It is time to get real discussing the journey of menopause and what it means for women. We talk about and prepare our daughters for the onset of menses and educate about fertility. It is so essential that schools incorporate the subject. Then, we talk a lot about pregnancy and celebrate that beautiful gift. But, when it comes to menopause and peri-menopause (a very important concept) we are sorely lacking in our resources and often get conflicting advice or worse, that it is inevitable to suffer.
Let’s start with some definitions. Most of us refer to menopause as the time in life when we stop having periods. And, the definition of menopause is actually, “when a woman goes 12 consecutive months without a period”, so technically this general thought is right on the money. But, let me introduce to you the concept of “peri-menopause” and encourage you to examine and recognize it in your own life. Whether we are talking about peri-menopause, menopause or post-menopause (the term used to describe the rest of our lives after menopause) it is important to understand that this is part of a continuum of gradual decline in hormone levels. This actually applies to both men and women and usually starts in our early 40s. It is somewhat sneaky, this process. It is easy to identify the classic symptoms associated with female menopause, the hot flashes, night sweats and changes in our cycle, but there is so much more to it. I say this is a sneaky process because so many things we struggle with in mid-life are attributed to stressful lifestyles and aging. Things such as difficulty sleeping, urinary urgency, lack of energy or motivation, skin changes in loss of elasticity and dryness, brain fog or trouble concentrating, irritability or even depression and anxiety. Sometimes it is the 10 pounds that we can’t seem to lose no matter what we eat or how many calories we burn. We accept that this is what life is like and don’t recognize that is may correlate with hormonal decline. When we become in tune with our own symptoms and understand the biology behind the proverbial curtain, we are better equipped to address these extremely frustrating things. Peri-menopause can include up to 10 years before our periods cease. And, symptoms often last 10 years post menopause. So, this is no short-term phase of life! It is a good chunk of time and one in which I suggest we embrace and mold to become better versions of ourselves. Not heavier, more exhausted or less productive versions.
How do you know where you are in this continuum of your hormonal decline? Well, labs can help, but only as a small piece of the puzzle. Hormonal levels vary from day to day and really even hour to hour. It absolutely takes some introspection and being “in tune” with your mind and body to take stock in how you feel. Like I said earlier, signs can be sneaky and easily chalked up to “life” and our circumstances. I encourage you not to ignore nagging frustrations. Then, it takes a conversation with a caring practitioner who will validate your suspicions and interpret your lab values with the lens of knowing how you are experiencing life currently. Each of us has a very unique experience with this journey. I always celebrate the patients that I talk with that actually feel really good and full of vitality. Unfortunately they are few and far between. Most of us deal with some of the things discussed above and we are complex in our individuality. Taking the path to addressing these issues is not a “one size fits all”. What worked for your sister or best friend may not be the answer for you.
What options are there? Traditionally, women were given synthetic hormones at the time of menopause to combat the more universal symptoms of night sweats and hot flashes. These have been around and were widely used since the 1940s. Premarin is one of the drugs used in this traditional therapy and is derived from pregnant mare urine. Yes, horse urine, as unappetizing as it sounds. In 2002, the results of a large retrospective research study (WHI trial) revealed that traditional, synthetic hormone replacement had a slightly but statistically significant increased risk for breast cancer, stroke and blood clots. Rightly so, this caused the medical community to pause and consider the utility of this type of hormone replacement. What is so important for us to understand is that synthetic hormones (and those derived from pregnant horses) are not the only option. Fortunately, bio-identical hormone replacement therapy (BHRT) is extremely safe and actually much more effective in treating ALL the symptoms of peri-menopause, menopause and beyond. These are exactly what the name states, identical to our own natural hormones. That being said, even natural hormone replacement isn’t right for everyone and it shouldn’t be the only tool in your tool belt! Stress management, mindfulness, optimal nutrition and exercise are essential to treating your whole person to achieve the best you.
It is my sincere hope and belief that someday all physicians and providers will be well versed in treating this important stage in life. In the meantime, this is a pendulum shift that is being championed by YOU! The health seeker and savvy consumer. Women are smart and complex and recognize that there might be a better option than what traditionally has been a short conversation with their physicians. This conversation is usually limited and almost certainly involves the concept that it is an inevitable, normal part of life to experience decline in our function and vitality. But, as we as providers become better listeners, have more tools medically and include practical education surrounding nutrition and lifestyle then I believe our daughters and future generations will surely benefit.
So, I encourage you to embrace whichever chapter of life you’re in currently. Equip yourself with the tools to stack the deck in your favor. Educate yourself about your choices. Be proactive and petition for your voice to be heard. Ask questions and be a champion for yourself and your health. If you are looking for a partner for this journey, schedule your free phone consultation with me today. I love to work with patients to create a custom path to living your best life!