Menopause – Disease or Dis-ease?

By: Erin Valasek

Last month I had a 30th birthday, and it was a very welcomed birthday indeed. We all tend to have different views on getting older, and I really embrace it. Before some of the older ladies begin rolling their eyes at that statement, allow me to explain. I personally feel the 20s are overhyped, as you are still really learning who you are (oh the hard lessons, and days of being so broke I could only eat pancakes twice a day) and haven’t quite found your footing yet. Now I realize 30 in the scope of age isn’t quite getting old. However, I think one naturally progresses to look forward to the coming years pondering what is next. Who will you be in 10-20 years? Is your view lens one of the glass half full or half empty perspective? For some, this can be a fearful thought, especially for women, and the dreaded stage of menopause looms over our young-ish heads. I don’t wish to move forward in a fear of uncertainty, especially regarding this important change in life. I want to be educated about what menopause is, what it means, and how I can experience the healthiest transition possible when my time comes. So my question is, where does this fear come from, and more importantly….

Why are we treating menopause like a disease?

Menopause is a natural stage of life, just as puberty is. Yet, the symptoms of puberty aren’t being beamed on the television for a new drug to take the painful awkwardness away (yet). Now, I realize it can be a very lengthy and extremely difficult transition for many women, but the key word is transition. It should be embraced as such. Allow me to demystify the negative stigma of this phase which women in the middle of their lives have absolutely no choice over. I seek to share what I have learned in researching this topic for myself and hope some comfort comes from what is presented here.

Menopause is the cessation of menstruation, typically occurring around 40-50 years of age in women. Perimenopause is the beginning transition into menopause, usually starting in a womans 40s. The length of perimenopause is different for every woman, generally ranging from a few months to several years (up to 10). As a woman ages, her eggs do as well, and ovulation slows. Estrogen and progesterone fluctuate and the first symptoms of menopause begin to occur. Many common symptoms of perimenopause include hot flashes, breast tenderness, worsening of premenstrual syndrome, decreased libido, fatigue, irregular periods, vaginal dryness; discomfort during sex, mood swings, and difficulty sleeping (WebMD). Many women will also experience weight gain due to the reduction of progesterone and estrogen.

Pregnancy is still possible at this stage so contraception should still be used. Perimenopause finishes when a menstrual cycle has ceased completely for a year. At this point, menopause begins. The ovaries have stopped releasing eggs, and any remaining estrogen dissipates.

A woman is postmenopausal when the symptoms of menopause begin to disappear and pregnancy is no longer possible. The hair tends to thin, skin loses some of its elasticity, muscle mass decreases, and the risk for osteoporosis becomes a concern for many women. Some women embrace this stage with joy, as the previous years of hormonal aggravation and suffering are over. There is a relief of no longer having to deal with monthly periods or worry about contraception. A small percentage of women may become despondent and depressed. The aging process becomes more of a reality and there may be a feeling of the loss of womanhood as she is no longer able to bring children into the world. A sullen version of “over-the-hill” mentality can unfortunately take residence in a woman’s mind as reality.

None of this sounds fun, of course, but it is not an unnatural experience. Every woman will respond to the changes of menopause differently. However, in our “pill for every ill” society, you better believe the drug companies have persuaded millions of women that they can be saved from the evils of menopause. When treating menopause as a deficiency disease, you can convince women the body is making a horrible mistake by no longer producing hormones, and these hormones can be replaced. This natural, biological change of life can be practically reversed with Hormone Replacement Therapy (or HRT) and/or bioidentical hormones.

Hormone Replacement Therapy is a synthetic combination of hormones (usually estrogen and progesterone) derived from pregnant horses urine used to “treat the symptoms” of menopause. (click here for animal welfare info) They go against the grain and essentially add what the body is working to diminish. Hormone Replacement Therapy (also known as HRT, or HT) has been successful in relieving hot flashes and night sweats, reducing vaginal dryness and improving libido, and relieving insomnia. The dangers far outweigh the benefits, however. Several studies have shown HT greatly increases the risk of breast cancer. A small percentage of women on HT are at risk for Cardiovascular Disease and blood clotting.

Bioidentical hormones became an alternative for many women afraid of the dangers of Hormone Replacement Therapy. It has been praised as a natural, safer source of hormones, yet there is no evidence to back this claim.  Bioidentical hormones are used like HT for the treatment of the symptoms of menopause. The term “bioidentical” means the hormones are chemically identical to those your body produces. (Mayo Clinic)  These hormones are labeled as natural as they are plant derived. However, they’re not found in this form in nature but are made, or synthesized, from a plant chemical extracted from yams and soy. Bioidentical estrogens are 17 beta-estradiol, estrone, and estriol. (Estradiol is the form of estrogen that decreases at menopause.) Bioidentical progesterone is simply progesterone. It’s micronized (finely ground) in the laboratory for better absorption in the body.( health.harvard.edu)

Although the risks generally seem to be less with Bioidentical hormones vs. HT, there isn’t a lot of research supporting the safety of them either. Dr. Andrew Weil has questioned the safety of these therapies and stated: “Two important issues surround the use of bioidentical hormones. First, some pharmacies selling these hormones over the internet had made misleading claims about their safety and effectiveness. In a 2008 letter to seven of these pharmacies, the FDA maintained that the compounded products were no safer than conventional forms of hormone replacement therapy. (Premarin and most other FDA-approved hormone therapies contain synthetic hormones.) In addition, the North American Menopause Society and the American College of Obstetricians and Gynecologists have questioned whether the bioidenticals from compounding pharmacies have been adequately tested and have stated that no evidence exists to demonstrate that compounded hormones are better or safer for women than the pharmaceutical drugs.” (drweil.com)

HT and Bioidentical hormones are not the only solutions on the planet to help women through the discomfort experienced in the transition of menopause. There are truly natural solutions, and many women handle the hormonal changes very well with a proper diet, exercise, and herbal supplementation.

Avoid processed, sugary, spicy, and high carbohydrate foods as they can increase hot flashes and disrupt a good night of rest.

Choose a diet rich in fruits and dark leafy greens, as they are high in B complex vitamins which help to boost serotonin and stabilize mood, and are rich in Calcium to promote bone density (with the exception of spinach).

Flaxseeds contain phytoestrogens and help to balance hormonal highs and lows.

Omega-3 rich Salmon is a great heart healthy choice and can aid with vaginal dryness.

Black Cohosh, Red Clover, and Dong Quai have excellent reputations for reducing hot flashes and night sweats. (As a conscious shopper, make sure to avoid standardized extracts to avoid possible solvent contamination and only use a brand that can offer you tests for herbal identity as black cohosh is an herb that is often adulterated with foreign herbal substances that may be harmful to your liver. Click here for more information.)

Siberian Ginseng has a adaptogenic and hormonal balancing effect, it’s useful for combating fatigue and boosting memory.

Exercise (be it yoga, running, or pilates) have innumerable benefits to menopausal women ranging from maintaining a healthy weight, to controlling mood swings and hot flashes.

I think a lot of the fear of menopause also stems from the fear of aging. Women are taught to fight the aging process tooth and nail. Our society perpetuates the attitude that a woman’s worth is measured by her youthfulness and attractiveness. Menopause is looked at in such a negative light, almost as something to be ashamed of.  In the book Feminine Forever, Robert Wilson writes about the wonders of HRT stating “breasts and genital organs will not shrivel. She will be much more pleasant to live with and will not become dull and unattractive.” Nice, Robert, reeeeeal nice. Now granted, that book is from the 60s, but I don’t see that those concepts have changed enough from then to today. Perhaps that perspective isn’t as blatant as is written in this book, but have you watched television or been to the grocery store lately? Thousands of products marketed specifically towards aging women on how to stay young and supple, and combat the signs of aging.

I don’t want to view menopause and getting older this way, and I hope other women won’t view it this way either. I am not alone in this, and subtly, attitudes are changing. Our thoughts about menopause will affect the way we experience the transition. Women are waking up to the idea that their lives are not over, and they still have value and a lot of living to do after the stage of menopause. I want to embrace the changes my body is making, reach the end of the transition, and say “Great! What’s next?”

If you try to find information on the benefits of menopause, you may discover there isn’t much out there. One of my favorite physician turned authors, Dr. Christine Northrup, encourages women to look at the advantages of menopause. “You become far more intuitive, you are no longer satisfied with the status quo, and you find your voice in a different way.” (WebMD) I think that is a beautiful way to look at it. You still get a chance to discover and define who you are, in every moment. For example, many women enjoy traveling at the end of menopause as there is no more need to plan around their monthly cycle. Some women enjoy this as precious time to themselves, deepening their self knowledge and re-directing their energy into new interests or hobbies. Volunteering opportunities attract many women who are postmenopausal as well.

Ladies (and gentlemen), menopause is not easy, but it is nothing to fear, and it is not a disease to be cured. Life is full of stages, and this could be one of the most exciting transitions. The cultivation of wisdom and understanding is something we can all look forward to.

Additional resources:

http://www.wholehealthchicago.com/724/siberian-ginseng/

http://www.greenmedinfo.com/blog/eating-your-way-hormonal-balance