Menopause: What to Expect, How to Handle It
Signs, symptoms and solutions.
Menopause is a major turning point in a woman’s life. As women age, physical and emotional changes occur as their levels of reproductive hormones decline and their ability to become pregnant ends.
During the process, some women have hot flashes and mood swings. Others have difficulty sleeping. Still others glide through menopause easily.
No matter how each woman experiences “the change,” each eventually reaches the milestone, usually between the age of 48 and 55.
“It’s like a bell ringing, saying, “Things are changing—time to move on to the next chapter of your life,” says Dr. Wulf Utian, a gynecologist and reproductive endocrinologist in Beechwood, Ohio.
While the years just before and after menopause can pose challenges, Dr. Utian says that menopause is a normal part of a life.
Understanding the challenges that menopause poses is essential to coping with the physical and emotional changes. During menopause, many women experience unexpected feelings of intense heat and sweating known as “hot flashes,” which are a major cause of sleep loss. While their exact cause is unknown, hot flashes may be related to hormone changes. Coping strategies include:
- Wearing breathable clothing in layers that can be discarded during a hot flash.
- Keeping a cool drink handy and avoiding hot or spicy food.
- Avoiding the use of alcohol, which can trigger a hot flash.
While the physical issues that accompany menopause receive the most attention, it’s the emotional ones that are troubling for many women. Every woman’s emotional response to menopause differs. Some woman may feel the best years of their lives are over; others may be conflicted with the transition itself—glad fertility has ended but worried about what lies ahead.
“But it also can be a time when she gains a new outlook on life,” says Jennifer Prouty, a nurse practitioner in Mattapoisett, Mass.
Recognizing and accepting as normal the emotional response to the hormone changes that come with menopause are key to making a smooth transition to a new phase of life.
Prouty encourages women to do physical activities they enjoy to benefit from the natural mood-elevating chemicals that exercise can bring. At the same time, women should avoid using alcohol, which can mask feelings.
Most importantly, “Talk about your feelings, whether it¨Ìs with other women or a therapist,” Prouty says. “Take a day off to relax and regroup. And every day, devote 10 minutes to prayer or meditation or deep breathing. Doing things that bring you peace and nourish your soul is an investment in your emotional well-being.”
Menopause also serves as a time for women to assess their overall health to ensure their well-being as they get older. For instance, as women age, their risk of heart disease and broken bones due to osteoporosis increases. While the precise link between menopause and heart disease is unclear, Dr. Utian speculates that decreasing hormone levels, along with age-related weight gain and inactivity, may be factors.
The higher risk of diabetes-related heart disease that comes with age, inactivity and being overweight provides women with multiple reasons to mind their heart health. While some women may benefit from hormone replacement therapy (HRT) for menopause-related health issues, it¨Ìs not for everyone. Dr. Utian advises women to talk with their physicians to determine if it is the right choice.
Osteoporosis is another concern for women as they age. Through their mid-30s, healthy people who eat calcium-rich foods build more bone than they lose. Beginning in her late 30s, bone-building slows as a woman¨Ìs hormones decrease. Bones can become weaker and prone to breaking. Particularly at risk for osteoporosis are fair-skinned, fine-boned women who have an inherited tendency for the disease.
Beginning in their 40s, women should talk with their physicians about calcium supplements and medications that can help with bone strength and quality. To reduce their risk of osteoporosis, women also should:
- Eat calcium-rich foods, including non-fat dairy products such as yogurt, milk and cheese, bone-in fish such as salmon, and green leafy vegetables.
- Do daily weight-bearing exercise, such as walking or swimming. Exercise also can ease menopause-related sleeplessness.
- And avoid tobacco, which can interfere with bone-building.