Watch: The Countess of Wessex speaks about 'tragic' impact of menopause in the workplace
It's World Menopause Day (18th October) but for plenty of women, every day is menopause day, over a period of years.
It's only recently that we've begun to talk about it openly, with The Countess of Wessex discussing debilitating symptoms and leading a campaign for menopause awareness in the workplace, and well known mid-life women such as Mariella Frostrup, Davina McCall and Lorraine Kelly producing books and documentaries on the topic.
Yet millions are still unaware of the symptoms of menopause and peri-menopause (the time leading up to the end of having periods), and may not ask for help that's readily available.
World Menopause Day is held on the same day every year, with the intention of reaching those who may be suffering symptoms and unsure of how to tackle them, as well as helping women take charge of their health and take steps to alleviate the issues that can become problematic after menopause, when hormones change.
This year's theme is bone health, and the prevention of osteoporosis and other bone diseases associated with ageing.
The organisers explain: "Bone renews itself constantly. Cells in your body remove the old bone and replace it with new bone. In healthy bone, before menopause, the production of new bone happens more than the removal of old bone.
"The opposite happens after menopause when ovaries stop the production of the hormone oestrogen. This leads to increased removal of bone which decreases bone strength. Osteoporosis does not cause symptoms until a bone is broken, which is why it is referred to as a 'silent disease.'"
They also point out that because we're living longer, "poor bone health is increasing. This can have an impact on day-to-day functioning, quality of life, ability to live independently and life expectancy."
However, diet and exercise can help to maintain healthy bones, and the organisers advise, we can "optimise dietary intake of calcium by using a calcium calculator (available online).
"Only supplement with calcium tablets if you're unable to get enough by eating foods rich in calcium such as milk, yogurt, and green leafy vegetables."
It's also vital to supplement diet with Vitamin D, commit to weight bearing exercise (such as walking) for 30 minutes most days of the week, cut down on alcohol and crucially, don't smoke.
Claire Hattrick, a beauty and wellbeing consultant, runs advice website the Menopause Lounge. She explains, "The joints most commonly affected by menopause are fingers, wrists, neck, shoulders, knees, and hips."
Maintaining a healthy weight means less pressure on knees and hips, she adds, and low-impact exercise such as yoga, swimming, and biking are a great way to stay fit without risking joint problems.
"Eat a balanced diet – including lots of nutrients, especially vitamin D and Calcium and avoid stress if possible," she adds. "This can have a negative effect on your joints as high quantities of the hormone cortisol are released."
She also warns against poor posture. "This puts extra pressure on your joints and limits your range of motion, making it harder for the muscles to take the load off your joints."
Pilates and yoga can help to strengthen muscles and bones too, while anti-inflammatory food containing Omega-3 oil such as salmon, sardines, tuna, almonds, chia seeds and soy is important.
"Add antioxidant-rich-foods help too - berries, broccoli and peppers and fruits and vegetables reduce inflammation, so keeping to a healthy diet with lots of fresh food such as pineapple, apples, mushrooms and avocados can be beneficial to keeping joint pain under control."
If you do suffer from menopausal joint pain, adds Hattrick, try "heat pads, warm baths or wheat scarves," which can help with flexibility. She also suggests asking for a referral to an osteopath, chiropractor or physiotherapist,
"Hormone replacement therapy (HRT) can be used to address joint pain and may be suggested by your GP," she adds. "It is thought to relieve some of the symptoms of joint pain but not all."
In the meantime, due to the decrease in oestrogen which supports bone strength, calcium is excellent and "magnesium is needed to help the calcium be absorbed into the bloodstream," she adds. "Research shows that a magnesium deficiency can contribute to inflammation which leads to pain in the joints."
The key message on #InternationalMenopauseDay is don't suffer in silence - if you're in pain, ask your doctor for support - on this, or any other day.
Watch: Best treatments for menopause