Holiday Menopause Survival Guide to Make Your “Peri” Merry!

Sabina Rebis MD

Many women are stressed out, exhausted and bloated during the holidays, but for women over 40, these may be signs of perimenopause – the transitional time leading up to menopause. According to women’s health advocate, Dr. Sabina Rebis, women can make their “peri” merry by following a self-care survival guide. 

“Symptoms of menopause can actually start as early as four years prior to full blown menopause,” said Dr. Rebis, founder of The Model of Health. “If you think you may be in perimenopause and your period is irregular, you can have bloodwork to confirm that is the cause of your symptoms in order to treat them correctly.” The tests check estradiol levels, follicle stimulating hormone and luteinizing hormone levels. It’s important to do these blood tests in the first 3 days of a woman’s menstrual cycle as the levels can vary daily and with ovulation. 

Dr. Rebis explains menopause occurs when a woman’s ovaries stop producing hormones and is defined as having no menstrual period for 12 months. Symptoms may include hot flashes, poor sleep, mood changes, memory problems, vaginal dryness and more frequent urinary tract infections. Women may also experience irregular bleeding or spotting in the years leading up to menopause.

Baby, It’s Hot Inside

As many as 75% of women experience hot flashes. There is nothing that can totally prevent the sudden heat, red face, rapid heartbeat and sweating that results from blood vessels near the surface of the skin widening to cool off. But women can lessen frequency and severity by avoiding triggers like hot liquids, spicy foods, alcohol, caffeine, stress and tropical temperatures.

Dress in loose layers, preferably cotton, for parties or holiday gatherings to be prepared for over-heated homes. Bring a spare top to change into in case of excessive sweating.

Mind-body interventions such as relaxation, mindfulness, and cognitive behavioral therapy (speaking with a therapist) can reduce stress and annoyance associated with menopausal symptoms across the board. Hypnosis intervention for hot flashes has been shown to result in a significant reduction (i.e., 50% or more) in symptoms. The natural remedy of black cohosh combined with St. John’s wort has been found to be effective for eliminating symptoms.

“Those with severe hot flashes should really pay attention to chest pain symptoms and make healthy lifestyle choices,” urges Dr. Rebis. “New research focused on the menopause transition from SWAN, the Study of Women’s Health Across the Nation found women with frequent hot flashes had double the risk of heart attacks, strokes and heart failure later in life.”

Visions of Sugar Plums

Traditional dishes and holiday favorites are filled with sugar and fat. Dr. Rebis points to a recent study that demonstrated that there is an inverse association between a fruit and vegetable dietary pattern and menopausal symptoms. In contrast, diets rich in mayo, sweets, dessert and solid fats and snacks worsen symptoms. Those who ate five servings of fruits and veggies and six servings of whole grains were also, not surprisingly, three times more likely to lose weight.

“Keep fat intake at less than 20 percent. Start your meal with veggies and protein and eat your starch last to reduce the sudden spike in blood glucose and insulin,” said Dr. Rebis. “Eating soy foods like edamame and tofu are healthy choices, however the benefits of eating soy foods to improve menopausal symptoms remains unclear.” 

Keep it Nice AND Naughty

Fluctuating levels of ovarian hormones during the transition to menopause can quickly change a mood from cheery to Grinchy with no warning. Lack of sleep due to night sweats may also increase irritability. According to, a low-dose oral contraceptive (OC) provides continuously stable hormone levels and may control mood swings. Plus the estrogen-progestin pills offer other health benefits such as regulation of uterine bleeding and decreased risk for uterine and ovarian cancer. Smokers over age 35 should not use OC’s. 

“Consider an SSRI (selective serotonin reuptake inhibitor) such as Effexor (venlafaxine) or Prozac (fluoxetine) as higher levels of serotonin help balance the roller coaster of emotions,” adds Dr. Rebis.

Emotions can impact a woman’s libido as much as physical changes. Dr. Rebis encourages women to talk openly with their partner and to not avoid sex. For those battling vaginal dryness, use a vaginal moisturizer or lubricant. Sexual activity improves vaginal tone and helps maintain the acidic environment that protects against urinary tract infections (UTI).

“Estrogen therapy is the most effective treatment for genital dryness, burning, and irritation, frequent UTI’s,” said Dr. Rebis. “Low-dose vaginal estrogen preparations are effective and generally safe due to minimal systemic absorption. Hormone therapy and low-dose vaginal estrogen therapy increase lubrication, blood flow, and sensation in vaginal tissues.” 

There are non-estrogen therapies approved for relief of dyspareunia (painful sex) in postmenopausal women. Ospemifene is an estrogen modulator and works to mimic the effect of estrogen. DHEA is a steroid hormone produced by the adrenal gland that diminishes as people age and may affect sexuality. Daily intravaginal administration of 0.50% (6.5 mg) DHEA (Prasterone) has been proven beneficial. 

Sleep in Heavenly Peace

Develop good sleep hygiene and make sleep a priority even during the hectic holiday season. Begin to wind down an hour or so before bed. Foods rich in tryptophan like milk, peanuts, or low-fat cheese lead to higher levels of serotonin which can help with sleep onset.

Keep the bedroom under 68 degrees and use pillows and mattress pads made with cooling material. There are also pajamas and sheets specially made to wick away moisture.

Moderate exercise, stress reduction and deep breathing can aid in falling asleep. Add resistance training to boost the effects of exercise. Those who did an hour of strength training twice a week for eight weeks reduced their body fat and had less body pain. Yoga has similar benefits.

A Word About Hormone Replacement Therapy…

Although hormone replacement therapy (HRT) can be highly effective in menopause, talk to a licensed medical professional about the benefits and risks. Excess estrogen can lead to blood clots and endometrial cancer if not appropriately prescribed. Low-dose estrogen is available by pill or patch, skin lotion or gel, but must be given with progestin in those who still have a uterus.

“HRT lessens hot flashes, overactive bladder, night sweats, vaginal dryness, poor sleep, irritability, and ‘brain fog’,” explains Dr. Rebis. “It can also strengthen bones and if started within 10 years of menopause, may even have a positive effect on cardiovascular health and lower the risk of developing type 2 diabetes.”

Those on estrogen therapy can take it for seven years before the risk of breast cancer risk increases. The risk goes up after three to five years for women who use estrogen progesterone therapy. 

About The Model of Health

The Model of Health is the premier resource for timely health news, tips, and trends to help everyone achieve optimal health. Motivation starts with inspiration! Dr. Sabina Rebis is committed to inspiring everyone to choose a healthy lifestyle by providing researched-based information, products, and recipes. For more information visit

Author Profile

The Editorial Team at Lake Oconee Health is made up of skilled health and wellness writers and experts, led by Daniel Casciato who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We aim to provide our readers with valuable insights and guidance to help them lead healthier and happier lives.