Education Menopause

Managing Menopause: What’s New and What’s True

Managing Menopause: What’s New and What’s True

Every day in the U.S., 6,000 women, give or take a few, enter menopause. Fortunately, we have reached a point where we view this time as a natural stage of life and not a disease or something shameful to only talk about in whispers.

This has not always been the case. Whether you are old enough to be nearing menopause or it’s still a tiny blip somewhere in your distant future, if you watch television, you have at least seen reruns of the popular 1980s sitcom, The Golden Girls. Rue McClanahan, in the role of Blanche Deveraux, won an Emmy for her performance about being told that she had reached menopause.  

“I just don’t know how it happened. Only yesterday, I was Magnolia Queen. I remember my Aunt Lynette going crazy about that time, my mother saying in a hushed voice, ‘She’s going through the change.’ I thought, ‘Poor Aunt Lynette having to go through this change thing.’ I had no idea what it was, but I knew it was never going to happen to me. Here I am. I’m Aunt Lynette.”

For Blanche, reaching menopause meant that her life was over; that she would no longer be the attractive, vibrant, sexually active woman that she had always been. While this has long been the predominant belief in many cultures, times have changed.  

In 2001, the hilarious Menopause the Musical hit the stage, and, after performances all over the world, it has become the longest running musical ever in Las Vegas. Set in New York City’s famed Bloomingdale’s lingerie department, four women, seemingly with nothing in common, share their experiences of hot flashes, mood swings, night sweats, memory loss and sexual dilemmas in a way that not only has the audience in stitches but also portrays just how normal and universal menopause really is.

What Is Menopause?

According to the World Health Organization, menopause is defined as the point where menstruation has permanently ceased due to the ovaries no longer producing the hormones estrogen and progesterone. Typically, this is considered to be the case when a woman has not had a period for at least 12 months. For many people, it would seem appropriate to include the more common symptoms of menopause in its definition. What is particularly interesting about menopause, however, is that while it is a biological stage in a woman’s life, symptoms vary from country to country and from culture to culture.

Hormone levels for women begin to slowly change when they are in their 30s and this leads to the stages of menopause; perimenopause, menopause and postmenopause.

  • Perimenopause – most women enter this stage at approximately the age of 47 when menstrual cycles become irregular. Periods may be missed but pregnancy is still a possibility.
  • Menopause – following the final period, menopause is official.
  • Postmenopause – once 12 months have passed with no reoccurrence of a menstrual period a woman is considered to be postmenopausal, which continues for the rest of her life.

While not all women enter into menopause at exactly the same age, it is a part of the aging process that normally happens naturally. When that is not the case, such as those times it is brought on by disease, surgery or other conditions, it may be described as induced or surgical menopause or primary ovarian insufficiency.

Symptoms of Menopause

The symptoms that are experienced during the stages of menopause vary widely, especially in different parts of the world and within different cultures. Those that are the most commonly reported by women in the U.S. include combinations of:

  • During the initial transition stage of perimenopause:
    • Breast tenderness
    • PMS (premenstrual syndrome) gets worse with the intensifying of mood swings, anger, depression, anxiety, irritability and confusion
    • Periods become irregular and may be uncharacteristically heavier or lighter
  • During menopause and postmenopause:
    • Hot flashes – these are a distinct feeling of heat that spreads through the body like a wave
    • Night sweats – often leaving bed clothes and linens soaking wet
    • Vaginal dryness – this can create difficulty and discomfort during sex
    • Urinary urgency – feeling a frequent need to urinate
    • Insomnia – difficulty going to sleep and staying asleep through the night
    • Mood swings
    • More than normal feelings of irritability
    • Mild to moderate depression
    • Dry eyes, skin or mouth
    • Racing heartbeat
    • Headaches, joint and muscle pain
    • Decrease in sex drive
    • Less ability to focus or concentrate, often referred to as brain fog
    • Temporary memory lapses
    • Weight gain, especially in the abdomen
    • Thinning or loss of hair

Cultural Differences in Menopausal Symptoms

While most of the symptoms that are associated with menopause eventually subside, none of them are pleasant. This makes the fact that the vast majority of these symptoms are not experienced by women in other parts of the world even more interesting. Nearly 50 years ago, research began that was designed to compare the symptoms of women in the U.S. with those in non-Western cultures.

Anthropologist Marcha Flint conducted a study of approximately 500 women in India and discovered that the only symptoms they reported were the actual changes in menstruation. Later, Canadian medical anthropologist, Margaret Lock, found that Japanese women experienced only mild symptoms and then the most common of those was shoulder stiffness. Hot flashes were extremely rare.

Why such a major difference? No one knows for sure, but it is believed that lifestyle and belief systems may play a far greater role than previously thought. Diet may be a significant factor. Could the amount of soy in the traditional Japanese diet at least partially account for the difference? What about cultural beliefs, specifically the way mature women are viewed in places where they are increasingly revered as they age, as opposed to cultures that place more value on youth?  

Alleviating the Symptoms of Menopause

Healthcare professionals recommend different approaches for reducing and managing the symptoms of menopause.  These include lifestyle changes, such as diet, exercise and quitting smoking, as well as nutritional supplements, stress reduction, hormone replacement and the treating of specific symptoms, like sleep medication for insomnia. Some women prefer to try alternative therapies like acupuncture, herbal treatments and meditation.

The practice of mindfulness, which is trying to focus only on the present moment and releasing judgment about any negative thoughts and feelings, was the subject of a study conducted by the Mayo Clinic to see if it had any effect on menopausal symptoms. Researchers found that the effort to be mindful was helpful with reducing irritability, anxiety and depression, which had a positive effect on quality of life.

In the U.S. and similar youth-obsessed countries, menopause is considered, at the very least, to be a challenging time. At its worst, in the words of Blanche Deveraux, “life is over”.  The good news is that more and more women are embracing the mindset of women who see menopause as a life stage of increased respect and freedom and the beginning of the best years of their lives.