It’s a marathon, not a sprint. And now, it means you have the opportunity to enhance your health and well-being for the rest of your life. It’s the “Menopause Marathon.” And just like the 26-mile run, preparation – body, mind, and spirit – is key to reaching the finish line. So make the decision now to manage your symptoms rather than allowing them to manage you.
Preparing for the menopause marathon
Like running, it’s never too early to start training for the menopause marathon. For most, the journey begins in their early 50’s, preceded by perimenopause. It may arrive early for some due to health events like cancer treatment, ovarian failure, or oophorectomy (removal of the ovaries). Factors such as race/ethnicity, culture, lifestyle, eating habits, genetics, and socioeconomic factors can affect your symptoms. And women often have a similar experience as their mothers.
But….. there is no way to know for sure exactly what you will experience and how long your symptoms will last. (And for a small percentage of women, the change is a non-event.) However, you absolutely can make (or maintain) lifestyle changes that will increase the likelihood of optimally managing your symptoms rather than your symptoms managing you. You have the power to take control!
In life, what you do today can impact how you feel tomorrow or even years from now.
PeopleTweaker surveyed women in all stages of menopause. One respondent suffered from severe bleeding and had an ablation to help. She also made lifestyle changes, like watching the foods she eats.
She encourages other women, through her practice as a holistic nurse practitioner, to take advantage of their heightened self-awareness and turn this life change into a positive force.
“Menopause can be a rebirth or rediscovery of who you are as a woman. It doesn’t have to be an ending but a new beginning for women. Standing up for themselves, coming into themselves, their power, their self-worth. A time of rediscovery,” she explained.
As the name suggests, you may benefit from hitting the pause button to reflect on who you are as a person and changes you may want to make to improve your health and increase your sense of well-being. Research indicates lifestyle choices related to your eating habits and physical activity levels as well as tobacco and alcohol use all may contribute to the type of menopause journey you experience.
“I wish I knew that what I was doing in my own lifestyle was impacting what was going on. I had to be reactive rather than proactive. If people knew about this before they ever get to perimenopause, they might be saving themselves potential problems, as far as the hormone imbalance or like heavy bleeding or hot flashes, and the like. It may not save them. It may decrease them, or it may prevent them altogether,” the holistic nurse practitioner explained.
She believes lifestyle choices impact how women feel during menopause and that it is a great time for deep personal reflection.
“They learn to have a greater awareness of how all the stuff that happened in their lives comes to a head. And, they’re doing a reflection on what all that was, and what they won’t put up with in their lives, and what they’ll change and start taking care of themselves and to not worry about taking care of others,” she explained.
For some of you, for the first time in your life, you may be an empty nester. You don’t have to run from one activity to another, because your children are likely older. So, take the time to invest in you! Begin as early as you can to make small adjustments to your eating habits, fitness, work-life balance, and emotional and mental health.
When you train for a marathon, your body begins to know what to expect. You’re not shocked when your leg cramps, and you learn how to pace yourself. So, when you go through perimenopause, use the early symptoms as an indication of what’s to come. Research treatment options, find doctors who will really listen, consider the effect lifestyle choices can have on how you’re feeling, and build a reliable support system.
By taking control early, you maximize the benefits of your actions and the positive impact they may have. After all, what do you have to lose? Even if you end up suffering unduly from menopause symptoms, you will be in better health – body, mind, and spirit – to manage things like weight gain, brain “fog,” insomnia, body aches, and night sweats. Taking steps to prepare proactively will help you weather the challenges menopause may throw your way. The stronger you are at the start, the easier it is to finish the race. Give yourself a head start in the menopause marathon by taking these steps now:
- Life is changing, so avoid comparing your current reality to “how I used to be.”
- Recognize that your journey is unique and be open to the possibility that you may emerge healthier, happier, energized, and more confident and content with the road ahead.
- Assess your current lifestyle in areas like eating habits, physical activity, sleep, and stress, and make a conscious commitment to actions that science and research have proven will be of benefit.
- Find a doctor who really listens and is interested in helping to support you during this stage in your life.
- Build/strengthen your support system and friendships.
- Explore integrative modalities like acupuncture, mindfulness, and meditation, journaling, practicing gratitude, guided imagery, Tai Chi, yoga, herbal medicine, and massage.
Menopause: a personal journey to a better you
Menopause is a personal journey that’s unique. The same is true for running. Some people breeze through a marathon, while others crawl across the finish line. The impact of a 26.2-mile run or a long journey through menopause impacts everyone differently. And hormones are only part of the equation.
The Study of Women’s Health Across the Nation (SWAN) is looking at menopause symptoms in five groups of women. Hot flashes and night sweats were lowest in Caucasian women and American women of Japanese and Chinese ethnicity. Hispanic and African American women tended to have more hot flashes and night sweats. Socioeconomic class matters too.
A University of Pittsburgh study found less educated women are more likely to experience symptoms and that the risk of symptoms was greater if you:
- drink alcohol moderately or heavily
- suffer from depression or anxiety
- are obese
- are in poor health
If you’re going into menopause with underlying health conditions like diabetes, heart disease, obesity, or high cholesterol, menopause may make their management more difficult. Prepare for this life change to help mitigate any potential negative impact on your overall health.
Even if you don’t have a health concern or weight issue, consider your stress levels. Stress impacts the entire body and your emotional health, as well. It can complicate or accentuate the symptoms you may experience.
A second PeopleTweaker menopause survey participant, who is a registered nurse, said symptoms like headaches complicated everyday stress. It’s the compounding effect that made menopause difficult for her.
Learn to manage your stress and work toward work-life harmony. Take time to notice when things are headed in the wrong direction, and make adjustments to help bring greater balance.
Menopause symptoms around the world
In a study in North America and Europe, menopause symptoms were more common in women from the U.S., U.K., and Canada than in women living in Sweden and Italy. Why the difference? Lifestyle factors like eating habits, physical activity, a culture with a more positive perception of aging, and expectations about menopause.
In another study, the Yale doctor who led the research found menopausal symptoms were less of an issue in countries where older women are considered wiser and are more highly regarded in general. In countries where phrases like “old age” are attached to the life cycle of women, symptoms are often more pronounced. Think about how American society typically views menopause.
For the nurse, there’s a stigma associated with it.
“Women go through the change, they’re moody, their sex drive changes, they’re empty nesters wrapped around in there or the cougar type of morphication,” the nurse said during our survey.
Even if society catastrophizes this stage in life, you do not have to buy into someone else’s mindset. Focus on ways to be mentally present and appreciate the positive moments in each day, even if you’re experiencing a lot of symptoms.
Healthy eating and physical activity during menopause
Although no one diet reduces menopause symptoms the most, research from the Women’s Health Initiative, suggests one low in fat and high in fruits, vegetables, and whole grains can lower your chance of experiencing night sweats and hot flashes — two of the more common symptoms. For some women, caffeine, alcohol, and spices become problematic, and for others, overweight/obesity can contribute to the type, number, and severity of symptoms.
There’s anecdotal evidence from women across the world that demonstrates the impact eating habits can have. In China, only 10 percent of women experience hot flashes. In the United States, 75 percent of women over age 50 do so. Why? Some studies suggest it’s a plant-based diet in Asia.
Dietary changes can help not only with menopause but the aging process as well. A Mediterranean diet is thought to slow down aging by lowering your risk of diseases.
The benefits of physical activity are well established:
- better management of weight and lower risk of obesity
- stronger bones and a lower risk of osteoporosis and associated fractures
- stronger muscles, better balance, and a lower risk of falling
- more flexibility
- greater emotional and mental health and better management of depression, anxiety, and stress
- better quality sleep and greater energy and focus
Healthy eating and adequate physical activity are a powerful combination at any age. As you move through perimenopause, menopause, and beyond, leverage your lifestyle choices to make things easier. Healthy eating and physical activity are also a big part of putting yourself first. There’s no better time than midlife to invest in you!
Many doctors not adequately trained for menopause management
While you can make lifestyle choices on your own, it’s helpful to work with a team, including a practitioner you trust and one who is a true advocate for you.
One survey respondent who was a nurse found a support system with her family doctor.
“He was really good about basically assisting or guiding you if you were a medical-based kind of person, or were OK with medicine, he would steer you in that direction. But, if you were more of a natural type person, he was OK with that too. And, would assist you in that way,” she commented.
She said her doctor respected her knowledge. “He also respected the fact that I was in the medical profession, and I kind of knew my body. If I was way off base, of course, he would say so, but a lot of the time, if I wanted to try this or that, he was OK with that,” she explained.
Her experience is not always the norm, though.
Menopause has been on the radar of doctors since 1921, yet there are still many questions surrounding menopause management. Despite the tremendous symptomatic differences from woman to woman, there is often a one-size-fits-all approach to treatment in the Western world. Hormone replacement therapy is also the treatment of choice for many physicians.
While the holistic nurse practitioner who took our survey made menopause a time of rediscovery, that advice didn’t come from her doctors. “There’s just more of the things women don’t want. Like here’s the pill you can take, or here’s the procedure we can do. And, that’s usually where it ends with providers when we don’t want to get into hormones. That’s the conventional way they’ve been taught. And, that’s not what a lot of people want,” she explained.
A Johns Hopkins-led study showed a concerning “training gap” with doctors. In a small study of OB-GYN residents, 70 percent would like to receive formal menopause training, but only 20 percent receive it.
As of 2020, more than 50 million women will be older than 51, which is also the average age when menopause begins. Yet there’s a shortage of practitioners who are interested and have the requisite knowledge to optimize the care experience for women in menopause.
The North American Menopause Society (NAMS) expands the spectrum of practitioners with the knowledge base needed to help address the potential challenges of care to include pharmacists, nurses, and psychologists through a certification process. You can find a NAMS-certified practitioner near you using their zip code search tool.
And with the advent of telehealth, if you can’t find someone who is a good fit for you in your area, you may have a different care option with companies like Genneve, which offers an online menopause clinic connecting women virtually with trained menopause providers.
Change is also happening at Northwestern Memorial Hospital in Chicago. Although it took some convincing to make it happen, the hospital created the Center for Sexual Medicine and Menopause. When the center opened, its schedule filled quickly, according to an article in AARP.
The center takes a holistic approach to treating menopause, looking at a woman’s entire health profile. There are specialists in everything from cardiology to psychotherapy. The multidisciplinary team helps individualize treatment based on each woman’s needs.
The holistic nurse practitioner believes menopause management requires a focus on the root cause of a woman’s symptoms. While she didn’t benefit from this approach during her menopause journey, she knows it works, and it gives women another alternative to HRT.
There’s also a push to make menopause training a requirement for residents at Northwestern, no matter their specialty, since menopause can impact your entire body as well as your emotional health. And if you already have underlying health conditions, menopause can impact those problems as well.
So, ask your doctor about his or her training and experience with treating menopause. If you don’t like the answers or feel the practitioner does not have the expertise you need, find a doctor who specializes in menopause management or approaches treatment holistically.
Menopause treatment options
Just like with a marathon, having a roadmap for treatment and support will help you manage your symptoms. Menopause is so much more than just hormone imbalances. How you cope with your symptoms may also depend on other factors in your life – personal and professional.
Menopause is a good time to be a healthcare rebel, and preventive care is among the best treatments:
- Be proactive.
- Educate yourself about your options –lifestyle changes (healthy eating, physical activity, adequate sleep of good quality, stress management), integrative modalities like acupuncture and meditation, and medications like hormone replacement therapy (HRT) and Bijuva (treats hot flashes in women who still have a uterus).
- Find a practitioner with whom to collaborate who you trust, who really listens, and who has the skills to help address the myriad symptoms women can face during this time in their lives.
- Ask questions and avoid a one-size-fits-all approach. Be persistent in your search for treatment options that are a good fit to meet your unique needs.
- Get the latest recommendations regarding hormone replacement therapy (HRT) if it is a consideration for you. There are a lot of factors that need to be taken into account, and the treatment algorithm is complicated.
- Finally, establish a support system. Just like in a marathon, you need people cheering for you. Find people who inspire and motivate you. While your healthcare practitioner is an essential member of your team, so too are friends and other “runners” in the menopause marathon. Many women in our PeopleTweaker survey benefited greatly from discussions with other women and leaned heavily on their friends.
“We learn from each other and other women all the time as far as their experience. And, always be cognizant that everybody’s experience is their experience and is unique to them,” one woman said.
Menopause is a very personal journey. Be kind to yourself, focus on self-care, and make room in your schedule for “me time.” And remember, it’s never too early to start training for the menopause marathon. The better prepared you are, the easier your road will be. You CAN cross the finish line a winner!
What’s the hardest part of this marathon for you?
As a physician, healthcare executive at a Fortune 100 company, and integrative health practitioner, Z. Colette Edwards, MD, MBA knows the unique value of a holistic, whole-person approach to health and well-being. She also understands the challenges health inequities can present. Known as “The Insight Doctor,” she offers guidance and powerful tools that prepare your body, mind, and spirit for menopause, stress, and inflammatory bowel disease. Lastly, Dr. Edwards coaches individuals in the development of self-advocacy and health system navigation skills.
The foregoing information, resources, links and/or references (collectively, the “Materials”) are provided solely for informational purposes and are not intended as medical or other professional advice. No representation or warranty of any kind is made in connection with the content of the Materials. The Materials may not be current and no one should take any action based on the Materials without first consulting their healthcare professional.