Menopause: Why is it taboo?

Author: Dr. K. Jennifer Voss, chair, OB/GYN department

Menopause is a normal life event all women experience, so why is it a taboo subject? To start, let’s look at its definition because most are still unsure of what it is and what to expect.

Mostly experienced by women between ages 40 to 58 (the average age in the United States is 51), menopause is defined as the final menstrual period and is confirmed after a woman has missed her period for 12 consecutive months.

Menopause can occur at different ages. Some women experience menopause earlier than usual before they are 42, also known as premature menopause.  Typically it takes one year of not getting your period to be considered menopausal. When a woman’s body is in the process of transitioning toward menopause, this stage is referred to as perimenopausal. Perimenopause occurs the 4-8 years before the last menstrual period, and lasts until one year after the final period. Embrace this time because it is coming, is completely normal and there are ways to get through it healthily, which I’d like to share here by listing the common symptoms and how to manage them.

Perimenopause is variable because different changes occur, such as hormone changes, changes in the menstrual cycle and physical changes in the body.  Symptoms include hot flashes, night sweats/sleep disturbance, changes in sexual function, weight gain and mood swings.

One of the most common symptoms I hear from patients in perimenopause are hot flashes. This symptom definitely has its triggers: stress, caffeine, alcohol, spicy foods/hot beverages/soups, tight clothing, heat and cigarette smoke. But before you fully contemplate a life without chai lattes, rosé or lamb vindaloo, know that there are lifestyle modifications you can make to alleviate these symptoms:

  • Avoiding those hot flash triggers.
  • Exercise (doing this is just as effective as any medication for treating hot flashes. I recommend to my patients that they get 20-30 minutes of cardiovascular exercise at least 5 days a week).
  • Weight loss.
  • Stop smoking.
  • Relaxation techniques.
  • Herbal options (black cohash, soy foods, flaxseed, evening primrose oil).
  • Hormone replacement/modulation (this is because all symptoms relating to menopause are due to low estrogen levels (hypoestrogenism).
  • Use of prescribed antidepressants.

Here are other ways to stave off those common symptoms of menopause:

Night Sweats/sleep disturbance: night sweats are hot flashes that happen at night. Lessen the effect of these by dressing in light nightclothes, particularly in natural fiber materials that breathe, such as cotton. Layer your bedding so that you can easily lessen your load or add to it as per your comfort. Another tip is running a fan in the bedroom. To avoid experiencing insomnia steer clear of alcohol, caffeine and electronic screens about an hour before bed. Three good qualities for your sleeping environment are to keep it dark, quiet and cool. Sleep aids are also an option.

Changes in sexual function: namely a lower libido (contributed to by factors such as stress, too little sleep and anxieties about body changes linked to getting older). As we age, arousal may need to follow desire, not the other way around, and that is O.K. Engaging in the actions first may lead to the feelings of desire, and incorporating that change into your life, like planning for intimacy, may be necessary though beneficial.

Weight gain: at this time a woman’s metabolism is decreasing as is muscle mass. Simply put: eat less and move more.

Mood swings: reduce stress in your life to create a better sense of balance and reduce anxiety. Adopting a health lifestyle helps; this means getting good nutrition through the foods you eat, participating in daily exercise and enjoyable, self-nurturing activities and nabbing seven to nine hours of sleep each night.

My words of wisdom are to take actions to make your transition to menopause a positive experience. Although it is a time of great change there is also a sense of freedom and personal growth. Take charge and find out what you really want in your life. Negative thoughts and attitudes actually make menopausal symptoms more intense, so instead focus on what you appreciate, keeping a journal for this exercise is helpful. Laugh, exercise, eat well, meditate and incorporate relaxation techniques into your day, not only for a smoother sail through menopause but for an overall healthful, well-balanced life.