Dr. Lovera Miller: A hundred years ago, [few] women lived long enough to reach menopause. There was nothing to talk about. Today, women live half of their lives in perimenopause and beyond. In the United States, 6,000 women reach menopause every single day. Education and awareness has not been able to catch up with the improvement in life expectancy, which is why we wrote Womenopause. Women can actually be healthier, happier, keener, leaner and sexier at age 60 than they were at 40, instead of dying at 40. Patients are embarrassed, doctors are embarrassed, and most do not know how to start the conversation.
Dr. Lovera Miller: Women need to be given permission. My patients are given a wScore sheet to fill out when they first arrive, where they grade themselves on all aspects and symptoms of menopause. An example of the wScore is found in our book, Womenopause. The form captures the degree of severity for common menopausal complaints such as hot flashes, night sweats, insomnia, mood, memory, arthritis, bladder problems and sex. There is no right answer, no right score. This empowers the woman to know herself, how she has improved and where she still needs or wants help. Women want frank discussion in a warm, comfortable, relaxed and confidential setting.
Dr. Lovera Miller: Perimenopause begins around age 40 (but may begin in the late 30s), when periods start to be irregular and symptoms begin. Mood disturbance and insomnia may precede menstrual irregularities by several years. Menopause is one moment in time, the final menstrual period, only known and identified after one year of no periods. It usually takes place around age 51 (plus or minus 10 years). Postmenopause is all the time thereafter, hopefully a very long time. No matter what a woman's age, today is the best day to commit to living the best possible life, which includes big-ticket items like regular exercise, sensible whole-food diet, alcohol in moderation and smoking cessation.
Dr. Lovera Miller: A resounding yes, and sex improves sex. Sexuality encompasses many aspects: partner relationship, mood, health, body image, timing, environment, estrogen and testosterone. All of these need to be nurtured and promoted. Withdrawal of estrogen (perimenopause) and deficiency of estrogen (menopause) may cause a dry, painful vagina, leading to avoidance of intercourse, wreaking havoc with sexuality and relationships. Exercise, fish oil, vitamin D and sex help restore the vaginal health. Mineral oil, olive oil and vitamin E oil moisturize and lubricate the vagina. Cetaphil cleanser and RepHresh balance the pH of the vagina. Local estrogen cream, which does not go to the rest of the body, replenishes the blood supply, the elasticity, the lubrication, the arousal, the pH, the folds, the size of the vagina and the labia. Testosterone improves sense of well-being, sexual desire and orgasm. Children are often gone, jobs are secure, there is now more time to explore new adventures and celebrate sex.
Dr. Lovera Miller:
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