As a 51 year-old female family physician, I am currently getting the opportunity of experiencing the changes involved in my own life as well as having shared several decades of helping many women through these interesting years that make up what we call menopause. The medical definition of menopause is one full year of no menstrual cycles. As you can see, this has to be done retrospectively, so another term, called perimenopause (meaning the time around menopause) is more relevant to most women who are experiencing challenges during the middle part of our lives on this planet.
What the Heck is Up with My Body?
Menopause is a time in a woman’s life that involves significant changes. Hormones that dominated the monthly cycle and were necessary to prepare the female body for child bearing are no longer running the show. Prior to menopause, the female body undergoes surges of different powerful chemicals (called hormones) that prepare the egg for ovulation as well as the uterus for pregnancy. If an egg is not fertilized that month, another big change in chemistry occurs, and the process begins again. This 28 day cycle results in massive weekly changes in a female’s body chemistry starting at the age of 12 and continuing through the age of 50. During perimenopause, the surging nature of hormones spaces out and then eventually becomes more of a constant flow, moving away from the merry-go-round of the monthly changes.
Fifty-one years of age is the average age of menopause for most women. (The best predictor of when you will go through menopause is your mother’s age when she went through natural menopause.) After 51 years of life, the ovaries of most women start decreasing how much estrogen they produce. The merry-go-round starts slowing down (for many of us the slowing down may feel much more like lurching!), which can manifest with many different symptoms. The most common impact of less estrogen is hot flashes, which can disrupt everything from sleep to relationships with co-workers (and cohabitors!) who seem to “always want the thermostat set too high.” When hot flashes occur at night, these disruptions can lead to decreased energy due to interrupted sleep.
Although estrogen is what is most focused on in menopause, other hormones play equal roles. Progesterone plays a role in making the smaller amounts of estrogen a woman continues to produce in and after perimenopause work better. Progesterone appears to have far fewer harmful side effects than estrogen and is available in over-the-counter forms.
In addition to the chemical changes, menopause can also be a time in life where relationships between mothers and their children begin to change. The children are developing their own identities and leading lives of their own, no longer needing us to keep them alive (kidlets can get themselves into trouble so quickly, in so many ways, for so many years….!) and no longer needing our direct assistance in providing for their basic needs (it is an exciting moment when they can operate the microwave safely on their own!). This can be a time of great relief for some women, but for many, it can be perceived as a time of loss. These realizations as well as chemical changes can lead to depression and low feelings of self worth, all of which lead to a low energy state of being.
Age 50 can also bring on questions for all women, with or without children, regarding their changing role in society and their own life. Aging parents or relatives may start playing a bigger role in daily life, as well as evaluating better balance between careers and self care.
So decreasing estrogen levels, life role changes, and new reflections on our role in life all can lead to low energy levels. Simple new habits can make this time of transition easier and can actually lead to a better state of health now than when we started our new transition.
What Can I Do About It?
There are many ways to make menopause a time of change that leads to better health and self awareness. Hormone regimens can be helpful, especially if symptoms are dramatically impacting your quality of life. You will need to seek the assistance of a clinician with experience in menopausal healthcare and the ability to determine if an estrogen prescription is safe and right for you. Estrogen, which can be taken orally, absorbed through the skin either in the form of a patch or a cream, can help with many of the more severe symptoms of menopause, such as hot flashes. Problems such as vaginal dryness and painful urination can be helped with estrogen creams. Side effects can be life threatening, however, and require guidance, so do not hesitate to ask questions about this option and if it is right for you.
Progesterone creams are available over the counter and in my clinical experience, can help many women with hot flashes. You can also speak with your health care professional about oral progesterone treatment, which does require a prescription. Oral progesterone can help reduce hot flashes and can also help with sleep issues.
Learn How to Meditate
The mental challenges of changing roles that cause us stress can also be used as an opportunity to choose new ways of dealing with life challenges. Learning how to meditate, or “take a moment to see a new perspective” can lessen the impact mental stress plays on our health. The stories we tell ourselves can cause just as much (or more) dis-ease as actual physical challenges. Learning new habits that allow us to reframe our life results in less energy expense in worry, anxiety, and depression and leads to significant increase in daily energy. Finding the right tools and guides in this area, combined with consistency in practicing these tools can have dramatic, life-changing impacts on health and well-being. Demonstrating how to take care of ourselves can be life changing for those who depend on our help as well. Our children and loved ones see the changes in us, and then want to follow our lead. There is tremendous truth in the fact that our children learn much more through our actions, than the words we tell them. Become the change you wish to see in others!
Consistent Lifestyle Intervention
Finally, our changing roles in our jobs, and the new possibility of having our elders start depending on us for care and support requires that we be at our best. The familiar instructions we receive prior to take off in an airplane can be directly applied to life. “Please secure your oxygen mask first, prior to assisting others.” If we do not make sure our needs are met, we are of little help to those who need us most. “Running out of oxygen” leaves us requiring help and just adds to the problem, so getting enough sleep, exercise and time to do what nourishes our bodies as well as our souls is not selfishness, but a critical component for our ability to help others, in whatever capacity that ends up being. A new habit involving strength training against our own body weight can easily be woven into our lives and can help with energy, reduction of pain, and weight loss. This training involves three simple ingredients: our body, the floor and consistency. No special equipment is required. Learning the right moves from qualified fitness professionals can turn our experience of daily fatigue into mornings where we have not only the energy to finish what needs to be done, but ample energy to do the activities we want to be doing.
I have always lived by the motto “Physician, heal thyself.” In order to keep me functioning at a capacity that is helpful and not harmful to those in my professional life, as well as my personal life, requires an ability to know when to ask for assistance from others, as well as consistent, daily habits that allow my body and mind to work at their best. Perimenopause and beyond can be times of great challenge, but more importantly, times of great personal growth and the beginning of a grand journey into exceptional health and wellbeing. By paying attention to hormonal, mental and physical needs during menopause, then learning simple lifestyle adjustments and consistent application of these new habits, the journey to the second half of a woman’s life becomes an easier and much more fun grand adventure!
Download our free recipe book “8 Delicious Recipes for Lasting Energy for Menopausal Women” here.