While earlier generations may have suffered through menopause in silence, today’s middle-aged women have embraced the inevitable “change of life” with a certain openness and often with a raw sense of humor. T-shirts, cocktail napkins, and even bumper stickers openly and boldly poke fun with slogans like: “I’m hotter than I look!”, “I’m still HOT – it just comes in flashes!” and “Menopause – it’s the new puberty!” However, when the laughter subsides, most women would agree that menopause is really no laughing matter. It comes with some very real and challenging changes in a woman’s body.
A Modern Woman’s Approach to Managing Menopause
By Linda Benton
Menopause is defined as the point in a woman’s life when her reproductive capabilities come to an end. The ovaries no longer produce eggs, and the menstrual cycle ends. Estrogen and progesterone levels decline, and with the declining hormonal levels, symptoms such as hot flashes, mood swings, sleeplessness, and loss of sexual desire begin. The age of onset varies greatly but can be expected anytime between the age of 40 and 58. The transition phase of menopause, known as perimenopause, is characterized by irregular periods and perhaps a few other symptoms of menopause, but with one very distinct factor. A woman can still get pregnant during the perimenopausal phase and diligence in using birth control is imperative to prevent unwanted pregnancies. The median age for complete menopause is 51. A woman is considered to have gone through menopause when she has not had a period for over one year.
Just as the age of onset varies, so does the severity of symptoms. When severe, the symptoms can threaten career, marriage, and personal self-esteem. “Because menopause can sometimes be debilitating, it must be addressed,” says Dr. Emily Reeves of Women’s Institute for Specialized Health. Reeves encourages women to have an open discussion about any troubling symptoms of menopause with their physician. “Together, we can work towards solutions that will improve quality of life,” she adds.
Reeves recommends that her patients engage in regular exercise, establish a solid sleep routine, consume minimal alcohol and caffeine, and establish a good weight-maintenance or weight-loss program to minimize the adverse symptoms. In some cases, a mild anti-depressant may be prescribed short term to relieve mood-related symptoms.
Some healthcare providers advocate the use of “natural remedies,” but Reeves cautions that “natural” does not always mean best. “Dietary supplements like black cohosh claim to reduce symptoms, but studies have also shown it to have adverse reactions to blood pressure levels as well,” she explains. Some experts suggest vitamin B complex, vitamin E, and soy, although no medical case studies have conclusively proven that these supplements effectively alter menopausal symptoms.
Hormonal replacement therapy, known as HRT, ERT, and SERM, is the only FDA-approved treatment for menopause; however, conflicting medical reports have left the general public confused. Do the benefits outweigh the risks? According to Dr. Chris Mullin of Life Circle Women’s Healthcare of Cleveland, Tennessee, hormone replacement therapy (HRT) is often indicated for women, who through menopause or hysterectomy are suffering severe, disabling symptoms.
While linked to an increased risk of breast cancer, heart disease, and stroke, Mullin says there is conflicting evidence. Age, family history, and duration of HRT have contributed to the mixed findings. “Hormone replacement therapy has been a treatment modality since the 1930s; however, in the early years, higher doses of the hormones were prescribed,” says Mullin. “Today, the doses are much lower, and the potential risks much smaller. For many women, the improved quality of life certainly outweighs the small risk.”
The current recommendations for women who are candidates for hormone therapies are to take the lowest possible dose of hormones needed to relieve the symptoms of menopause and/or prevent osteoporosis. It is recommended to limit the use of the hormones to the shortest time period, typically no more than a couple of years, and, as with any prescription medication, the therapy should be re-evaluated every 6-12 months. Hormonal patches, creams, gels, and vaginal rings may be alternatives to the traditional pills. While Mullin agrees that HRT is right for some women, he always encourages his patients to incorporate a healthy lifestyle first to minimize symptoms. “Typically, patients who are involved in a sport or active lifestyle seem to suffer fewer symptoms from menopause,” he adds.
While most women feel free to joke around about hot flashes, mood swings, and brain fog, they often feel intimidated about discussing some of menopause’s most challenging symptoms — loss of libido and vaginal dryness. The later issue may be easily solved with over-the-counter suppositories. Vaginal suppositories, like K-Y Liquibeads and Replens, often provide adequate moisture to the vagina, making sexual relations more comfortable. However, when over-the-counter products are ineffective, prescription creams and suppositories containing extremely small doses of estrogen can be effective in controlling vaginal dryness.
Unfortunately, dealing with loss of libido is not as easily solved as vaginal dryness. It is a complex issue involving hormonal and physical changes, a change in the role of a woman in a relationship, and the societal pressures of youth and beauty. While entering a new phase of life free from pregnancy worries can be liberating for some women, it can be sad for others to put their childbearing role behind them. Open communication is a key element for couples during the transition. Giving special attention to understanding the needs of both people in the relationship can ease the strain.
“Women often feel intimidated about discussing some of menopause’s most challenging symptoms.”
Learning to accept menopause as just one of the many “changes” our body experiences in the journey of life may be the best approach. Meditation, journaling, and even trying a new sport or hobby can redirect the negative thoughts that often accompany menopause. Perhaps a different bumper sticker sentiment actually sums it up best: “If nothing ever changed, there would be no butterflies.” Don’t let menopause manage you; instead, manage your menopause. Spread your wings and fly; just see where life takes you.
Linda Benton is a resident of Signal Mountain. She earned the distinction of Magna cum Laude with a BBA in Marketing from the University of Memphis. Linda has been an active member and leader of community and health organizations, and is currently serving as a member of the Chattanooga/Hamilton County Medical Alliance. She is married to Dr. Oliver Benton III and has three children.Resource websites: www.webmd.com; www.hotmamas.com