The ABCs Of Menopause
A- Active Lifestyle
When I was younger, almost every workout was an all-out push. Now, I allow more recovery time between strenuous workouts and I practice what’s called “active recovery”, involving gentler, low-intensity exercise on those days. While I do something active every day, frequently it’s a low-stress activity such as walking or yoga, aimed at getting my blood circulating and staying limber.
B- Bedroom Fun
There’s hardly a menopausal symptom that exercise doesn’t improve: From low libido to fatigue to mental alertness to insomnia—exercise is my candidate for a wonder drug. When I first got involved in running, I discovered what a miraculous mood booster it could be. I could go from “I can’t do it; nobody likes me . . .” to “Hey, I’m a superstar!” in just forty-five minutes of running.
C- Cardiovascular exercise
Keeping up a walking program during perimenopause and menopause will help strengthen the heart and boost your mood.
D- Drying Vagina
Load up on Vitamin E! This supplement relieves vaginal dryness, hot flashes and protects your heart.
E- Estrogen Drop
Loss of estrogen causes the vagina to become shorter and narrower, and lose some of its elasticity. Blood supply and secretions decrease, and the vagina doesn’t lubricate as well during sex. The once succulent inner walls may become tissue-thin and dry. Intercourse can become uncomfortable or even painful. The thinner vaginal walls are also more vulnerable to infection.
The first line of defense against hot flashes is to address the triggers. This means:
- Dressing in layers
- Switching from steaming lattés to iced herbal drinks
- Using breathable 100% cotton bedding and sleepwear
- Reducing your stress through progressive relaxation, yoga, meditation, or other means (all are discussed in chapter 10 of Moving Through Menopause)
Meanwhile, inventive women have developed dozens of strategies for keeping their cool: Portable spritz fans, for instance, combine a spritzer bottle with a handheld fan. Some women install a ceiling fan over their bed. One woman I know soaks her socks in water before wearing them to bed: The water evaporates as she sleeps and helps keep her cool. In general, turning down the thermostat will help, especially at night.
G- Good Health
However varied women’s experience of menopause may be, however complex the physiologic changes, I believe it all comes down to this simple formula: The healthier you are, the easier your menopause will be.
H- Hormone Replacement Therapy
Hormone replacement can relieve some of the worst short-term symptoms of menopause. For women who’ve reached the end of their rope because of hot flashes and mood swings, HRT can be a godsend. On the other hand, it’s not an exact science. Tinkering with your hormones to find the right balance may be a trial-and-error process, and some women don’t find the relief they seek. In addition, there can be side effects and possible long-term risks of taking these drugs. Some doctors feel that most of the side effects can be avoided by taking “bioidentical” hormones (those identical to what our body produces) and by avoiding oral hormones in favor of a patch. The real gray area has to do with long-term effects of HRT—the risks and the benefits. Currently, most doctors feel HRT provides solid defense against osteoporosis and may offer some protection against heart disease, at least in healthy women. Others are optimistic about HRT’s potential for preventing or delaying Alzheimer’s disease. However, the jury’s still out on much of this. New findings are being published every day, which is why it’s so important to find a doctor who is up on the latest research.
In Chapter 12 of Moving Through Menopause, I try to provide the reader, in ten pages or so, with a clear understanding of both sides of the issue so that she can have an informed discussion with her doctor and feel that she asked all the right questions.
I- Information Gathering
It’s not easy to gather accurate information! There’s a lot of information out there and it can be very confusing for two reasons: First, women’s experiences vary widely; and second, the standard medical wisdom is changing constantly as new research comes in. Still, that “happy medium” you’re talking about is exactly what I hope to provide with my book, Moving Through Menopause.
I’ve kept a journal off and on throughout my life. I notice I tend to do it during especially emotional periods. It’s a great way to relive anxiety in the moment, and it’s also a good way to track your personal growth over time.
K- Kegel Exercises
Kegels are exercises that tone and strengthen the pubococcygius, or PC muscle—the muscle surrounding the opening of the vagina. A strong PC muscle is vital to the health of the reproductive organs. Like any other muscle in the body, the PC muscle needs regular exercise to remain firm, especially after childbirth or menopause. When done correctly, “Kegeling” can alleviate up to 90 percent of stress incontinence and heighten pleasure and sensitivity during intercourse.
L – Lifestyle measures
While not necessarily a substitute for hormone therapy or other medication, switching up your lifestyle measures are the the best starting point for everyone.
M- Mood Swings
You probably already know about the importance of limiting your intake of sugar, caffeine, and salt, but the need is even greater when you’re on that hormonal trampoline preceding menopause. Cutting back on these much overdone dietary crutches will help you avoid mood swings, weight gain and insomnia—as well as long-term threats like hypertension and bone loss.
N- Nutritional recommendations
In Moving Through Menopause, I’ll guide you through nutritional recommendations to help you keep your weight down (weight gain is a common complaint at menopause), while providing high-energy, heart-healthy fuel for daily activity.
Most women report some change in sexual function at menopause. Surveys show that women typically have fewer sexual thoughts, experience poorer lubrication, and may feel less satisfied with their partners as lovers. Frequency of intercourse often declines, and some studies show a correlation between this and declining levels of testosterone. Other changes may occur, too, such as decreased arousal and ability to orgasm.
The good news is that for many women, the changes are mild, and the majority of women report feeling satisfied with their sex lives after menopause. How you feel about any changes you experience depends on you, and your attitudes about sex. How you’ll solve them depends on the exact mix of factors causing them.
There’s a definite tendency in our culture to overreact to the approach of menopause. In my book, I quote one woman whose friends literally shunned her when she admitted to being perimenopausal, because they had this idea that menopause “would reduce them to asexual blobs, or turn them into their grandmothers overnight.” In our youth-hungry culture, any hint that we’re getting older is frightening. The truth is, 50 isn’t old at all. It’s a fantastic moment in our lives, actually, because we have experience and wisdom, and yet we still have our strength and vitality. We’re free from the physical demands of childbearing and we can now pursue any course that seems meaningful to us.
Q- Quiet Time
Stress is normal, but if you let it escalate and peak, it can start costing you sleep, or worse. That’s why it’s your responsibility to find ways to find quiet time and take the edge off.
Here are a few of my favorite emergency remedies:
- Switching the car radio to a classical station—rock music and talk radio are designed to stir you up; sometimes that’s one stimulant too many.
- A cup of herbal chai tea at my favorite teahouse—this gives me fifteen or twenty minutes of restful quiet time while I sit and drink it.
- A hot bath (just be aware that hot baths can be a hot-flash trigger).
- A yoga class.
- Deep, rhythmic breathing.
- Juggling—I love it; it forces me to clear my thoughts and be in the present!
When I turned 50 and began the move through perimenopause, the changes in my body mirrored significant changes in my life. At that time, I had recently gone through a separation and divorce. I saw my daughters poised at the brink of their teen years, knowing that soon they’d be pursuing independent lives. Like so many other women, I was trying to make sense of all the changes, and set meaningful goals for this new era. One of the most exciting outcomes of the sense of freedom I felt was the rediscovery of my female friends, who all seemed to re-emerge as the demands of family-raising ease. I realized how important these relationships are, and will continue to be.
S- Strength training exercises
Performing regular strength-training exercises will help preserve bone density while also improving sleep. Strength training and aerobic exercise have been shown to improve sleep. Don’t overexert immediately before bedtime, however. If possible, try to exercise no later than the early evening.
There are many types of hormone replacement therapy involving estrogen and progesterone, either separately or in combination. Sometimes testosterone is prescribed as well. Some formulas give you a monthly period, others don’t. Hormone therapy is available in many forms, including pills, patches, creams, drops, and injections. Some formulas are aimed at improving symptoms; some are designed only to strengthen your bones and heart; still others do both. The choice of hormone will depend on your needs, but finding just the right formula and dose for your body can be a trial-and-error process.
U- Universal Themes of Menopause
In the end of my research for Moving Through Menopause, I realized that there are three universal themes of menopause. First, the immediate hormonal symptoms, such as hot flashes and mood swings; second, the need to reexamine your life and find a deeper sense of meaning; and, finally, long term health issues, specifically heart disease and bone loss. I think every woman should consider these areas, and talk with her doctor about them. Just remember, again, that the scientific information is always being updated. For that reason, it’s a good idea to see a specialist. The doctor that delivered your baby may not be up on the latest research concerning menopause and hormone replacement.
Vitamin C gives your adrenals a boost, which will help with fatigue and may boost bone mineral density. In a study in the Journal of Bone and Mineral Research, researchers concluded that vitamin C appeared to enhance the effects of estrogen therapy and calcium supplements. Women who took 1,000 milligrams or more of the vitamin C had higher levels of bone density than those who took less.
W- Wrinkles & Changing Breasts
One of the liberating things about this stage of life is that you get to readjust your priorities a bit. What’s important now isn’t cosmetic perfection, it’s how well your body works, as well as what it says about your inner self, through qualities like posture and energy. Sure, I notice little signs of aging in my body just like everyone else. Rather than obsessing over them, though, I use them as a reminder to put more effort into things I still have control over—my physical strength and stamina, my relationships, and my place in the world.
X- X-Treme Heat
If you find you’re always the one asking whether it’s “hot in here,” you’re not alone. Hot flashes, or flushes, are the classic emblem of menopause, and, in this country at least, they affect up to 80 percent of all women.
A hot flash happens when the part of your brain that regulates body temperature gets the mistaken idea that you’re too hot. In response, your body follows its normal procedure for cooling itself, exactly as it would if you were overheated: Your heart rate speeds up, your face turns red as blood moves toward the skin’s surface, and you may break out in a sweat. Hot flashes are often followed by a chill, as your body temperature stabilizes again.
Every woman tends to have her own pattern of flashes. These can vary enormously, but they average about three and a half minutes, and usually happen three to four times a day.
Throughout perimenopause and menopause, keeping up a yoga program and other stress-reducing techniques can help keep you centered and calm.
Z – Zzz’s
I highly recommend paying attention to your sleeping patterns. Sleep is a pivotal aspect of menopause. Changing hormonal levels and symptoms like hot flashes can disrupt good sleep and leave you feeling more vulnerable the next day. To make matters worse, lack of sleep saps your energy, making it harder to exercise, thereby robbing you of the stress-reducing benefits of physical activity. That’s why I say anything you can do to improve your sleep will help you across the board. Of course, I’ve included a number of sleep-enhancing strategies in my book. In addition, I recommend a stress-reducing technique called “Breathing/Listening.” First, inhale for a count of six and exhale to a count of six. Do five cycles. Then, inhale for a count of six and hold for a count of six. As you’re holding, listen attentively to the sounds around you: a clock ticking, clothing rustling, the traffic outside—try to notice every sound, no matter how distant. Exhale for a count of six. Repeat for five cycles. The rhythmic breathing will calm your body, while the act of listening will help you tune out negative thoughts and bring you into the present.