The Transition To Menopause Information helps give women new insight By Joan Morris Oct. 15, 2002 CONTRA COSTA TIMES
This isn't your mother's menopause.
The biology is the same -- the hot flashes, the mood swings, the changes in body shape and resiliency -- but the dreaded, solitary journey our mothers and grandmothers often labored through is being transformed.
"Menopause has come out of the closet," says Pamela Boggs, director of education and development for the North American Menopause Society. "Today's women know it's perfectly normal and that we shouldn't have to giggle when we say the word."
Friday is International Menopause Day, a day dedicated to educating women about menopause and health issues. Experts estimate that by 2025, more than 1.1 billion women will be age 50, the average age of menopause.
The United States was one of the last industrialized countries to form a menopause society. The group, formed in 1989, is a nonprofit organization dedicated to promoting women's health during midlife and beyond through an understanding of menopause.
Like most things, Boggs says, each experience is unique to the individual. And it's been that way for centuries. What's different now is that people are much more willing to talk about menopause, to recognize its symptoms and -- gasp -- to even celebrate the life that waits on the other side of youth.
In the past, menopause has been seen as a cruel punch line in a woman's life. When it was talked about at all, it was in tones of fear and loathing. Menopause -- the transition that mark's the end of a woman's reproductive cycle -- has carried a host of negatives.
For women who equate fertility with youth and usefulness, menopause can be viewed as a sort of death of self and purpose. For others, it has been a not-so-subtle sign of aging, of a life half over. In a society where youth is idealized, it can be a bitter pill to swallow.
Doctors who specialize in midlife issues say menopause often is seen as an illness that must be "cured." That way of thinking has led to the development of synthetic and natural hormones, which in turn has led to a fear of side effects the treatments can produce.
Earlier this year some women were sent into a panic when a federally funded hormone replacement therapy study abruptly called it quits, citing higher than acceptable health risks among the subjects.
Women taking HRT rushed to their doctors, afraid that they were at greater risk of heart disease, breast cancer and other ailments. Some, with debilitating symptoms, said they preferred the risk over losing control of their lives again.
Boggs says in the months that followed, most women and their doctors realized that the risk had to be assessed by each person; there also are different types of HRT and only one was involved in the study. If anything, Boggs says, the controversy has served to better educate women and to further advance menopause dialog.
Specialists are urging women to embrace menopause simply as another part of life. And just as women sought drug-free "natural" births, in menopause many are choosing to weather the symptoms or use so-called natural remedies to help ease them. In extreme cases, pharmaceuticals are needed to control symptoms that range from hot flashes to severe mood swings.
"Today's menopausal women don't look anything like they used to," Boggs says. "Baby boomers are changing everything. Women today are much more active than they were 30 years ago. They are into promoting healthy behaviors. They are vibrant and active women in contrast to women decades ago who almost expected, when they reached a certain age, to stop doing things."
A Gallup poll conducted by the Menopause Society, brought some surprises. Most women surveyed said they don't dread menopause as much as they once did, and many even said they were looking forward to it. With families grown and retirement looming, post-menopausal women are facing futures with fewer responsibilities, no fear of unwanted pregnancies and more time for themselves.
That's not to say menopause is always easy. Alice Stamm, founder of the midlife Web site power-surge.net, says her site was developed to help women struggling with the physical and emotional changes.
About 15 percent of all woman going through menopause have few or no symptoms. Another 15 percent have symptoms so severe that they disrupt their lives and those around them. The remaining 60 percent waiver between the two extremes.
Stamm herself had a difficult menopause, and she was frustrated by not being able to find answers to her questions. She wanted to talk with others who were experiencing the things she was, to see what lay ahead and to help other women just beginning the journey.
In 1993, before there was an Internet, Stamm joined the fledgling AOL and set up what would eventually become a bulletin board. The idea has grown and matured into a Web site that now consumes much of Stamm's time and energy. In addition to the bulletin board, where people write their thoughts and ask their questions, the site features frequent online chats and conversations with national experts. Power-surge has been recognized by Forbes and Health magazines as a top site for women's health, and has won a bushel of praise.
"At no other time in a woman's life does she need as much support as she does now," says Stamm, who is known online by her pseudonym, "Dearest." "Power-surge is a group of wonderfully caring, sensitive and supportive gals. The issues we address are not limited to hot flashes, soy isoflavones, estrogen, progesterone, herbs, insomnia, hormones, depression, vitamin E and the dreaded night sweats, but the myriad changes endemic to menopause -- how menopause impacts every nuance of our lives, our families, our self-esteem, our work, our weight, our relationships, our emotions, our sexuality. The entire person.
"The time had finally come for menopause discussions to be taken from the closet into the living room for intelligent discourse. Good grief, this is the new millennium."
As most women approach menopause, their menstrual periods become irregular, occurring closer together or further apart. Other symptoms include: Achy joints Hot flashes Temporary and minor decrease in the ability to concentrate or recall Changes in sexual desire Extreme sweating Headaches Frequent urination Early wakening Vaginal dryness Mood changes Insomnia Night sweats
You may have one, some or none of these symptoms. Also, some of these symptoms may be from an illness, not associated with menopause. For that reason, a doctor should be consulted with the onset of symptoms.
To relieve symptoms and ease problems associated with menopause, physicians and organizations recommend these treatments. (Excerpted from the Planned Parenthood Web site.)
Hot flashes: Avoid getting too warm by dressing in layers and sleeping in a cool room. Avoid getting too warm inside, too, by not drinking hot beverages and eating hot soups. Avoid hot-flash triggers, such as drinking alcohol and eating spicy foods. Reduce stress. If you feel a hot flash coming on, take slow, deep breaths and the hot flash may be lessened or avoided altogether. If more help is needed, some research suggests that mild hot flashes can be relieved by consuming a serving of soy foods daily or taking a supplement of black cohosh. Effects, if any, may take a few weeks. Several prescription drugs that are FDA-approved for other uses have been found to help some women with hot flashes: the antidepressants Effexor, Prozac, Paxil and the cardiovascular drug Catapres.
Osteoporosis: After menopause, a woman's risk of osteoporosis (thin bones) increases, making it more likely to sustain a fracture. Talk to your health care provider about determining the strength of your bones, perhaps by getting a bone scan. A complete discussion of other risk factors is also recommended. If you are not at risk, it's still a good idea to make sure you get adequate calcium and vitamin D. Getting appropriate exercise is also recommended. If you are at risk or have osteoporosis, you need calcium and vitamin D plus a bone drug. There are many well-proven prescription therapies from which to choose.
Vaginal Dryness: Vaginal lubricants and moisturizers available over the counter can help lubricate the vagina and ease intercourse. Severe cases respond only to prescription estrogen. Prescription estrogen products are available that are specifically for the inside of the vagina. They are not absorbed to a great extent into the circulation. These include estrogen creams, an estrogen tablet and an estrogen plastic ring. Estrogen used this way will not help with hot flashes or any other condition, but it is not associated with any side effect.
Heart Disease: After menopause, a woman's risk of heart disease also increases. Talk to your health care provider about your risk. A cholesterol test is also recommended. If your blood pressure is high, or your cholesterol is not at a healthy level, there are several well-proven prescription therapies to choose from. If you have diabetes, make sure you control your blood sugar, as risk for heart disease is increased when you don't.
General health: Don't smoke. Eat a healthful diet. Maintain a healthy weight. Get adequate exercise. Reduce stress.
North American Menopause Society: For information and to find physicians, write to 5900 Landerbrook Drive, Suite 195, Mayfield Heights, OH 44124; or call 440-442-7550. www.menopause.org
Planned Parenthood: Many Planned Parenthood centers offer midlife services. Contact your area Planned Parenthood health center to ask if midlife services are offered, or call toll-free 800-230-7526 for information on where services are offered. www.plannedparenthood.org
The National Osteoporosis Foundation: For bone-density information, testing and physician referrals, write to 1232 22nd St. N.W., Washington, DC 20037; or call 202-223-2226. www.nof.org
National Center for Homeopathy: 801 N. Fairfax St., Suite 306, Alexandria, VA 22314; or call 877-624-0613. www.homeopathic.org
power-surge.net: For information, discussion and conversation, go online to www.power-surge.net. Registration is required to access some areas of the Web site.