS... SUDDENLY BLANK
Brain fog isn’t a medical term, but that hardly matters
to a perimenopausal woman who can’t tell you the title
of the book she just read. “Your estrogen levels are fluc-
tuating and falling, and that can interfere with your
ability to concentrate,” says Hatipoglu. It can also disrupt
sleep, leaving you doubly sluggish. Hypothyroidism,
which is more common in older women but can occur
in your 20s and 30s, may also lead to muddled thinking
and mild short-term memory loss. Two more trouble-
makers to rule out: an iron or vitamin B 12 deficiency.
WHAT TO DO: Double down on efforts to sleep well, get
regular aerobic exercise, and follow a Mediterranean diet
(high in fish, olive oil, fruits, greens, and whole grains,
and moderate on alcohol: for women, up to one drink a
day, and no more than five a week). Research has found
that all these habits can sharpen memory and cognition,
says Hatipoglu. Medication can help clear fuzziness re-
lated to low thyroid hormones or estrogen (for more on
hormone therapy, aka HT, see Rx Estrogen, right), and
supplements or dietary shifts can reverse an iron or B 12
deficit. Quick tip: On your daily trip to Salads, Inc., order
dark greens like raw spinach (0.81 milligrams of iron
per cup) and broccoli (0.66 milligrams).
(^3) SEX? WHAT SEX?
Exhaustion, weight gain, certain meds, and (of course)
relationship problems can send your libido packing. But
hormones play a part, too. Suspect number one: com-
bination birth-control pills. “When you swallow estrogen,
your liver produces sex-hormone-binding globulin,
which makes testosterone unusable,” says Becky Lynn,
MD, an associate professor of obstetrics and gynecology
at the Saint Louis University School of Medicine. “When
testosterone levels drop, some women
experience vaginal dryness, while
others find that their desire all but
disappears.” Suspect number two:
naturally declining estrogen and
testosterone levels during peri- and
postmenopause. Good times!
WHAT TO DO: Move it or lose it. Per a
2018 University of Texas at Austin
study, exercise may revive sexual
arousal by heightening blood flow
and nerve connections to the areas
that count (the other one’s your
brain), and by improving body image
and mood. You can also try non-oral
birth control, which won’t affect your
testosterone; or if you’re peri- or
postmenopausal, low-dose estrogen
can help with dryness.
(^4) I FEEL LIKE DR.
JEKYLL AND MS. HYDE
Fiery rage, exhilarating joy, crushing
anxiety, weepy sadness. Did we just
describe your morning? Emotional
swings can be tied to estrogen drops,
which happen in the second half
of your menstrual cycle, right after
ovulation, and irregularly during
peri- and postmenopause. Estrogen
is linked to the brain neurotransmit-
ters associated with mood, includ-
ing serotonin.
WHAT TO DO: All together now: Exer-
cise. Research shows aerobic activity
is one of Mother Nature’s best mood
stabilizers, reducing irritability,
anxiety, and depression while hiking
up happiness. Birth-control pills can
also temper menstrual-cycle swings
for some women. If you have pre-
menstrual dysphoric disorder (PMDD,
a severe version of PMS), you may
want to try an SSRI antidepressant,
like Sarafem, for the last two weeks
of your cycle. Yo-yoing around meno-
pause? HT may help—a small Uni-
versity of North Carolina at Chapel
Hill study published in 2018 found
it prevented depressive symptoms
for some women—but more research
needs to be done.
Rx Estrogen:
Yay or Nay?
We understand if the
whole concept of hormone
therapy (HT) has given
you whiplash. In the ’90s,
a prescription was stan-
dard to fight insomnia,
hot flashes, vaginal dry-
ness, and other superfun
menopausal side effects.
Experts also thought it
could reduce the higher
risks of heart disease
and bone fractures that
come with losing estro-
gen. By the early 2000s,
the tide had turned.
Women’s Health Initiative
(WHI) hormone-therapy
trials found that taking
estrogen plus progestin
(for women who haven’t
had a hysterectomy) made
breast cancer, stroke,
heart disease, and blood
clots more likely, and
that estrogen alone (for
those who have had one)
upped odds of a stroke.
But then, starting in 2006,
new findings began to
emerge showing that HT’s
benefits outweigh its risks
for most healthy women
under age 60. If you’re in
one of the following groups,
talk to your doc. The
pros may make it worth
your while.
You’re 59 or under, healthy,
and within 10 years since
your final period.
You hit menopause
pre-40. Taking HT until
at least around age 51
can help prevent bone
loss, heart disease,
mood disorders, dementia,
sexual dysfunction, and
Parkinson’s-like symptoms.
You’re at high risk for
osteoporosis. WHI data
shows HT can cut bone-
fracture odds by up to 33
percent. Other studies
indicate even low doses
can avert bone loss.