Menopause: Everything You Wanted to Know and the Mind-Blowing Stuff You Didn't

Growing up, I remember my mom getting dressed to go out. Even though she was freshly showered and standing in front of a fan, her make-up melted like wax and her armpits dripped sweat. She was constantly wiping sweat from her face and neck complaining about how hot it was. I thought my mom was some sort of human furnace. How is she sweating with the AC on blast and the fan in her face? I wondered. Now I realize she was suffering from hot flashes, a symptom of perimenopause and menopause.  Today I find myself walking, or should I say sweating,  in her shoes. 

Let the hot flashes begin!

They came out of nowhere and showed up at the most inopportune times:  during meetings,  on airplanes, at 3:00 in the morning-they did not discriminate.  A  colleague at work told me red wine was a hot flash trigger (thanks Terri), so I switched to white wine, and they practically disappeared.  Problem solved, right? Wrong!  A tidal wave of new symptoms began with headaches, brain fog, muscle aches, fatigue, weight gain. What on earth was happening?  Could all these symptoms be related to menopause?  

I jumped on my phone and scoured the internet for anything I could find about menopause. I read articles, watched videos and read research conducted by the top menopause doctors and agencies.  My suspicions were confirmed, partly.  I’m experiencing symptoms of perimenopause.  I’d never heard of it.  Perimenopause is the big sister to menopause.  She shows up on the scene between the ages of 30 and 50 and rolls out the red carpet for menopause.  I wish I had known about perimenopause sooner because as it turns out, there are tons of preventive measures we can take to minimize the symptoms and prolong our lives.  Yes, I said prolong our lives! I’ll get to that part in a minute.  But let’s start by talking about these two unacknowledged, misdiagnosed phenomena I affectionately refer to as the pauses.

Definition

Menopause is the stage when your period stops and you can no longer get pregnant. It typically occurs between age 45 and 55.

Perimenopause occurs 8-10 years before menopause and begins when your estrogen and progesterone levels start to decline.  It lasts four years (on average) but can span from a few months up to 10 years.  Perimenopause hands off the baton to menopause 12 months after your last period. 

Symptoms

Dr. Mary Claire Haver, a board-certified Obstetrics and Gynecology specialist, and Certified Menopause Practitioner from The Menopause Society, describes over 70 symptoms of the pauses. The most common symptom – you guessed it- hot flashes!  Other symptoms include:

·      Tender breasts

·      Low sex drive

·      Fatigue

·      Irregular periods

·      Vaginal dryness

·      Leaking urine (during coughing or sneezing)

·      Urgency to urinate

·      Mood swings

·      Insomnia

·      Poor memory

·      Trouble concentrating

·      Joint pain

·      Muscle aches

·      Weight gain

Any of those sound familiar?

Diagnosis

The pauses can be quite tricky to diagnose.  The pauses present themselves in a variety of ways -  the same set of symptoms do not occur in every woman.  OB/Gyn’s receive little to no training on menopause, so they often misdiagnose it as something else.  Doctors may attribute the symptoms to:  fibromyalgia, long COVID, ADHD, leaky gut syndrome, interstitial cystitis, adrenal fatigue, fatty liver disease, depression, or anxiety. Blood test, such as the Follicle-Stimulating Hormone or FSH are often used to check hormone levels in a woman’s blood in an attempt to diagnose the pauses. High FSH levels may point to the pauses, but hormone levels fluctuate throughout perimenopause, so the FSH test is not definitive.

Life Impact

The pauses have a significant impact on the quality of your life. The symptoms alone are enough to disrupt daily life,  but the drop in hormone levels affects every system in your body and can be the preamble for serious health problems like osteoporosis, heart disease, cognitive decline and certain cancers.  Other symptoms such as low sex drive, mood swings and poor memory can impact your career and relationships with loved ones.

Myths and Misconceptions

Doctor Fabrisia Ambrosio, Director of the Discovery Center for Musculoskeletal Recovery said,  “We lack data to understand how menopause affects aging and how it might contribute to disease or age-related declines. In preclinical models, it’s something that we just haven’t effectively addressed, and so we haven’t been able to study it well. The science has so much catching up to do.”

Gaps in medical research on aging women has contributed to the following myths and misconceptions about the pauses:

MYTH: You can't get pregnant during the pauses.

FACT: If you’re in true menopause and have not had a period in 12 months, you can’t get pregnant. If you are still having periods, you can.

MYTH: The pauses only happen after 40.

FACT: The most common age for menopause is 45 to 55, but it’s possible to start  as early as your 30s.

MYTH: There’s nothing you can do about the pauses.

FACT: Diet, exercise and lifestyle play a huge role in symptoms.  There are several effective medications and treatments.

Disproportionality in Black Women

The Study of Women’s Health Across  the Nation (SWAN), conducted the largest ongoing study of menopause. They found that Black women have a very different experience with the pauses in terms of symptoms and care.  The SWAN found the following:

·      Black women reach menopause about 8.5 months earlier than white women

·      Black women experience hot flashes, disturbed sleep and other symptoms more than white women

·      Black women are less likely to receive hormone therapy, mental health services or medical help than white women

·      Black women are more likely to have untreated hypertension due to menopause than white women

Black should talk to their doctors about symptoms they are experiencing and consider treatment options that can help to include medicine and lifestyle changes.  If your doctor is dismissive, find a doctor that is knowledgeable about the pauses.  Websites like the Menopause Society have a health professional search feature to help you find a doctor that is right for you.

Treatment

There is no cure for the pauses (other than menopause itself) but there are treatments that can help ease the symptoms. See the list of prescription and home remedies available below. Please note that taking medication is a personal choice. All medications come with side effects, and you should consult your doctor before starting a prescription.

Medications:

·      Birth control pills – stabilize hormones and ease symptoms

·      Estrogen therapy – stabilizes estrogen levels – comes in creams, gels, patches and pills

·      Antidepressants – help with mood

·      Vaginal creams – decrease dryness and sex-related pain

Home Remedies

·      Exercise

·      Stop smoking

·      Get more sleep

·      Decrease alcohol

·      Avoid caffeine

·      Reduce stress

·      Get enough calcium

As with any medical condition, maintaining a healthy lifestyle will decrease your symptoms of the pauses and the chances of symptoms leading to a chronic disease.  I hope the information in this article empowers you. Take control of the pauses, so they don’t take control of you!