Some Thoughts On Menopause

In my mid 40s I noticed I was starting to sweat a lot, and this was unusual as normally my hands and feet are as cold as ice blocks. Sometimes I experienced painful headaches, irritability, and insomnia. My metabolism slowed down and my clothes felt tight. My energy level plummeted and became unpredictable. And so began my adventures in Menopause. Most of the women I know are reluctant to talk about menopause; especially here in Los Angeles. In writing this article my aim is to reduce the shame associated with menopause by sharing my own story.

One of my close friends recommended Dr. Christiane Northrup’s book The Wisdom of Menopause, in which Northrup candidly describes her own menopause. Reading her book brightened my grim outlook on menopause. Northrup talks about the loss of control women experience when our hormones begin to change and how scary it can be when your physical and psychological identity change simultaneously. Menopause officially begins when a woman has not had a period for a year or more. “Peri” means near or around. So technically this article should be titled “Nearing Menopause” as I am still a member of the “peri” club.

According to Dr. Northrup, 75% of peri-menopausal women experience symptoms. There are a large variety of treatments available including: hormone therapy, nutritional changes, exercise programs, supplements, etc. Each woman gets to decide what treatment (if any) works best for her body. Northrup talks about how empowering menopause can be, stating that many women make career changes and/or end relationships during this time. I chose to go back to school and become a therapist in my mid- 40s; I was motivated by the idea that I had a limited amount of time left on the planet, and I wanted this second half of my life to be more meaningful. I am enjoying being in my early fifties; I have a stronger sense of who I am and what I want, and my self-confidence has risen during this time.

Since I am a recovering control freak as well as an addiction specialist, I thought it might be helpful to use the 12 Steps of Alcoholics Anonymous as a framework for explaining my attempt to control and understand peri-menopause. First, I had to take the 1st step and admit I was powerless (just means I couldn’t control it) over menopause and what was happening inside my body. I needed some help to manage my life which included this new health challenge. I am a very self-sufficient person so I read ten or twenty books about menopause and set out to design my own menopause recovery program. Although I felt a little bit better I often awoke feeling a sense of what a friend called “crashing fatigue.”

Now I arrived at the second step. I came to believe that a power greater than myself (in this case my doctor) could restore me to sanity in the area of menopause. I made an appointment and the doctor recommended bio-identical (natural) hormone therapy. Natural hormones have the same chemical structure as hormones that are made by the human body. The key to natural versus synthetic is the molecular structure of the hormone. In order for a replacement hormone to fully replicate the function of hormones present in the human body, the chemical structure must exactly match the original. I was given an estrogen patch (which is much less expensive if you order it from a Canadian pharmacy) and some progesterone cream (which is a bit messy and required flapping my arms around so it dries before I fall asleep). One friend didn’t like the patch and chose to try a bio-identical “hormone pellet” which is embedded into the hip or buttock area. Another friend chose not to take hormones and utilized herbal remedies and supplements. I am not advocating one therapy over another, just sharing my experience, strength and hope.

Then I took the 3rd Step and turned my will and my life over to my doctor (and my higher power, of course) with one small reservation. I knew my case was different and that I would sail through peri-menopause more quickly than my less healthy friends. I figured I would be finished with my symptoms in a few months. I had been healthy all my life, ran 3 marathons and many half-marathons, practiced yoga, didn’t smoke or drink. I was in for a big surprise! It took several years for me to discover what worked for me and what didn’t.

My experience was complicated by the fact that I also have a thyroid condition. Mary Shomon’s book The Menopause Thyroid Solution is useful for women experiencing thyroid symptoms along with menopause. I did some writing (something like a 4th and 5th step) and realized I was still holding onto some old ideas about the way my body should function. I was exercising and eating the same way I had in my 30s and that needed to change. I needed to get more sleep and do less. In the past I enjoyed testing my limits (sometimes it felt like I was training for the Olympics) by running long distances, alternating running with yoga. It seemed I was more tired on the days after I had gone running so I experimented with shorter runs and it helped a great deal. Sugar and caffeine (particularly coffee) were no longer working for me so I switched to tea and reduced my sugar intake.

Right around this time I was diagnosed with a digestive disorder that I refer to as a “cousin” of Irritable Bowel Syndrome. The treatment of this disorder involves a very strict diet consisting of no sugar and no refined carbohydrates; nearly a death sentence for this pasta loving Italian girl! So I became entirely ready to have my old ideas about diet and exercise removed and humbly asked my higher power for help (steps 6 and 7). The main person I harmed (Steps 8 and 9) was me so I needed to be more gentle with myself and have some compassion for the changes that my body was experiencing. Then in the 10th step I continued to take personal inventory, keeping a daily calendar where I recorded my cycle, symptoms, exercise and the types of foods I was eating. It’s important to have good data with you when you go to the doctor; I noticed a pattern to my symptoms based on where I was in my cycle. There were days where I felt extra anxious about situations that normally did not bother me. The 11th Step talks about prayer and meditation. Studies show that peri-menopausal women often experience higher levels of anxiety. Meditation has been a constant in my life for many years, it soothes me. I have a daily meditation practice and I also take lots of quiet time throughout the day. Mindful dishwasherloading really helps along with following my breath while driving on the 10 freeway, particularly at the 405 interchange.

And now here I am carrying the message (Step 12). It has been so helpful for me to talk about perimenopause with my friends and colleagues; we are all learning from each other. I hope this article inspires you to begin a discussion with your friends, family and health professionals.