How to keep hydrated during perimenopause and menopause

Find out what you need to know about hydration and your hormones

What signs to look out for that suggest you are dehydrated
How to check you are drinking the right amount
Tips on drinking enough through the day to keep hydrated

More than half of your body is water and, as the weather starts to get warmer, it is essential you keep your hydration levels topped up.

But how do you make sure you are drinking enough, can the perimenopause and menopause affect your hydration needs, and should you really be aiming for eight glasses of water a day?

Here, we look at the issues.

What is hydration and dehydration?

Water is essential for life and has many critical roles in your body. Water transports nutrients and compounds in blood, removes waste products through urine, helps to regulate body temperature through sweating and acts as a lubricant and shock absorber in joints, according to the British Dietetic Association (BDA) [1].

Being hydrated means drinking enough so that fluid levels are at the optimum level for your body.

When you don’t drink enough you can become dehydrated, and this has an impact even when your hydration dips only slightly. Headaches, tiredness, confusion, lack of concentration, constipation and urinary tract infections can all be signs of dehydration.

How much water should I be drinking?

You have probably heard before the often-repeated recommendation that adults should drink six to eight glasses of water a day. This is also backed by the NHS and included in its healthy eating guidance [2].

But where did this idea originate? This is a source of some debate, with a number of researchers pointing towards a 1945 document from the US Food and Nutrition Board of the National Research Council [3]. The document advised 2.5 litres of water was suitable for most people and, while it also states most of this fluid will be obtained from food, the message has stuck.

The BDA says that women need about 1600ml a day, although this will vary depending on temperature, humidity levels and exercise. About 20 to 30% of this is likely to come from food [1].

Rather than worrying about how many glasses you have drunk, monitor the colour of your urine. If your urine is pale straw coloured, that means you are well hydrated, while a darker yellow colour means you are likely dehydrated.

Thirst is a less reliable indicator as we often stop feeling thirsty before we are fully hydrated.

Should I be avoiding tea, coffee and caffeinated drinks?

Drinking water remains the best option, as it has no calories or sugar, but there are other good choices. While caffeine has a small dehydrating effect, the amount of water in a mug of tea or coffee means that there is usually an overall benefit from the fluid consumed, so unsweetened tea and coffee can help maintain hydration. Herbal teas are also a good alternative to caffeinated drinks.

Caffeinated drinks such as cola are often best to avoid especially as they often contain sugars, sweeteners and other chemicals which can be detrimental to health too.

Milk (or plant-based alternatives) is also an option. You should limit other drinks containing sugars and sweeteners, such as fizzy drinks and juices.

Is dehydration more of an issue during perimenopause and menopause?

Oestrogen and progesterone, which fluctuate and decline as you approach menopause, play a role in the complex pathways which control hydration. They are involved in several different systems in your body which control thirst, how much you drink, the regulation of levels of sodium and kidney function [4].

Oestrogen can help to increase the amount of water your body holds, while progesterone has an important role in helping you get rid of excess fluid through urine. When levels of these hormones fluctuate and fall, it can impact your internal fluid balance.

In addition, some perimenopause and menopause symptoms can also impact your ability to stay well hydrated.

If you experience night sweats, you lose water through sweating and may wake up dehydrated. You may also be having an increased urge and frequency to pass urine. As a result, you may be tempted to drink less to reduce your trips to the toilet, however this should be avoided as can affect your overall hydration.

What else can affect my hydration levels?

Independent of your changing hormones, increasing age also affects your ability to stay hydrated. As you age, you feel less thirsty when exercising or when you haven’t drunk enough, and your body takes in fluid more slowly, probably due to the kidneys not working as effectively [4].

This means it becomes harder to stay hydrated as you get older.

Independent of your changing hormones, increasing age also affects your ability to stay hydrated. As you age, you may feel less thirsty when exercising or when you haven’t drunk enough fluids, and your body absorbs fluid more slowly, probably due to the kidneys not working as effectively [4]. This means it can become harder to stay hydrated as you get older.

How should I keep hydrated?

It can be easy to forget to drink enough, so here are some tips to keep fluid levels high:

Drinking little and often is best to keep hydrated
Keep a bottle water on your desk, carry one with you and put a jug of water on the dinner table
Drink more fluids if you have been exercising or are somewhere hot or humid
Keep an eye on the colour of your urine to see if you’re drinking enough
Remember food is a valuable source of water, especially fruit and vegetables, soups and stews
Monitor how much alcohol you’re drinking. Alcohol is a diuretic, which means it promotes water loss from the body. Consider swapping some alcoholic drinks for water or non-alcoholic alternatives.

References

British Dietetics Association ‘Fluid (water and drinks) and hydration’
NHS.uk ‘The Eatwell Guide’
Valtin H. (2002), ‘”Drink at least eight glasses of water a day”. Really? Is there scientific evidence for 8 × 8?’ Am J Physiol Regul Integr Comp Physiol, 283(5):993-1004. doi: 10.1152/ajpregu.00365.2002
Stachenfeld N.S. (2014), Hormonal changes during menopause and the impact on fluid regulation, Reprod Sci. 21(5):555-61. doi: 10.1177/1933719113518992