Dr Ivana Matic-Stancin | Melbourne Lifestyle Medicine GP

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Menopause demystified

Let’s talk about Menopause.

 Humans born in a female body start realising the feminine nature of the body they were born into between the age of nine to sixteen. This period of body awakening is called puberty. This is when all reproductive hormones wake, flourish and shape the body into a female gender characteristic. This period is turbulent for most of us.

 Women enter their twenties, thirties and forties when life maintains steady patterns, shapes and stories. Of course, we all have many pleasant and unpleasant events during these years, but for most of us, hormones do not add much to the big drama of life. Life can be eventful enough in those years without extra hormonal help. (There are many medical conditions, such as PCOS and PMS, with which hormonal changes can be unpleasant, but this is not the topic of this article).

 The big M happens at some point, usually in the late 40s to early 50s. Menopause is a word we all avoid, as it can have a stigma attached to it, stigma and fear. It is a time when we were told that our hormones are ‘drying out” and when we fear life might start drying out, fading, becoming stale, and there is nothing good, new or exciting ahead of us! It sounds scary, or at least unpleasant.

But is that true?

 NO!

This does not need to be true. Let’s first distinguish three different terms here and straighten out some facts.

 Menopause, Perimenopause and Postmenopause:

 Perimenopause is the period (usually anywhere between 1-10y before the last period) when a woman starts experiencing symptoms of hormonal fluctuations in her body.

 Menopause is a period of 12 consecutive months without menstruation.

 Post-menopause is everything that follows those 12 period-free months.

 Perimenopause is usually the first unpleasant hormonal life transition for many women. In perimenopause, most women start to experience unusual and confusing symptoms. The list of possible symptoms is long, but to mention some of them: mood swings, depression, insomnia (difficulty sleeping), foggy brain, difficulty finding words, aches and pains, sore joints, skin-crawling sensations, loss of libido, painfully sex, frequent urinary symptoms, hot flushes and night sweat. Perimenopause starts subtly and gently for some (20%), moderately unpleasant for others (60%), or highly undesirable, like a wild roller-coaster ride, for a few of us (20%). One way or the other, it happens to all women. Most women dread those early signs of menopause. We mostly dread the experience because of the stigma of aging and the shame of losing the femininity that social media and the general public usually portray about menopause. We also dread the experience because we connect menopause with poor health, weight gain, and old age.

The last few years of research strongly argue against this old paradigm. There is a paradigm shift in how scientists and doctors view Menopause. Menopause is a normal physiological stage in any woman's life. Menopause is a golden opportunity for women to review their lifestyles and values and realign them to achieve better health outcomes in the next life chapter. Menopause is a crossroads where we can change the trajectory of our future years towards healthier and more fulfilling lives.

 Only a very small percentage of women continue to suffer long into post-menopausal. The transition often leads to a more pleasant life for most women.

Post-menopause is generally a stable and even pleasant period for most women. A few women need medical interventions, referral to a psychologist, other specialists, medications, etc.

According to The Melbourne Women’s Health Midlife Project, most of us come out on the other side of the hormonal roller-coaster better off. With an improved sense of well-being, better mood, and more enjoyable sex life.

What makes the difference, and why do some women go through a rough ride whilst others gently sail through menopause? This is a question without a definite or clear answer at this stage. Many current findings indicate that women who spend their earlier lives practising healthier lifestyles and enduring less stress are likely to suffer less through the transition. Many contributing factors include personal lifestyle, adverse past childhood experiences, socioeconomic status, current life circumstances, personality type, history of mental disease, gynecological history, unique sense of well-being, accomplishments and meaning, sense of connection to a broader group, etc. Some of those factors we can actively manage, others not.

The factors that we can influence and manage are our lifestyle choices. The way we plan our time and choose our company, the food we eat, how and when we move and exercise, our sleep and relaxation time, how we treat our bodies, our thoughts and emotions, and other people in our lives. These are all variables that we can change. However, we all know it is difficult to make sustained changes. If a change is not possible or easy, and symptoms are very rough, we can take medications to alleviate the nasty symptoms. These medications are called MHT (menopause hormone therapy). The general population still has lots of controversies and fear about MHT. Current science is precise that some women can safely use modern forms of MHT. Many options can help the transition through menopause. It is all about understanding your situation and desires and choosing suitable options. Every woman is a unique story and should be treated as such. Please remember that most of us can feel better mentally, physically and emotionally in the post-menopausal years.

 If you would like to learn more about menopause, please refer to the following:

 1/  https://www.jeanhailes.org.au/health-a-z/menopause

 2/https://www.menopause.org.au/