What part of menopause don't you get?

4 years ago




Lots of questions and concerns…. That’s the part of menopause that I understand and can impact positively for my friends, family and readers wanting to know more about this life changing, physiological event every woman experiences.  

No surprise there is consternation when what I hear from women, read in books and see in advertisements is: My body is changing in a bulkier kind of way; my periods have become irregular and heavier; I am moody; I am tired; I am hot flashing; I am told I have bone loss and I lost my desire for sex.   Hopefully, some of the anxiety due to the less than pleasant parts of the change (or should I say:  THE CHANGE!) will be reduced when there is better understanding.  

One of my very favorite bloggers, HomeRearedChef, has been writing about menopause and requested that I do an elaineR.N. VLOG on the topic.  While her posts are laugh out loud funny and reflect what a lot of aging women go through physically, there is a certain angst and despair to her observations.   She does all women a good service, though, by raising awareness of some of the more disquieting aspects of menopause through her stories about her own personal experiences.

While I tend to be less a storyteller and more of a fact presenter, I think there is a place for both.  That is why, on this topic, I will leave the experience to HomeRearedChef and provide facts and access to options for reducing the negative symptoms some women experience.  One point I want to emphasize before I begin is that the symptoms of menopause have a physical reason for their occurrence.  It isn’t in your head – or as I have read in some old self-help books, a figment of your imagination that a hot cup of “tonic” could cure.  

What is menopause?  Menopause happens when a woman’s ovaries stop producing estrogen and progesterone.  Actually, a woman is premenopausal until her periods stop for a year, then she is considered to be in menopause.  As this is a gradual process, it can take some women up to 10 years to have an actual cessation of her periods.  Good news, for some:  You can no longer get pregnant after menopause; for others, no more periods.   

Do all women go through menopause?  Yes,  though some women may experience menopause through the surgical removal of her ovaries.  For them, symptoms are experienced because of the abrupt decrease of hormone levels.   Some women being treated with chemotherapy and radiation may experience menopause too.  And, women with Primary Ovarian Insufficiency, (approximately 1% under the age of 40) whose ovaries stop producing normal levels of estrogen and progesterone, may experience menopause.   Also to note, not all women are happy about not being able to get pregnant any longer.  For some, it is a real loss that must be mourned.  

How do hormone changes relate to irregular and/or heavy periods?  Perimenopause can happen as early as the 30s.  That is when women begin to notice a change in the menstrual cycle and flow due to the hormone changes that regulate menstruation.  Periods can become heavier or lighter.  And, cycles can become shorter or longer until periods stop completely.   

Heavy periods are because there is less progesterone regulating the monthly development of the endometrium, the uterine lining.  The lining may become thicker before it’s shed, resulting in very heavy periods.  Medical experts warn that it should NOT be assumed that just because your periods are changing it is due to menopause.  If you note spotting or bleeding between periods you should let you Health Care Provider (HCP) know.  And, if you have stopped periods for a year and then begin spotting let your HCP know, as cancer or another health issue could cause it.  

What is with the belly fat??  (note the double ??, that is because belly blubber is my own personal angst)  Yep, the answer is hormone changes.  Those changes are more likely to cause weight gain around the abdomen rather then the thighs and hips.  That, along with genetics, is mostly responsible.  However, the good news is that life style can make a difference.  Exercise and healthy eating are a great ways to counter your natural predisposition to belly bulking.  

What is the relationship between hot flashes and hormone changes?  Also called hot flushes, the actual reason isn’t known.  However, the hormone changes somehow influence your body’s thermostat or hypothalamus.  For some women, the hot flashes can disturb sleep, which can lead to anxiety, depression and memory issues.  While we joke about hot flashes, there is nothing funny when being rousted at 3:00 a.m. night after night with the sweats.  The Mayo Clinic site offers some advice on what to do about hot flashes beyond just sleeping naked or throwing your clothes off in public places.   

Why am I so moody and depressed?  The North American Menopause Society (NAMS), is a wonderful resource to better understand why some women get boohooey while in the premenopausal state of being.  They offer reassurance that this can be related to hormone fluctuations.  Important to note is that women who suffered from PMS depression are more inclined to suffer from mood changes when in perimenopause.  NAMS offers treatment options that you can explore.  It is always helpful to discuss what you are considering with your HCP, so you can make decisions together on what may be the best choices for your unique being.  

What is the relationship between osteoporosis and menopause?  
Osteoporosis, which means porous bone, is the loss of bone mass and strength.  It can lead to pain and fractures.  While the exact cause of osteoporosis is unknown, there is a direct relationship between it and the lack of estrogen after menopause.  It seems that after menopause, bone breakdown is greater then bone building.  The Cleveland Clinic offers a very helpful summary of osteoporosis, along with treatment options.  

Why has my sex drive declined?  It seems that low sexual desire is one of the more angst producing menopausal-related symptoms,  yet can it brings about some of the more humorous dialogue.  In fact, it was HomeRearedChef’s recent featured BlogHer post: http://www.blogher.com/menopausal-malfunction-vagina-out-order
that prompted me to write this post.

Virginia is looking for spicy from me on the subject.  Perhaps when a group of us are together sharing a bottle of wine and talking life’s issues she will get spice along with saucy.  Right now though I will take the virtual baton that Virginia is passing me, as we informally team up on menopause, and will stay elaineR.N. in support hose, white shoes and uniform.  The reason being is that for many women reduced sexual desire is a serious and complex problem impacting important relationships.  There can be multiple reasons for the loss of desire.  For some, it is related to body image; a traumatic event; or a partner who is not supportive.  For others sexual intercourse may be painful because of vaginal dryness due to decreased estrogen levels.   For other women, their testosterone levels are low (yes, women have testosterone) and that hormone impacts desire too.  

As  I said, low sexual desire is a very complex topic and my answer just barely touches on the subject.  However, Dr. Laura Berman offers some background and some very realistic solutions for those of you looking for advise from a sex expert.   Check out 10 keys to great sex during menopause:  http://www.drlauraberman.com/sexual-health/menopause-and-midlife/great-…

Please let me know if you have any questions about menopause, as I am happy to help in any way.  While I can’t diagnose, I can provide information and, hopefully, understanding.  Also I can point you to some solutions to consider.   Also, if there is a topic here that you would like me to expand on, I am happy to do that too.

I will end with a thank you to Virginia for inspiring this post.

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