It’s not unusual to feel increasingly thirsty during perimenopause and menopause. As estrogen and progesterone levels start to fluctuate, these hormonal changes can affect hydration by disrupting fluid balance and electrolyte levels in the body.(1) Dehydration occurs when fluid output is greater than fluid intake. While menopause does not directly cause dehydration, the hormonal shifts during this transition, along with menopausal hot flashes and night sweats, can increase the risk of dehydration.
Fluid intake is key in maintaining overall health, and hydration becomes even more important with age. This article explores the impact of menopause on the body’s hydration levels, the effects of dehydration on the severity of common menopausal symptoms, and some tips to help women stay hydrated during this phase in life.
Causes of Dehydration During Menopause
Menopausal dehydration may be related to a number of different factors, including hormonal fluctuations, vasomotor symptoms, and natural aging.
1. Hormonal Shifts
Women may be more susceptible to dehydration during menopause because of changing hormones that influence body systems responsible for fluid regulation, including those involved in thirst, fluid intake, and sodium balance.(1)(2)
Estrogen and progesterone receptors are located in fluid-regulating body tissues. Both hormones help maintain a careful balance of body fluid and electrolytes. This state of fluid homeostasis supports proper nerve and muscle function, waste removal from the cells, and the transport of nutrients into the cells. When sex steroid levels change, so do levels of fluid-regulating hormones. Some women may feel these effects on thirst and hydration beginning in perimenopause as hormone levels start to shift.(1)(3)(4)
2. Hot Flashes and Night Sweats
Hot flashes and night sweats can cause increased body water loss, which can lead to dehydration. Although more research is needed, vasomotor symptoms are believed to be related to hormonal shifts during perimenopause that cause the body’s thermoneutral zone to narrow. The thermoneutral zone is the range of temperatures in which the body can maintain its core temperature through skin blood flow alone.(5)(6)
As a result of this narrowing of the thermoneutral zone, even small increases in body temperature during menopause can prompt the body to produce sweat in order to cool down. If fluid levels are not replaced to replenish what was lost from sweating, it can lead to dehydration.
3. Natural Aging
Dehydration is estimated to affect between 17% and 28% of older adults in the United States.(7) In addition to aging-related hormonal shifts that affect fluid balance in the body, older adults often drink less water due to impaired functioning of parts of the central nervous system that regulate thirst.(8)
Thirst sensitivity may also be reduced in older women in response to changes in central body fluid volume. This loss of thirst sensitivity may cause older women to rehydrate less often.(8)(9) As such, it’s particularly important for women to stay hydrated during postmenopause.
The Role of Hormones in Fluid Retention and Dehydration
Changes in body fluid balance, influenced by hormonal imbalances, can increase fluid retention, which occurs when the body holds on to excess fluid in the tissues.(1)
Estrogen has been associated with increased fluid and sodium retention. Progesterone helps regulate estrogen’s effects on fluid balance by reducing sodium retention through urination. Changes in estrogen and progesterone levels during menopause may, therefore, cause fluid and electrolyte imbalances, potentially leading to or exacerbating dehydration.(9)
Combined hormone replacement therapy (HRT) may help prevent menopausal dehydration. Replenishing declining estrogen levels can increase body water retention and lower the risk of dehydration. The addition of progesterone can help maintain fluid and electrolyte balance and reduce the risk of health issues associated with excess fluid retention.(9)
Common Symptoms of Menopausal Dehydration
Dehydration symptoms vary based on severity. Women may experience some of the following symptoms of dehydration during menopause:(7)
Increased thirst
Fatigue
Headaches
Lightheadedness
Dizziness
Dry skin
Dry mouth
Symptoms of severe dehydration that may warrant medical attention include the following:
Muscle cramping
Dark urine
Reduced urine output
Fainting
Significant drop in blood pressure
Heart palpitations
Some dehydration symptoms may overlap with symptoms of menopause, such as fatigue, dizziness, dry skin, or dry mouth. This is because menopausal hormonal fluctuations can affect energy levels, skin hydration, oral health, and the vestibular system, among other body functions. Dehydration may also exacerbate menopausal vasomotor symptoms.
Can dehydration worsen hot flashes and night sweats?
Just as vasomotor symptoms can worsen dehydration, dehydration may also increase the intensity of menopausal hot flashes and night sweats. When the body is in a state of hypohydration, it stores more heat, and its tolerance for heat strain decreases.(10)(11)
The body works to regulate body temperature by sweating. However, as dehydration worsens, the loss of body water makes it difficult to produce sweat, making it harder for the body to cool down.(11)
How to Stay Hydrated During Menopause
It’s important to keep the body hydrated during menopause. However, some drinks may worsen dehydration. The following are menopause hydration tips including which beverages can effectively restore fluid levels.(12)(13)(14)
1. Drinking Enough Water
Everyone’s water needs are different, but it’s suggested that women drink approximately 11.5 cups of water per day to maintain healthy hydration levels. Sparkling or flavored water are all tasty, hydrating options.
2. Drinking Nutritional Beverages
Water isn’t the only option when it comes to hydration. Herbal teas, milk, 100% vegetable juices, or low-sodium broth can also go towards women’s recommended daily fluid intake.
3. Choosing Electrolyte-Rich Drinks
Sports drinks, coconut water, and lemon water all contain electrolytes. Drinking these beverages can help restore electrolytes lost through sweating. However, many sports drinks are often packed with sugar and are best consumed in moderation.
4. Eating Hydrating Foods
Eating foods largely made up of water can also keep the body hydrated. Celery, watermelon, cantaloupe, lettuce, and spinach are among foods with the highest water content.
How to Prevent Dehydration in Menopause
Practicing prevention can reduce excess body water loss during menopause. The following are strategies that may help prevent menopausal dehydration.
1. Tracking Fluid Intake
Many reusable water bottles come marked with fluid-ounce measurements or time stamps to help people keep track of their water intake throughout the day. Several hydration-tracking apps are also available.
2. Avoiding Dehydrating Beverages
Consumption of alcohol and caffeine increases urine output, which can lead to fluid imbalances and increase the risk of dehydration.
3. Drinking Water in the Mornings and Evenings
Drinking water throughout the day is essential, especially in the mornings and evenings. Hydrating first thing in the morning can help replenish low fluid levels from reduced water intake while sleeping. Additionally, drinking water in the evening can help keep the body hydrated overnight. However, because drinking a glass of water right before bed may increase nighttime bathroom trips, it’s recommended to minimize fluid intake before bedtime.
4. Staying Cool in Hot Weather
Keeping the body cool in hot temperatures can reduce fluid loss from sweating. Drinking plenty of water, wearing breathable clothing, and staying in the shade while outdoors can prevent dehydration during the hotter months of the year.
5. Consuming Dietary Sources of Electrolytes
Calcium, potassium, magnesium, and sodium are key electrolytes that support bone health, muscle function, and many other body systems affected by hormonal fluctuations during menopause. Whole grain bread, legumes, fruit, green vegetables, and nuts and seeds are all dietary sources of electrolytes. Because there’s a risk of oversupplementation, electrolyte supplements are not typically recommended unless a person has experienced significant water loss due to illness or vigorous exercise. Women should consult with their doctor before taking any medications or supplements.(15)
Dehydration Remedies and Hydration Tips
The following strategies can make staying hydrated during menopause simple and easy:
Taking small sips of water throughout the day
Keeping a water bottle on hand
Infusing water with mint or cucumber to enhance flavor
Sucking on ice chips
Making flavored ice pops
The Importance of Staying Hydrated During Menopause
Hydration is vital for everyone, but it’s particularly important for women during menopause. Staying adequately hydrated can help reduce common menopausal symptoms like hot flashes, brain fog, and dry mouth. However, managing and preventing dehydration is about more than drinking water. It also involves understanding the intricate ways in which hormonal fluctuations during menopause can disrupt the body's balance of fluid and electrolytes.
While lifestyle modifications can help, if dehydration symptoms persist or worsen, it’s crucial to consult a healthcare provider for proper treatment and assessment for any underlying health conditions.
