Menopause - New Growth or Going to Seed

I’ve been spending the last several days photographing and looking at flowers. In all stages. Buds, opening blooms, full-on vibrant blossoms, fading flowers. All different. All beautiful.

Since the advent of the Big M, I’ve suffered some confusion as to whether we goddesses are blossoming anew or beginning to wilt. Certainly, for me, the answer depends on the day. Or the hour. I sometimes feel like I’m the subject of one of those time lapse films where the flower goes from closed to open. Then in a diabolical turn, the film reverses and I go from open to closed. Closed, open. Open, closed. I don’t know if I’m blossoming or going to seed.

But what if it isn’t one or the other? What if it’s both? It seems that the nature of the menopause transition makes us more comfortable living with paradox. It sure makes us more comfortable dealing with change! Each of us may be growing and blooming into a new form, a new “me”. At the same time we have seeds of wisdom that we disseminate to ourselves and one another. Like the rosebushes in the garden, we are budding, bursting forth into the sunlight, flashing our brightest colors and dropping a few petals here and there. All at the same time. All different. All beautiful.

Who Are The Menopause Experts? Menopausal Women!

I had my mammogram the other day. And since the x-ray technician performing my exam was a menopausal goddess, we struck up an instant rapport. Upon finding out about the Venus group, she asked me to distill what we’d learned together - sort of a 25 words or less synopsis because other mammos were waiting to be grammed. I summed it up this way. “Every woman is different and has to conduct her own risk benefit analysis to decide what is best for her. And the way we get wisdom is through woman-to-woman sharing.”

After agreeing wholeheartedly, she shared that two of the gynecologists at the big medical center in our nearest city offer no other recommendations for women suffering menopause symptoms than HRT (Hormone Replacement Therapy.) “And they are young! In their 30’s still.” Proving what I’ve always suspected: that hardening of the attitudes is not an age-related phenomenon.

Although menopause is not a disease, it is still important to be followed by a physician. Notice that I say “followed” by a physician. It’s all too easy to find ourselves being be “led” by our health care providers. You and your primary care provider must work together. If you cannot form a partnership with your doctor, then find another who will work with you. I cannot emphasize this strongly enough. You are responsible for your own healthcare. Educate yourself.

My professional training in nursing school covered the area of women’s health as the “Reproductive” module. We learned a great deal about fertility, the birth process, and diseases of the reproductive system. We learned almost nothing about menopause. 1200 pages of textbook and virtually none of it dedicated to the second half of a woman’s life.

Even today many health care practitioners have learned little more, or they have only learned some standard practices that may exclude some of your choices. In all fairness, so little research exists on The Big M that it’s no wonder there is a dearth of expertise among health care personnel.

We must become our own experts in the areas of women’s health and menopause, and more specifically on our own individual bodies. Thankfully, there are a great many menopausal goddesses out there willing to share all they’ve learned and to offer support and laughter as we travel this journey we didn’t choose.

Hormone Replacement Therapy (HRT) - The HeaRT of the Matter

I was getting my hair done a couple years ago at my favorite salon, along with five other women 'of an age', when talk turned to the Change. Most of us were loudly proclaiming our favorite natural remedies and fixes. The woman in the chair adjacent to mine finally spoke up apologizing to the roomful of menopausal goddesses for having “caved”, finally starting HRT (Hormone Replacement Therapy)..

“It's just that I couldn't sleep,” she told us shamefacedly. “I couldn't sleep at all. I was so tired I couldn’t function. And nothing else worked.” We all leapt in to assure her that there was no need to feel guilty. The risk-benefit ratio seemed pretty clear to all of us. Underscored for us was that we women need to support one another through this process rather than judge anyone, including ourselves.

But I have to admit that I was feeling pretty smug and blessed that I was coping without HRT. My symptoms were manageable. What’s that thing they say goeth before a fall? Oh yeah, pride. I no longer have a surplus of that. I eventually ended up on low dose HRT myself. And honestly, I wish I’d taken it sooner.

First welcomed as a godsend, now seen as a terrifying, politically incorrect alternative for menopause symptom relief, HRT may actually be neither. In deciding whether we wish to consider HRT as a viable option, we really need to evaluate our personal risk-benefit analysis. In other words we need to list pros and cons, and then weigh those pros and cons in order of importance.

History of breast or other reproductive cancers in your family would cause you to rate your risk higher. Family history of blood clots, stroke, or heart disease also put you at higher risk. If you have or have had any of these conditions yourself, the risk may be too high and you'll want to look elsewhere for help. And if you are a smoker? HRT is not a great idea for you; your risk of heart attack, stroke and other cardiovascular disease spikes.

On the benefit side, if your hot flashes are 30+ per day, so intense that you are nauseous, or your sleep deprivation from insomnia is making you psychotic, then HRT may be a valuable help in the short term. More risk is associated for all women with long term usage of HRT, so taking it to “get over the hump” may be an option. Above all, do not feel guilty if you decide that the herbal, natural route didn't work for you and you need to avail yourself of HRT. Our own Beej-Venus tried herbs and immediately stopped using them because they “gave me a rush”.

If you should decide to consider HRT as an alternative, be sure to stay aware and re-evaluate periodically whether you might be ready to slowly decrease and ultimately discontinue your hormones. Above all, be gentle with yourself and choose what’s right for you. (Next blog entry, we’ll examine briefly both bioidentical and synthetic hormones. Material partially adapted from our upcoming book -to be released very soon. We’ll keep you posted. For the latest, visit our mothership blog at menopausegoddessblog.org)

Soy For Menopause Symptoms: Oh Soy! or Soy Vey!

For just about a year, my hot flashes, insomnia, and mood alterations were down to a dull roar thanks to my natural progesterone cream. And then I started down the next dip on the Menopause roller coaster.

Early in perimenopause, progesterone levels drop. Later in the transition, estrogen levels decrease as well, causing a resurgence of hot flashes, mood swings, insomnia, vaginal dryness, and more. The progesterone cream that worked initially is no longer enough. We may feel the need for estrogen supplementation. I surely did. Following the rules and guidelines for remedies, I wished to start with the least heavy duty, most “natural” remedy first. Enter natural remedy #1: soy.

Natural Soy - The Good News
I decided to do a little research - here’s what I found. Soy has been touted as a healthy food alternative to almost everything: meat (tempeh, tofu), milk (soy milk), cheese (yep, soy cheese), appetizers (edamame soybeans), snacks (soy crackers and chips.) and so on. Soy is also a phytoestrogen or plant estrogen precursor. Ergo, if you want to have “natural” symptom relief from your hot flashes, insomnia, and the like - eat soy. Still have symptoms? Eat more soy. Don’t like the taste or texture of bean curd? You can ingest soy in the form of pills or capsules. A number of popular products can be found in the health food aisle of your grocery store, such as Estroven. For many women, soy has made the transition much milder.

Needless to say, this sounded like THE ANSWER. (However, in my excitement, I forgot the all important rule that “There Is No Silver Bullet” or single panacea for the menopause maladies.) I started taking a natural soy remedy and switched to soy milk.

And I got worse. My hot flashes increased. I couldn’t sleep. I was REALLY cranky. Add to this bloating, stomach aches, and nasal congestion and you have the makings of a Menopausal Monster. I decided a little MORE research was in order. And here’s what I found:

Soy Vey - The Bad News
While soy is a healthy choice for many people, it makes the list of the top 8 food allergens, along with milk, eggs, peanuts, tree nuts, fish, shellfish, and wheat. (source: Mayo Clinic.com) The FDA now requires that all food be labeled if it contains any of these.

Although it is estimated that only 1% of the population has true allergies to these foods, a large number of the population may be intolerant or sensitive to them. What “intolerance” means is that they can ingest small amounts of these substances with no ill effects, but with larger doses symptoms appear. (Those who have true allergies cannot tolerate even a tiny amount of the reactive food without a serious allergic reaction: difficulty breathing, hives, swelling of face, neck, tongue, or shock).

In a nutshell, many of us are unknowingly sensitive to soy. When we increase our intake of soy, we may develop symptoms consistent with food intolerance such as cramping, diarrhea, bloating, dizziness, nasal congestion, and flushing. If we are soy-sensitive, we may actually find our hot flashes and other Change symptoms increasing, as we stress our body beyond the already overwhelming stressors of menopause. Luckily, those of us with soy intolerance have the option of soy-free herbal preparations that contain phytoestrogens, which we’ll touch on in the next blog.

For those who are not allergic or sensitive to soy, ingesting tofu, soy milk, and soybeans might be a godsend. Beware, however, of taking too many soy pills which contain high levels of soy isoflavones. More is not better. There is concern about interference with thyroid function (which translates to even more symptoms for a menopausal goddess). Monitor yourself and your response along with your trusted health practitioner. (See April 3 and March 28 blog entries for guidelines in “Choosing The Right Menopause Remedy for You.”)

So what happened? I stopped the soy. And while my menopause symptoms continued unabated, they decreased slightly while the bloating, stuffy head, and abdominal pains disappeared. (My MD tested me for food intolerances - the only one I was sensitive to was indeed soy.) I tried various other remedies: black cohosh, dong quai, primrose oil. None of them seemed to have any effect (except some flushing and heat sensations with the dong quai.) Yet, I knew women where each of these remedies had worked like magic.

What next? My estrogen levels were subterranean. My thermostat was in the nuclear zone. How was I going to cool off literally and emotionally? The saga continues in the next blog entry where we’ll discuss [ominous drum roll please] HRT, also known as Hormone Replacement Therapy.
(material adapted from our upcoming book “Venus Comes of Age”)

Natural Symptom Relief for Menopause

Early in perimenopause, I was complaining to Lei-Venus that I was feeling heat crest in waves over me, but even more upsetting to me was the change in my sleep patterns. Having always slept soundly, I was now waking every hour or two and experiencing nights of restless, broken sleep. Without a word, Lei grabbed me by the hand and pulled me bodily down the street to the health food store. She plunked a jar of Natural Woman progesterone cream in my hand, declaring “Buy this now - it may take up to two weeks to help, but you’ll be a new woman.” I felt the difference in two days. After a week, I was sleeping through the night again.

In the beginning of perimenopause, progesterone levels drop which can begin the annoying symptoms of hot flashes, insomnia, and mood swings. Natural progesterone cream is a good first step and may be all you need to weather the storm of symptoms. I can report that it was a godsend for some of us goddesses during this transition - and, sad to say, didn’t work much for others. Remember rule # 2 from March 28 blog entry on “Choosing The Right Menopause Remedy For You”? What Works for One Venus May Not Work For Another. You’ll have to try it and monitor your own response to see if it helps you.

Emerita’s Pro-Gest (www.emerita.com), and Natural Woman (www.prodnature.com) are the Venus group’s favorite natural progesterone creams but there are others on the market. A cautionary note: Mexican wild yam cream is not as effective as natural progesterone cream, as it is a precursor to the hormone and not in a usable form for our bodies.

Dong Quai, Burdock Root, Red Clover, Black Cohosh, Evening Primrose Oil, Cod Liver Oil
Studies show that women in Japan and China have much lower incidence of PMS or menopausal symptoms than do Americans. This could be due to DNA, but also could result from the facts that the usual Japanese diet is high in soy and dong quai is taken by many Chinese women from the time they are young.

Black cohosh, primrose oil, red clover, and burdock root are also time-honored remedies for menopausal symptoms. Blog reader Jacqueline has alerted us to cod liver oil as a remedy (Many thanks, J!) She recommends lemon flavor to overcome those nasty childhood memories of fish oil.

However, side effects do exist for these remedies and some women cannot tolerate these herbs. Natural does not necessarily mean completely harmless. Black cohosh and dong quai have been associated with high blood pressure in some women. Cod liver oil has been known to raise blood sugar and cholesterol, although it appears to be a dose dependant effect. It is also very important to assess whether there might be potential interactions with other medications that you are taking, before you take ANY supplements.

There are plenty of products that contain more than one of these herbs, however many also contain soy so read the labels if you are soy sensitive. (We”ll focus on soy next blog entry, since that’s a longer story.) Emerita makes a popular multiherbal supplement that contains no soy called “Menopause Plus Formula” (www. emerita.com). Remifemin is a popular black cohosh remedy. (www.remifemin.com) Both are sold in health food stores and many grocery stores as well.

Whatever remedies you choose, go slowly. Try one at a time and allow it sufficient time to work. Run all your choices by your trusted health care partner. Good luck and happy herbals to all goddesses in search of cooler days, restful nights, and emotional balance!

Menopause Matchup: Fitness Freak vs. Sloth Bear

Remember those cartoons with the angel on one shoulder and the devil on the other tormenting some hapless soul who is struggling to make a decision? Usually the battle is between something she wants vs something she should do. Well, I can relate. I have my own little menopause advisors perched on my shoulders who go at me every day. I even have names for them: the Fitness Freak and the Sloth Bear.

The Fitness Freak drives me bonkers. She wants me to go go go. “Lift weights,” she exhorts. “You know those flabby underarms need toning.” “Go walking - aerobic exercise is absolutely necessary for good heart health.”. “Pilates, yoga, dance - let’s get going. Why’d you buy all those DVD’s if you were only going to use them once or twice?” “I only have your best interests at heart.” Oh sure. That and four bucks will get me a latte. I know her (since she is me.) She’s the Queen of Ulterior Motives. Her secret agenda is to get us skinnier as well as more fit. She wants to lose a dress size.

On my other shoulder reclines the Sloth Bear. She hates it when Fitness Freak gets rolling. She stretches and whines, “I don't wanna exercise, we exercised yesterdayyyyyyyy. I wanna read or maybe take a nap. Why do we always have to doooooooo something. I’ll give you some health tips: wine is good for heart health, chocolate is a kickass antioxidant, and REST will keep you young. Most Americans are sleep deprived - I read that somewhere. Take care of yourself - hey how about an at home spa day?”

I have to step in and mediate at some point. “Okay, Fitness Freak, let’s get real. We will never look like 30 year olds even if we exercise all day every day, so relax. We simply want to be healthy, flexible, and active, okay?”

“And Sloth Bear? Girl, you’ll get yours. Only one day a week of total entropy, though, okay?. And of course, we’ll take it easy some between exercisings. Oh and the chocolate and wine? Say no more, I’m all over it.”

Then I speak seriously to both of them. Here’s a couple things I know about this stage of life, from my nursing background, good old-fashioned life experience, and observing the women I want to be when I grow up.

Probably the most important thing we can do to stay vibrant and live fully is to exercise our bodies. I’m not talking ultramarathons or benchpressing big poundage. Flexibility, strength training, and moderate exercise can significantly enhance our present quality of life. A little yoga for flexibility (I like Gaiam’s Yoga DVD’s www.gaiam.com), a little walking, and a little weight lifting of LITTLE weights. Bigger is not better, surely we’ve learned THAT by now. 3-10 pound weights with repetitions three times a week and we’re suddenly much stronger with denser bones to boot. Best of all, exercise is insomnia’s worst enemy.

Maybe equally important is to ENJOY ourselves simply. Quietly. All too often our recreation is as frenetic and stressful as work. Rest, nap, sit on the porch and stare at the yard. It’s amazing what you see when you slow down. Read a novel or listen to music. Paint your toenails and sit still until they really dry. Put on a facial mask and a big fluffy robe and watch a weepy movie. Or a funny one. Not educational or ‘good for you’. And if guilt starts haranguing you? Let Sloth Bear roll over and lie on it till it quits. Still feel guilty? Try SARK’s fabulous little book “Change Your Life Without Getting Out of Bed”. See this month’s book club entry for more on what she calls “the ultimate nap book.”

You likely have your own menopause advisors. It’s okay to listen to them; just don’t let them run the show or paralyze you with indecision. After they’ve had their say, just get up and go. Or lie down and be. You choose. And be happy with your choice - fling yourself headlong into it and ENJOY. Hey, if not now, when?

Who Do You Want To Be When You Grow Up?

Auntie Kauila is a kumu hula - a hula master in Hawaii. She is 84 and can bend lower than I and most of my hula sisters. She passes on her vast repertoire of knowledge of chant and dance to her students, most of whom are midlife and older. Her day job consists of teaching Hawaiian culture to elementary school children. She is active, fit, and a powerhouse of energy. And she was bubbling over the other day about a new hula she had learned. That’s right - “learned.” She is a renowned expert and she’s still learning. I want to be Auntie Kauila when I grow up.

While I admire her accomplishments, grace, and stamina, I mostly want to be her because she is so interested. In everything. And being interested makes her interesting. She gets high marks on the role model scale for the second half of my life.

I read a quote recently from a midlife woman who said “I pay attention to women older than I am. They are my future.” To discover and create our future, we menopausal goddesses would do well to pay attention to older women we admire and hope to emulate.

My mom also pegs the needle on my role model meter. She bought her first home computer about 5 years ago I now refer to her as the Internet Queen. She finds and forwards the most thought provoking, insightful, and amazing sites. Great jokes too. Sister goddess Theresa gave her the highest compliment: “I never delete Lynette’s Mom’s emails.” She’s taken up painting in oils and acrylics recently - her art is unique and beautiful. She continues to explore her creativity. Yep, I want to be Mom, too, when I grow up.

Whom do we admire? And why? That’s a question the Venuses sat down to answer during one of our meetings. Each goddess wrote down two women that she felt were glowing examples of who she’d like to be when she grew up, and listed the traits that made them such shining stars for her. Then we shared our lists with one another.

While the individual mentors we chose were illuminating, the reasons we held these women up as our ideals were considerably more important. Each of us admired different attributes: grace under pressure, living largely, empathy and kindness, strength, optimism, creativity, etc.

The most stunning insight arising from this exercise and discussion revolved around how often the qualities that a Venus admired in her two role models were the very qualities she embodied for the rest of us! And each Venus was unable to see it for herself until her sister goddesses pointed out the obvious. Can it be that what we most admire, we unconsciously already are? We saw it over and over again in our round robin about the women we most esteemed.

While it might be possible that I am already interested/interesting and creative, my midlife growing up is still a work in progress. I expect that Auntie Kauila and my mother Betty will keep me focused and challenging myself. The same goes for the other Venuses and their chosen role models. These elder women are our future. And the future looks very good indeed.