What a menopause expert does daily to feel healthy and happy

Women in midlife need cardiovascular exercise for heart health, and resistance exercise to maintain their metabolic rate, prevent muscle loss and preserve bone health, says Dr Tania Adib. Photo / Logan Weaver, Unsplash

Dr Tania Adib is consultant gynaecologist clinical lead for the Lister Menopause Clinic at Lister Hospital, London, and founder of Luminosa London. She shares her advice for a healthy menopause.

First thing

I wake at 5:30, make myself a latte with almond or hazelnut milk and take it back to bed, to gently wake up. Then, I do a five-to-10-minute mindfulness body scan. I discovered mindfulness 10 years ago and it’s been life-changing. Before, I was always anxious, now I’m much more grounded. It really sets me up for a balanced day – it’s amazing for menopausal anxiety, mood and coping with stress.

Breakfast

I’m at work by seven. I’ll eat a pot of chia seeds I’ve soaked overnight, adding almond butter and blueberries. Chia seeds are full of fibre and keep my blood sugar sustained until lunch.

At least half of menopausal women have insulin resistance so it’s important to adapt your diet and manage your blood sugar. High insulin drives glucose into your cells and turns to fat, which is why so many women gain weight. My metabolism changed at menopause so I’ve completely altered how I eat. It really matters what we put in our bodies for “part two” of our lives.

Dr Tania Adib.

Exercise

Exercise is key. You need cardiovascular exercise for heart health, and resistance exercise to maintain your metabolic rate, prevent muscle loss and preserve bone health. I stay active through the day, fast walking between clinics to raise my heart rate. Once a week, I swim 40-50 lengths for cardio.

If I can’t get outside, I love using my rebounder (trampoline). It’s great cardio exercise without stressing the joints and gets your lymph flowing, which is good for immune cells. I’m sure it does great things for the collagen in your face too! Once a week, I do resistance training with a personal trainer – osteoporosis is a silent disease so maintaining bone density is vital and you need to start now. Also do your daily pelvic-floor exercises.

Lunch

I have a plant-based diet and advocate eating the rainbow – you need to keep your microbiome happy as it’s essential for regulating oestrogen. When you hit the menopause, you need to change the proportion of foods on your plate - you need less carbs, but more protein to maintain your muscles and bones, and lots of vegetables. I’m big on salads for lunch. Today it was falafel and hummus. At weekends, I’ll make a massive salad for my children with parsley, mint, onion, tomato, cucumber, lentils and a tahini, olive oil and lemon dressing. After lunch, I might have tropical fruit and coffee - my weakness.

HRT

"I understand how menopause can damage mental and physical health, and see from my patients how HRT changes lives."

I became menopausal at 43. I was determined to do it naturally. But I turned into an old woman. My joints were stiff and creaky, I wasn’t sleeping, I had no energy, I couldn’t exercise and I struggled with concentration. I was doing all the right things - exercise, green smoothies, eating well - but it wasn’t hitting the mark. As a single mother of three (my children are now 21, 19 and 15), I became exhausted.

Then I started HRT (oestrogen, progesterone and testosterone - people don’t realise it but women have testosterone too) and it’s been life-changing. I feel better now than I ever did. So I understand how menopause can damage mental and physical health, and see from my patients how HRT changes lives. I’m happy that women in their 40s are realising they’re experiencing perimenopausal symptoms. Usually, they don’t need full HRT as they’re still producing oestrogen, so I put them on progesterone - brilliant for irritability, anxiety and sleep, and sometimes a little testosterone if they need energy and libido.

This careful rebalancing makes them feel normal again. As long as you make positive changes, “part two” can be a really wonderful stage in your life.

Supplements

I take a multivitamin plus vitamin D, omega-3, probiotic and DIM (diindolylmethane), which helps adjust oestrogen. I recommend appropriate supplements to my patients too. If sleep’s an issue, I suggest magnesium glycinate; for anxiety I suggest taurine and L-theanine; and chromium picolinate for sugar cravings.

Dinner

I love to cook from scratch and don’t eat processed food. It absolutely helps my energy. I’ll make salmon or beluga lentils with truffle oil and a little rice, then a big salad or vegetables. I don’t drink alcohol, it wrecks hormonal balance in the menopause, disrupts your sleep and you feel dreadful the next day. There’s no point drinking! My treat is dark chocolate. To unwind, I’ll watch a travel documentary while cooking.

Sleep

I sleep much better now I’m hormonally balanced. I’m also a big fan of melatonin; it helps me sleep more deeply. I aim to be in bed by 10.30pm so I get seven hours, but it doesn’t always work out that way, especially if I’m out for dinner. If you’re struggling with sleep, a warm bath and camomile tea is amazing. Or try reading before bed.

Therapies

I ask patients directly about vaginal dryness and loss of sexual pleasure as many are too shy to ask. The vaginal oestradiol Gina is a great thing. It’s super low-dose and safe. A whole year’s worth of Gina is equivalent to one day of HRT. It can really help with vaginal dryness and bladder symptoms by improving the vaginal tissues. The supplement sea buckthorn oil is also great for dryness.