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Coronavirus and Menopause

How does COVID-19 impact menopausal women?

With Barb DePree MD and Lakeisha Richardson MD

Menopause can affect immunity.

If you’re going through menopause during the COVID-19 crisis, or if someone you love is, you may be wondering if the novel Coronavirus affects menopausal women. Are menopausal women more at-risk? Are there ways to decrease the risk?

These are all good questions, since menopause can already be a trying time (to say the least!) without a pandemic halting normal life. Menopause generally hits at an average age of 51. It’s the culmination of a natural process that occurs when the ovaries stop making estrogen and progesterone. Other causes of menopause, including early menopause, are treatments like chemotherapy, hysterectomy, or other ovarian issues. 

After a year without a regular monthly period, menopause begins, bringing with it several not-so-pleasant side effects, such as hot flashes, mood swings, depression, thinning hair, breast fullness loss, slowed metabolism, dry skin, an increase in facial hair, cognitive issues (think: forgetfulness and focus issues), and sleep problems. 

All of this can take a real toll on you — especially if you don’t have a proper support network in place. A good doctor, an understanding spouse or family, and supportive friends are a must, as menopause can be emotionally and physically exhausting. You’ll also want to seek good preventative care by getting regular mammograms, colonoscopies, and other screenings.

Hormone therapy, lifestyle changes, and other therapies may be utilized at this time, but nothing prepares you for a global pandemic during menopause, so it’s important to understand how this novel virus might affect you. 

Are menopausal women specifically more at risk for the Coronavirus?

According to gynecologist Barb DePree, MD, “COVID-19 is not likely to be a significant additional risk to menopausal women per se, but menopause is a time women begin to have increased risk for heart disease and type 2 diabetes, once they lose the protective effects of estrogen. These co-morbidities definitely increase risk for women who may contract COVID-19.”  

In fact, the Centers for Disease Control and Prevention (CDC) says age, heart disease, and diabetes can all increase your chance of being severely ill with the Coronavirus. More so, weight gain, which may be caused by menopause, can also complicate matters.

Frustratingly, for women in menopause, a decrease in estrogen could potentially cause increased vulnerability to severe symptoms. “There is some investigational research data suggesting estrogen may be somewhat protective for women exposed to the Coronavirus,” Dr. DePree says. 

Menopause itself can therefore impact immunity, says Dr. DePree. “Immunity is a complex issue that is impacted by multiple factors — some of which we control, and some less so,” she says. The hormone estrogen is shown to have a protective role in women, so women who are not on hormone therapy during menopause might be more at-risk than those without a decline in estrogen. 

Menopause is also linked to cancer risk, as well as a decrease in T-cells, the immune system’s cells that work to fight off cancer cells and foreign invaders, and which bolster the immune response in general. 

Inflammation is yet another issue. According to studies, as women age, inflammatory levels increase — leading to pain, autoimmune issues, weight gain, and susceptibility to illness. 

So, it’s not that menopause in and of itself can put you at-risk, but the health factors associated with menopause can create complications. 

What you can do right now to support your physical and mental health during menopause and Coronavirus?

Aside from consulting with your doctor about any potential health issues, such as heart health and diabetes, you’ll want to engage in healthy lifestyle activities that can help you stay healthier during menopause and during quarantine, when health issues are compounded by both loss of routine and chronic anxiety. 

There are plenty of lifestyle modifications you can make (or re-explore!) to protect your body and keep yourself healthy — especially during a pandemic when you need to stay healthy. This starts with maintaining social distancing and protecting yourself by avoiding crowds, as well as washing your hands and disinfecting your home regularly. 

Consider hormone therapy

“We are not suggesting that women necessarily start hormones as a result of this pandemic,” Dr. DePree says, “but the findings that fewer women are dying from the virus versus men, and that estrogen may be a factor, hopefully will lead to a better and broader understanding of our immune systems, gender differences, and to be better able to inform women on making those treatment decisions.” If you are having bothersome menopausal symptoms, check with your doctor about what hormone therapy could be right for you. There are more safe and low-dose options available than ever before. 

Eat well

Menopause can also bring with it some frustrating weight management obstacles. Coupled with the fact that quarantine and other pandemic stressors — such as a loss of income — can cause the stress hormone cortisol to exacerbate health issues and further weight gain, it’s important to prioritize caring for your body at this time. 

Dr. DePree recommends eating whole, plant-based foods (think veggies, nuts, legumes, seeds, and fruits). These foods assist both immune health and weight management. Think about ordering a plant-based delivery service such as Daily Harvest if you’re having a hard time getting your hands on fresh produce or worried about going to the grocery store. 

Embrace movement

Dr. DePree knows it isn’t easy, but holding yourself to the task is key. “Maintaining or achieving a healthy body weight takes effort, day in and day out. It requires attention to detail.” 

Movement is critical — but you don’t need a gym with expensive equipment to make it happen. “With most of us at home, it is more realistic to do multiple brief exercise interludes in the day,” Dr. DePree says. You might think of resistance work using your own body weight, weights, yoga, stretching, a brisk walk, hiking, or cycling—while maintaining social distancing, of course. You can even set up a virtual workout session with friends on FaceTime or Zoom.

Stick to a routine or establish a new one

Beyond working out to maintain weight, regular, routine workouts help stabilize hormone levels, according to Dr. Richardson. “When you stay in a fitness routine, the adrenal glands, which control our stress pathways, stay calm.  I know a lot of routines have been disrupted by this pandemic — so you may even need to create a new routine to stay healthy.” 

Beyond regular movement, your routine should also include self-care and drinking loads of water, she says. “Water is the fuel the body runs on. I suggest taking your body weight and dividing it in half. That’s how many ounces per day you need."

Practice good sleep hygiene

Another routine you’ll want to adopt? A healthy bedtime. “When women go into menopause and their hormones are out of balance, they may have trouble getting to sleep and staying asleep,” Dr. Richardson says. “Study after study shows that sleep really helps your metabolism, so not getting the right amount and type of sleep can really affect your ability to lose or maintain weight as you age and in times of stress.”

Get into bed early, aim for seven hours, and make your bedroom a place where you can achieve undisturbed sleep, if possible. She recommends taking L-theanine (an amino acid that can affect your emotions and sleep) in the evening to calm you down and achieve deep sleep, but check with your doctor first. Try to think of your bedtime as a respite from the daily anxiety of a global pandemic. 

Give yourself a break

Introduce self-care into your daily life, even if it’s only for a few moments each day or scattered throughout your day as small breaks. Dr. DePree recommends trying new things. If you’ve always wanted to journal, do yoga, or start meditating—now’s the time. And stay connected with others through phone calls and letters. Human connection can bolster our wellbeing in ways we don’t even realize—especially if we’re self-isolating alone. 

The benefits of self-care are multi-layered. While they can help us feel better when everything around us seems chaotic and uncertain — allowing us an outlet to express emotion or find solace — stress management can also help to reduce physical inflammation. It’s a win-win for the body and mind.  

If all of this feels overwhelming, know that you are not alone — and that you can take control of your health and wellness with the proper care and lifestyle adjustments. Introduce small, doable changes each day, and stick to them. Hold yourself accountable, but be self-compassionate and patient with yourself as you adopt any new lifestyle changes. 

Find a menopause certified practioner

The North American Menopause Society has a feature on their site where you can search by zipcode to find a NCMP (NAMS Certified Medical Practioner) in your area. They receive special training to help you arrive at the best treatments to assuage your symptoms and protect your health in menopause during this trying time.

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