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Menopause
©2003 Alva Irish Menopause
Basics
TIMING AND TERMINOLOGY What Are the Menopausal Years? Human females are unique from all other females on two counts (at least): we menstruate; and we cease to be reproductively available after we've lived only half our life span. (Estrus bleeding in dogs is not menstruation.) The ancient women's mysteries tell us of the powers and initiations of these unique events: menstruation and menopause. This book focuses on the latter - the years of transformation from potential mother to wise, whole crone - the menopausal years. Meno (menstruation) pause (stops) is, technically, the last menstrual flow of a woman's life. The years just before and just after the menopause itself are referred to as the climacteric. For most women the climacteric spans from early/mid 40s to late 50s/early 60s, including the premenopausal years, the menopausal climax years, and the post-menopausal years, popularly known as the Change of Life. This Change is a metamorphosis (complete change at a cellular level). This metamorphosis follows, and may even be the matrix for, the three classic stages of initiation: isolation, death, and rebirth/reintegration. Each woman's Change includes these three stages, as well as three phases (before menopause, during menopause, and after menopause). Each stage and phase of our metamorphic, menopausal Change is different; each has special needs and offers special challenges. Learn more about the stages of menopause the Wise Woman Way: CONFIRMING MENOPAUSE STATUS Premenopausal Years The actual age at which menopausal Change begins varies considerably from woman to woman; the norm is 45, with a normal range of 35 to 55. During these premenopausal years, menstrual periods may become noticeably different (closer together, farther apart, scantier, more profuse). Night sweats or hot flashes come, if at all, only occasionally and are usually blamed on too many blankets or a rich meal. Nourish and tonify your entire hormonal system. Menopausal changes occur not only in the ovaries, but also in the adrenal, thyroid, pancreas, pineal, and pituitary glands. Herbal allies are remarkably safe and effective glandular nourishers. Increase the number and amount of calcium-rich foods you consume. No single effort ill repay you more richly. High levels of calcium in the diet protect you from osteoporosis, heart disease, and emotional swings. Green leafy vegetables (herbs and weeds) are exceptional sources of calcium. Maintain regular menses. Non-ovulatory menstrual cycles, common during the premenopausal years, lack a progesterone surge. Lack of progesterone contributes enormously to loss of bone mass, and vaginal atrophy. Herbal allies can support progesterone production. Find some regular physical activity to fall in love with. Even gentle exercise, done regularly, helps maintain peak bone mass, strengthens the cardiovascular system, and insures deep sleep. Gain up to a pound a year for ten years. Thin women have more hot flashes and an altogether more difficult menopause than heavier women. Fat cells produce estrone, a kind of estrogen. (If you won't let yourself gain ten pounds, at least stop trying to lose weight. Dieting decreases bone mass and weakens the heart.) Plan yourself a “Time Away”. The initial step of your initiation is isolation. As menopausal Change picks up speed at the end of the premenopausal years, many women find themselves desperate to be alone. Planning now can help make it a reality when you need it. Like an extended visit to a Spa, “Time Away” is a special time when the menopausal woman is freed from all social responsibility and encouraged to tend solely to herself. An extended vacation or sabbatical ideal, but you can stay home and still take “Time Away”. Menopausal Climax Years The menopausal climax years include the year or two before and a year or more after your very last menstruation. The average age of a woman in the midst of her Change is 51. But women come to their menopausal climax in their 20s, 30s, and 40s, as well. Some achieve menopause by surgical means, some by way of chemotherapy or radiation, and some just naturally arrive early. (Menopausal climax before the age of 40 is considered "premature.") During this 2-5 year climax period, the bones refuse to take in calcium and bone scans will show growing osteoporosis; flashes, flushes, and night sweats may be frequent; palpitations, emotional sensitivity, and sleeplessness are common. Depending on the individual woman and her circumstances, other physical and emotional changes may come with the Change, or she may experience next to nothing. Take time for solitude. Although many women feel enormous satisfaction in tending and nourishing others, as our reproductive years come to a close, it is appropriate to turn away from care-taking. Hot flashes, sleeplessness, moodiness, and the like are easier to recognize as allies of wholeness when you are free to follow your own needs without concern for others. Take one day to be totally by yourself, or a “Time Away”, or anything in between. Experiment with eggs, meat, and butter in your diet. Some women find these foods, especially if from organic sources, decrease menopausal symptoms. Some practitioners insist they increase menopausal distress, especially when from commercial sources. Relax and enjoy your hot flashes. Ride them like waves, feel them in your spine, ski the edges of your flushes, honor the volcanic heat of your core. Like labor pains, hot flashes are the outward sign of metamorphosis. Like labor pains, they are worse when resisted. Herbal allies help those with unrelenting flashes relax and enjoy, too. Spend time with a journal. Buy a blank book and write in it, draw in it, paste articles in it. Visions and dreams are particularly vivid and intense in the menopausal climax years; keep your journal handy so you can record them. Your emotional energies are readily available during the menopausal climax years; draw them in your book. Memories abound during these years; cherish them in your journal. Write your autobiography. Plan your Future. As months pass and the moon waxes and wanes without drawing forth your menses, you pass through the second stage of initiation, death. Your identity as Mother dies. Let yourself break all the rules. Be someone totally different than you thought you could be. Post-Menopausal Climax Years The post-menopausal years symbolically begin on the fourteenth new moon after your final menstruation. (And continue, of course, for the rest of your life.) Hot flashes, aching joints, heart disease, incontinence, vaginal atrophy, and broken hips may diminish the quality and quantity of these years. Use of herbal and Nutritive supplements in the post-menopausal years can halt and reverse osteoporosis (the bones accept calcium once again), keep estrogen- and progesterone-sensitive tissues in the vagina and bladder from weakening and drying out, and maintain a healthy, vigorous heart and circulatory system. Eat vegetables, fruits, and grains instead of meat. Eating meat and meat fat weakens your bones as well as your heart, promotes cancer, and may contribute to post-menopausal hot flashes. Move, dance, walk, stretch, go, inquire, keep active. The essence of vitality is change. Now that you've been through the Change, don't stop, keep changing. Break the rules and the taboos. Become an expert on pelvic floor exercises. Take up belly dancing. Pump iron. Wear purple. Write a legal will. And revise it every ten years. Face your own death. Plan for your own death. This completes the second stage of your initiation. Nourish yourself with every bite. Aging increases our needs for many nutrients while reducing our digestive ability. Make every bite count toward optimum vitality and step up digestive efficiency by using dandelion root tincture before meals. Discover new ways to serve yourself calcium-rich foods at every meal. Use herbal vinegars regularly. Gradually replace bone-depleting white flour products (bread, pasta, pretzels) with fiber-rich whole grains and whole grain products. Drink vitamin- and mineral-rich herbal infusions instead of mineral-depleting coffee, tea, and soft drinks. Try yogurt and fresh fruit instead of ice cream for stronger bones and fewer vaginal infections. Plan your Future in your Community. Anytime after your second Saturn return (age 57-61), you are ready for the third stage of your menopausal initiation: rebirth. You are She-Who-Holds-the-Wise-Blood-Inside. You are newly crowned, newly born, new woman. After isolation, after death, you rejoin the community. In your isolation, you envisioned yourself. By giving death to yourself as Mother, you claimed all of yourself. It is time to share that vision, to name yourself publicly, Woman of wholeness. "I am Woman. I feel my way along paths following the energy and warmth that others have placed here. Trusting the dark, I am guided not by light, but by the flowing movements I sense. I am like the water that follows, without sight or foreknowledge, the ancient river's channel." Here is a brief synopsis of what is going on with menopause. Perimenopausal Changes
Postmenopausal Health
Menopause Treatment Options
Achieving Optimal Health A TIME OF NEW BEGINNINGS
Androgens Prior to menopause androgens, mostly testosterone, are produced by the ovaries and adrenal glands. Androgens are important for maintaining bone density and sex drive. After menopause the ovaries stop making androgens, the adrenals continue, but the total amount produced by the body is greatly diminished. Androgens are available combined with estrogen, for replacement therapy. The only combination drugs is ESTRATEST®,. This is prescribed as second line therapy. For women who have not achieved good relief from hot flashes, or who are complaining of loss of sex drive, on estrogen. BONE MINERAL DENSITY ( BMD ) After menopause bones loose significant amounts of calcium. In 25% of women this bone loss can result in osteoporosis with the resultant high risk of broken bones. Taking estrogen* stops the loss of any more calcium but does not replace the calcium already lost. Taking calcium supplements and vitamin D will not replace the lost calcium either. There is now evidence that taking an estrogen-androgen combination* can promote new bone formation. SEXUAL FUNCTION Loss of interest in sex is a common complaint of postmenopausal women. Androgens have been shown, in several studies, to improve libido ( sex drive ) in postmenopausal women. One study of 136 postmenopausal women complaining of sexual dysfunction were treated initially with estrogen alone. The estrogen therapy relieved vaginal pain associated with vaginal dryness, but did little for the loss of sex drive. The women were not depressed and were in stable marital relationships. When they were given estrogen-androgen combination therapy 80% reported improved libido. PSYCHOLOGICAL WELL BEING Between 30% - 70% of postmenopausal women complain of psychological symptoms such as moodiness, anxiety and irritability. Higher androgen levels have been associated with better energy levels and an increased sense of well being. Harmony* is an excellent supplement to take during this stressful period. SKIN CHANGES Androgen-estrogen combination therapy has been shown to increase skin thickness and suppleness. There may also be an associated increase in oiliness and acne. VIRILIZATION and HIRSUITISM Virilization is the appearance of masculine sexual characteristics, such as acne, deepening of the voice, baldness and increased muscle mass. Hirsuitism is the appearance of facial hair. Some women on androgens do show some of these symptoms however, the symptoms are mild and readily reversible by lowering the dose or stopping the medication. Some studies have shown that these changes are LESS frequent in estrogen-androgen users. There is no evidence for an increase in liver disease in women who use estrogen-androgen therapy. However women with liver disease should not start HRT. HEART DISEASE Androgen-estrogen therapy generally decreases HDL ( good cholesterol ). Estrogen alone increases HDL and this is considered the reason that estrogen protects from heart disease. Risk factors for heart disease need to be taken into consideration before starting androgens. CONCLUSION Should you be on an estrogen-androgen combination? Possibly, if 1. You are on estrogen and still experiencing hot flashes. 2. You are at high risk for osteoporosis. 3. You are on estrogen and still experiencing loss of sex drive. There are other questions you must answer with your physician. What is your BMD ? What is your cholesterol HDL ratio? There are still unanswered questions concerning androgens. How will androgens impact on heart disease and breast cancer over the long term? More long range studies are needed. For now take the information you have and discuss it with your physician if you think you might be a candidate for androgen therapy. Some of the symptoms attributed to menopause may be secondary to lifestyle factors or the aging process itself. When considering alternative measures to treat menopausal symptoms, the first consideration should be your base line health. First, if you smoke you must quit! Smoking will decrease the effectiveness of the estrogen your ovaries are making. Smokers go through menopause two to three years earlier than their non-smoking peers. They are also more likely to suffer from osteoporosis. Exercise to maintain your ideal body weight. This will reduce your risk of heart disease, colon, lung and bowel cancer, diabetes and lung disease. Exercise improves your mental outlook, reduces stress and anxiety. Regular physical exercise will help prevent or relieve many of the Common Discomforts of menopause. It will also go a long way to wards preventing the Major Health Problems we have identified. Weight bearing exercises, such as walking, stair climbing and jogging can help prevent osteoporosis. Monitoring intake of fat, calcium, and vitamins can help treat problems associated with menopause, strengthen bones and maintain healthy distribution of body fat. Prescription Drugs Several drugs are available by prescription for the treatment of discomforts such as hot flashes or problems such as bone loss. There are restrictions on who can take these drugs based on factors such as the degree of suffering and combination with other treatments. Glandulars Glandulars* are basically preparations of animal glands (ovaries and adrenals) for menopause. They are usually from cows. There are three classes:
Throughout history people have eaten the glands of animals and found them to be nutritionally sound. They have eaten liver, kidney, brain, etc. It appears by some studies that PMG's are absorbed in the gut and are transported to the target tissue in this case, the ovaries. However whether the ovaries use them to produce more estrogen and progestogen has not been shown.
References: A Practical Guide to a Positive Transition by Anne Dickson and Nikki Henriques HOMEOPATHY FOR MENOPAUSE by Beth MacEoin Creating Physical and Emotional Health and Well-Being By Christiane Northrup, M.D. What Your Doctor May Not Tell You about Premenopause! : Balance Your Hormones and Your Life from Thirty to Fifty by John R. Lee, Virginia Hopkins, Jesse Hanley Could It Be... Perimenopause? : How Women 35-50 Can Overcome Forgetfulness, Mood Swings, Insomnia, Weight Gain, Sexual Dysfunction & Other Telltale Signs of Hormonal Imbalance by Laurie Ashner, Steven B. Goldstein The Hormone of Desire : The Truth about Testosterone, Sexuality & Menopause by Susan Rako The Menopause Diet : Lose Weight & Boost Your Energy by Larrian Gillespie The Estrogen Alternative : Natural Hormone Therapy with Botanical Progesterone by Raquel Martin, Judi Gerstung |