Handbook Excerpts

Excerpt from Chapter 2

Thirty, twenty, even ten years ago, menopause was rarely discussed. The baby boom generation has grown up with the womenís movement; consequently, women are sharing more intimately with each other, discussing what is happening to their bodies, and replacing negative stereotypes. Menopause is a phase in a woman's lifeóand, as with all phases of human life, sometimes one needs help with it and sometimes not. In the Harvard Womenís Health Watch, August 1998, they state, "In some ways, menopause is similar to pregnancy. It is a natural, healthy state that nonetheless may require some attention."

Menopause is a time of change: physical, emotional, psychological, spiritual. Change. Not necessarily unpleasant, perhaps unexpected. No matter how positive, change is difficult. And the potential result? The obvious one is no more periods, but women say there is so much more. Women, aging like fine wine, improving with each year, throwing away stereotypes. Finally taking time for themselves, discovering who they are.

Right now the number of American women experiencing some form of menopause is 43 million! (Gail Sheehyís The Silent Passage) That's a relief because with those numbers, the experience must be normal.

Hormones at Work

The hormones (estrogen, progesterone, androgens, and many others) produced throughout a woman's life affect her general health and well being, including bone strength, sexuality, and reproduction. Understanding how these hormones affect a woman's cycle will help one to understand menopause.

During the first half of the menstrual cycle, the ovaries produce estrogen, which causes a thick lining to grow inside the uterus. At mid-cycle, one ovary releases an egg cell that travels down the fallopian tube into the uterus. (This is the time when pregnancy is most likely to occur.) During the next two weeks the ovary produces progesterone to strengthen the lining of the uterus and prepare for the fertile egg. If the egg is not fertilized, the levels of estrogen and progesterone diminish quickly; the lining of the uterus loses hormonal support and is shed during menstruation. Then the cycle begins again.

Estrogen protects arteries, increases production of HDLs (the "good" cholesterol) and reduces LDLs (the "bad" cholesterol), helps maintain bone mass by assisting calcium absorption, supports production of collagen (which maintains elasticity of the skin), and may protect against Alzheimerís disease.

Progesterone, produced by the ovaries and adrenals, has a calming effect on a woman, maintains the nervous system, and is the stimulator for new bone production. The lack of this hormone may be associated with mood swings, weight gain, anger and anxiety, depression, night sweats, osteoporosis, and diminished libido.

The hormone DHEA has received more attention in recent years. Produced mainly by the adrenal glands, it is associated with strengthening the immune system, reducing fat deposits in the arteries, improving cognition and mood, and promoting bone growth.

Androgens maintain strength, sex drive, and the elasticity of the vagina, as well as influencing general health. Some androgens are converted to estrogen in the fat cells of a woman's body. Recent studies indicate that even 80-year old women produce some androgens. Good reason to think twice about having healthy ovaries removed during a hysterectomy.

During perimenopause, which usually begins after forty (and sometimes earlier), your body runs out of eggs. Without eggs, there is little need for progesterone to strengthen the uterine lining. We still have periods. Your body continues to do what itís become accustomed to doing; it feels as if you are going to ovulate, then you donít.

Excerpt from Chapter 7

Life-Style Changes

I preface this section with a quote from Rebecca Latimer (Youíre Not Old Until Youíre Ninety, Best to be Prepared, However), as she urges us to add 15 minutes of meditation per day, for our own good. She says, "It is a hard fact that if you want to make the most of your old age, you probably will have to change, and change doesnít come easily or painlessly. You will need to apply self-discipline. You may think that itís too late for you to change yourself, that your habits are too deeply rooted, that you are too old to experiment with odd and difficult exercises, but I must tell you that I donít think anyone is too old to change, just as I think anyone can learn a new skill at any age." (Latimer was 91 when she finished her book.)

Every expert agrees that if you smoke or drink heavily (alcohol, more than one drink per day, and caffeine, more than two cups per day), you should stop or at least cut back. Either can be toxic to your bone cells and reduce your body's absorption of calcium. Also, pre-, post- and menopausal women need to watch the amount of protein, especially from meat, as it increases the body's acidity. In order for the body to maintain the proper pH, it depletes calcium directly from the bones. Many women who eat meat with hormones in it find that their hot flashes and mood swings increase. Even post-menopausal women who havenít had a hot flash in years suddenly begin to have them following several days of eating meat and/or dairy with hormones.

Exercise, ideally weight bearing, at least three times a week for 20-30 minutes each time, can decrease the risk of osteoporosis. (Exercising for longer period of time provides more benefit.) Adding up to 1500 mg. of calcium plus 100 to 400 mg. of magnesium per day helps too. Magnesium is a critical part of the picture. Some experts claim that magnesium is more crucial than calcium. Women who begin exercise and supplements in their early thirties build strong bones as a good base prior to menopause. Women in their 40s, 50s, 60s, and so on, can markedly improve their bone structure.

Reduce or eliminate processed sugar from your diet. It seems that everything has sugar in it. I noticed that my hot flashes were far worse when I ate sugar. Eliminating processed sugar and only eating foods with small amounts of pure maple syrup or fructose were easier for me to digest and didnít cause my body heat to rise. This is a time when it is important to pay attention to how food, people, life effects you. Try to avoid that which affects you negatively. For several years, I had to avoid all alcohol; even organic wines gave me hot flashes. Now I can drink a glass or two of wine with dinner and experience no ill effects.

Vitamin supplementation may need to be a part of your life style change. Throughout this chapter are suggestions of what to supplement and why. In addition to those, take 50% more magnesium than calcium for up to three months for hormone imbalance and to increase your energy and reduce tension. It is a favorite supplement for naturopathic physicians in treating premenstrual syndrome.

Drink plenty of water throughout the day. If you find that you rise often during the night to relieve yourself, drink most of your water before 3 PM. Avoid stimulants, fad foods, and fad diets.

Consistently, women tell me that the message they are getting from their bodies is to slow down during perimenopause and after. Experts reinforce this notion. Take more time for yourself. Let go of some of your projects. Take time at home, alone. Pay attention to you and your body. Take walks on the beach or in the woods or even around the block. Consider taking vacation with a group of women friends. With the help of friends, loved ones, a therapist find what fits for you, whether it is exercise, diet, time alone or with others. This is the beginning of the second half of your life, and itís about you.