You were expecting the night sweats. But the rage, the bawling, the exhaustion, the forgetfulness, the stalled sex drive and the new knees above your knees?
What. The. Hell!
Like death and taxes, menopause is a certainty, making its way into your life, so rather than climbing down into the denial dumpster, why not try to get ahead of the dreaded changes before they start winding their sturdy vines around your ankles?
This is where Holly L. Thacker, M.D., director of the Center for Specialized Women’s Health at Cleveland Clinic and certified menopause specialist (yep, that’s a thing), comes in. At the heart of Dr. Thacker’s work is a passion to help women gain a better understanding of what’s happening to their bodies during menopause. She literally wrote the book on it. (It’s called Women’s Health: Your Body, Your Hormones, Your Choices.) Who better to set the record straight on what’s throwing you off your game?
You’re expecting: A sudden stop to your periods.
Reality deals you: Four to five years of irregularities in your cycle.
It’s true that you’re officially in the menopause business once you’ve gone a full 12 months without a period. But your hormones (estrogen, progesterone, and cortisol) start to play tricks on you way before you’ve bought your last box of tampons. “It’s a phase known as perimenopause, or transitional menopause,” says Dr. Thacker, “and it’s much more challenging for women to experience and for doctors to evaluate and treat. The symptoms sneak up on you—until they’re screaming for your attention. So there’s detective work to be done.”
Her best guidance: See your doctor once you begin to notice any change in your menstrual cycle. “More frequent irregular periods are your cue to get checked out,” she says. “You can’t just blame the changes on fluctuating hormones. You want to rule out an anatomic problem or something as serious as cancer. Even though skipping periods or lighter periods is common in this phase of life, it’s still not ‘normal.’”
Something you might find helpful right about now is a menopause tracker. A good no-nonsense app is Clue, which lets you track your cycle and add personal notes. (Bonus: Clue lets you share your cycle with your partner, so they can adjust their behavior accordingly-wouldn’t that be nice?) Also in the tech battle is:The North American Menopause Society. They have a free MenoPro app with two modes—one for you, one for your doctor—that make it easy to share symptoms, ask questions, and find answers.
You’re expecting: Unbearable hot flashes.
Reality deals you: A mixed bag of symptoms.
“Every woman thinks hot flashes are going to be the worst part of menopause,” says Dr. Thacker, “but in truth not all women have them, and of those who do have them there is a wide range of severity.” The root of hot flashes isn’t fully understood, but experts believe the drop in estrogen tinkers with the body’s thermostat. The degree of heat ranges from a brief flush to more intense heart palpitations and sweating.
Hot flashes are the symptom that gets all the buzz, but there are many troublemakers lurking about in this phase: Low libido, insomnia, wild mood swings, vaginal dryness, short-term memory loss, incontinence, difficulty concentrating, weight gain and hair loss are all hallmarks of this transitional time.
“You should not grin and bear any of your symptoms,” says Dr. Thacker. “If your hot flashes are interfering with your daily life we can help you. And the same can be said for any menopause symptom that you’re experiencing.”
There are several forms of hormone replacement therapy (HRT) and estrogen replacement therapy (ERT) that are effective in treating your hot flashes. Some come in pill form, others are patches or gels and lotions that you apply directly to your skin, and still others are vaginal rings that you insert. (See sidebar for more on the safety of HRT.) The antidepressant Brisdelle is an FDA-approved non-hormonal medication for hot flashes.
There are natural approaches to consider, too, of course. For mild to moderate hot flashes, some simple lifestyle changes might bring you the right amount of relief. Start with things like dressing in layers and toting ice water. Also consider drinking less caffeine and alcohol and eating more high fiber foods (like the fruits, vegetables, legumes and grains that make up the Mediterranean diet), which may help stabilize estrogen levels and soothe symptoms. Supplemental vitamins B and E may help, too, just be sure to loop your doctor or pharmacist in on your choices so they can check for possible medication interactions.
“Again,” says Dr. Thacker, “while all of these signs may be common, it doesn’t mean you’ll experience them, and if you do you shouldn’t view them as normal. Let your doctor know what you’re going through so you can get help lessening the intensity.”
You’re expecting: No upside to menopause.
Reality deals you: A silver lining.
“Menopause is a natural life event,” says Dr. Thacker. “There’s no point in viewing it with a sense of dread.” In fact, one perk is a reduced risk of depression after menopause. She says many of her patients use this time to shift priorities and move self-care to the top. And, you can always take cues from A-list company: Oprah, for one, approached this phase of life as a time for reinvention. Whoopi Goldberg admitted menopause “hits you hard,” but also remembers the time as “wonderful and liberating.” Even the Divine Miss M has said that this time of life is “not worth obsessing over.”
Maybe, just maybe, there’s something to be said for (apologies extended) embracing the change…at least some things in life are certain.
For everything you need and deserve on your menopause journey, check out our Menopause Registry.
