They have arrived, and their name is hot flashes! The good news is that they only last a few minutes, but they can come back again several times a day. Movement helps improve blood circulation and enables you to tolerate changes in temperature better. Always carry a fan with you - this little feminine affectation comes in very handy! Follow a healthy diet and reduce smoking. Dress in layers, choosing clothing that is easy to take off the moment that blaze hits you (light T-shirts and blouses, open sweaters, etc.), and that is made ​​of natural fabrics that absorb sweat. Try to avoid hot baths as well. Learn to relax and take it easy; tension worsens hot flashes.

Just keep in mind that they are a passing symptom, sure to disappear. If they are too intense, however, ask your gynecologist for advice.

Night sweats can be a real nuisance. To get a bit of relief, keep the temperature cool in the bedroom. Use only underwear made of natural fabrics (polyester and nylon do not "breath" and promote sweating). White cotton is always the best, but summer linen is also very cool. Keep a small battery-powered fan by the bedside table, along with a bowl or spray bottle filled with water and a sponge so you can quickly cool yourself down.  It's better to use tepid water and let it evaporate. This helps to remove heat from the skin and accelerate the feeling of relief. Relaxation therapies can also be effective because they calm the mind and body. If you aren't able to get relief, hormone replacement therapy is effective on both hot flashes and night sweats, which usually travel in pairs.

Carla's testimonial is one of many that we have collected: "The hot flashes had become unbearable. I was always worried that they would suddenly hit me when I was with a client. And let's not even mention the night sweats. I really just could not do it anymore. At first I tried to deal with it by trying out the advice given by some of my friends, but it would have been better to ask my gynecologist immediately. It was only with hormone replacement therapy that I really found an effective and evident solution that allowed me to maintain my job stress free, and continue to pursue it with passion.

I continued to use the therapy for a few years, then I gradually stopped over the course of a few months as recommended by my gynecologist. I remember him telling me not to do it too quickly, in order to prevent the reappearance of hot flashes or sweats, which to be honest, I haven't suffered from anymore. If I had not done this therapy, I have no idea how I would have managed.  The good thing is that it exists. Additionally, I've read in the past month that there are now solutions that are even better tolerated with respect to those from a few years ago."

With the hormonal changes taking place, it's not surprising that the sleep-wake cycle will change as well. Try to develop a personal rite of sleep preparation - a sort of relaxation mantra that will help favor a rejuvenating night's rest. Include a herbal tea in this "good sleep ceremony." The Valerian plant has been used for centuries against sleep disorders, but passionflower, chamomile, peppermint, catnip and hops also work great.  If your sleep continues to be disturbed, you wake up during the night or too early, or you find it difficult to fall asleep, ask your doctor for advice. You might also find it useful to take melatonin together with amino acids. This not only regulates the sleep-wake cycle, but it is an excellent antioxidant and protects the cells. Don't test it on your own though, always consult your doctor or gynecologist first.

The hard truth is that smoking is bad. Furthermore, it accelerates menopause, makes the skin pallid, damages the lungs and the heart, inflames the blood vessels (more than half of all heart attacks sustained by people in their 40s are due to smoking), and increases the risk of osteoporosis without you even noticing. Not convinced yet? The list is still long. It also causes about 30% of tumors in general (lungs, cervix, breast). The good news is that the damage is reversible from the moment you stop. Think about it!

It could be the first sign of osteoporosis, warning you that your bones are losing density, and it's time to start thinking about it. What follows are bones that are more fragile, with a greater risk of fractures in the future. There are cases in which osteoporosis is not completely silent and can manifest with bone pain, especially in the back, particularly in the lumbar area, which is often underestimated if not ignored altogether (especially by us women who endure pain better than men). It might also be confused with pain due to 'osteoarthritis ("joint pain"), which is also related to a lack of estrogen. The best thing to do is to talk to your doctor immediately and evaluate together whether it is appropriate to do a Bone Mineral Density (BMD).

Read what Silvia wrote us: "Basically it's an investment in my future health, in addition to making me feel good even during this difficult time in which I see my friends suffering. I've always intended to do the hormone replacement therapy. Of course, before taking it, I informed myself very well, and talked about it at length with my gynecologist.  I wanted to keep the most disturbing symptoms under control, including hot flashes, night sweats and the like, but I also wanted to protect myself from the later disorders of menopause, such as osteoporosis, osteoarthritis and cardiovascular risk. It is important to invest in health. I'm happy with my choice. I would do it again and would also recommend it to a friend. It has enabled me to live my life in full, even during this delicate time, making me feel better about myself and with others."

As a result of osteoarthritis, during menopause, all our joints begin to wear out, and for those who are predisposed it begins even earlier. For this reason, prevention is crucial. In practice, the joints, which act as shock absorbers between the bones, progressively lose their function. This is caused by age but also by poor posture, genetic reasons, trauma or diseases such as diabetes or gout. The fact that osteoarthritis progresses more rapidly after menopause also calls the hormone estrogen into question.  Movement, at all ages, is always a good way to fight osteoarthritis. It is essential to have an adequate intake of calcium and vitamin D in your diet

Why does this happen? On one hand, the lack of estrogen hormones alters the vaginal acidity (the famous pH), opening the door to any germs present in feces (remember that it is always important to wipe from front to back in order to avoid contamination of the most sensitive intimate areas). On the other hand, it causes vulvar dryness and weakens the mucous membrane of the vagina and urethra (the duct through which urine comes out), making it thinner, more fragile and easily irritated. Additionally, the lack of estrogen deprives the urethra of that "shock absorber," with its protective functions, which is normally created by the congestion of blood vessels during sexual intercourse. This is why it is also easier to trigger cystitis 24-72 hours after sexual intercourse.

You are not alone, there are plenty of women in the same boat! There are those who need to run to the bathroom after a sudden urgent need to urinate, or those who have to pee every half hour (pollakiuria), or those who wake up several times a night to pee (nocturia) perhaps waking their partner as well.  There are those who suffer more from recurrent cystitis or small involuntary leakage of urine (incontinence), which may have begun after childbirth and was neglected. There are those who find it difficult to empty their bladders completely, and constantly feel the sensation that they still have a couple drops left. How can you prevent all of this? In addition to asking your doctor, you can definitely strengthen the pelvic floor muscles by doing specific exercises several times a day. Manage your weight and eat healthy, avoiding spicy foods and alcohol. Avoid wearing underwear that is too tight, and always choose natural fabrics. Wash yourself with products that have a physiological pH so you don't alter the acidity of the intimate mucous membranes.

Estrogen keeps the skin beautiful, and its deficiency tends to make it progressively thinner, fragile and dehydrated. It gets irritated over nothing. Itching and dry skin may manifest (experts call it "xerosis"), as well as a feeling of tingling or pins. What can you do? Above all, keep the skin well hydrated and always very clean, avoiding aggressive detergents and using appropriate creams and lotions (ask your pharmacist for advice). Protect your skin from sun exposure at all times during the year. Even diet can help; eat foods that are rich in vitamins A, C and E, which are powerful antioxidants that fight the aging of the skin. Drink plenty of water throughout the day to keep the tissues well hydrated. Accept small wrinkles and expression lines; they are part of your personal experience and highlight your personality.

Maybe you didn't know this, but estrogen affects the quality and quantity of tear secretion, which has protective, lubricating, nutritional, antibacterial and optic functions. The modification of the tear film that covers the eye is the basis for many of the eye disorders that menopausal women complain of: "My eyes are burning." "It feels like I have sand in my eyes." "My vision is declining." "Light bothers me." "I can't tolerate contact lenses anymore." "I always have heavy eyelids." Hormone replacement therapy improves these symptoms, and you can also use a tear substitute in conjunction with it. There are numerous ones available on the market, and an ophthalmologist can help you identify the one that is most suitable for you based on a tear film exam.

Until menopause, we women enjoy the so-called "estrogen umbrella," or greater protection of the heart and blood vessels than men of the same age, precisely due to the action of the female hormone. When this is reduced, there is less protection and we run the same risks as our male counterparts. Lack of estrogen tends to raise the amount of LDL-cholesterol (the "bad" one) and triglycerides in the blood, and reduce the amount of HDL-cholesterol (the "good" one), increasing the risk of formation of atherosclerosis plaques inside the blood vessels. The reduction of blood flow wherever there is a plaque tends to raise the blood pressure. Therefore, it is important to maintain a proper body weight for your age and height through moderate but regular physical activity, and to eat a healthy and well-balanced diet. Ask your doctor or gynecologist for advice.

A swollen stomach happens as a result of gas produced by the fermentation of the food, present in the large intestine, that may stagnate in small bulging pouches in the intestinal wall (diverticula).  Constipation is another disorder caused by menopause since intestinal motility is affected by hormones; estrogen favors it, and progestins reduce it. In the case of these disorders, it is good to increase the amount of both fiber and liquids in the diet, and do regular physical activity. A sedentary life is deleterious for digestion. You must also reduce the intake of sugars, dairy products, alcohol and coffee. Especially in the evening, it is better to limit foods that cause fermentation, such as yeast (pizza, focaccia, leavened bakery products). An excellent remedy for constipation is to eat a lot of fruit (with the peel), unless you have diabetes. In this case, consumption should be moderated as indicated by the diabetologist. Sunflower or flax seeds are also a good remedy; they "massage" the intestinal walls and have a soothing effect.