Change of Life: The Menopause Handbook

Once upon a time, menopause was a deep, dark secret. But not today.
 
Today we want to know exactly what to expect, how to deal with our physical and emotional changes, and how to continue to live life to the fullest.
 
• The menopause handbook answers all your questions. You’ll learn
• How and why menopause occurs—and how to recognize the physical signs 
• What to eat for your changing nutritional needs to avoid weight gain and stay healthy
• How menopause may affect your sexuality—and why many women find sex better after menopause
• What types of exercise are best for you
• Strategies for coping with the “middle-age blues”
• How to prevent osteoporosis
• What causes hot flashes—and how to get fast relief
• The truth about the emotional side of menopause—career and role changes, men’s own mid-life crises, and how to deal with stress

Combining solid, up-to-date medical information with personal anecdotes from women who have been there, this comprehensive handbook dispels the myths about menopause and guides every woman through this time with confidence.

Introduction
 
As a health writer headed toward her middle years, I felt compelled to read about the changes going on within my body. I searched for a good book on menopause. While the market was flooded with literature on pregnancy and childbearing, I found that little attention had been paid to the needs of older women. Many of the books available were dry and technical, dealing with the problems of menopause and estrogen therapy. This focus on medical problems made menopause sound like some dread disease of the middle-aged.
 
Menopause is not a shameful ailment of aging women. It does involve some physical and emotional changes. But then, so do puberty and pregnancy—the other major milestones in a woman’s reproductive life. After looking at recent statistics I found that the majority of women get through menopause without taking hormones or seeking medical care. In fact, many women who have been through menopause say that it marks a time of renewed self-growth and recharged sexual energy.
 
I wanted to write a book that would cut through all of the technical terminology, and lead women through the menopause experience in a clear and positive way. It would include all of the traditional medical topics: the physiology of menopause; understanding and coping with hot flashes; the pros and cons of estrogen therapy; body changes at menopause; male and female sexual response in the middle years; and the prevention and treatment of osteoporosis.
 
I felt it equally important to address the emotional side of menopause—career and role changes, the aging and sometimes death of one’s parents, children leaving home, a husband going through mid-life crisis—all of these can take a toll on a woman going through her “changes.”
 
Well-care advice would also be featured, including natural alternatives to estrogen, nutritional needs during menopause, exercise guidelines, dieting tips, stress management techniques and care of aging skin and hair.
 
It took nearly two years of intensive research to complete Change of Life. During that time I corresponded with national women’s health groups and major medical organizations, and consulted with experts in many fields—gynecologists, nutritionists, sex counselors, physical education specialists, naturopaths, herbalists, psychologists, career counselors and health educators.
 
Most importantly of all, I talked to numerous women in all stages of the menopause experience. These women ranged in age from thirty-five to seventy-five. Some were on the threshold of menopause, and beginning to feel the first subtle effects of declining estrogen levels; others were smack dab in the middle of their “changes”; and still others were well past this stage of life.
 
My subjects included relatives, neighbors, friends and my friends’ parents. They were women who exercised with me at the local gym, and senior citizens who attended a local community center. I distributed questionnaires to an ongoing menopause support group sponsored by a family services agency, led a menopause workshop in my living room, and even stopped total strangers at random in public places and asked if they’d be interested in discussing the subject with me. Women referred me to other friends, and so my list grew. I am indebted to these many women. Their personal experiences and helpful advice are interspersed through Change of Life.
 
As you read through Change of Life you may find that there are some subjects that you’d like to pursue in more detail. At the end of the book you will find a full list of references for each chapter. I have also compiled a bibliography of suggested readings and addresses of helpful agencies you may want to contact.
 
Menopause may not be an easy transition for everyone. But it is not so fearful when you understand the events leading up to it, and how to deal with its possible discomforts. My hope is that Change of Life will help guide you through menopause in a more confident way.
 
Chapter 1
What Is
Menopause?
and Other Good
Questions
 
“My body, in subtle ways, tells me that it’s beginning to change. A rush of dizziness now and then, and irregularities in my menstrual cycle made me run to the doctor in a panic. I was told that my problems were hormone-related. That these symptoms were typical for a woman ‘of my age.’
 
“At forty, I still don’t think of myself as being middle-aged. I keep trim and active and am doing more things with my life now than I did when the children were babies. I guess my age is sneaking up on me anyway. I’ve always equated menopause with crazy ladies breaking out in sweats. And worse, with being ‘over the hill.’ The thought of it depresses me.”
 
“I’ve heard such scary things about menopause. I’ve heard that you’ll become cranky and irrational and have a diminished sex drive. I’m afraid that I’ll become fat and lazy—like an altered cat. It’s something I don’t want to face. I’ll think about it when it happens.”
 
“I’ve always taken pride in my looks. I wonder how my husband will feel—seeing me with sagging skin and droopy breasts. Will it turn him off? Will he still want me?”
 
“The childbearing years are a fruit-bearing time. But menopause—it’s like becoming a dried-up peach.”
 
Mention the word menopause to women who have not yet gone through it, and chances are you’ll see them flinch, joke uncomfortably about it or sigh with resignation. “I know absolutely nothing about it,” confesses one forty-one-year-old woman. “I just refuse to believe it’s really going to happen to me.”
 
But menopause happens to all healthy and normal women. And the vast majority pass through it beautifully, with only minor complaints. They do not lose their minds or their capacity to enjoy sex. And, if they take good care of themselves, they remain vigorous and attractive.
 
While menopause is as old as womankind, some dramatic breakthroughs in health care in the past century have put it into an entirely new perspective. It wasn’t so long ago that most women died before reaching menopause, or else shortly afterward. A woman living in seventeenth-century Europe had a 28 percent chance of surviving to menopause.1 By 1900 the female life expectancy in the United States was only forty-eight.2 It’s no wonder that women feared menopause and talked about it in hushed whispers. It was, for them, a sign of declining health and old age.
 
As a woman today you can expect to live well into your late seventies.3 That means that you will live a full third of your life after menopause. Put another way, you will probably outlive your ovaries by twenty-five to thirty years!
 
And many women say that the postmenopausal years are some of the best in their lives. Unhampered by child rearing, mothers at last have the time to devote to their own self-fulfillment. With fear of pregnancy past, sexual relationships often bloom anew.
 
Women entering their middle years today are fortunate in other respects too. They are more open about their bodies and more health conscious than their mothers were. They have been touched by the prepared childbirth movement, the women’s movement and by self-help trends in the health field. They are better medical consumers who ask more questions and demand a greater role in their own care.
 
Since more women than ever before are living past menopause, there is a burgeoning of interest in the subject. Books and articles are beginning to focus on this relatively unexplored area of women’s health. But myths and fears that have spanned centuries do not die that easily. And you may find that you still have many unanswered questions about the basic facts of menopause.
 
What Is Menopause?
As you age and become less fertile, you are said to be entering your climacteric. The word comes from the Greek, klimakter, meaning the step of a staircase or rung of a ladder. It signifies a critical period of life when some important change happens. This image of ascending life’s ladder and reaching new heights is fitting for a woman in the prime of her middle years. In medical terms, climacteric is defined as the transitional period between a woman’s reproductive life and the end of her fertility.
 
Sometime during your climacteric your ovaries will stop releasing eggs and you will no longer have periods. The time of your last menstrual period is called menopause. You won’t know for sure that you have reached menopause until you have gone at least twelve consecutive months without menstruating.
 
Technically speaking, the years leading up to menopause are called premenopausal or perimenopausal. The year or two after the final period is defined as postmenopause.
 
Most of us, when talking about menopause, do not make such neat distinctions. In common usage menopause has come to mean any of the changes a woman experiences either before or after she stops menstruating.