By Rachel Lankester.
Why is menopause still taboo? It happens to all women and is just another stage in life’s rich pattern. But it’s not something most of us feel comfortable talking about, even with friends. It seldom gets a mention in the media and when it does, is it ever positive? And doctors often automatically hand out pills for it as though it is an illness rather than a natural stage in life. Imagine doctors giving out pills to cope with puberty!
If it’s so natural, then we need to talk about it and make sure we know how to thrive through menopause.
A new stage of life
The very wise Dr Marilyn Glenville, the UK’s leading nutritionist specialising in women’s health, has this to say:
The menopause is not an illness. If you subscribe to the standpoint currently held by the conventional medical profession, you’d be forgiven for thinking it was. Women in many other cultures do not experience the menopause as a crisis demanding medical intervention. Many of them simply do not suffer the physical and emotional symptoms that women in the West are programmed to accept as inevitable. In our society the focus of the menopause is one of loss.
Women are programmed to dwell on loss – the loss of periods, the loss of the ability to create life, the loss of hormones, the problems of the ’empty-nest’ syndrome. In other societies, this time in a woman’s life is seen as one of gain, a time of great wisdom. A time when the emphasis shifts away from doing the chores, working in the fields, to the role of lawmaker and counsellor to younger couples, where maturity and experience make a significant and valuable contribution to the family and society.
Depends where you live
A time of change the menopause certainly is, but it doesn’t have to be seen only as a time of loss. In many parts of Asia, for example, where older people are revered, this period in a woman’s life is often welcomed for the transition away from a mainly nurturing role into one where experience and wisdom are put to good use.
And weirdly Asian women don’t report half as many menopausal symptoms as women in the West nor as much breast cancer! Is that because of different diet, circumstance or mental attitude? Or a combination? It’s certainly not just genes, on the women’s cancer front at least. When Asian women move to the West, for example, their rate of breast cancer becomes similar to that of women brought up in the West.
Challenging the perceived wisdom
In her book, The Second Half of Your Life, Jill Shaw Ruddock quotes an International Menopause Society study which found that British women suffer the worst menopausal symptoms in the world. Could the prevalence of alcohol in our society be a factor perhaps? We know for a fact that alcohol effects hormones. Or our love of dairy products that are not yet so popular in the East? Phytoestrogens, found in soya, which is a common foodstuff in Asia, for example, are known to help with menopausal symptoms.
Or are Western menopause symptoms at least partially in the mind? There’s a contentious thought! Perhaps our youth obsessed culture coming back to bite us in the arse? Who knows?
The Mutton Club is all about challenging established perceptions of women in midlife and inspiring women to embrace all that life offers, take the lead and do great things. When we surveyed women over forty about what they like most about the age they are, they talked of being more self-confident, calmer, more free, having perspective and wisdom. At the same time, they hated the idea of becoming invisible and continued to crave learning more about the world, and finding more purpose and meaning in their lives.
Far-sightedness, thinning hair and lower metabolism are certainly tedious, but those afflict both men and women, so they can’t be blamed on the menopause! Changing how we feel about the menopause might just help us thrive through it.
A new beginning
There’s another reason why menopause can and should be seen as a new beginning. After menopause, you’ll have lost 100% of your progesterone, 99% of your oestrogen and 70% of your testosterone. Do the maths. Which is the dominant hormone in your body? Testosterone. And that doesn’t just mean whiskers on your chinny chin chin! You may, in fact, have as much testosterone in your body after menopause, as you had in your twenties. So your sex drive may be raring to go, even if your body’s response is different.
Having more testosterone in your system than other hormones, can also mean you are on a hormonally more level playing-field with men. You may feel less impulse to nurture others, if that has been important before, and more desire to push ahead and conquer the world! So men may discover more of their emotions as testosterone converts to oestrogen in their bodies as they age, but we may be less encumbered by ours.
So what are the facts?
- The word menopause was first used in 1879 and was a combination of two Greek words; mens meaning monthly and pausis meaning cessation.
- The average age of menopause is 51.4 years and the typical length of the transition is five and a half years. There are two phases to natural menopause, peri or pre-menopause and menopause itself.
- You have officially gone through menopause when you have not had a menstrual period for twelve months.
- Peri-menopause can actually start at any time and often by your mid-forties, so if you’re experiencing menopause-like symptoms earlier than you’d expect, go and get your hormones checked – it’s likely you’re experiencing peri-menopause rather than menopause.
- There are technically three kinds of menopause:
- Natural which happens between age 40 and 58
- Premature if it happens before 40, usually due to an autoimmune disorder or genetics
- Artificial or induced which affects on in four women and is caused by both ovaries being surgically removed or after chemotherapy or radiation
- Humans are one of a small group of mammals that go through menopause. Women share the experience with female killer whales, lions, elephants and gorillas!
- The peri-menopausal years usually last 2-6 years but could last longer and bring a range of symptoms as your hormones go on a rollercoaster akin to puberty
- The symptoms of menopause can last more years after menopause itself has ended – but hopefully won’t!
Symptoms of menopause
Many women sail through menopause without noticing anything more than the end of their periods. For others, symptoms often attributed to the menopause can include:
- Hot flushes (flashes)
- Irregular periods
- Trouble sleeping
- Aching joints, muscles and feet
- Breast tenderness
- Weight gain
- Urinary incontinence
- Changes in skin and hair
- Irritability and forgetfulness
- Anxiety and feelings of insecurity
- Diminished sex drive
- Vaginal dryness
Doctors will often prescribe HRT if you visit complaining of menopause symptoms. If you are below the average age of menopause (51-52), with bad symptoms, there is a case for taking HRT, because it will help with symptoms and is also thought to strengthen your bones and heart (particularly useful with early menopause).
If you decide on the HRT route, ask your doctor about body-identical (sometimes also called bio-identical) hormones – or ones that are as ‘natural’ as possible. Some HRT comes from horse urine, for example! Do we really want that in our bodies? HRT carries increased risk of breast and ovarian cancer, which needs to be balanced against the benefits. Body-identical hormones are available from your GP in the UK. Some private practitioners also promote bio-identical hormones that they claim are different to what you can get from your doctor but these are un-regulated. In the UK at least, if you ask for plant-based HRT from your NHS doctor that will likely be all you need.
Instead of depending on HRT, a good diet, exercise and several natural remedies can all help alleviate some of the symptoms of the menopause. Start with making sure you eat a healthy diet as small changes can make a big difference. Eat plenty of vegetables and at least two portions of oily fish a week. Cut down on caffeine and avoid added sugar to stop blood sugar (and mood) swings. Reducing alcohol intake may also help as alcohol is well known to affect hormones.
If hot flushes are an issue, cut down or cut out chocolate, lemon, red wine, caffeine, dried fruit, cheddar cheese and any foods that contain sodium nitrate such as processed meats. In fact try to avoid processed foods completely. The more natural your diet the better. Increase your intake of calcium, magnesium and vitamin D. Black cohosh and sage are both thought to help with hot flushes and night sweats. Black cohosh can be found as a supplement in health food stores. Also, if you think of hot flushes as power surges, they become a lot more palatable!
Phytoestrogens, which naturally occur in several foods, are thought by many to be beneficial during the menopause. Soya is a good source, as are flax seeds. The easiest way to take flax seeds, which are not particularly appetising, is to grind them (and add to other cereals, for example) or take flax seed oil. Red clover, which can also be found in health food stores, is also a good source of phytoestrogens.
Regular exercise is also key to thriving through the menopause. Think several sessions a week and enough to get your heart really going. Mix up aerobic exercise such as running or a vigorous exercise class with yoga and or pilates to stretch out your muscles. Check out our features on running and yoga to help you stay in tip top condition.
Marilyn Glenville’s page on the menopause is a wealth of information and her best selling book Fat Around the Middle has lots of ideas to also shift middle-age spread that can afflict many of us during menopause! Of course, eating a healthy, balanced diet and getting plenty of exercise is also going to help you limit extra weight gain! Apple cider vinegar is thought to be good at kick-starting your metabolism and helping to slow down weight gain too.
Your pelvic floor may also need exercise, particularly if you have given birth vaginally. Women in menopause and beyond are at increased risk of urinary incontinence, as changes in oestrogen levels can cause thinning of the urethra lining combining with weaker muscles as we age. This is not, however, an inevitable result of ageing and regular pelvic floor exercises can radically improve muscle strength and even cure urinary incontinence completely. Such exercises have the added bonus of also intensifying orgasms!
Diminished sex drive and vaginal dryness are big issues for some women during and after menopause. And can really affect our self esteem. But remember what we said earlier about increased testosterone levels and the impact this can have on your sex drive. By the way, if testosterone is found to be lacking, this can also be prescribed as HRT.
But there doesn’t have to be a physical reason for diminished sex drive and we need to consider our emotions too. We have lots of great ideas to help in our Sex and the menopause feature so check that out for more tips.
With a proactive approach and maybe also a shift in mental attitude, you have a much better chance of thriving through the menopause.