Oct. 22--Women must take control of their health and educate themselves about menopause and the ways to manage symptoms during this natural life stage, according to experts.
The International Menopause Society made national headlines last week for releasing a review on menopause and weight gain to mark World Menopause Day on Oct. 18. According to the findings, published in the October issue of the journal "Climacteric," going through menopause does not cause weight gain. Instead, the hormonal changes during menopause are associated with a change in the way that fat is distributed, which leads to more belly fat, according to the study.
As these findings continue to draw attention, we asked local experts to help women better understand menopause and the different ways they can manage their symptoms.
Menopause is the time when a woman's ovaries stop functioning, and her menstrual periods stop, marking the end of her reproductive years, according to The American Congress of Obstetricians and Gynecologists. About 6,000 U.S. women reach menopause each day, according to the organization.
"The population of women nearing menopause in our nation is quickly growing, and we have not done a good job of educating women on what to expect," said Dr. Kelly McCluskey, a partner at Far Hills OB/GYN Inc. in Dayton. "It is as important to know what to expect is normal near and after menopause (as) it was when we first began having menses."
The technical definition of menopause is "the cessation of periods for 12 months in a row which is due to the ovaries' failure to continue producing hormones, which is a permanent change," McCluskey said. Perimenopause is the time leading up to the stopping of a woman's period that is marked by symptoms including hot flashes, night sweats and irritability, she said. The average age at which women reach menopause is 51, but many start experiencing perimenopausal symptoms in their late 40s, McCluskey said.
Signs of menopause include atrophy, or thinning, of the vagina, and a loss of bone density.
As women near menopause, they sometimes begin to experience a sensation of flushing associated with an overall increase in body temperature, McCluskey explained. Some women experience sweating episodes at night that can require them to change clothes or their sheets, short-term memory difficulty or painful intercourse, she said.
Most women are diagnosed as perimenopausal due to their symptoms, and sometimes this is confirmed by testing their follicle stimulating hormone levels, although confirmation is not typically necessary, McCluskey said. Perimenopausal symptoms usually last from two to five years after menopause, but some women experience them for longer and can even continue to have symptoms long after menopause, she said.
Women should be educated about treatment options available for managing menopause symptoms, according to Dr. Heather Hilkowitz, an obstetrician and gynecologist at Hilltop OBGYN, Inc. in Middletown.
"Because the various treatment options can carry some risks as well as benefits, it is important for women to be informed," she said. "Menopause itself can leave women vulnerable to osteoporosis, unpleasant hot flashes and night sweats, mood problems, sleep disturbances, vaginal dryness, changes in libido, and even increased risk of cardiovascular disease as the aging process continues. Being informed about your treatment options is very important, so an educated decision can be made along with your doctor in the best way to treat you. It is definitely not a one-treatment-for-all solution."
Treatment options for menopause include: lifestyle adjustments to make it easier to deal with changes the body is going through; hormone replacement therapy, which may come in the form of pills, patches, creams, rings and sprays which supply estrogens and/or progesterones; estrogens alone for women who have had a hysterectomy; vaginal estrogen to treat vaginal dryness; and pharmaceutical medications like Zyrtec (an antihistamine), Effexor (an anti-depressant which may treat hot flashes) and Clonidine (a blood pressure medication that reduces hot flashes); and testosterone or testosterone-like supplementation in isolated cases.
Here is Hilkowitz's advice for managing the symptoms of menopause.
-- "Understand that your body will be experiencing some unpredictable changes, which are very individual. You may suffer with significant hot flashes, whereas your best girlfriend may instead experience marked mood changes. Everyone's experience is different."
-- "Dress in layers to help manage the unpleasant hot flashes."
-- "Develop a consistent sleep routine, and consider a gentle herbal supplement like melatonin to help you sleep."
-- "Consider a calcium supplement. A safe range is around 1,000 milligrams a day, perhaps more if you have bone thinning. Discuss this with your doctor."
-- "Make sure you are getting enough vitamin D, which helps us absorb calcium as well as other health benefits like immunity and energy."
Menopause and natural remedies
Women should learn more about natural remedies for treating menopause symptoms, said Donna Walls, a clinical nurse and lactation consultant at Miami Valley Hospital in Dayton.
"Menopause is a great time to re-evaluate your lifestyle and incorporate exercise, relaxation techniques, daily meditation, stress management, dietary changes and possibly herbal support," she said. "Simple changes like adding two tablespoons of flaxseed meal daily along with herbs such as black cohosh, usually taken in capsule form, or red clover tea have been shown to be effective in reducing hot flashes. Adding healthy isoflavone-containing foods like whole organic soy, citrus fruits, beans, legumes and tomatoes are helpful for hormone balancing."
Here are Walls's tips for "surviving and thriving" during menopause.
-- "Eat only hormone-free meats and dairy."
-- "Choose a more plant-based diet, increasing fruits, vegetables, nuts and seeds."
-- "Avoid environmental estrogens by minimizing food contact with plastic containers. Use glass, bamboo or stainless steel containers for food preparation and storage."
-- "To help with sleep problems, try a cup of chamomile or passion flower tea about an hour before sleep time."
-- "Switch to organic produce whenever possible."
-- "Learn relaxation breathing. Sit quietly, and really think about your breaths. Exhale tension as you exhale your breath; try to imagine breathing in calm as you inhale."
-- "Lemon or tangerine essential oils diffused into the air can be mood lifting and cooling."
Menopause and nutrition
Women should know more about the importance of good nutrition during menopause, according to Ashleigh Giltz, a registered dietitian at Mercy Health -- Healthy Weight Solutions in Fairfield.
"It is important for women to be knowledgeable about menopause and good nutrition in order for them to be proactive about their health and lifestyle," she said. "During menopause, hormonal changes are taking place in a woman's body, and good nutrition can help to lessen the side effects and improve health and quality of life. From decreasing discomforts associated with menopause to maintaining a healthy weight, good nutrition is vital during this life stage."
Here is Giltz's advice for helping women to achieve and maintain a healthy weight.
-- "Eat three meals and one to two snacks daily to help keep (your) metabolism stimulated throughout the day."
-- "Include a source of lean protein with every meal and snack."
-- "Fill up on whole grains and low-calorie fruits and vegetables."
-- "Cut out all calorie-containing beverages such as fruit juices, sugary drinks, sweetened coffees or teas, and soda."
-- "Avoid fried foods and sweets such as cookies, candy, cake, etc."
-- "Women should aim to get 30 minutes of exercise most days of the week. Strength training is important to help increase muscle tone, which helps to increase metabolism. Weight-bearing exercises also help to improve bone strength. Women can prevent bone loss with regular exercise. Check with your doctor before beginning a new exercise routine."
Local women share experiences
Michele Gannon, 50, of Kettering, started experiencing menopause-like symptoms around age 38. She began to grow some facial hair, and experienced sleepless nights and hot flashes. At first fearing the symptoms pointed to heart problems, she was eventually diagnosed with perimenopause, a transitional stage when women may experience menopause-like symptoms.
At 47 years old, Gannon reached menopause after undergoing a hysterectomy. After her surgery, she began taking hormones containing estrogen to relieve her menopause-related symptoms.
According to Gannon, women must be informed about menopause and the process that leads up to it.
"For some, it starts in their 30s," she said of women's menopause-like symptoms. "You can get a feeling that something is wrong with your mental (health). ... Once they told me it was menopause, and this was natural, I began to think, 'I'm not losing my mind or having a mental breakdown.' My husband began to understand ... and the kids, too. They had to know. When I became educated, I could help them deal with my symptoms, too."
Michelle Flory, 57, of Dayton said her experience with menopause was much more "mild" compared to what other women report.
She began experiencing some menopause-related symptoms including irregular menstrual periods and restless nights in her late 40s. Flory, who reached menopause at 52 years old, said she experienced few hot flashes and other typical symptoms.
"I hear other ladies say how hot or moody they are, but I never had any of those symptoms," she said.
Whether a woman's menopause experience is mild or severe, it's important to be informed about this stage of life, Flory said
"I think we need to be just overall aware of our own bodies and the health concerns that are out there," Flory said. " ... Women should be concerned (about) what's going on with their body."
Local experts help women understand changes and how to cope with them, ease symptoms
Menopause and hormone imbalance
Menopause is associated with decreased functioning of the ovaries, which results in lower levels of estrogen and other hormones, according to The North American Menopause Society.
Lyn Hogrefe, 57, of Lebanon, is the director of The Happy Hormone Cottage. The organization, which opened in 2009 in Centerville, and now also has offices in Kettering and Mason, along with locations in Kentucky and Missouri, is a resource center where women can get information and education on natural hormone balance.
While menopause represents a "small window" of time, hormone imbalance is a "big umbrella term" Hogrefe said describes the cause of the symptoms related to menopause women often experience for years leading up to their last menstrual periods.
When Hogrefe was in her 40s, she began to experience symptoms including hot flashes, brain fog and fatigue. Her doctor discovered she had thyroid tumors, and she had a hysterectomy. After her surgery, a customized natural hormone plan helped relieve her menopause-related symptoms, and now, she and her staff members are helping other women to adjust their hormone levels in a natural way, too.
Women should be educated on options available to treat their menopause symptoms, including healthy, natural choices like natural customized hormones, which are Food and Drug Administration-approved, plant-based powders, she said. Medications like antidepressants often are one-size-fits-all and may not be right for every woman, Hogrefe said.
"The world we work in is functional medicine, and the world doctors work in is conventional medicine," she said. "We are more holistic."
Hogrefe encourages women to consider natural hormone therapies beginning in their 30s when menopause-like symptoms often begin.
"Women should take this into their own hands and learn what their options are," she said. "... Every woman should be in charge of their own journey."
Doris Jones, 55, of Miami Township, also said women must take responsibility for their own health.
Jones, a previous client and now a client consultant at The Happy Hormone Cottage, started experiencing menopause-related symptoms including night sweats, irritability and weight changes at age 47.
Jones said she pursued many remedies, including diet and exercise, but nothing worked until she began receiving hormone therapy at age 53.
"If you really are experiencing these symptoms, be a little proactive," Jones said. "Don't wait until they're so severe. ... We're in charge or our own health."
Debbie Scheiding, 46, of Beavercreek, is a client of The Happy Hormone Cottage. Scheiding began experiencing menopause symptoms, including a lack of focus and no libido, at age 42.
At age 44, she reached menopause, and she soon began taking natural hormones. After three months, many of her symptoms were relieved. Scheiding said she will continue to take these hormones for the rest of her life.
"The natural hormones benefit you so much better," she said. "I don't know a lot of women that like taking prescribed drugs. ... (Women) have to step up to their doctors and say, 'This is what I want, what I choose. It's my body. ... You can live a much happier and healthier life if you are educated and get on something quickly."
For more information about The Happy Hormone Cottage, go to www.happyhormonecottage.com.
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