Menopausal Transformations

Instead of seeing the “change of life” as a string of symptoms, many
women today treat menopause as a chance to consider new possibilities.


July/August 2010

by Claire Sykes

 

Millions of women worldwide, right this minute, suddenly are feeling a rush of heat rising through their bodies, their necks and faces glowing red. Is it anger? Is it ecstasy? Or is it something else?
Hot flash. Hot flush. Power surge. Whatever you call it, this sensation is one of the many signs from your body, mind and emotions during your menopausal years. Every woman’s experience is different—from debilitating night sweats to annoying memory loss to liberating lifestyle choices. Holistic healthcare, natural remedies and the right attitude can help make this very natural “change of life” nothing less than life-changing.

“The menopausal years are about the self coming to the forefront,” says Christiane Northrup, MD, author of The Wisdom of Menopause (Bantam). “Your changing biology is enabling you to be more attentive to the dictates of your soul, instead of focusing so much on others. It’s asking you to wake up.”

The events typical of this life stage may last years, but menopause itself is a mere moment, the time you have your final menstrual period. However, by definition, you won’t know that until 12 months have passed. After that, you’re postmenopausal.

Hormonal Fluctuations

It all begins six to 13 years before menopause, at perimenopause (meaning “around menopause”), when hormone levels begin to change. As you age, your body gradually shuts down the baby-making machine (versus the immediate off switch that comes with surgical removal of the ovaries), sometimes years before any outward menopausal signs occur.


Contrary to popular belief, the first hormone that decreases is progesterone, n ot estrogen. Estrogen often stays the same or even increases, sometimes fluctuating widely. It often waits until less than a year before menopause to ebb, though it never completely runs out. Meanwhile, testosterone levels usually don’t decline, and can actually climb. Because your menstrual cycles depend on estrogen and progesterone counterbalancing each other (taking turns rising while the other falls), an overall drop in progesterone results in a relative excess of estrogen—a condition called estrogen dominance.

These hormones, produced mainly in the ovaries, interact with three others. During perimenopause, the hypothalamus’s GnRH (gonadotropin-releasing hormone), and the pituitary gland’s FSH (follicle-stimulating hormone) and LH (luteinizing hormone) prepare your brain for this new life phase. “Then, a couple of years after menopause, your hormones return to where they were before you got your first period,” says Northrup.

Perimenopausal hormonal upheaval first appears, commonly, as irregular periods, like those of Kimberly Windstar, ND, an associate professor at the National College of Natural Medicine, in Portland, Oregon. “Since age 40, my periods came monthly, and then got closer together and
further apart,” says Windstar, 52. “Then, after eight months without one, boom, I got another period.”

Unstable Thermostat

Once periods end, most menopausal signs dissipate within one to two years. Meanwhile, some women go through perimenopause with few or no felt indications, but 70% to 85% struggle with mild to severe hot flashes. They last from several seconds to half an hour, often followed by a chill. Joni Corby, 54, of Black Canyon City, Arizona, sometimes feels three a day. “It’s like someone turned up the thermometer in me,” Corby says. Some women also experience night sweats that leave them drenched.

Hot flashes and night sweats happen when surface blood vessels in your head and neck flare open, inviting more blood—and therefore heat and redness—into those areas. But Chinese medicine sees it another way. “During menopause, yin begins to wane, and cannot properly store yang, internally. This allows yang to float outward, giving a sensation of heat, that is, hot flashes,” says Michael Berletich, LAc of Blue Sky Wellness Studio in Portland.


Night sweats often means insomnia; Windstar is sometimes up for hours. (To learn more about insomnia, see page 32.) PMS-like signs such as mood swings and bloating are not uncommon, and migraine headaches, swollen breasts and painful joints may also occur. Heart palpitations are also common, though rarely dangerous. As hormone levels dip, skin becomes dryer and thinner. So does the vaginal lining, which can cause painful intercourse, while low testosterone levels can take a toll on sex drive.

On top of this, fuzzy thinking may make you forget names or where you put your keys. “You’re not losing your mind,” assures Northrup. “The logical, linear thought process of the left brain is no longer so dominant, and the right brain is becoming more active. Hormonal changes also affect the temporal lobes, the part of the brain associated with intuition, and you begin to shift your attention inward. That’s where the wisdom comes in.”

The Inner Woman Emerges

Don’t be surprised if menopause arrives as anger and frustration, insecurity and fear—all possible catalysts for positive change. As you cope with your own bodily and emotional changes, you may also be facing an empty nest, aging parents, divorce or thoughts of your own mortality. “I’ve felt more emotionally sensitive than ever,” says Corby. “But I’m also more compassionate toward people.”

Menopause can be downright exciting. Your reproductive hormones have done their job. Even if you never had children, you may have put more energy into others than yourself. Now it’s time to explore your inner hidden treasures and rekindle your creativity.

Meanwhile, those perimenopausal signs may be flashing in bright-red neon. The worse your PMS experience, the higher your stress level and the less healthy your diet and lifestyle, the more likely you’ll have a difficult menopause. But remember, meno­pause is not a disease; it’s a normal stage of life. Says Windstar, “If you can get through it naturally, instead of being medicated, you can grow.”

Start with a blood test to confirm your hormone levels. You want to check for hypothyroidism, which mimics menopause; and know where you are in the menopausal timeline, so you can take the right action. Many holistic approaches that help may also fend off health risks of the aging female body—heart disease, depression, weight gain, breast cancer and osteoporosis (low bone mass).

Healthy Responses

A diet rich in phytohormones (natural hormones found in plants), such as soy, calms hot flashes, mood swings, PMS discomfort and migraines, and helps with irregular periods and weight gain. A daily tablespoon of ground flax seeds provides fiber and omega-3 fats (also found in salmon and other fish, egg yolk and certain algae species such as spirulina). Northrup recommends a low-glycemic diet—fresh fruits and vegetables, whole grains, legumes and no sugar or processed foods—for healthy blood sugar and weight. Also steer clear of bad fats, caffeine, alcohol and tobacco.

Stay physically active. Work out, swim or take up a sport. To help build bone density, “walk every day for 20 minutes with a weighted backpack, to put weight on the spine,” says Marianne Marchese, ND, who practices in Phoenix. She also recommends 1,200 milligrams of calcium and 4,000 to 5,000 IU of vitamin D every day for post-menopausal women.

For mild menopausal signs, try herbs. Amanda McQuade Crawford, medical herbalist and author of The Natural Menopause Handbook (Crossing Press), suggests using chasteberry for irregular periods. “It also increases low progesterone up to a healthier level, normalizing action on the ovaries according to the body’s needs,” she says. Skullcap and passionflower help with irritability and insomnia. And black cohosh, motherwort, sage and evening primrose minimize hot flashes. For hers, Windstar takes maca; and Corby has had good results with St. John’s wort and kava.

Eastern medicine also offers menopausal relief. “Ayurvedic herbs such as Indian asparagus root (Shatavari), fennel and licorice root promote natural estrogen production and help balance out the three doshas [body types vata, pita and kapha],” says Nancy Lonsdorf, MD, Ayurvedic physician and author of The Ageless Woman (MCD Century Publications). And acupuncture “helps balance your deepest levels of internal energy, freeing up your body’s natural healing mechanisms,” says Honora Wolfe, LAc, author of Managing Menopause Naturally with Chinese Medicine (Blue Poppy Press). “Acupuncture is especially helpful for women who have memory problems, anxiety, depression and insomnia.” And don’t forget yoga, tai chi and meditation to bring calm and relaxation.

Let hormone replacement therapy (HRT) be your last resort, “but just enough to offer comfort,” says Northrup. Bioidentical hormones, lab-synthesized from natural sources, match those found in the body. They tend to have fewer negative, unpredictable side effects than synthetic, nonbioidentical hormones.

Your own hormones may run amok during menopause, but that doesn’t mean you have to, especially if you keep your head. “[I]t is possible for your expectation of your menopausal experience to become your reality simply because it’s what you believe will happen,” says Northrup. In the end, “it is your attitude, your beliefs, and your daily thought patterns that have the most profound effect on your health.”

Menopause calls attention to your older self, with the inevitable wrinkles, gray hair and death. “But you can decide how it’s going to go,” says Northrup. You can let yourself buckle under the weight of age and believe it’s the beginning of the end. Or you can buck up—and know that the best is yet to come.

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