Menopause & perimenopause

What I love about menopause

Understanding what menopause is —
and how to make these the most vibrant years of your life

by Marcelle Pick, OB/GYN NP

Topics covered in this article:

• The gifts of menopause and post-menopause for women
• Stamping out the stigma of menopause
• The journey to menopause: midlife transitions
• The Women to Women approach to menopause
• How to make your menopause positive and joyful
• A final word on menopause and post-menopause

It astounds me that women are still being told that (and treated as if) menopause and midlife are a disease — something to be avoided at all costs — when the very opposite is true. Menopause is a gift, a lantern lighting the way to significant transformation in all areas of your life. I want you to know, unequivocally, that you can feel and look better than you ever imagined after menopause, even if your symptoms right now are terrible. It just takes a little help and a lot of self-care. I know this to be true because I’ve experienced it myself and I’ve seen it time and again in my medical practice.

Women to Women sometimes feels like an island surrounded by a sea of negative thinking — especially when it comes to menopause. But from where I sit, the view of midlife is gorgeous: the waters are Caribbean blue, the skies balmy, and the horizon has never looked brighter.

Menopause is a developmental milestone in women’s health— like puberty in reverse — and it’s different for every woman. The word menopause comes from two Greek words: menos or “month,” and pausis or “cease.” At menopause, your ovarian function declines, your menstruation cycle stops, and the monthly spike of reproductive hormones recedes.

This does not mean your body stops making sex hormones altogether — it means you don’t get your period and, if you haven’t menstruated for over 12 months, you almost certainly won’t get pregnant. So go ahead and throw out those tampons and Kotex and buy yourself some nice new underwear. The cessation of monthly cycles can be incredibly liberating.

This doesn’t mean there won’t be some stormy seas. It means that paradise doesn’t come in a pill — it comes from finding out who you really are, what your body really needs, and what you really want to do with this part of your life.

So let’s brave this new sea and swim for shore — I promise you, the water is fine.

The gifts of menopause and post-menopause for women

Once a woman reaches menopause, life gets simpler. Post-menopausal women can maintain regular cycles of energy with much less fatigue. Plus, strange food cravings and binges disappear, as do monthly mood swings and breast tenderness. And there are no more awkward moments walking backwards out of a restaurant with your sweater tied around your hips.

The secret no one tells you is that midlife can be the most radiant, passionate years of your life. Self-knowledge and self-confidence are the true gifts of menopause — they create an inner glow that more than cancels out other physical changes. One patient describes it as finally owning her skin after years of struggling to pay rent.

You may be asking: what about aging, wrinkles and weight gain? What about becoming metaphorically invisible? Surely there must be something backing up those dried-up menopause clichés. After all, if menopause is so great how come there’s so much bad press?

Well, it’s a fact that everyone gets older every day and this comes with some inevitable physical changes — it’s a price we all pay for getting to stick around. Gravity does exert its pull — but menopause is not the wicked witch. She does not drain women of any vital function nor turn them old, weak, crotchety, or unattractive with a wave of her wand. We do that to ourselves by buying into a prepackaged idea of what being older (and younger) means.

It’s time to retire that tired old stereotype of the post-menopausal woman and take a good look at the real women who are living it.

Stamping out the stigma of menopause

Lauren Bacall once said during midlife, “I am not a has-been, I’m a will-be.”

Just think of the number of highly successful, gorgeous women now in their 50’s and beyond (Kim Basinger, Oprah, Vera Wang, Diane Sawyer, Patti Labelle, Goldie Hawn, Suzanne Somers), and you get an exciting look at the new face of menopause. There’s a reason they’re saying that 50 is the new 30.

These women — and the list gets longer everyday — are defying the stereotype and shifting the public’s attitude. They are sensual and accomplished and no one really cares when or whether they’ve stopped menstruating. Think of the women you most admire — chances are they are not twenty, or even thirty-something. Baby-boomer women have changed the world already, and in menopause they will do it again.

Yet even with these living, breathing, dynamic beacons, the stigma of menopause has staying power. Why? Partially, it’s our youth-obsessed culture, and partially we’re hard-wired as all species are to place a greater value on the attributes that make us mate-able. (Outward signs of abundant sex hormones are on the top of that list.)

But aside from biology, something else is happening.

Symptoms of menopause begin to bother many women (but not all) at a particularly stressful juncture in their lives. Often they are dealing with aging parents. If you have children, it’s likely that they are almost grown but still requiring a great deal of attention. If you are working, you may be feeling pressure from younger workers angling for your job. Increasingly, bittersweet reminders show you that time is passing — all of which can weigh you down and make you feel stuck.

And that’s just when menopause comes to the rescue.

The journey to menopause: midlife transitions

When we talk about menopause, we usually think of it as a transition or change. In reality, menopause is a destination — the date on which it has been a year since you’ve had a menstrual period. The journey we take to get there is more accurately referred to as perimenopause and can begin many years — even decades — earlier and be marked by all the stresses I mentioned above. This often leads to symptoms of hormonal imbalance as a woman’s body struggles to cope.

These physical changes can be unsettling (and for the unlucky few, a living hell). The road to menopause has an unmasking effect on your biology. Physical conditions that were hidden by higher estrogen levels reveal themselves. Emotional issues — often left over from childhood — resurface unexpectedly. You may find yourself awash in unfamiliar, unwanted sensations. Many women in perimenopause feel out of control, miserable, and powerless.

Understand that these symptoms are actually urgent requests from your body for attention — big red flags signaling to you to slow down the train. If you take the time to pay attention, they’ll stop.

If I know one thing from all my years of practice it is this: no woman has to suffer during this time in her life. But you do have to tune in and act — the more severe the symptoms, the more diligent you’ll need to be.

This can take time and a lot of women can’t do it alone — a reality that HRT can postpone but not avoid. Eventually, you will have to discover the missing pieces of your individual puzzle — and it may not be easy (that’s why I call it work).

Often the most uncomfortable symptoms stem from adrenal exhaustion or a poorly functioning digestive tract. It takes a good partnership between you and your practitioner to identify and address those issues before you can even begin to talk about hormones.

But that’s why menopause is so great — it forces you to finally come home to yourself, to really understand what makes you who you are, whether you want to or not.

The Women to Women approach to menopause

At Women to Women, we think of menopause as a critical time in a woman’s lifecycle: one in which we help our patients interpret what their bodies are saying. We call it identifying their emotional and physical roadmap. Every woman has one and each one is different.

For some women this roadmap takes them on a relatively straightforward journey, others need a lot of help to untangle years of physical and emotional knots. What works for one woman may not work for another and you may need a professional (or several) to support you in the process.

Helping women to begin this transformative and empowering journey was one of the inspirations for our Personal Program — we wanted to share what we know to be true with as many women as we can, but keep in mind it’s only the foundation. I encourage you to find some trusted health professionals and learn as much as you can. Like I said, the water may get choppy at times but the rewards are phenomenal if you keep your head up and swim.

How to make your menopause positive and joyful

Start with your core foundation of health. If you have not found a doctor or health professional you can talk openly with about menopause, try another. Take a medical-grade vitamin supplement on a daily basis to fill in any nutritional gaps and support hormonal balance. We prefer those that are readily absorbed and contain a rich supply of omega-3’s, vitamins, minerals, and other nutrients. Eat a balanced diet of whole foods, including a good ratio of protein, carbohydrates, healthy fats, and fiber. Limit your exposure to toxins by purchasing organic foods whenever possible. Drink at least eight glasses of filtered water a day and limit caffeine and alcohol. If you are smoking, get help to stop. Get some fresh air and exercise daily — 30 minutes or more, if you can.

If you think you’re experiencing symptoms of hormone imbalance, take our Hormonal Health Profile. This is a good place to start, and it’s free! Determining whether your symptoms are mild, moderate, or severe will give you some insight into what kind of work lies ahead. Don’t worry if your symptoms are severe — often my patients who feel the worst recover the fastest.

Many women trying to restore their hormonal balance will benefit from progesterone support, at least in the beginning of their efforts. Progesterone is a building block for estrogen and other hormones, so your body can use it in an adaptogenic way to restore hormonal balance.

So many women we see are in the throes of adrenal fatigue and don’t know it. Cortisol is a major hormone, and until it’s in balance you won’t be able to balance your estrogen and other sex hormones. So if your body isn’t responding to the fundamental steps we’ve already discussed, learn about this problem and figure out if it’s blocking your progress.

If your symptoms don’t respond to these basic steps, you might want to discuss hormone replacement therapy alternatives with your healthcare practitioner. Many of my patients go on bioidentical hormones in perimenopause and for some time after menopause. They do so for various health reasons, but also because they think they look better — which makes them feel better. When they feel better, they have the energy to do some of the emotional work that helps them grow from the inside. This in turn gives them the confidence to take care of themselves so they don’t have to take the hormones anymore.

Don’t ignore any issues of vaginal dryness and loss of sexual libido. One of my patients began the most passionate marriage of her life at age 60 — proof positive that sex is as good if not better later in life. Topical estrogen creams containing estriol will help the dryness that often accompanies the drop in blood estrogen levels at menopause. Bioidentical hormones and exercise are also helpful in this area.

At some point it’s essential that you examine the relationship between your emotional experience and health. Examine unhealthy habits and relationships. As you look inward, building your cocoon, ask yourself what and whom you want to bring along with you. If you are weighed down by your relationships (to others, to work, to food), find someone to talk to. Ask your friends or family for a referral. Your local religious institution or your healthcare practitioner is a good place to start.

Read our article on alternative medicine for information on different techniques that can help you with intractable symptoms or to give you new insight into yourself and your total well-being.

Try a lifecoach. Lifecoaching is a targeted therapy that helps people of all ages discover what they are inherently good at and what kind of work/relationships would give them the most satisfaction. There are life coaches in almost every part of the nation. For more information on this process, log on to Cheryl Richardson’s website. Think about the things you love to do in your leisure time: listening to music, decorating, knitting, reading — they can be a launching pad to something new.

Have a financial health check-up. This is an area many women find intimidating, but it is a crucial part of your personal life picture. If you don’t understand what’s happening with your money, chances are you won’t have very much of it. Talk to your local bank or business bureau for information about upcoming seminars and training sessions. You may also like Suze Orman’s website.

Don’t be afraid to express yourself. You’ve got a lot to say! A majority of women at this time find they no longer have patience for the incessant demands of others; they are more in touch with their emotions, including anger, and begin to figure out that now is the time to put themselves and their own well-being first. This is a good thing! Besides, you’ve earned the right to speak your mind — it’s one of the perks of being on the planet a little longer. Start a journal or buy a sketchbook and record your thoughts as you make this journey. Most of all enjoy yourself and have a little fun!

Go ahead, be high-maintenance! This can mean many things, from treating yourself to some expensive bath oil or a new haircut to exploring plastic surgery. Often women go through such an amazing emotional transformation at menopause that they feel their outside doesn’t reflect their inside anymore. (We do recommend you start from the inside out — not the other way ‘round!)

If there is something that doesn’t feel like the real you (maybe you’re hiding your inner redhead), change it. At age 58, one of my patients finally spent the money to get a bunion shaved off her foot that she’d had for 20 years. No one saw it, but she knew — and it made her feel great.

Read and learn as much as you can. There are many wonderful books on Women to Women’s reading list on menopause. I also like Suzanne Somers’s The Sexy Years. Another lovely book edited by Connie Goldman called The Ageless Spirit, gathers essays about getting older — from both men and women — that are very inspirational.

A final word on menopause and post-menopause

Whatever age you are right now, I encourage you to look inside and listen to your body’s signals. If you are unhealthy or unhappy, don’t ignore it or surrender. If you are worried about menopause, or post-menopause, ask yourself why? Whose voice are you hearing when you think about aging?

Changing your perspective on what it means to get older is a powerful first step in changing how you will age. I can’t promise that you will ever be 21 again, but I can promise you that if you eat well, take your nutrients, and make some positive lifestyle choices, you will be something — triumphantly — else.

 

Original Publication Date: 10/15/2002
Last Modified: 02/16/2010
Principal Author: Marcelle Pick, OB/GYN NP