Preparing for “The Change”, AKA Menopause

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This is for the ladies
(or any hubby that is wondering what’s going on)…
Preparing for the change
(or that lovely time of life when menopause strikes)

Women go through an awful lot of changes during their lifetimes, like puberty, pregnancy and childbirth, and menopause. Menopause is often dreaded because of the unpleasant things, like hot flashes, mood changes, and vaginal dryness. With a little bit of knowledge and a few ideas on how to cope, it can be less of something to fear. As they say, knowledge is power. Or in other words, if you are prepared, you will not fear (paraphrased from the original). Here are a couple of things that might help you roll through menopause with little collateral damage.

First, you need to realize that no one can predict exactly when menopause will start. Just because Mom and Aunt Ethel experienced the “change” at 54, doesn’t mean that’s when it will happen for you. So don’t fret as to when things will begin to change. The average age in the US is 51. Most experts would say that menopause has “arrived” when a year has gone by after a woman’s last period.

Perimenopause can begin anywhere from 2 to 8 years before having periods ends. This time can bring along with it hot flashes, thinning hair, trouble sleeping, and mood swings. I have a friend who is one of the most thoughtful and fun people to be around. She said she hated the mood swings because she couldn’t predict how she was going to feel or act. She has since left that phase behind and is still her normal self. Another friend used to keep a handheld fan at the nurses’ station and would power it on when she knew a hot flash was coming. Cotton clothing is cooler and wicks away moisture from your skin. Remember, these too shall pass.

Bone loss can occur as estrogen levels decrease. On the flip side cholesterol levels can rise. Bone loss can put a woman at risk for osteoporosis or fractures. Increased cholesterol levels can contribute to heart disease, especially for those with fatty diets who haven’t watched what they’ve eaten anyway. Walking and jogging, etc., can keep the bones strong. Many women are deficient in Vitamin D which has a lot to do with bone growth. I take 5,000 units of Vitamin D daily, but that was after my doctor did Vitamin D levels (which go by long names) and found the levels were a bit low. Some women take calcium tablets. This works well if you are not a heavy yoghurt lover or milk drinker. I love milk and drink a lot. I had to stop the calcium replacement tablets because I had two bouts of kidney stones (Oh, the pain!) which contained a large portion of calcium. (The most common culprit in kidney stones is calcium oxalate.) I get enough calcium from milk and California sunshine. That doesn’t mean what works for me is the best thing for you. The wisest advice it to get regular medical check-ups and get your doctor’s advice on what plan of care will work for you. Save your bones (and your lungs) by not smoking. If you smoke, get into a program that will help you quit. It isn’t ever too late. There are a lot of programs out there. Your nurse or doctor can give you information.

Let’s talk more about management strategies. Estrogen levels drop as I mentioned. Hormone therapy can help with menopausal symptoms such as mood swings, hot flashes, and is actually a protective agent against heart disease. Make sure you have a thorough discussion with your care provider. Unopposed estrogen therapy (which means taking estrogen only and not its sister, progesterone, along with it) has been shown to have a clear correlation to uterine cancer. If you are at risk for osteoporosis, your doctor may recommend that you have a Dexa Scan or bone density study to determine percentage of bone loss, if any. If needed there are prescription drugs that can be given to reduce bone loss.

Many women who have successfully navigated menopause have done so by exercising regularly, eating a balanced diet, and giving up smoking, as was mentioned above.

On a plus side, many women have been grateful they went through the change. Why? Because they can enjoy their sex lives more without worrying about another baby coming along. For vaginal dryness which can make sexual intercourse uncomfortable, there are several products over the counter that can help moisturize the tissue of the vagina. One that we recommended frequently to our female oncology patients was Replens. If you have questions about the various agents available, you can also ask the nurse. (What can I say? Nurses are very knowledgeable and helpful. This has nothing to do with the fact that I am a Registered Nurse, right?)

Life is good. Even with the blips in our health, there are a lot of ways that we can make the best of or remedy the situation. Wishing you a happy and healthy life, even if menopause is included!

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