The seasons are changing, but as we move into cooler weather, what does that mean for those going through menopause?

“The cold weather can make going through perimenopause and menopause worse for some women, and make their symptoms harder to manage,” says Dr Nikki Ramskill, women’s health GP, British Menopause Society (BMS) registered menopause specialist and founder of The Female Health Doctor Clinic in Milton Keynes.

“Declining oestrogen levels not only affect how a body regulates temperature, but a whole host of symptoms caused by hormonal changes are compounded by cold weather and lack of sunlight.”

Here’s what you might experience as a result of the changing weather…

1. Low mood

(Alamy Stock Photo)

Getting up in the dark is a struggle for most people, but Ramskill explains why it’s worse when oestrogen levels are in decline: “Lack of sunlight and shorter days make everyone feel miserable. Less daylight can affect our circadian rhythm, and lack of vitamin D from sunlight will cause tiredness and aches and pains.

“But if your oestrogen levels are low, it also reduces serotonin and dopamine activity in the brain which then leads to low mood and anxiety. Also, hormonal shifts make women at this stage of life more vulnerable to Seasonal Affective Disorder (SAD).”

2. Joint and muscle pain

Many menopausal women say they feel stiffer in colder weather, which Ramskill explains is also down to a lack of vitamin D. She says: “If you’ve got got darker skin or you cover up a lot in the summer, you won’t build up the vitamin D stores in the summer, and then when we hit winter, many people dip into deficiency.

“So, if you’re already getting a lot of aches and pains because of low oestrogen, lack of vitamin D just compounds the problem, which we then make worse because we move about less because it’s dark and cold outside, and we put off going to the gym.”

She also suggests that the old wives’ tale of people ‘feeling weather’ in their joints is backed up by science. “Some people are very sensitive to barometric changes and get pains in their fingers or knees. This is because we’ve got fluids in our joints which are probably responding to the environment, and without the anti-inflammatory effect of oestrogen, inflammation can be a problem.”

(Alamy Stock Photo)

3. Disrupted sleep

Not being naturally woken up by the sunlight in winter flattens the circadian rhythm and stops morning serotonin production, which means menopausal women get a double whammy of lack of serotonin in winter from lower oestrogen levels.

Ramskill explains: “The lack of serotonin affects melatonin production, which is the hormone that controls your sleep-wake cycle, leading to fragmented sleep.

“Plus, low oestrogen affects the body’s ability to regulate its temperature, causing night sweats, which will be worse in winter due to heavier night clothes and bedding.”

And she adds: “Reaching for the hot drinks in the cold weather may also mean you’re inadvertently having more caffeine than you need.”

4. Itchy skin and dry eyes

Lack of oestrogen causes the skin’s natural moisturisers of oils and ceramides to decline sharply during menopause, causing dry and itchy skin. “Add to that the drying effects of central heating, or getting dehydrated because we’re not stimulated to drink as much in the colder weather, and going out in cold  – all these things are going to make your skin worse,” says the medic.

Having dry eyes can make them stream, but Ramskill reveals that often people don’t recognise that’s the problem. She says: “The constant watering is your eyes trying to get back what they need.

“The lack of ceramide and oils impact the skin around your eyes and the lubrication of the eyes themselves, and cold winds are going to make that problem even worse.”

(Alamy Stock Photo)

5. Hot and cold flushes

There is a biological reason why women tend to feel colder than men generally.

“Oestrogen makes our blood vessels naturally more expanded, so we lose heat quicker and feel colder,” says Ramskill. “Which is why some women struggle with air conditioning in the office, and feel the cold in the winter.”

Dropping oestrogen levels causes the brain’s internal thermostat to mistakenly think menopausal women are overheating, triggering an emergency response and activating sweat glands.

“Being bundled up in winter clothes and sitting in a centrally heated room will make those sudden hot flushes even worse when all the layers have to be pulled off in a hurry,” says Ramskill. “And these can be followed by the post-flush chill, which leaves women feeling cold and shivery.”

The winter’s Christmas party season can also take its toll, as Ramskill says, “Alcohol can make hot flushes worse and it can disrupt sleep.”

Strategies to help control symptoms

Not all women can take Hormone Replacement Therapy (HRT), so Ramskill suggests other strategies. “Body identical progesterone can help with sleep as it causes drowsiness. And melatonin, which although NICE says is technically for over 55s, I do prescribe for younger women.”

The medical expert also advises: “Vitamin D should be taken all year round, supplements for iron deficiency could help with restless legs, and magnesium glycinate can aid sleep.”

She adds: “I also advise patients to eat a Mediterranean-style diet rich in Omega-3, and foods that are high in tryptophan, as well as staying hydrated, maintaining exercise, getting out in the sunshine and practising good sleep hygiene. Keep achy joints warm and try a SAD lamp or glasses to help with light exposure.”