Menopause: Understanding Your Changing Body

Every woman who goes through middle age will
experience menopause. For a fortunate few, this
transitional time is relatively easy; for many
others, "the change" is marked by a number of
physical and psychological challenges that may
leave them frustrated and physically drained. As
with any health issue, the more a woman
understands the process of menopause, the better
she will be able to deal with it.

WHAT IS MENOPAUSE?

Medically speaking, menopause is said to be the
stage of life when no menstrual periods have
occurred for a period of one year. This cessation
of menses is due to decreasing ovarian function.
In the United States, the average age is 51 years
old; however, it can happen any time from your
30s to your mid-50s or later.

It's important to understand that this process is
not a disease; it's a normal part of a woman's
life. But just as puberty can be a scary and
confusing time for young girls, the entrance to
this stage of adulthood can leave us wondering
why our bodies appear to be "rebelling" against
us or even questioning our own sanity! Our
lifestyles can also be a contributing factor in
the severity of menopausal symptoms: stress, poor
diet, and lack of good exercise habits can often
exacerbate the problems we encounter.

SIGNS AND SYMPTOMS

For some, the symptoms associated with the
changing levels of estrogen and progesterone in
their bodies may be relatively mild. For others,
however, the physical symptoms can be moderate to
severe and may include hot flashes, night sweats,
headaches, and atrophic vaginitis (inflammation
of the vagina due to thinning and shrinking
tissues and a decrease in lubrication) which can
cause burning, itching, or bleeding. Weight gain
and changes in blood pressure can also accompany
menopause.

Many women may also find themselves going through
psychological changes, as well. Fatigue, insomnia,
anxiety, depression, memory loss, mood swings,
irritability, and an inability to concentrate are
common.

TREATMENT

While this is a normal part of life, for many
women it is very difficult to deal with the
symptoms as their bodies adjust to the changes
they are going through. The good news is that
there are things we can do-often through natural
therapies-that can help. If you are experiencing
some of the symptoms listed above, you may want
to seek medical help in coping with the problems.

Many women who seek medical help for their
symptoms (particularly for anxiety and depression)
may find that their doctors are quick to
prescribe drugs such as antidepressants or
sleeping pills that simply mask their symptoms
and can lead to dependency or unwanted side
effects. This treatment can certainly be
appropriate at times, but it is often possible to
approach the root causes of the symptoms in
natural ways that are ultimately more effective.

In my practice the first step, as always, would
be a complete medical history and physical exam.
It's important to determine whether the reported
symptoms are really menopause-related or if there
are other medical conditions that need to be
taken into account as part of the treatment
program.

Laboratory tests, if indicated, can be very
helpful. For instance, if FSH (follicle-
stimulating hormone) is markedly elevated and
estrogen is depressed, this constitutes a lab
diagnosis of ovarian failure. A salivary hormone
evaluation would also include testing levels of
estradiol (E-2), progesterone, testosterone, DHEA,
cortisol a.m. level, and the ratio of
progesterone to estradiol. These tests can help
the doctor develop an individualized protocol for
bioidentical hormone replacement therapy (BHRT),
if needed.

There are a number of other things women can do
along with BHRT to help alleviate the symptoms of
menopause and head off potential post-menopausal
problems like osteoporosis and cardiovascular
disease. A proper diet, a good exercise regime,
and dietary supplements and vitamins all should
be part of an overall wellness program.

I believe a woman should be evaluated
holistically. I spend time not only teaching
about the physical and mental aspects of
menopause, but the spiritual aspects, as well.
For years we may have given ourselves to the
nurture and care of others. This change of life
speaks to us to return to self and embrace
ourselves with kindness and love. An important
part of my therapy program is a reminder of the
importance of taking time for oneself and
nurturing self during this transition.