Complete Wellness

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Menopause

Menopause….Ugh

There comes a time in a woman’s life when she must have reading glasses and feminine hygiene products stashed in all the nooks and crannies of her life; junk drawer, glove box, purse. You just never know what’s going to happen in the menstrual arena, and you never know when you might need to be able to read something.

Menopause is not a moment in time. It is an era in a life. Menopause is official when there has been no menstrual bleeding for a full year. Alas, the lack of periods is only one of the huge variety of delights that come along with the hormone changes of aging. The average age for women to enter menopause is from 45 to 55 years of age. Women (you will RARELY hear me call women of this age “girls”) can start having menopausal symptoms at 35, or even younger, and they can last for years in any given person.

Incidentally, if you haven’t had a period for a year and you get one, please alert your health care professional. He or she should do some testing to make sure you don’t have cancer of the uterus. It probably isn’t but, as I so often explain, the job of the doctor is to think of the worst thing your symptoms might be and prove that it’s not.

Some women get periods that just stop. Others find their periods getting closer together and heavier, and then begin to get further apart and lighter till they fade away into the sunset. For other women, it is just a crap shoot; nothing for months, then some kind of period, then nothing again for months. Or nothing for months, then regular periods for a few months. You just never know. If the bleeding gets out of control, sometimes we need to see a specialist and deal with it more aggressively.

Bleeding is only part of the story. Hot flashes are another classic piece. These also have tremendous variability. Terrible dripping sweats, or just a red face. Some women have heat rising from the crotch or the chest. This hot flash, or vasomotor instability can last minutes and can be so compelling as to make a perfectly sane woman feel the need to start undressing in the middle of her workplace, or jog across a store to the freezer aisle and stick her head in the freezer case. We try anything and everything to get this annoying/ debilitating symptom under control.

And here’s the craziest part of the whole hot flash thing; even though it seems like we are burning calories like crazy generating all that heat, it is actually just the opposite. As we enter menopause, our temperature set point gets dropped. Our “thermostat” that had been set at 98 degrees Fahrenheit or so gets reset to 97ish. So now, once in a while, our body goes on about it’s business, heating up to 98, and then it gets the signal from the new set point, “Get down to 97F, NOW.” And, boom, heat. It’s like when we break a fever. Our bodies dissipate heat by bringing blood to the surface, the skin flushing, and sweat, to cool us by evaporation.

One of the more difficult issues to deal with is mood. We have all heard about menopause making women volatile and irrational. It is so difficult to assess this on from “the inside”. Sometimes we have to rely on the perspective of those around us. We might think it perfectly reasonable to be angry at some small misdeed or slight, but others around us recognize that the reaction is out of our usual character, or at least out of proportion.

If there is any doubt that this might be happening, I always find it most useful to ask a loved one or co-worker if they have noticed this phenomenon, but we have to be ready hear the answer. The other way to gauge this problem is to think about the number of times we’ve had the thought, ”Why did I say that?” or “What was I thinking?” Is it hard not to get angry/cranky/irritable on a daily basis? There may be an issue that needs to be addressed before we, and everybody around us starts to believe that’s what we are really like. Talk to a medical professional about fixing that fast.

Our bodies go through some physical changes that are more or less inevitable, but just as variable and genetically driven as the rest of the menopausal symptoms. Our waists get bigger, our butts get flatter and not uncommonly, we gain a little weight. It seems that, just like men whose musculature suffers as their testosterone levels fall, we also have a loss of musculature causing these changes. It is, of course, very variable due to genetics and lifestyle.

I always am reminded of little teeny Nancy Reagan. She was skinny as a skeleton in her years as first lady, but she always had that little round poochy tummy in those shiny ball gowns. It’s just what happens. Exercise, surgery and good foundation garments can help, but the changes are to some degree, inevitable.

I know trying to reassure a woman that this is OK and not to worry about it is like trying to tell an insomniac to just go to sleep or a person afraid of flying, not to panic. Not helpful. The changes of aging are coming and I wish peace and contentment to all of us. Be healthy. Keep working out. Live fully. That is the best response. If we need more help than that, we can ask for it from compassionate and supportive people around us.

Sexually, things can get challenging as well. (See “How to Stay Married”) Libido, or sexual drive, can be diminished. That is not really surprising considering that when your baby-making hormones are fading, the primal urge to have sex is going to be gone. And when our bodies are doing the weird things we just discussed, self-esteem might be an issue. (Not to mention that our partners bodies are changing too.)

 

 

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