Every woman who goes through middle age will experience menopause. For a fortunate few, this transitional time is relatively easy; for many others, "the change" is marked by a number of physical and psychological challenges that may leave them frustrated and physically drained. As with any health issue, the more a woman understands the process of menopause, the better she will be able to deal with it.



WHAT IS MENOPAUSE?

Medically speaking, menopause is said to be the stage of life when no menstrual periods have occurred for a period of one year. This cessation of menses is due to decreasing ovarian function. In the United States, the average age is 51 years old; however, it can happen any time from your 30s to your mid-50s or later.

It's important to understand that this process is not a disease; it's a normal part of a woman's life. But just as puberty can be a scary and confusing time for young girls, the entrance to this stage of adulthood can leave us wondering why our bodies appear to be "rebelling" against us or even questioning our own sanity! Our lifestyles can also be a contributing factor in the severity of menopausal symptoms: stress, poor diet, and lack of good exercise habits can often exacerbate the problems we encounter.

SIGNS AND SYMPTOMS

For some, the symptoms associated with the changing levels of estrogen and progesterone in their bodies may be relatively mild. For others, however, the physical symptoms can be moderate to severe and may include hot flashes, night sweats, headaches, and atrophic vaginitis (inflammation of the vagina due to thinning and shrinking tissues and a decrease in lubrication) which can cause burning, itching, or bleeding. Weight gain and changes in blood pressure can also accompany menopause.

Many women may also find themselves going through psychological changes, as well. Fatigue, insomnia, anxiety, depression, memory loss, mood swings, irritability, and an inability to concentrate are common.

TREATMENT

While this is a normal part of life, for many women it is very difficult to deal with the symptoms as their bodies adjust to the changes they are going through. The good news is that there are things we can do-often through natural therapies-that can help. If you are experiencing some of the symptoms listed above, you may want to seek medical help in coping with the problems.

Many women who seek medical help for their symptoms (particularly for anxiety and depression) may find that their doctors are quick to prescribe drugs such as antidepressants or sleeping pills that simply mask their symptoms and can lead to dependency or unwanted side effects. This treatment can certainly be appropriate at times, but it is often possible to approach the root causes of the symptoms in natural ways that are ultimately more effective.

In my practice the first step, as always, would be a complete medical history and physical exam. It's important to determine whether the reported symptoms are really menopause-related or if there are other medical conditions that need to be taken into account as part of the treatment program.

Laboratory tests, if indicated, can be very helpful. For instance, if FSH (follicle-stimulating hormone) is markedly elevated and estrogen is depressed, this constitutes a lab diagnosis of ovarian failure. A salivary hormone evaluation would also include testing levels of estradiol (E-2), progesterone, testosterone, DHEA, cortisol a.m. level, and the ratio of progesterone to estradiol. These tests can help the doctor develop an individualized protocol for bioidentical hormone replacement therapy (BHRT), if needed.

There are a number of other things women can do along with BHRT to help alleviate the symptoms of menopause and head off potential post-menopausal problems like osteoporosis and cardiovascular disease. A proper diet, a good exercise regime, and dietary supplements and vitamins all should be part of an overall wellness program.

I believe a woman should be evaluated holistically. I spend time not only teaching about the physical and mental aspects of menopause, but the spiritual aspects, as well. For years we may have given ourselves to the nurture and care of others. This change of life speaks to us to return to self and embrace ourselves with kindness and love. An important part of my therapy program is a reminder of the importance of taking time for oneself and nurturing self during this transition.