Self-Care Strategies for Postmenopausal Women: Sleep, Hormones, and More

Self-Care Issues After Menopause

Dear Dr.
Chang,
I have two concerns I would like to consult you about: 1.
Sleep and tinnitus, 2.
Hormones.
I often wake up at 3 AM and find it difficult to fall back asleep.
If I do manage to sleep again, it is usually brief and filled with dreams.
This situation began after I sustained an injury before the age of 30, which led to a herniated disc that compressed the nerve in my right leg.
Due to improper treatment, I also strained my back.
Since then, I have struggled to sleep well at night, often feeling discomfort in my back that prevents me from falling asleep again.
For the past two to three decades, I have needed to take naps to compensate for my sleep, which also helps alleviate my chronic lower back pain.
However, this year, I have frequently experienced insomnia even during my naps.
Additionally, after experiencing a "transient ischemic attack lasting about one minute" in September of the year before last, I began to have tinnitus in both ears.
Earlier this year, I visited an ENT specialist who found no hearing loss and, after blood tests, the doctor firmly stated that my tinnitus and sleep disturbances were due to "menopause." I was prescribed Vivelle-Dot and a sedative.
Since I do not have severe symptoms like hot flashes or night sweats, I am primarily concerned with getting enough sleep to feel refreshed.
I am nearly sixty years old and have experienced a transient ischemic attack, and I am currently taking anticoagulant medication.
I am uncertain whether hormone therapy is suitable for me.
I would like to ask Dr.
Chang: In my postmenopausal condition, are there other treatment options besides hormone therapy? Some have suggested taking soy isoflavones; I drink two cups of strong soy milk daily, which contains 130 mg of soy isoflavones.
Is this sufficient supplementation? Additionally, I have heard that taking royal jelly along with calcium, magnesium, and vitamin D can help prevent osteoporosis.

I sincerely request your guidance on how to take care of myself during this postmenopausal phase.

Wu Tai, 50~59 year old female. Ask Date: 2021/05/18

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, if you have experienced improvement in your symptoms after using Veenina tablets and sedatives, but are not suitable for hormone replacement therapy due to the risk of thrombosis, you may try the methods you mentioned to see if they are effective.
However, if your symptoms have not improved after using Veenina tablets and sedatives, it may be due to other causes of tinnitus and sleep disturbances, and you should consult a physician for further evaluation.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2021/05/18

More Info

Navigating the challenges of postmenopausal life can be complex, especially when dealing with issues like sleep disturbances, tinnitus, and hormonal changes. Your concerns regarding sleep, ear ringing, and hormone therapy are valid and common among women approaching or experiencing menopause. Here’s a comprehensive approach to self-care strategies that may help you manage these symptoms effectively.

Sleep Disturbances
Sleep issues are prevalent during menopause, often exacerbated by hormonal fluctuations. Your experience of waking up at 3 AM and struggling to return to sleep can be linked to several factors, including anxiety, chronic pain, and hormonal changes. Here are some strategies to improve your sleep:
1. Sleep Hygiene: Establish a consistent sleep schedule by going to bed and waking up at the same time every day. Create a restful environment—dark, quiet, and cool. Limit exposure to screens before bedtime, as blue light can interfere with melatonin production.

2. Relaxation Techniques: Incorporate relaxation methods such as deep breathing, meditation, or gentle yoga before bed. These practices can help reduce anxiety and prepare your body for sleep.

3. Pain Management: Since you have a history of chronic back pain, addressing this discomfort is crucial. Consult with a healthcare provider about pain management strategies, which may include physical therapy, acupuncture, or appropriate medications.

4. Limit Naps: While napping can be beneficial, excessive daytime sleep can interfere with nighttime sleep. Try to limit naps to 20-30 minutes and avoid napping late in the day.

Tinnitus Management
Tinnitus, or ringing in the ears, can be distressing, especially when linked to hormonal changes. Here are some strategies to manage tinnitus:
1. Sound Therapy: Background noise, such as a fan or white noise machine, can help mask the ringing in your ears. Some people find relief with soothing music or nature sounds.

2. Cognitive Behavioral Therapy (CBT): This therapeutic approach can help change the way you perceive tinnitus and reduce the distress it causes. A trained therapist can guide you through techniques to cope with the sound.

3. Hearing Aids: If you have any hearing loss, using hearing aids can improve your overall auditory experience and may help reduce the perception of tinnitus.

Hormonal Considerations
Regarding hormone replacement therapy (HRT), it’s essential to weigh the benefits against the risks, especially given your history of transient ischemic attacks (TIAs) and current medications for blood clot prevention. Here are some considerations:
1. Consultation with a Specialist: Given your medical history, it’s crucial to discuss the potential risks and benefits of HRT with a gynecologist or a menopause specialist. They can provide personalized advice based on your health profile.

2. Alternative Therapies: If HRT is not suitable, consider discussing non-hormonal options with your healthcare provider. These may include medications like SSRIs or SNRIs, which can help with mood and sleep disturbances.

3. Dietary Supplements: You mentioned taking soy isoflavones and considering royal jelly and calcium with vitamin D. Soy isoflavones can be beneficial for some women, but the effectiveness varies. Ensure you’re consuming a balanced diet rich in calcium and vitamin D to support bone health, especially post-menopause.

Lifestyle Modifications
1. Regular Exercise: Engaging in regular physical activity can improve sleep quality, reduce anxiety, and help manage weight. Aim for a mix of aerobic exercises, strength training, and flexibility exercises.

2. Healthy Diet: A diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health. Omega-3 fatty acids found in fish may also help reduce inflammation and improve mood.

3. Stay Hydrated: Dehydration can exacerbate symptoms like fatigue and headaches. Ensure you’re drinking enough water throughout the day.

Conclusion
Managing postmenopausal symptoms requires a holistic approach that includes lifestyle changes, potential medical interventions, and self-care strategies. It’s essential to work closely with your healthcare provider to tailor a plan that suits your individual needs and health history. By addressing sleep, tinnitus, and hormonal issues proactively, you can improve your quality of life during this transitional phase. Remember, you are not alone in this journey, and support is available.

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