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Menopause
Basics
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 c, 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
-
REDUCED
FERTILITY
-
BIRTH
CONTROL AS MENOPAUSE APPROACHES
-
CHANGES
IN MENSTRUAL PERIODS
-
HOT
FLASHES
-
INSOMNIA
-
UROGENITAL
CHANGES
-
CHANGES
IN SEXUAL FUNCTION
-
PSYCHOLOGICAL
CHANGES
-
OTHER
HEALTH CHANGES
Postmenopausal
Health
-
HEART
DISEASE
-
OSTEOPOROSIS
-
C
Menopause
Treatment Options
Achieving
Optimal Health
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 a
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 c 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 c, 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
are basically preparations of animal glands (ovaries and adrenals) for
menopause. They are usually from cows. There are three classes:
- Whole
concentrates
which can include active hormones.
- Protomorphogeous
(PMG's)
which include the protein building blocks of the hormones.
- Aqueous
extracts,
which can contain both, the hormone and the building block.
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
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