Own Your Health with Facts and Feminism

1. Menopause is a natural phase, not a disease

Menopause isn't a disease. It is an evolutionary adaptation that is part of the survival of the species, like menstrual periods or the ability to suppress the immune system during pregnancy.

Evolutionary advantage. Menopause played a crucial role in human evolution. The "grandmother hypothesis" suggests that post-reproductive women contributed significantly to the survival of their grandchildren by providing care and resources. This evolutionary adaptation allowed for longer lifespans and better survival rates for offspring.

Challenging misconceptions. Contrary to popular belief, menopause is not a modern phenomenon resulting from increased life expectancy. Historical and anthropological evidence shows that women have experienced menopause for thousands of years. The idea that menopause is a disease or a sign of weakness is a harmful misconception rooted in patriarchal views of women's bodies and value.

Reframing the narrative. By understanding menopause as a natural and important life phase, women can approach this transition with confidence and empowerment. This perspective shift allows for better preparation, management of symptoms, and overall well-being during and after menopause.

2. Understanding the biology of menopause empowers women

Facts can bring order to the chaos and uncertainty of menopause, because knowledge can dispel fears and open up treatment options.

Hormonal changes. Menopause is characterized by a decline in ovarian function and hormonal production, particularly estrogen. This process typically begins in a woman's 40s or 50s and involves:

• Declining follicle count in ovaries
• Fluctuating levels of estrogen, progesterone, and follicle-stimulating hormone (FSH)
• Eventual cessation of menstrual cycles

Stages of menopause. Understanding the different stages helps women navigate this transition:

1. Perimenopause: The years leading up to menopause, characterized by hormonal fluctuations and irregular periods
2. Menopause: Officially diagnosed after 12 consecutive months without a menstrual period
3. Postmenopause: The years following menopause

Individual variations. Every woman's menopausal experience is unique, influenced by factors such as genetics, lifestyle, and overall health. Recognizing this diversity helps women approach their own menopause journey with realistic expectations and personalized strategies.

3. Hormonal changes affect multiple body systems during menopause

Menopause is clearly not an artifact of industrialization or modern medicine. What sanitation, improved nutrition, and medicine appear to have given women as well as men are more years beyond seventy.

Vasomotor symptoms. Hot flashes and night sweats are the most commonly reported menopausal symptoms, affecting up to 80% of women. These result from the brain's altered temperature regulation due to hormonal changes.

Genitourinary changes. Declining estrogen levels can lead to:

• Vaginal dryness and discomfort
• Increased risk of urinary tract infections
• Changes in sexual function and libido

Bone and cardiovascular health. Estrogen plays a crucial role in maintaining bone density and cardiovascular health. Its decline during menopause increases the risk of:

• Osteoporosis and fractures
• Cardiovascular disease, including heart attacks and strokes

Cognitive and emotional effects. Some women experience mood changes, anxiety, or depression during menopause. While often attributed to hormonal fluctuations, these changes can also be influenced by other life factors coinciding with this life stage.

4. Menopausal Hormone Therapy (MHT) can alleviate symptoms and protect health

MHT is FDA approved for prevention of osteoporosis and for treatment of hot flushes, and GUSM and is associated with a small but definite increased risk of stroke, blood clots, breast cancer, and gallbladder disease.

Benefits of MHT. Hormone therapy can effectively manage many menopausal symptoms and provide long-term health benefits:

• Reduction in hot flashes and night sweats
• Prevention of bone loss and fractures
• Potential cardiovascular benefits when started early in menopause

Risks and considerations. While MHT can be beneficial, it's not without risks:

• Slightly increased risk of breast cancer with long-term use
• Increased risk of blood clots, especially with oral formulations
• Contraindications for women with certain medical conditions or histories

Individualized approach. The decision to use MHT should be made on an individual basis, considering:

• Severity of menopausal symptoms
• Personal and family medical history
• Age and time since menopause onset
• Personal preferences and risk tolerance

5. Non-hormonal treatments offer alternatives for managing menopausal symptoms

Cognitive behavioral therapy or CBT involves harnessing the mind-body connection. This doesn't mean hot flushes are made up or "all in our head"; rather, hot flushes can have an impact on how we feel, and the reverse is true because the same neurotransmitters that direct thoughts and behaviors can also impact hot flushes.

Lifestyle modifications. Simple changes can significantly impact symptom management:

• Dressing in layers and using fans for hot flashes
• Regular exercise for mood and overall health
• Stress reduction techniques like meditation or yoga

Non-hormonal medications. Several prescription options can help manage specific symptoms:

• Selective serotonin reuptake inhibitors (SSRIs) for hot flashes and mood changes
• Gabapentin or pregabalin for hot flashes and sleep disturbances
• Ospemifene for vaginal dryness and painful intercourse

Alternative therapies. While evidence is mixed, some women find relief from:

• Acupuncture
• Herbal supplements like black cohosh or red clover
• Mind-body practices such as cognitive behavioral therapy or hypnosis

6. Lifestyle choices significantly impact menopausal health and well-being

Exercise is good medicine—especially when it comes to menopause.

Physical activity. Regular exercise offers numerous benefits during menopause:

• Helps maintain healthy body weight
• Improves mood and reduces stress
• Strengthens bones and muscles, reducing the risk of osteoporosis
• May help alleviate hot flashes and improve sleep quality

Nutrition. A balanced diet supports overall health and can help manage menopausal symptoms:

• Emphasize fruits, vegetables, whole grains, and lean proteins
• Include calcium-rich foods and vitamin D for bone health
• Consider limiting caffeine, alcohol, and spicy foods if they trigger hot flashes

Sleep hygiene. Prioritizing good sleep habits can improve overall well-being:

• Maintain a consistent sleep schedule
• Create a cool, comfortable sleeping environment
• Limit screen time before bed
• Consider cognitive behavioral therapy for insomnia (CBT-I) if sleep problems persist

7. Navigating contraception during the menopause transition is crucial

No blood test or ultrasound can tell a woman that she no longer needs contraception.

Fertility considerations. Women remain potentially fertile until menopause is confirmed (12 months without a period):

• Pregnancy is still possible, though less likely, during perimenopause
• Contraception should be continued until menopause is confirmed or age 55, whichever comes first

Contraceptive options. Several methods are suitable for perimenopausal women:

• Hormonal IUDs: Provide contraception and can help manage heavy periods
• Combined hormonal contraceptives: Can alleviate menopausal symptoms and regulate cycles
• Progestin-only methods: Suitable for women with contraindications to estrogen
• Sterilization: A permanent option for women certain they don't want more children

Transitioning to MHT. Some contraceptive methods can seamlessly transition to menopausal hormone therapy:

• Hormonal IUDs can provide the progestogen component of MHT
• Lower-dose combined pills can be used for symptom management in early menopause

8. Critical evaluation of supplements and alternative therapies is essential

Supplements are an unregulated multibillion-dollar-a-year industry, and many companies have financial ties with the providers and influencers who recommend their products.

Limited regulation. The supplement industry lacks the strict oversight applied to pharmaceuticals:

• Products may not contain the ingredients or doses listed on the label
• Safety and efficacy testing is often inadequate or non-existent
• Marketing claims can be misleading or unsubstantiated

Evidence-based approach. When considering supplements or alternative therapies:

• Look for products that have been independently tested for purity and potency
• Seek out high-quality scientific studies on efficacy and safety
• Consult with healthcare providers who are knowledgeable about integrative medicine

Potential risks. Some supplements can interact with medications or cause side effects:

• St. John's Wort can interfere with many prescription drugs
• High doses of certain vitamins (e.g., A, E) can be harmful
• Some herbal products may contain estrogenic compounds, potentially impacting hormone-sensitive conditions

9. Open communication about menopause challenges societal stigma

It shouldn't require an act of feminism to know how your body works, but it does. And it seems there is no greater act of feminism than speaking up about a menopausal body in a patriarchal society.

Breaking the silence. Openly discussing menopause helps:

• Normalize the experience for women going through it
• Educate younger generations about what to expect
• Challenge ageist and sexist attitudes in society

Empowering women. Knowledge about menopause allows women to:

• Advocate for appropriate healthcare and treatment options
• Make informed decisions about their bodies and well-being
• Support other women going through similar experiences

Changing the narrative. Reframing menopause as a natural life transition rather than a medical condition or sign of decline can:

• Improve women's self-image and confidence during this phase
• Encourage a more holistic approach to menopausal health
• Promote research and development of better treatments and support systems

Last updated: August 22, 2024