Menopause
Menopause
A Kind of Midlife Puberty
Today, as baby boomers move into midlife with a whole new mind-set, menopause doesn't have quite the alarming effect that it used to. Yet it remains a time of profound transformation in a woman's life, as her ovaries start shutting down and production of the female hormone estrogen plummets, signaling an end to her childbearing years.
"Menopause is a perfectly normal process that occurs over several years," points out M. Eileen Beiler, Psy.D., a psychologist in Dallas and adjunct faculty member in the Department of Psychiatry and Division of Psychology at the University of Texas Southwestern Medical Center at Dallas. She says that in a group she leads for women in transition, "Menopause is compared with puberty. Remembering the process of adapting to those earlier changes can help put current changes in a familiar perspective."
The physical and emotional changes associated with menopause vary from woman to woman, but may include hot flashes, insomnia, mood swings and memory difficulties, to name a few. And some women--up to 38 percent, according to estimates--experience no symptoms whatsoever.
ATTITUDE COUNTS
If your doctor has determined that you are going through menopause, you and she may decide on hormone replacement therapy to deal with some of the symptoms--or maybe not. (For nondrug ways to deal with other bothersome changes, read about hot flashes, insomnia and mood swings on pages 292, 317 and 374.)
Women doctors offer expert advice on ways to cope with other, more general aspects of menopause.
Acknowledge sadness. If menopause feels like a loss, allow yourself to feel sad about it, says Dr. Beiler. "But remember that the ability to have a child is only one way to define yourself as a woman. Everybody experiences menopause very differently. Some women are happy to not have to worry about birth control and periods anymore."
When To See A Doctor
Menopause isn't a disease, so you don't necessarily need to see your doctor unless you are very uncomfortable, are experiencing very early signs of menopause (before age 40) or you're just plain curious, says Liliana Gaynor, M.D., D.D.S., clinical assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Medical School in Chicago. Your physician can perform a blood test measuring follicle-stimulating hormone, or FSH. This female hormone shows up if you're approaching menopause, even if you're still having periods. The higher your blood levels of FSH, the closer you are to menopause. A woman who thinks that she may be experiencing premature menopause (before age 40) and wants to have a child should see her physician or a fertility specialist immediately, says Margory Gass, M.D., director of the University Hospital Menopause and Osteoporosis Center at the University of Cincinnati. With prompt treatment, it may still be possible to sustain a pregnancy. Donor egg programs are available at some fertility centers. This allows a woman to carry a pregnancy by an in vitro procedure when she is no longer producing eggs of her own.
|
Talk to your partner. Open communication with your intimate other is especially important, says Dr. Beiler, both to "normalize" menopause and to address specific issues, such as the physical changes that can make sex uncomfortable. "Share your thoughts and concerns and get closer instead of creating distance."
Lubricate your love life. The once supple tissues of the vagina that produce lubrication become thin and dry in the absence of estrogen, which normally sends messages to the genitals to prepare for intercourse, says Mary Jane Minkin, M.D., associate clinical professor at Yale University School of Medicine and co-author of What Every Woman Needs to Know about Menopause. If sex is uncomfortable, use a lubricant like K-Y jelly or a product called Astroglide, which Dr. Minkin says is highly recommended by many of the women she counsels.
Seek emotional support. "Connecting with other women, not isolating yourself, will help you feel better," says Dr. Beiler. Check with your doctor or local hospitals for menopause support groups in your area, she suggests, "or start your own." Get together with other women friends, reminisce about your lives and plan changes that you'd each like to make in the future.
Get enough shut-eye. Hot flashes can jolt you from your sleep, says Dr. Minkin. What's more, your pituitary gland, which normally works the night shift, can wake you if it goes into overdrive because of low estrogen levels. If you need help dozing off again, try a glass of warm milk, a hot shower or an occasional sleeping pill. (Follow package directions or use only as prescribed.)
Exercise regularly. The depression that can come with menopause may be related to low levels of serotonin and endorphins, brain chemicals that influence mood, says Liliana Gaynor, M.D., D.D.S., clinical assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Medical School in Chicago. "Exercise is a form of self-medication for depression, raising the level of endorphins in the brain." Low-impact aerobic exercises like running or walking are especially helpful, two or three times a week for 30 to 60 minutes each time.
Stay away from smoke. "Smoking directly affects the production of estrogen and brings on menopause two to four years earlier," says Dr. Gaynor. And smoking while on hormone replacement therapy carries a risk of blood clots and stroke.
