Features
Menopause: It'll Happen to You
Menopause:
It'll Happen to You
by Renee Lang, ND
All
women who live long enough, go through menopause. Menopause is a natural
transition of change. Currently about 50 million women in the US are menopausal.
That number will rise to nearly fifty percent of the total U.S. population
by 2014. Menopause, the permanent cessation of menstruation due to loss
of ovarian follicular activity, occurs when a women has 12 consecutive
months without a menstrual period.
The average age of menopause is 51.
However, women may go through menopause as early as 39 or as late as 54.
Surgical menopause, the removal of both ovaries, does not conform to the
above timeline. Women who have undergone surgical menopause often experience
more severe symptoms and require a period of hormone replacement therapy
to treat symptoms and prevent osteoporosis.
In the three to five years prior to
menopause, called perimenopause, a woman may begin to experience a variety
of common symptoms including: hot flashes, waking in the middle of the
night around 2-3 am “for no apparent reason,” night sweats,
irritability, depression/anxiety, fatigue, irregular menses, memory loss,
brain fog, decreased libido, insomnia, and poor concentration.
However, no rule exists stating that
a woman must experience any of these symptoms. In fact, in some cultures
women don’t have any symptoms, and look forward to ending their
“duties” of childbearing to become wise elders.
Lesbians of course, experience menopause.
However, some social and cultural differences exist between lesbians and
heterosexual women. An obvious difference lies in the fact that two women
create a lesbian partnership. Thus the experience of menopause will either
happen twice if they differ in age, or two women will be going through
menopause at the same time.
Is this a blessing or something else?
Do these women support one another through the new and strange symptoms
each experience? Do they suffer brain fog at the same time, lose important
documents, miss appointments, forget to lock the doors, and forget to
feed the cats? Is one woman’s libido gone and the other one experiencing
an elevated libido? The answer to these questions depends on the particular
relationship, and may change daily or weekly.
Whatever the specifics, lesbians enjoy
the unique opportunity to share their menopause experience with another
woman intimately and on a daily basis, an experience that may be unknown
to and often desired by heterosexual women.
Menopause brings not only the possible plethora
of symptoms listed above, but also physical changes. You’ve heard
of the “freshman ten?” Well, get ready for the “meno-ten.”
Most women gain about ten pounds as they progress through menopause. The
weight gain usually occurs in the belly and around the hips. Though distressing
to many women, this fat distribution serves an important purpose - Mother
Nature knew what she was doing. Weight gain in this area protects bone
health and density as ovarian estrogen levels decline. So the next time
you look down and see your new protruding belly, thank Mother Nature for
protecting your bones.
Additional physical changes may include
wrinkles, vaginal dryness, vaginal atrophy (thinning of vaginal tissue),
hair thinning, and thyroid changes. These changes occur primarily due
to loss of estrogen.
Women on thyroid replacement therapy may
need to adjust their dose while going through menopause. However, the
fluctuations should normalize in post-menopause. Hair thinning may be
caused by multiple factors and should be investigated if excessive or
worrisome.
Vaginal dryness and atrophy may present
with irritation,
sharp shooting, pin-like pain, or bleeding. These symptoms may only occur
with sexual activity or if severe, may occur anytime. Treatment ranges
from using lube to herbal preparations to hormone creams. The decision
to treat rests on the desire of each woman and the extent to which quality
of life is affected.
Diagnosis of menopause results primarily
from the symptomatic picture and clinical assessment of the menstrual
cycle, and from family history. If a diagnosis cannot be determined from
this information, then testing for elevated blood levels of the hormone
FSH provides a definitive diagnosis.
However, the most effective way to determine
if a woman is beginning her transition is to listen to her and to assess
her array of symptoms. Her age and prior-year menstrual history provide
a clear picture of where she may be in the transition process.
Menopause is not a disease. No absolute
requirement for treatment exists. Each woman determines whether or not
she needs treatment. If her quality of life remains unaffected by her
symptoms, she may not need any treatment. However, some asymptomatic women
may need treatment due to the increased susceptibility of post-menopausal
women to other conditions. If risk factors or family history exist for
these conditions then preventative measures must be put in place.
These conditions include osteoporosis,
arthritis, breast cancer, and heart disease, which is the number one killer
of woman.
Many treatment options exist for those seeking
help including (in ascending order of invasiveness): diet and lifestyle
changes, homeopathy, supplements and herbal remedies, and bio-identical
hormones. I do not recommend synthetic hormones at all due to recent evidence
of increased health risks including breast cancer, heart disease, and
stroke.
These increased risks may be associated
more with the synthetic progestins than the synthetic estrogens. However,
I won’t take the risk with my patients’ health by using either
of them. In fact, I rarely need to prescribe any oral hormone replacement
therapy for symptom management. Diet and lifestyle changes, herbal preparations,
and vitamin/mineral therapy adequately address symptoms in the majority
of my patients.
These therapies treat the underlying
cause of the many menopausal symptoms including adrenal fatigue and burnout.
Dr. Renée Lang is a licensed naturopathic physician practicing
at The Healing Way clinic in Brattleboro. Dr. Lang provides naturopathic
options for women’s health, cancer, chronic illness, mood and substance
abuse disorders, and digestive disorders. Visit her website at www.thehealingway.net
or call 802-254-4369, for more information.