Women's Health: Menopause
Every woman in our global village will experience the transformative journey of menopause. And each woman's menopause will be different for many reasons, from the culture she lives in to her own personal experiences as a woman. A woman's view of menopause, and how this has been shaped by what she has been told, seen in her mother's experience, or learned through others, is very important. As women, if we fear menopause, we will probably have a more difficult time with the changes it brings.
If we welcome menopause as a new phase in the natural cycle of female life, we may find it freeing and joyful. Women sensing the arrival of menopause can feel very anxious, concerned, or depressed as they begin to see themselves change. As women, the importance of understanding ourselves and our bodies, building self-esteem as our bodies change, staying connected to the world around us, and nurturing our own creative outlets are important goals as we approach mid-life.
Many, many cultures around the world view female reproduction and menopause in positive way. Women are seen as powerful creators and the keys to the continuing survival of the society and its customs. This begins early in a woman's life with the beginning of menstruation. Girls who begin menstruating are honored and recognized for their transition into womanhood.
Older women are held in high esteem for their creative female wisdom, wealth of life experience and understanding of human nature. Often older women are included in important decisions in society and enjoy new societal freedom and status with age. We would do well to remember this as menopause approaches. As we move forward into the unknown changes the passing of time brings, we can learn to rely on our inner wisdom to guide us through the experiences of menopause.
What every woman wants to know about menopause is what to expect. Menopause brings changes to menstrual cycles and bleeding, hot flashes, sexual sensitivity, and hormonally influenced emotions. For some women, as in premature menopause, this can occur at a young age. It is very important to find a doctor, nurse practitioner, gynecologist, general internist, or other health care provider who is interested in women's health.
Your health care provider should take the time to listen attentively to any complaints of symptoms and perform a thorough examination of your blood pressure, breasts, heart, lungs, abdomen, pelvis, and rectum. A medical practitioner should have an open mind about the benefits and risks of HRT and be able to advise you on questions about medications, alcohol, smoking, exercise, stress, and nutrition.
As a patient, be sure to keep records of your medical visits and request information and advice before agreeing to any treatment. Make sure you inform your health care provider about all the medications, nutritional supplements, and any herbal supplements you are taking. If you have questions, try writing them out before your visit, so you can be sure to get answers while you are there.
Ask a friend to go with you to your appointment if you feel nervous. Realize you have the freedom to see another doctor for a second or third opinion if you feel that any treatment seems unnecessary. Follow the same careful steps when choosing other health care professionals such as a counselor for emotional and psychological guidance and support. Look for a social worker, licensed counselor, psychiatrist, or psychologist who helps patients deal with emotional pain and encourages positive growth.
On average, as a woman approaches her mid-40s, ovulation is less regular and hormone levels vary. A woman's cycle will often become shorter, with bleeding every 21 to 25 days instead of every 28 days. Menstrual bleeding may be lighter than before, or heavier than before. Sometimes a period is skipped because ovulation does not occur.
A woman may have breast tenderness, abdominal bloating, and the feeling that her period is coming for several weeks without experiencing any bleeding at all. A return to a more normal cycle may resume the next month. Near age 50 or 60, periods become further apart and lighter, finally stopping altogether. After one full year without bleeding, a woman has completed menopause. Usually by age 55 menopause has passed.
Many different patterns of bleeding occur during menopause. Some are normal and others signal problems. Sometimes women abruptly stop menstruating after discontinuing birth control pills in their 40s or after a stressful or emotional shock. Bleeding between periods, irregular periods that are close together, and very heavy bleeding may signal hormonal imbalance, uterine fibroids, uterine overgrowth, endometriosis, or possibly cancer.
Humorously known as 'tropical moments,' hot flashes are physical signs that an average of 3 out of 4 women experience with the hormonal changes of aging. Women suddenly become very sensitive to changes in temperature, often feeling the heat and cold more intensely and adding and removing layers of clothing. A woman's face, upper body, or entire body becomes flushed and warm. Heart rate goes up and sweating, either a little or a lot, occurs.
Even though a woman's skin temperature rises a few degrees, no fever occurs in the body. Most often this lasts about 5 minutes, but can last longer. After a hot flash, body temperature drops slightly and evaporating sweat can cause a chill feeling. Hot flashes can happen at night and interrupt a woman's sleep. This can lead to insomnia, tiredness and difficulty concentrating on tasks during the day.
Thankfully, these intense experiences usually last no more than 6 to 12 months and generally occur in the first 2 years of menopause. Although they cannot be prevented, women can live well with hot flashes by learning what triggers them and what remedies help. If more relief is needed, medications for hot flashes can help. Women will need to weigh the risks and benefits of HRT before making a decision to begin therapy.
Common Hot Flash Triggers
Hot meals and hot drinks
Consume cool, fresh and refreshing food and drinks in small, frequent meals and snacks.
Reducing stress and practicing stress reduction techniques regularly once or twice a day can help.
Keep cool, carry a fan, take cool drinks of water or juice and exercise during the coolest times of day, or indoors where the climate is controlled. Keep the bed only lightly covered when sleeping.
Women who get regular exercise tend to experience hot flashes less often and less intensely than women who do not exercise.
Avoid alcohol in excess and if you drink at all, be moderate, meaning no more than one drink each day.
Estrogen is made in a woman's body fat from other hormones after menopause. A very thin woman has less natural estrogen in her body, which may lead to more problems with hot flashes.
Medications for Hot Flashes
Hormone Replacement Therapy (HRT)
Effective at reducing or eliminating hot flashes, night sweats and relieving insomnia during menopause. When hrt is stopped, hot flashes return, but tapering off gradually helps curb the severity of symptoms.
Prescribed by a doctor, progestin is a hormone similar to the body's progesterone that can reduce hot flashes, but not as effectively as HRT.
A combination of medication, it can be helpful at night if hot flashes are severe, but has too many undesirable side effects to take continuously.
A blood pressure lowering prescription drug available in pills or patches.. Low doses are effective for some women who do not take HRT.
Hormonally Influenced Emotions
Hormones can have profound effects on mood. Mood shifts during a menstrual cycle or depression after giving birth are examples of the influence of these compounds. Women experiencing menopause may also notice changes in mood or mood swings.
During menopause, a woman experiences many complex changes in a relatively short period of time. Each woman will experience this transition differently, depending on her body awareness, her overall health, and the rate of hormone decline. Her biochemistry and her external circumstances will determine her psychological response. A symbiotic relationship between a woman's inner health and her outer world exists, as both are in continuous interaction, dependent upon each other. A balanced approach to staying centered within a healthy lifestyle is a wonderful ally during the transition of menopause.
Evidence from clinical studies indicates that estrogen replacement has a beneficial influence on mood, memory, and quality of life for many women. However, in some studies the results were inconclusive. Other women have side effects of anxiety or depression, feeling uncomfortable emotionally when taking estrogen. Consult your physician to discuss all your options if you are experiencing mood swings.
Choosing to Thrive After Menopause
Women enter a time which can be new and vibrant as they become free from the continuous cycle of menstrual periods. On the other hand, some suffer from depression, illness, or become reclusive. Many women past menopause have learned what they really value about living. Now is the time to choose how to continue the next chapters of life.
While spending time alone is important for self-rejuvenation and creative work, it can be a problem for those suffering from depression. Stay connected, to the natural world and to other people, and live a happier, longer life. A walk in the woods, hike in the hills, and a stroll on the beach help remind us of the continuous cycle of life on earth. Stay attached to a network of people through volunteering, taking a more active role in the community, learning new skills, or by getting involved in other ways with the world. All of these are life-affirming actions that can be very rewarding.